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)).

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.

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.

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.

Development of biosimilars in an era of oncologic drug shortages

PubMed Central

Li, Edward; Subramanian, Janakiraman; Anderson, Scott; Thomas, Dolca; McKinley, Jason; Jacobs, Ira A

2015-01-01

Acute and chronic shortages of various pharmaceuticals and particularly of sterile injectable products are being reported on a global scale, prompting evaluation of more effective strategies to manage current shortages and development of new, high-quality pharmaceutical products to mitigate the risk of potential future shortages. Oncology drugs such as liposomal doxorubicin and 5-fluorouracil represent examples of first-choice drugs critically affected by shortages. Survey results indicate that the majority of hospitals and practicing oncologists have experienced drug shortages, which may have compromised patient safety and clinical outcomes, and increased health care costs, due to delays or changes in treatment regimens. Clinical trials evaluating novel agents in combination with standard-of-care drugs are also being affected by drug shortages. Clinical and ethical considerations on treatment objectives, drug indication, and availability of alternative options may help in prioritizing cancer patients involved in active drug shortages. The United States Food and Drug Administration and the European Medicines Agency have identified manufacturing problems, delays in supply, and lack of available active ingredients as the most frequent causes of recent or ongoing drug shortages, and have released specific guidance to monitor, manage, and reduce the risk of shortages. The upcoming loss of exclusivity for a number of anticancer biologics, together with the introduction of an abbreviated approval pathway for biosimilars, raises the question of whether these products will be vulnerable to shortages. Future supply by reliable manufacturers of well characterized biosimilar monoclonal antibodies, developed in compliance with regulatory and manufacturing guidelines and with substantial investments, may contribute to prevent future biologics shortages and ensure access to effective and safe treatment options for patients with cancer. Preclinical and clinical characterization is ongoing for potential biosimilars of trastuzumab, rituximab, and bevacizumab, with promising results. PMID:26150698

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.

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…

Unavailability of Outpatient Medications: Examples and Opportunities for Management

PubMed Central

McLaughlin, Milena M.; Lin, Jenny; Nguyen, Rosie; Patel, Pratixa; Fox, Erin R.

2017-01-01

Drug shortages create significant challenges for patients and health care providers. Pharmacists play important roles in managing medication therapy during drug shortages. The management of drug shortages by the community pharmacist is an expanding role. Adverse drug reactions and delayed treatments are highlighted in the literature as some of the consequences of outpatient drug shortages; it is likely these harms are underreported. This commentary reviews examples and opportunities for the management of outpatient drug shortages.

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...

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)

Increasing The Supply of Medical Personnel: Needs and Alternatives. Evaluative Studies Series.

ERIC Educational Resources Information Center

Steward, Charles T., Jr.; Siddayao, Corazon M.

This paper considers medical personnel shortages, especially the shortage of physicians, and the different ways to alleviate these shortages. Chapter I gives a brief history (1963-1972) of legislation intended to increase medical manpower supply and Chapter II discusses the causes of the shortage, analyzing the elements affecting demand for…

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.

Selegiline shortage: Causes and costs of a generic drug shortage.

PubMed

Dorsey, E R; Thompson, J P; Dayoub, E J; George, B; Saubermann, L A; Holloway, R G

2009-07-21

In September 2007, shortages of generic selegiline occurred, forcing patients to either switch to more expensive alternatives or forego treatment. We sought to evaluate prescription trends of generic selegiline and to quantify the economic impact of any resulting drug substitution of more expensive alternatives. We analyzed proprietary data from IMS Health on monthly prescriptions in the United States for selegiline and potential substitutes from February 2002 through December 2007. Linear regression was used to predict the number of expected prescriptions after August 2007 had a shortage not occurred. The main outcome measures were the changes in prescriptions filled and the economic impact of drug substitution. Prior to the shortage, total prescriptions filled for generic selegiline decreased 42%, and supply consolidated into one company, Apotex Inc., Toronto, Canada, whose market share increased from 41% to 83%. During the first 4 months of the shortage, Apotex Inc. filled 10,500 fewer prescriptions than projected and other selegiline manufacturers filled 7,400 more than projected for a net shortage of 3,100 prescriptions. The number of branded selegiline capsules filled during this period increased by 1,800 above projections, and 1,300 prescriptions for generic selegiline were not refilled or substituted. The societal cost of substituting generic selegiline with branded capsules was $75,000 over the first 4 months of the shortage. Generic drug shortages carry economic and health implications. Given ongoing consolidation in the generics drug industry, these shortages may become more common and may require heightened regulatory scrutiny of the generic drug industry.

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.

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.

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.

Admission Policies and Attrition Rates in California Community College Nursing Programs

ERIC Educational Resources Information Center

Seago, Jean Ann; Spetz, Joanne

2003-01-01

California is experiencing a critical shortage of nurses -- a shortage that is likely to increase in the coming years (Coffman & Spetz, 1999). Although much of the nation is also experiencing similar shortages, California's shortage is more severe than that of any other state in the nation (Bureau of Health Professions, 2002). Most analyses of…

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...

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…

A 2006 Study of the Supply and Demand of Minnesota Public School Administrators

ERIC Educational Resources Information Center

Haar, Jean M.; Robicheau, Jerry W.

2007-01-01

For the past decade, attention has been drawn to a perceived shortage of school leadership applicants. Establishing an accurate perception of the shortage issue, however, is complex. One challenge with the perception of the shortage is the connection made between quality and shortage. The interpretation of quality is often times determined by a…

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.

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…

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...

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…

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-Surgery Incentive Payment: 6,156,138; Δ+4.9%). Based on the difference-in-differences analysis, the increase in the trend of surgical procedures at Health Professional Shortage Area hospitals was much more notable after Surgery Incentive Payment implementation (Δ+75.2%). The Medicare Surgery Incentive Payment program was associated with an increase in the number of surgical procedures performed at Health Professional Shortage Area hospitals relative to non-Health Professional Shortage Area hospitals during the study period, reversing the trend from negative to positive. Copyright © 2018 Elsevier Inc. All rights reserved.

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…

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.

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

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

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.

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.

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.

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.

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.

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.

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

PubMed

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

2012-01-01

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

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.

Micro and Nano-mediated 3D Cardiac Tissue Engineering

DTIC Science & Technology

2011-10-01

Engineering Dr. M. Gibb, Head of Cardiology, Carle Hospital Dr. Sherrie Clark, UIUC swine species veterinarian 7 Year 3 Project Goals Interface DFB...engineering and regenerative medicine in the 1990s to accommodate for the shortage of organ donors. Today, the shortage still exists and the development...medicine in the 1990s to accommodate for the shortage of organ donors. Today, the shortage still exists and the development of tissue equivalents has

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)

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.

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.

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.

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

Perspectives: Using Results from HRSA's Health Workforce Simulation Model to Examine the Geography of Primary Care.

PubMed

Streeter, Robin A; Zangaro, George A; Chattopadhyay, Arpita

2017-02-01

Inform health planning and policy discussions by describing Health Resources and Services Administration's (HRSA's) Health Workforce Simulation Model (HWSM) and examining the HWSM's 2025 supply and demand projections for primary care physicians, nurse practitioners (NPs), and physician assistants (PAs). HRSA's recently published projections for primary care providers derive from an integrated microsimulation model that estimates health workforce supply and demand at national, regional, and state levels. Thirty-seven states are projected to have shortages of primary care physicians in 2025, and nine states are projected to have shortages of both primary care physicians and PAs. While no state is projected to have a 2025 shortage of primary care NPs, many states are expected to have only a small surplus. Primary care physician shortages are projected for all parts of the United States, while primary care PA shortages are generally confined to Midwestern and Southern states. No state is projected to have shortages of all three provider types. Projected shortages must be considered in the context of baseline assumptions regarding current supply, demand, provider-service ratios, and other factors. Still, these findings suggest geographies with possible primary care workforce shortages in 2025 and offer opportunities for targeting efforts to enhance workforce flexibility. © Published 2017. This article is a U.S. Government work and is in the public domain in the USA.

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 experiences and lessons drawn from these initiatives should be carefully evaluated, monitored, and presented to a wider international audience for careful appraisal. To be able to find solutions to the problem of drug shortages, there is an urgent need to develop a set of agreed definitions for drug shortages, as well as methodologies for their evaluation and monitoring. This is being progressed.

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 experiences and lessons drawn from these initiatives should be carefully evaluated, monitored, and presented to a wider international audience for careful appraisal. To be able to find solutions to the problem of drug shortages, there is an urgent need to develop a set of agreed definitions for drug shortages, as well as methodologies for their evaluation and monitoring. This is being progressed. PMID:29403372

7 CFR 3431.4 - Solicitation of stakeholder input.

Code of Federal Regulations, 2013 CFR

2013-01-01

... AND AGRICULTURE VETERINARY MEDICINE LOAN REPAYMENT PROGRAM Designation of Veterinarian Shortage... process and procedures used to designate veterinarian shortage situations prior to the publication of the solicitation for nomination of veterinarian shortage situations. A notice may be published in the Federal...

7 CFR 3431.4 - Solicitation of stakeholder input.

Code of Federal Regulations, 2014 CFR

2014-01-01

... AND AGRICULTURE VETERINARY MEDICINE LOAN REPAYMENT PROGRAM Designation of Veterinarian Shortage... process and procedures used to designate veterinarian shortage situations prior to the publication of the solicitation for nomination of veterinarian shortage situations. A notice may be published in the Federal...

7 CFR 3431.4 - Solicitation of stakeholder input.

Code of Federal Regulations, 2012 CFR

2012-01-01

... AND AGRICULTURE VETERINARY MEDICINE LOAN REPAYMENT PROGRAM Designation of Veterinarian Shortage... process and procedures used to designate veterinarian shortage situations prior to the publication of the solicitation for nomination of veterinarian shortage situations. A notice may be published in the Federal...

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...

The Discrepancy between The Programs and Disaster Management Policy in Klapanunggal District, Bogor, West Java

NASA Astrophysics Data System (ADS)

Puspito Sari, D. A.; Listiyowati, I.; Nefianto, T.; Lasmono

2018-03-01

Bogor regency consists of 40 districts, 23 are prone tonatural disasters. Klapanunggal district is listed in 10 districts declared as most vulnerable to natural disasters. Natural disasters could lead to loss of property and infrastructure damage and will affect the food security in the region. Food shortages is one example of the condition which causes food insecurity. The aim of this research is to analyze the government's food security strategy in anticipation of disaster with a case study of food insecurity in Klapanunggal district. The analysis suggested that; 1) FSVA is an appropriate program to identify food shortage areas, 2) Food Shortage Relief Program (Program Penanganan Daerah Rawan Pangan-PDRP) is the optimal efforts in reducing food shortages in the region, 3)The mismatch between FSVA indicators and Food Shortage Relief Program makes Klapanunggal district difficult in achievingfree status food-shortage. Based on the analysis, it is suggested that the implementation of Food Shortages Relief Program could be carried out based on the priority issues and implemented with integrated coordination and assistance among stakeholders. Such priority issues, integrated coordination and assistance are fully analyzed in this study.

7 CFR 3431.6 - Review of nominations.

Code of Federal Regulations, 2013 CFR

2013-01-01

... AGRICULTURE VETERINARY MEDICINE LOAN REPAYMENT PROGRAM Designation of Veterinarian Shortage Situations § 3431.6 Review of nominations. (a) Peer panel. State shortage situations nominations will be evaluated by... and activities of the veterinarian position in the veterinary service shortage situation and the risks...

7 CFR 3431.6 - Review of nominations.

Code of Federal Regulations, 2014 CFR

2014-01-01

... AGRICULTURE VETERINARY MEDICINE LOAN REPAYMENT PROGRAM Designation of Veterinarian Shortage Situations § 3431.6 Review of nominations. (a) Peer panel. State shortage situations nominations will be evaluated by... and activities of the veterinarian position in the veterinary service shortage situation and the risks...

7 CFR 3431.3 - Definitions and acronyms.

Code of Federal Regulations, 2012 CFR

2012-01-01

... AGRICULTURE VETERINARY MEDICINE LOAN REPAYMENT PROGRAM Designation of Veterinarian Shortage Situations § 3431... veterinarian, or equivalent, who will be responsible for nominating and certifying veterinarian shortage... process in subpart A of this part, determines has a shortage of veterinarians: (1) Geographical areas that...

7 CFR 3431.3 - Definitions and acronyms.

Code of Federal Regulations, 2014 CFR

2014-01-01

... AGRICULTURE VETERINARY MEDICINE LOAN REPAYMENT PROGRAM Designation of Veterinarian Shortage Situations § 3431... veterinarian, or equivalent, who will be responsible for nominating and certifying veterinarian shortage... process in subpart A of this part, determines has a shortage of veterinarians: (1) Geographical areas that...

7 CFR 3431.6 - Review of nominations.

Code of Federal Regulations, 2012 CFR

2012-01-01

... AGRICULTURE VETERINARY MEDICINE LOAN REPAYMENT PROGRAM Designation of Veterinarian Shortage Situations § 3431.6 Review of nominations. (a) Peer panel. State shortage situations nominations will be evaluated by... and activities of the veterinarian position in the veterinary service shortage situation and the risks...

7 CFR 3431.3 - Definitions and acronyms.

Code of Federal Regulations, 2013 CFR

2013-01-01

... AGRICULTURE VETERINARY MEDICINE LOAN REPAYMENT PROGRAM Designation of Veterinarian Shortage Situations § 3431... veterinarian, or equivalent, who will be responsible for nominating and certifying veterinarian shortage... process in subpart A of this part, determines has a shortage of veterinarians: (1) Geographical areas that...

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.

7 CFR 3431.2 - Purpose.

Code of Federal Regulations, 2012 CFR

2012-01-01

... MEDICINE LOAN REPAYMENT PROGRAM Designation of Veterinarian Shortage Situations § 3431.2 Purpose. The... veterinarian shortage situations for the VMLRP. Applications for the VMLRP will be accepted from eligible veterinarians who agree to serve in one of the designated shortage situations in exchange for the repayment of...

7 CFR 3431.2 - Purpose.

Code of Federal Regulations, 2014 CFR

2014-01-01

... MEDICINE LOAN REPAYMENT PROGRAM Designation of Veterinarian Shortage Situations § 3431.2 Purpose. The... veterinarian shortage situations for the VMLRP. Applications for the VMLRP will be accepted from eligible veterinarians who agree to serve in one of the designated shortage situations in exchange for the repayment of...

7 CFR 3431.2 - Purpose.

Code of Federal Regulations, 2013 CFR

2013-01-01

... MEDICINE LOAN REPAYMENT PROGRAM Designation of Veterinarian Shortage Situations § 3431.2 Purpose. The... veterinarian shortage situations for the VMLRP. Applications for the VMLRP will be accepted from eligible veterinarians who agree to serve in one of the designated shortage situations in exchange for the repayment of...

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

The nursing shortage continues as faculty shortage grows.

PubMed

Allen, Linda

2008-01-01

To combat the nursing shortage, efforts to promote nursing as a career have been successful. However, academic nursing institutions are not adequately prepared for this new influx of applicants. The lack of faculty to educate the growing demand for baccalaureate-prepared RNs directly impacts the nursing shortage. The nursing shortage thus directly impacts safe patient care. The main reasons for the lack of faculty to meet the demand for more nurses include the increased age of the current faculty and the declining number of years left to teach, expected increases in faculty retirements, less compensation for academic teaching than positions in clinical areas for master's-prepared nurses, and finally, not enough master's and doctoral-prepared nurses to fill the needed nurse educator positions It is in the best interest of the nursing profession to do what it does best by incorporating the nursing process to solve the faculty shortage and secure its future in order to protect the lives of patients.

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. Of unique countries and territories, 95 (83%) responded or had information evaluable from public records. Of these 95 countries and territories, 39 (41%) reported a BPG shortage, and 56 (59%) reported no BPG shortage; 10 (12%) countries with and without BPG shortages reported use of antibiotic alternatives to BPG for treatment of maternal syphilis. Market exits, inflexible production cycles, and minimum order quantities affect BPG supply. On the demand side, inaccurate forecasts and sole sourcing lead to under-procurement. Clinicians may also incorrectly prescribe BPG substitutes due to misperceptions of quality or of the likelihood of adverse outcomes. Conclusions Targets for improvement include drug forecasting and procurement, and addressing provider reluctance to use BPG. Opportunities to improve global supply, demand, and use of BPG should be prioritized alongside congenital syphilis elimination efforts. PMID:29281619

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 territories, 95 (83%) responded or had information evaluable from public records. Of these 95 countries and territories, 39 (41%) reported a BPG shortage, and 56 (59%) reported no BPG shortage; 10 (12%) countries with and without BPG shortages reported use of antibiotic alternatives to BPG for treatment of maternal syphilis. Market exits, inflexible production cycles, and minimum order quantities affect BPG supply. On the demand side, inaccurate forecasts and sole sourcing lead to under-procurement. Clinicians may also incorrectly prescribe BPG substitutes due to misperceptions of quality or of the likelihood of adverse outcomes. Targets for improvement include drug forecasting and procurement, and addressing provider reluctance to use BPG. Opportunities to improve global supply, demand, and use of BPG should be prioritized alongside congenital syphilis elimination efforts.

77 FR 11519 - Commission Information Collection Activities; Comment Request; Extension

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-27

... collection, FERC-585, Reporting of Electric Energy shortages and Contingency Plans under PURPA. DATES... shortages and Contingency Plans under PURPA. OMB Control No.: 1902-0138. Type of Request: Three-year... Energy Shortages and Contingency Plans under PURPA'', is used by the Commission to implement the...

76 FR 50442 - Negotiated Rulemaking Committee on Designation of Medically Underserved Populations and Health...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-15

... Designation of Medically Underserved Populations and Health Professional Shortage Areas; Notice of Meeting... Designation of Medically Underserved Populations and Health Professional Shortage Areas. DATES: Meetings will... Medically Underserved Populations and Health Professional Shortage Areas is to establish a criteria and a...

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…

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

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…

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...

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...

Predictors of Job Satisfaction amongst Baccalaureate Nurse Faculty

ERIC Educational Resources Information Center

Overstreet, Lori M.

2017-01-01

The nursing shortage and the nurse faculty shortage are concomitantly connected. Considering the worsening shortage of nurse faculty, inquiry into factors which may influence the job satisfaction of faculty was warranted. The purpose of this quantitative correlational research study was to explore whether a significant relationship existed for…

18 CFR 375.303 - Delegations to the Director of the Office of Electric Reliability.

Code of Federal Regulations, 2010 CFR

2010-04-01

... uncontested contingency plans regarding shortages of electric energy or capacity, circumstances which may result in such shortages, and accommodations of any such shortages or circumstances, if said contingency... Commission, if the filings comply with the terms of the waivers; (ii) Reject a contingency plan regarding...

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…

Academic Incivility in Nursing Education

ERIC Educational Resources Information Center

Marlow, Sherri

2013-01-01

A well-documented and growing problem impacting the nursing shortage in the United States is the increasing shortage of qualified nursing faculty. Many factors contribute to the nursing faculty shortage such as retirement, dissatisfaction with the nursing faculty role and low salary compensation (American Association of Colleges of Nursing (AACN),…

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...

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...

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...

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…

[Nursing manpower and solutions in Taiwan].

PubMed

Teng, Su-Wen

2014-04-01

The shortage of nursing manpower is a long-term problem worldwide that affects Taiwan despite this country's internationally admired achievements in terms of its healthcare and national health insurance systems. This article reviews discussions related to the nursing shortage issue published by the World Health Organization, International Council of Nurses, and Taiwan Ministry of Health and Welfare. Next, an overview is given of the nursing workforce profile, causal factors behind the nursing shortage, and demand for and supply of nursing manpower. Finally, problems, resolutions, and expected outcomes for the nursing shortage in Taiwan are analyzed.

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.

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.

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 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...

77 FR 20645 - Agency Information Collection Activities: Proposed Collection: Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-05

... care facility with a critical shortage of nurses as defined by the program. NSP recipients must be... critical shortage of nurses in the United States, which includes, in addition to the several States, only... health care facility with a critical shortage of nurses in the United States or these territories are...

Preparation of Experienced Teachers to Address Teacher Shortages: A Quantitative Study

ERIC Educational Resources Information Center

Clark, Lisa Davis

2009-01-01

Public educational institutions are facing the problem of a shortage of experienced, certified, skilled teachers in the areas of special education, English as a Second Language, mathematics, biology or life science, bilingual education, and music. This shortage compounds difficulties in serving students in these areas. Reasons for this shortage…

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…

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…

FCS Tackles Shortage of Healthcare Workers in Nebraska

ERIC Educational Resources Information Center

Gifford, Kathy; Kropp, Karen

2004-01-01

Nebraska, like many states, is facing a shortage of healthcare workers. As a result of this shortage, the Area Health Education Center was formed and the cities of Kearney and Grand Island were selected to develop and implement a Health Care Sciences program for Nebraska. A team of professionals from government agencies, businesses, and secondary…

Attrition in the Trades. NCVER Monograph Series 07/2011

ERIC Educational Resources Information Center

Karmel, Tom; Lim, Patrick; Misko, Josie

2011-01-01

Shortages in the trades are again becoming a prominent issue as Australia emerges from the Global Financial Crisis. The existence of shortages puts the immediate focus on the apparent inability of the training system to supply sufficient skilled tradespersons, but shortages in an occupation are as much related to the rate at which individuals…

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.

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...

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…

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…

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

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.

Contingency plan implementation.

PubMed

Neurath, D; Cober, N; Owens, W; Giulivi, A

2012-06-01

Although the National blood system in Canada reduces the risk of inventory shortages the possibility of a blood supply shortage still exists. The Ontario Ministry of Health and Long-Term Care developed a provincial plan to manage blood transfusion needs and inventory in the event of a National blood shortage. The Ontario plan was developed to align with the National plan as well as other provincial plans in order to ensure consistency in blood management strategies across the country. The Ontario plan was released in 2008, along with a toolkit to aid hospitals in developing their facility specific plans. In the Champlain region of Ontario, a group of 16 hospitals worked collaboratively to develop a regional blood shortage plan. A provincial blood shortage simulation exercise was held in 2010 to test out these plans. The Director of Transfusion Medicine of the largest facility in the group of 16 hospitals (The Ottawa Hospital) took the lead in the development of the regional blood shortage management plan. Working groups from all 16 sites contributed to the plan development. The proposed plan was presented to the Medical Advisory Committee for approval. The plan consists of activities relating to the severity of the supply shortage as defined by Amber, Red, Recovery and Green phases. The plan includes a communication plan for notifying stakeholders including patients whose treatment may be affected. Inventory management and triage guidelines are provided to reduce the demand for blood and to conserve inventory for those patients whose need is prioritized as highest. The regional blood shortage management plan was tested successfully during the provincial simulation exercise. Where regional hospitals work together to provide healthcare, it is beneficial to develop a standardized plan to provide guidance to hospital personnel in response to a blood supply shortage. A consistent plan will ensure patient care is provided in a consistent manner across a health region. Mock or simulation exercises can aid in testing plans and raising the awareness of stakeholders. Copyright © 2012 Elsevier Ltd. 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.

Human resources in nursing education: a worldwide crisis.

PubMed

Potempa, Kathleen M; Redman, Richard W; Landstrom, Gay

2009-01-01

The global shortage of nurses is escalating. A key contributing factor to the production of new nurses is the growing shortage of qualified faculty. This paper explores the forces influencing the global faculty shortage, including those that increase demand and those that limit the supply of nursing faculty. The authors discuss potential solutions to the shortage, placing particular emphasis on leveraging the strengths of the profession to accelerate the progression of nurses to graduate school, the enhancement of funding for graduate education, changing the paradigm of clinical education, and the expansion of the science base for practice.

Strategies to address the nursing shortage in Saudi Arabia.

PubMed

Aboshaiqah, A

2016-09-01

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

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.

77 FR 34390 - Agency Information Collection Activities: Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-11

... the NSP) at a health care facility with a critical shortage of nurses as defined by the program. NSP... facility with a critical shortage of nurses in the United States, which includes, in addition to the States... health care facility with a critical shortage of nurses in the United States or these territories are...

The Information Technology Workforce Crisis: Planning for the Next Environment. NYSFIRM Government Information Focus.

ERIC Educational Resources Information Center

Maxwell, Terrence A.

Attention has been focused on critical shortages of information technology professionals. These shortages have begun to affect the ability of state and local governments to perform core operations, meet new agency program needs and support the development of new enterprise-wide capacities. The shortages are not expected to disappear any time soon.…

42 CFR 23.10 - Under what circumstances may a National Health Service Corps site's reimbursement obligation to...

Code of Federal Regulations, 2010 CFR

2010-10-01

..., private organizations and individuals; (iii) The need of the health manpower shortage area for health... personnel. (2) A significant percentage of the individuals who are located in the health manpower shortage... the health manpower shortage area and the area's cost-of-living index. (b) The Secretary may waive in...

42 CFR 23.10 - Under what circumstances may a National Health Service Corps site's reimbursement obligation to...

Code of Federal Regulations, 2011 CFR

2011-10-01

..., private organizations and individuals; (iii) The need of the health manpower shortage area for health... personnel. (2) A significant percentage of the individuals who are located in the health manpower shortage... the health manpower shortage area and the area's cost-of-living index. (b) The Secretary may waive in...

42 CFR 23.10 - Under what circumstances may a National Health Service Corps site's reimbursement obligation to...

Code of Federal Regulations, 2014 CFR

2014-10-01

..., private organizations and individuals; (iii) The need of the health manpower shortage area for health... personnel. (2) A significant percentage of the individuals who are located in the health manpower shortage... the health manpower shortage area and the area's cost-of-living index. (b) The Secretary may waive in...

42 CFR 23.10 - Under what circumstances may a National Health Service Corps site's reimbursement obligation to...

Code of Federal Regulations, 2013 CFR

2013-10-01

..., private organizations and individuals; (iii) The need of the health manpower shortage area for health... personnel. (2) A significant percentage of the individuals who are located in the health manpower shortage... the health manpower shortage area and the area's cost-of-living index. (b) The Secretary may waive in...

42 CFR 23.10 - Under what circumstances may a National Health Service Corps site's reimbursement obligation to...

Code of Federal Regulations, 2012 CFR

2012-10-01

..., private organizations and individuals; (iii) The need of the health manpower shortage area for health... personnel. (2) A significant percentage of the individuals who are located in the health manpower shortage... the health manpower shortage area and the area's cost-of-living index. (b) The Secretary may waive in...

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…

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,…

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…

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...

Foreign Languages: Human Capital Approach Needed To Correct Staffing and Proficiency Shortfalls. Report to Congressional Requesters.

ERIC Educational Resources Information Center

Christoff, Joseph A.

This report examines the use of foreign language skills within the Army, Department of State, Department of Commerce's Foreign Commercial Service, and Federal Bureau of Investigation, discussing the nature and impact of foreign language shortages, strategies for addressing these shortages, and efforts to address current and projected shortages.…

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…

Solving nursing shortages: a common priority

PubMed Central

Buchan, James; Aiken, Linda

2009-01-01

Aims and objectives This paper provides a context for this special edition. It highlights the scale of the challenge of nursing shortages, but also makes the point that there is a policy agenda that provides workable solutions. Results An overview of nurse:population ratios in different countries and regions of the world, highlighting considerable variations, with Africa and South East Asia having the lowest average ratios. The paper argues that the ‘shortage’ of nurses is not necessarily a shortage of individuals with nursing qualifications, it is a shortage of nurses willing to work in the present conditions. The causes of shortages are multi-faceted, and there is no single global measure of their extent and nature, there is growing evidence of the impact of relatively low staffing levels on health care delivery and outcomes. The main causes of nursing shortages are highlighted: inadequate workforce planning and allocation mechanisms, resource constrained undersupply of new staff, poor recruitment, retention and ‘return’ policies, and ineffective use of available nursing resources through inappropriate skill mix and utilisation, poor incentive structures and inadequate career support. Conclusions What now faces policy makers in Japan, Europe and other developed countries is a policy agenda with a core of common themes. First, themes related to addressing supply side issues: getting, keeping and keeping in touch with relatively scarce nurses. Second, themes related to dealing with demand side challenges. The paper concludes that the main challenge for policy makers is to develop a co-ordinated package of policies that provide a long term and sustainable solution. Relevance to clinical practice This paper highlights the impact that nursing shortages has on clinical practice and in health service delivery. It outlines scope for addressing shortage problems and therefore for providing a more positive staffing environment in which clinical practice can be delivered. PMID:19146584

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

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.

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

Underrepresented groups

NASA Technical Reports Server (NTRS)

Peters, David A.

1990-01-01

The problem with the shortage of under represented groups in science and engineering is absolutely crucial, especially considering that U.S. will experience a shortage of 560,000 science and engineering personnel by the year 2010. Most studies by the National Science Foundation also concluded that projected shortages cannot be alleviated without significant increases in the involvement of Blacks, Hispanics, Native Americans, handicapped persons, and women.

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…

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...

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…

Nursing Educator Retention: The Relationship between Job Embeddedness and Intent to Stay among Nursing Educators

ERIC Educational Resources Information Center

Hamlin, Amy S.

2013-01-01

The United States is in the midst of an increasingly worsening shortage of registered nurses, due, in part, to the nursing educator shortage. Further, nursing programs nationwide are turning away qualified applicants because of a lack of nursing educators. Unfortunately, the nursing educator shortage is not a problem that will be easily fixed. As…

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…

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…

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.

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.

Nurse Workforce Challenges in the United States: Implications for Policy. OECD Health Working Papers, No. 35

ERIC Educational Resources Information Center

Aiken, Linda H.; Cheung, Robyn

2008-01-01

The United States has the largest professional nurse workforce in the world numbering close to 3 million but does not produce enough nurses to meet its growing demand. A shortage of close to a million professional nurses is projected to evolve by 2020. An emerging physician shortage will further exacerbate the nurse shortage as the boundaries in…

Optimization of Marine Forces Reserve Equipment Redistribution

DTIC Science & Technology

2016-06-01

a unit (used as a surrogate for actual transfer cost), and (b) inventory shortages . MCERM allows planners to influence recommended transfers by (a...placing a weighted penalty on transfers that cross between commands, and (b) increasing the shortage penalty over the transfer penalty. It also...on April 22, 2016. From the results, MCERM’s recommended transfers decreased the overall shortage penalty by a large margin while incurring a

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 recurrence of disease activity.

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. Increases in lysoGb3, however, suggest recurrence of disease activity. PMID:22041095

A national view of rural health workforce issues in the USA.

PubMed

MacDowell, Martin; Glasser, Michael; Fitts, Michael; Nielsen, Kimberly; Hunsaker, Matthew

2010-01-01

Regional or state studies in the USA have documented shortages of rural physicians and other healthcare professionals that can impact on access to health services. The purpose of this study was to determine whether rural hospital chief executive officers (CEOs) in the USA report shortages of health professions and to obtain perceptions about factors influencing recruiting and retention. A nationwide US survey was conducted of 1031 rural hospital CEOs identified by regional/state Area Health Education Centers. A three-page survey was sent containing questions about whether or not physician shortages were present in the CEO's community and asking about physician needs by specialty. The CEOs were also asked to assess whether other health professionals were needed in their town or within a 48 km (30 mile) radius. Analyses from 335 respondents (34.4%) representative of rural hospital CEOs in the USA are presented. Primary care shortages based on survey responses were very similar to the pattern for all rural areas in the USA (49% vs 52%, respectively). The location of respondents according to ZIP code rurality status was similar to all rural areas in the USA (moderately rural, 29.3% vs 27.6%, respectively), and 69.1% were located in highly rural ZIP codes (vs 72.4% of highly rural ZIP codes for all USA). Physician shortages were reported by 75.4% of the rural CEOs, and 70.3% indicated shortages of two or more primary care specialties. The most frequently reported shortage was family medicine (FM, 58.3%) followed by general internal medicine (IM, 53.1%). Other reported shortages were: psychiatry (46.6%); general surgery (39.9%); neurology (36.4%); pediatrics (PEDS, 36.2%); cardiology (35%); and obstetrics-gynecology (34.4%). The three most commonly needed allied health professions were registered nurses (73.5%), physical therapists (61.2%) and pharmacists (51%). The percentage of CEOs reporting shortages of two or more primary care specialties (FM, IM or PEDS) was 70.3% nationally, with no statistically significant regional variation (p = .394), while higher for the New England through Virginia region (83.9%) than for all other regions. The CEOs reported the highest specialty care shortages for psychiatry (46.6%) followed by general surgery (39.9%), neurology (36.4%), cardiology (35.0%) and obstetrics-gynecology (34.4%). Major specialty shortages varied among regions and only for neurology and cardiology were regional differences statistically significant (p < .05). Marked variation between need for healthcare professionals were reported ranging from approximately 73% for registered nurses (RNs) to 16% for health educators. Reporting of need for RNs in rural areas was nearly 74% nationally and 35% reported a need for nurse practitioners. Differences for both RNs and nurse practitioners were not statistically significant among regions. Nationally, approximately 30% of CEOs reported a shortage of licensed practical nurses, which differed significantly among regions (p = .006). There was variation in physical therapist shortages among regions (p = .001), with 61.2% of CEOs reporting shortages nationally. Regional variation pattern was observed for pharmacists (p = .004) with approximately 50% of rural CEOs reporting a need for pharmacists nationally. The association between CEOs' reported shortages of two or more primary care doctors and their indication of the need for other health professionals was statistically significant for nurse practitioners, physician assistants, pharmacists, and dentists. The recruitment and retention attributes deemed to be of greatest importance were: (1) healthcare is a major part of the local economy; (2) community is a good place for family; (3) doctors are well-respected and supported; and (4) people in the community are friendly and supportive of each other. These were remarkably similar across 6 US geographic regions. Similarities in shortages and attributes influencing recruitment across regions suggest that major policy and program interventions are needed to develop a rural health professions workforce that will enable the benefits of recent US health reform insurance coverage to be realized. Substantial and targeted programs to increase rural healthcare professionals are needed.

A national view of rural health workforce issues in the USA

PubMed Central

MacDowell, M; Glasser, M; Fitts, M; Nielsen, K; Hunsaker, M

2013-01-01

Introduction Regional or state studies in the USA have documented shortages of rural physicians and other healthcare professionals that can impact on access to health services. The purpose of this study was to determine whether rural hospital chief executive officers (CEOs) in the USA report shortages of health professions and to obtain perceptions about factors influencing recruiting and retention. Methods A nationwide US survey was conducted of 1031 rural hospital CEOs identified by regional/state Area Health Education Centers. A three-page survey was sent containing questions about whether or not physician shortages were present in the CEO’s community and asking about physician needs by specialty. The CEOs were also asked to assess whether other health professionals were needed in their town or within a 48 km (30 mile) radius. Analyses from 335 respondents (34.4%) representative of rural hospital CEOs in the USA are presented. Results Primary care shortages based on survey responses were very similar to the pattern for all rural areas in the USA (49% vs 52%, respectively). The location of respondents according to ZIP code rurality status was similar to all rural areas in the USA (moderately rural, 29.3% vs 27.6%, respectively), and 69.1 % were located in highly rural ZIP codes (vs 72.4% of highly rural ZIP codes for all USA). Physician shortages were reported by 75.4% of the rural CEOs, and 70.3% indicated shortages of two or more primary care specialties. The most frequently reported shortage was family medicine (FM, 58.3%) followed by general internal medicine (IM, 53.1%). Other reported shortages were: psychiatry (46.6%); general surgery (39.9%); neurology (36.4%); pediatrics (PEDS, 36.2%); cardiology (35%); and obstetrics-gynecology (34.4%). The three most commonly needed allied health professions were registered nurses (73.5%), physical therapists (61.2%) and pharmacists (51 %). The percentage of CEOs reporting shortages of two or more primary care specialties (FM, IM or PEDS) was 70.3% nationally, with no statistically significant regional variation (p = .394), while higher for the New England through Virginia region (83.9%) than for all other regions. The CEOs reported the highest specialty care shortages for psychiatry (46.6%) followed by general surgery (39.9%), neurology (36.4%), cardiology (35.0%) and obstetrics-gynecology (34.4%;). Major specialty shortages varied among regions and only for neurology and cardiology were regional differences statistically significant (p < .05). Marked variation between need for healthcare professionals were reported ranging from approximately 73% for registered nurses (RNs) to 16% for health educators. Reporting of need for RNs in rural areas was nearly 74% nationally and 35% reported a need for nurse practitioners. Differences for both RNs and nurse practitioners were not statistically significant among regions. Nationally, approximately 30% of CEOs reported a shortage of licensed practical nurses, which differed significantly among regions (p = .006). There was variation in physical therapist shortages among regions (p = 001), with 61.2% of CEOs reporting shortages nationally. Regional variation pattern was observed for pharmacists (p = .004) with approximately 50% of rural CEOs reporting a need for pharmacists nationally. The association between CEOs’ reported shortages of two or more primary care doctors and their indication of the need for other health professionals was statistically significant for nurse practitioners, physician assistants, pharmacists, and dentists. The recruitment and retention attributes deemed to be of greatest importance were: (1) healthcare is a major part of the local economy; (2) community is a good place for family; (3) doctors are well-respected and supported; and (4) people in the community are friendly and supportive of each other. These were remarkably similar across 6 US geographic regions. Conclusions Similarities in shortages and attributes influencing recruitment across regions suggest that major policy and program interventions are needed to develop a rural health professions workforce that will enable the benefits of recent US health reform insurance coverage to be realized. Substantial and targeted programs to increase rural healthcare professionals are needed. PMID:20658893

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.

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, priorities and timelines; workplace culture that is resistant to change; and organisational boundaries. For training-only models, additional barriers were: technology; low educational levels of trainees; lack of health professionals to provide training and/or supervision; and cost of training. Key enhancers for the development of models were identified as: commitment by all partners and co-location of partners; or effective communication channels. Key enhancers for model effectiveness were: first considering work tasks, competencies and job (re)design; high profile of the model within the community; community-based models; cultural fit; and evidence of direct link between skills development and employment, for example VET trained aged care workers upskilling for other health jobs. For training only models, additional enhancers were flexibility of partners in accommodating needs of trainees; low training costs; experienced clinical supervisors; and the provision of professional development to trainers. There needs to be a balance between short-term solutions to current skill shortages (training only), and medium to longer term solutions (job redesign, holistic approaches) that also address projected skills shortages. Models that focus on addressing skills shortages in aged care can provide a broad pathway to careers in health. Characteristics of models likely to be effective in addressing skill shortages are: responsibility for addressing skills shortage is shared between the health sector, education and training organisations and government, with employers taking a proactive role; the training component is complemented by a focus on retention of workers; models are either targeted at existing employees or identify a target group(s) who may not otherwise have considered a career in health.

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

PubMed

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

2016-05-25

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

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."…

Foreign Languages: Workforce Planning Could Help Address Staffing and Proficiency Shortfalls. Testimony before the Subcommittee on International Security, Proliferation, and Federal Services, Committee on Governmental Affairs, U.S. Senate.

ERIC Educational Resources Information Center

Westin, Susan S.

This statement examines the nature and impact of foreign language proficiency and personnel shortages in the Army, State Department, Central Intelligence Agency, and Federal Bureau of Investigation (FBI), discussing strategies used to address these shortages and efforts made to address current and projected shortages. All four agencies reported…

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…

Report on Enhancing Security and Stability in Afghanistan

DTIC Science & Technology

2015-06-01

Warrior helicopters, the AAF’s organic capability to provide aerial fires continues to grow. However, the AAF continues to struggle with a shortage ...of pilots and aircrews, as well as the maintenance of air platforms. To address the pilot shortage , coalition forces are pursuing the addition of...historically ordered supplies for the ANDSF, Afghan personnel have little experience doing it themselves. As a result, reported shortages in operational units

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

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 potential imposition of wage controls on nurses: a threat to nurses, patients, and hospitals.

PubMed

Buerhaus, Peter I

2008-01-01

When there are shortages of RNs, hospitals and health care organizations in competitive nurse labor markets respond by increasing wages: some hospitals will respond faster and some will offer higher wages than others. The wage increase brings about two important short and long-run outcomes that, together, will increase the supply of RNs in the labor market. Because wage controls prevent the flexibility of wages to adjust, they can cause a shortage to develop when the demand for RNs is increasing (as in the 1970s), and wage controls will lengthen the duration of a shortage once it has begun. The impacts of prolonged RN shortages are multifaceted and destructive to nurses, patients, and hospitals. Looking ahead over the next 15 years when the demand for RNs is expected to grow by roughly 3% per year and the supply of RNs by much less than that, a new nursing shortage is projected to develop and reach a deficit of 285,000 RNs by 2020. The worst thing that could happen to the nursing profession would be to impose wage controls on nurses as this would prevent the needed short and long-run labor supply responses from developing and thereby eliminate the 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.

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.

[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.

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

Analysis of Army Contracting Officer Representative Role in Contingency Operations

DTIC Science & Technology

2011-12-01

oversight. There may be a shortage of experienced and 12 well-qualified CORs” (Thibault et al., 2011, p. 85). The report also made recommendations to...percent over the same period (Gansler et al., 2007). The shortage of contracting procurement personnel, including CORs, is detrimental to the...According to the Interim Report to Congress in June 2009, There is a critical shortage of qualified contract management personnel in theater and those

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…

7 CFR 3431.1 - Applicability of regulations.

Code of Federal Regulations, 2012 CFR

2012-01-01

... AGRICULTURE VETERINARY MEDICINE LOAN REPAYMENT PROGRAM Designation of Veterinarian Shortage Situations § 3431... veterinarian shortage situations as well as the administrative provisions for the Veterinary Medicine Loan...

7 CFR 3431.1 - Applicability of regulations.

Code of Federal Regulations, 2014 CFR

2014-01-01

... AGRICULTURE VETERINARY MEDICINE LOAN REPAYMENT PROGRAM Designation of Veterinarian Shortage Situations § 3431... veterinarian shortage situations as well as the administrative provisions for the Veterinary Medicine Loan...

7 CFR 3431.1 - Applicability of regulations.

Code of Federal Regulations, 2013 CFR

2013-01-01

... AGRICULTURE VETERINARY MEDICINE LOAN REPAYMENT PROGRAM Designation of Veterinarian Shortage Situations § 3431... veterinarian shortage situations as well as the administrative provisions for the Veterinary Medicine Loan...

A View from the Professional Schools: Public Health.

ERIC Educational Resources Information Center

Gemmell, Michael K.

1987-01-01

Issues and trends affecting professional education for public health careers are examined, including specialization shortages, physician faculty shortages, declining federal support, and changing student demographics. (MSE)

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.

Forecasting the regional distribution and sufficiency of physicians in Japan with a coupled system dynamics-geographic information system model.

PubMed

Ishikawa, Tomoki; Fujiwara, Kensuke; Ohba, Hisateru; Suzuki, Teppei; Ogasawara, Katsuhiko

2017-09-12

In Japan, the shortage of physicians has been recognized as a major medical issue. In our previous study, we reported that the absolute shortage will be resolved in the long term, but maldistribution among specialties will persist. To address regional shortage, several Japanese medical schools increased existing quota and established "regional quotas." This study aims to assist policy makers in designing effective policies; we built a model for forecasting physician numbers by region to evaluate future physician supply-demand balances. For our case study, we selected Hokkaido Prefecture in Japan, a region displaying disparities in healthcare services availability between urban and rural areas. We combined a system dynamics (SD) model with geographic information system (GIS) technology to analyze the dynamic change in spatial distribution of indicators. For Hokkaido overall and for each secondary medical service area (SMSA) within the prefecture, we analyzed the total number of practicing physicians. For evaluating absolute shortage and maldistribution, we calculated sufficiency levels and Gini coefficient. Our study covered the period 2010-2030 in 5-year increments. According to our forecast, physician shortage in Hokkaido Prefecture will largely be resolved by 2020. Based on current policies, we forecast that four SMSAs in Hokkaido will continue to experience physician shortages past that date, but only one SMSA would still be understaffed in 2030. The results show the possibility that diminishing imbalances between SMSAs would not necessarily mean that regional maldistribution would be eliminated, as seen from the sufficiency levels of the various SMSAs. Urgent steps should be taken to place doctors in areas where our forecasting model predicts that physician shortages could occur in the future.

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.

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.

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.

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.

7 CFR 3431.6 - Review of nominations.

Code of Federal Regulations, 2011 CFR

2011-01-01

... AGRICULTURE VETERINARY MEDICINE LOAN REPAYMENT PROGRAM Designation of Veterinarian Shortage Situations § 3431... and activities of the veterinarian position in the veterinary service shortage situation and the risks...

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.

The state of world hunger.

PubMed

Uvin, P

1994-05-01

Three distinct but related concepts have been used to estimate the numbers of people affected by hunger and to analyze the global food situation: food shortage, food poverty, and food deprivation. They focus on different aspects of the phenomenon of hunger and different levels of aggregation involved in its study. Food shortage occurs when total food supplies within a designated area--the world as a whole or continents, countries, or regions within countries--are insufficient to meet the needs of its population. Food poverty refers to the situation in which households cannot obtain enough food to meet the needs of all their members. Food deprivation refers to inadequate individual consumption of food or specific nutrients, also known as undernutrition. The relationships between food shortage, food poverty, and food deprivation are complex. If a region suffers a food shortage, some households will be food poor, and at least one household member will suffer food deprivation. Conversely, food poverty also can (and does) occur within regions where there is no aggregate food shortage, and individual food deprivation can occur in households that are not food poor. The key factor in both cases is distribution.

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.

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.

A United States Civil Affairs Response to the Pending Humanitarian Crisis Following the Collapse of the North Korean Regime

DTIC Science & Technology

2012-06-08

greater under its new leader, Kim Jong Un. The humanitarian problems, shortages of food, clean water, and medicine, will only become worse... shortages of food, clean water, and medicine, will only become worse following a collapse of the North Korean regime. This study explores the niche role...despite severe food shortages .16 By the 1990s, North Korea was almost completely dependent on foreign food aid. Prior to 1995, North Koreans would eat

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.

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.

Evaluation of public private partnership proposals.

DOT National Transportation Integrated Search

2010-06-01

In Alabama, a shortage of transportation funds requires the Alabama Department of Transportation (ALDOT) to combat that shortage by implementing innovative programs. Nationwide, Public Private Partnerships (PPP) in transportation projects are increas...

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)

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 providing Iran relief from the international economic sanctions regime. This specifically includes advocating for the application of "health diplomacy" in ongoing multilateral negotiations following commencement of "implementation day," by advocating for an additional set of reform measures incorporated into this historic negotiation that will finally address the humanitarian and medical crisis of drug shortages in Iran.

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)

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.

[The Hessian care monitor. Transparency on regional labor markets].

PubMed

Lauxen, O; Bieräugel, R

2013-08-01

The Hessian Care Monitor is a Web-based monitoring system of the regional care labor market. It contains information on the current labor market and on future developments. Official statistics are analyzed, primary data are collected, and forecasts are calculated. Since 2008, the demand for nurses in Hesse has been higher than the supply. In 2010, there was a lack of more than 4,400 nurses. Moreover, in 2025, around 5,500 additional nurses will be needed to meet the increasing demand arising from demographic changes. However, there are three different regional patterns: regions with high current shortages but little additional demand in the future; regions with low current shortages but large future needs; and regions with high current shortages and large future demand. Appropriate strategies for handling labor shortages have to be selected according to the different regional patterns.

Nursing faculty--an endangered species?

PubMed

De Young, S; Bliss, J B

1995-01-01

A present faculty shortage has been documented, and the potential for an even worse shortage in the future is very real. Implications of a continued shortage for both nursing education and practice are serious. They include limitations on enrollments leading to future nursing shortages, burnout of present faculty, or possible decline in the quality of programs. Contributing factors such as aging of educators, fewer graduate students going into teaching, non-competitive salaries, and increased job opportunities for nurses with graduate degrees are explored. Possible solutions include adding more education courses or tracks in graduate programs, obtaining increased federal funds for graduate education, emphasizing the many rewards and benefits of the faculty role, recruiting faculty from new areas, mentoring people into teaching, giving flexible teaching assignments to older faculty members, and making changes in the ways that clinical instruction is performed.

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.

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

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.

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 and temporary drug shortages are being implemented in Israel, such as suspending any further reductions in drug prices below 17 new Israeli shekels, instructing all MAHs to maintain no less than 1 month supply of all registered and non-registered drugs in Israel and allowing an expedited registration pathway for well-established use/grandfather drugs. Drug shortages pose significant public health hazards worldwide. Early notification to the MoH and open dialog with MAHs are essential for managing DSs and mitigating their impact. Despite the efforts carried out by health regulatory authorities worldwide, DSs still pose a significant threat to public health.

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

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.

Feasibility study guidelines for public private partnership projects : Vol. 1 & 2

DOT National Transportation Integrated Search

2010-10-01

For many state Departments of Transportation (DOTs), a shortage of transportation funds requires the : agencies to combat that shortage by implementing innovative programs. Nationwide, Public Private : Partnerships (PPP) in transportation projects ar...

18 CFR 401.36 - Water supply projects-Conservation requirements.

Code of Federal Regulations, 2014 CFR

2014-04-01

... the event of a drought or other water shortage condition. Contingency plans of public authorities or... including emergency conservation measures to be instituted in the event of a drought or other water shortage...

18 CFR 401.36 - Water supply projects-Conservation requirements.

Code of Federal Regulations, 2013 CFR

2013-04-01

... the event of a drought or other water shortage condition. Contingency plans of public authorities or... including emergency conservation measures to be instituted in the event of a drought or other water shortage...

18 CFR 401.36 - Water supply projects-Conservation requirements.

Code of Federal Regulations, 2012 CFR

2012-04-01

... the event of a drought or other water shortage condition. Contingency plans of public authorities or... including emergency conservation measures to be instituted in the event of a drought or other water shortage...

Feasibility study guideline for public private partnership projects : volume I & II.

DOT National Transportation Integrated Search

2010-10-01

For many state Departments of Transportation (DOTs), a shortage of transportation funds requires the : agencies to combat that shortage by implementing innovative programs. Nationwide, Public Private : Partnerships (PPP) in transportation projects ar...

Genetics Home Reference: SOST-related sclerosing bone dysplasia

MedlinePlus

... that cause sclerosteosis prevent the production of any functional sclerostin. A lack of sclerostin disrupts the inhibitory ... van Buchem disease result in a shortage of functional sclerostin. This shortage reduces the protein's ability to ...

Insights in Public Health

PubMed Central

Hayes, Donald

2014-01-01

There are significant shortages in the public health workforce and it's expected to worsen. Efforts to reduce this shortage are varied and include building the workforce by increasing exposure of students and young professionals in applied public health experiences. Providing these experiences increases productivity, and may help alleviate some of the workforce shortages in public health. This article seeks to highlight the work done at the Family Health Services Division (FHSD) in the Hawai‘i Department of Health over the past 6 and half years in working with students in epidemiology practicum and fellowship experiences. PMID:24660128

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

A call to action for nurses: declining enrollment and the nursing shortage.

PubMed

Albaugh, J A

2001-10-01

Once again, nursing and health care face a crisis related to the continued decline in nursing school enrollment and the nursing shortage. This particular shortage seems to be especially problematic because of the increased number of aging baby boomers and the dwindling professional nurse pool. Nurses must work together to increase understanding and awareness of the opportunities in the profession and to resolve this crisis. There are specific actions nurses can take to improve the perception of nursing and renew interest in a dynamic field that is so crucial to society.

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

Maldistribution or scarcity of nurses? The devil is in the detail.

PubMed

Both-Nwabuwe, Jitske M C; Dijkstra, Maria T M; Klink, Ab; Beersma, Bianca

2018-03-01

The goal of this paper was to improve our understanding of nursing shortages across the variety of health care sectors and how this may affect the agenda for addressing nursing shortages. A health care sector comprises a number of health care services for one particular type of patient care, for example, the hospital care sector. Most Western countries are shifting health care services from hospital care towards community and home care, thus increasing nursing workforce challenges in home and community care. In order to implement appropriate policy responses to nursing workforce challenges, we need to know if these challenges are caused by maldistribution of nurses and/or the scarcity of nurses in general. Focusing on the Netherlands, we reviewed articles based on data of a labour market research programme and/or data from the Dutch Employed Persons' Insurance Administration Agency. The data were analysed using a data synthesis approach. Nursing shortages are unevenly distributed across the various health care sectors. Shortages of practical nurses are caused by maldistribution, with a long-term projected surplus of practical nurses in hospitals and projected shortages in nursing/convalescent homes and home care. Shortages of first-level registered nurses are caused by general scarcity in the long term, mainly in hospitals and home care. Nursing workforce challenges are caused by a maldistribution of nurses and the scarcity of nurses in general. To implement appropriate policy responses to nursing workforce challenges, integrated health care workforce planning is necessary. Integrated workforce planning models could forecast the impact of health care transformation plans and guide national policy decisions on transitioning programmes. Effective transitioning programmes are required to address nursing shortages and to diminish maldistribution. In addition, increased recruitment and retention as well as new models of care are required to address the scarcity of nurses in general. © 2017 John Wiley & Sons Ltd.

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 theoretical distributions.

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.

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)

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.

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).

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.

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...

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;

Professionals: Their Availability in North Carolina Communities. Progress Report 68.

ERIC Educational Resources Information Center

Sawhney, M. Mohan; And Others

Leaders in 446 communities throughout North Carolina answered questionnaires designed to determine the perceived need for trained personnel in their communities. The leaders described the availability of 33 professional/occupational categories as "serious shortage", "minor shortage", "sufficient",…

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.

Looking for a Few Good Librarians.

ERIC Educational Resources Information Center

Everhart, Nancy

2000-01-01

Discusses the impending shortage of school librarians. Topics include state hiring mandates that don't require certified media specialists; certified library personnel shortages; staffing ratios; support staff; access to library education programs, including distance education via the Internet; and future concerns. (LRW)

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.

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…

[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.

Addressing the migration of health professionals: the role of working conditions and educational placements.

PubMed

Witt, Julia

2009-11-18

This article provides a brief overview of the global health-worker shortage, which could undermine the Millennium Development Goal to halt and begin to reverse the spread of HIV/AIDS. The current situation suggests that long-term solutions to shortages can only be found by addressing the problem from a global perspective; that is, to eliminate shortages through substantial investments in training and retaining health workers in developed and developing countries, and not through policies that do not work towards solving this underlying problem, such as ones that restrict migration.

Organ shortage: the greatest challenge facing transplant medicine.

PubMed

Shafran, David; Kodish, Eric; Tzakis, Andreas

2014-07-01

The success of organ transplantation as a treatment for end-stage organ disease has yielded a series of ethical quandaries originating from the issue of organ shortage. Scarcity of organs for transplantation necessitates formulation of just and fair allocation policies as well as ethically viable solutions to bridging the vast gap between organ supply and demand. The concept of "triage" provides a useful paradigm in which to contextualize the organ shortage issue. This entails subjugating the welfare of the individual patient for the benefit of the wider community as an ethically justified response to the challenge of scarcity.

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.

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.

Residential Segregation and the Availability of Primary Care Physicians

PubMed Central

Gaskin, Darrell J; Dinwiddie, Gniesha Y; Chan, Kitty S; McCleary, Rachael R

2012-01-01

Objective To examine the association between residential segregation and geographic access to primary care physicians (PCPs) in metropolitan statistical areas (MSAs). Data Sources We combined zip code level data on primary care physicians from the 2006 American Medical Association master file with demographic, socioeconomic, and segregation measures from the 2000 U.S. Census. Our sample consisted of 15,465 zip codes located completely or partially in an MSA. Methods We defined PCP shortage areas as those zip codes with no PCP or a population to PCP ratio of >3,500. Using logistic regressions, we estimated the association between a zip code's odds of being a PCP shortage area and its minority composition and degree of segregation in its MSA. Principal Findings We found that odds of being a PCP shortage area were 67 percent higher for majority African American zip codes but 27 percent lower for majority Hispanic zip codes. The association varied with the degree of segregation. As the degree of segregation increased, the odds of being a PCP shortage area increased for majority African American zip codes; however, the converse was true for majority Hispanic and Asian zip codes. Conclusions Efforts to address PCP shortages should target African American communities especially in segregated MSAs. PMID:22524264

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

Understanding the supply and distribution of registered nurses: where are the data and what can they tell us?

PubMed

Martiniano, Robert; Mcginnis, Sandra; Moore, Jean

2010-01-01

Health workforce researchers routinely conduct studies to determine whether a profession is currently in short supply and whether future shortages are likely. This is particularly important for registered nursing since the profession has experienced periodic shortages over the past three decades. Registered nurse (RN) forecast studies can be valuable in quantifying supply and demand gaps and identifying the most appropriate strategies to avert future shortages. In order to quantify RN supply/demand gaps, it is important to have accurate data on RNs, including the number of active RNs as well as their demographic, education, and practice characteristics, and work location(s). A lack of relevant and timely data on the nursing workforce is a significant barrier to identifying where nursing shortages exist, where they are most severe, and determining the factors that contribute to them. This lack of understanding impedes the development of effective health workforce programs and policies to mitigate shortages and the ability to evaluate these programs and policies for effectiveness. This study describes the national data sources available to nursing researchers to study the supply and distribution of the RN workforce and assesses the sources' strengths and limitations. This study also explores the potential for using state-level data for nursing workforce research.

75 FR 54349 - Negotiated Rulemaking Committee on Designation of Medically Underserved Populations and Health...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-07

... Rulemaking Committee on Designation of Medically Underserved Populations and Health Professional Shortage... on Designation of Medically Underserved Populations and Health Professional Shortage Areas. Date and... Negotiated Rulemaking Committee on Designation of Medically Underserved Populations and Health Professional...

42 CFR 491.2 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-10-01

... shortage of personal health services (under section 1302(7) of the Public Health Service Act) or a shortage... CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STANDARDS... context indicates otherwise: Direct services means services provided by the clinic's staff. FQHC means an...

7 CFR 3431.16 - Certifications and verifications.

Code of Federal Regulations, 2011 CFR

2011-01-01

... AND AGRICULTURE VETERINARY MEDICINE LOAN REPAYMENT PROGRAM Administration of the Veterinary Medicine... requirements of: (1) The veterinary service shortage situations as defined in the RFA; (2) The eligibility.../or maintain a veterinary practice in a veterinary service shortage situation as defined in subpart A...

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...

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...

Paraprofessional Work with Troubled Children.

ERIC Educational Resources Information Center

Gardner, James E.

There is a severe shortage of professionally trained workers in the fields of remedial reading, psychotherapy, and preventive psychological/educational preschool programs. In response to this shortage, many paraprofessional workers have entered these fields. Since 1966, the Children's Center for Educational Therapy in Venice, California, has…

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

PubMed

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

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

Déjà-vu all over again: using simulation to evaluate the impact of shorter shelf life for red blood cells at Héma-Québec.

PubMed

Blake, John T; Hardy, Matthew; Delage, Gilles; Myhal, Geneviève

2013-07-01

Since the 1970s red blood cells (RBCs) have had a rated shelf life of 42 days. Recently, studies have suggested poorer patient outcomes when older blood is transfused. However, shortening the shelf life of RBCs may increase costs and lead to greater instances of outdates and shortages. A simulation method to evaluate the impact of a shorter shelf life for RBCs on a regional blood network was developed. A network model of the production and distribution system in the province of Quebec was built and validated. The model suggests that a shelf life of 21 or 28 days will have modest impact on outdate and shortage rates. A shelf life of 14 days will create significant challenges for both blood suppliers and hospitals and will result in systemwide outdate rates of 6.64% and shortage rates of 2.75%. The impact of a shorter shelf life for RBCs will disproportionately affect smaller and midsize hospitals. A shelf life of 28 or 21 days is feasible without excessive increases to systemwide outdate, shortage, or emergency ordering rates. Large hospitals will see minimal impact; smaller hospitals will see larger increases and may be unable to find inventory policies that maintain both low outdate and shortage rates. Reducing the shelf life to 14 days, or lower, results in significant challenges for suppliers and hospitals of all sizes. All hospitals will see an impact on outdate and shortage rates; overall systemwide outdate rates (6% or more) will reach levels that would currently be considered unacceptably high. © 2012 American Association of Blood Banks.

A news media analysis of economic sanction effects on access to medicine in Iran.

PubMed

Kheirandish, Mehrnaz; Rashidian, Arash; Bigdeli, Maryam

2015-01-01

In the past decades economic sanctions have been used by different countries or international organizations in order to deprive target countries of some transactions. While the sanctions do not target health care systems or public health structures, they may, in fact, affect the availability of health care in target countries. In this study, we used media analysis to assess the impacts of recent sanctions imposed by the Central Bank of Iran in 2012 on access to medicines in Iran. We searched different sources of written news media including a database of nonspecialized weeklies and magazines, online news sources, web pages of daily newspapers and healthcare oriented weeklies from 2011 to 2013. We searched the sources using the general term "medicine" to reduce the chances of missing relevant items. The identified news media were read, and categorized under three groups of items announcing "shortage of medicines," "medicines related issues" and "no shortage." We conducted trend analyzes to see whether the news media related to access to medicines were affected by the economic sanctions. A total number of 371 relevant news media were collected. The number of news media related to medicines substantially increased in the study period: 30 (8%), 161 (43%) and 180 (49%) were published in 2011, 2012 and 2013, respectively. While 145 (39%) of media items referred to the shortage of medicines, 97 (26%) reported no shortage or alleviating of concerns. Media analysis suggests a clear increase in the number of news media reporting a shortage in Iran after the sanctions. In 2013, there were accompanying increases in the number of news media reporting alleviation of the shortages of medicines. Our analysis provides evidence of negative effects of the sanctions on access to medicines in Iran.

7 CFR 276.1 - Responsibilities and rights.

Code of Federal Regulations, 2010 CFR

2010-01-01

... responsible for preventing losses or shortages of Federal funds in the issuance of benefits to households... unaccounted shortages that occur during issuance, unless otherwise specified. Issuance functions begin with the State agency's creation of a record-for-issuance to generate each month's issuances from the...

Pakistan Country Analysis Brief

EIA Publications

2016-01-01

Over the past few years, Pakistan has experienced a major energy crisis as a result of expensive fuel sources, chronic natural gas and electricity shortages, circular debt, and insufficient transmission and distribution systems. According to the Asian Development Bank, prolonged power shortages cut GDP by 2-3% in 2013.

76 FR 39062 - Negotiated Rulemaking Committee on Designation of Medically Underserved Populations and Health...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-05

... Designation of Medically Underserved Populations and Health Professional Shortage Areas; Notice of Meeting... Designation of Medically Underserved Populations and Health Professional Shortage Areas. DATES: Meetings will... Negotiated Rulemaking Committee on Designation of Medically Underserved Populations and Health Professional...

Who Will Teach Montana's Children?

ERIC Educational Resources Information Center

Nielson, Dori Burns

Montana is experiencing three types of teacher shortages, each requiring different intervention strategies. These situations include shortages in specific subject areas, most notably in music, special education, and foreign languages, followed closely by guidance and library; many job openings, caused by rapid enrollment growth, a large number of…

7 CFR 3431.1 - Applicability of regulations.

Code of Federal Regulations, 2011 CFR

2011-01-01

... AGRICULTURE VETERINARY MEDICINE LOAN REPAYMENT PROGRAM Designation of Veterinarian Shortage Situations § 3431... veterinarian shortage situations as well as the administrative provisions for the Veterinary Medicine Loan Repayment Program (VMLRP) authorized by the National Veterinary Medical Service Act (NVMSA), 7 U.S.C. 3151a. ...

Voices of the poor from the margins of Bengal: structural inequities and health.

PubMed

Dutta, Mohan J; Dutta, Uttaran

2013-01-01

In opposition to the traditional approaches to health communication that treat the subaltern sectors as passive recipients of messages of enlightenment configured in top-down interventions, the culture-centered approach foregrounds the importance of listening to subaltern communities at the margins through dialogue. We build on earlier culture-centered projects in rural communities of West Bengal, India, to develop participatory research strategies for understanding the local processes through which the structural marginalization of the poor plays out in rural Bengal. Study results point toward the marginalization of the poor both communicatively and economically, attending to the ways in which communicative marginalization lies at the heart of economic oppressions. Through locally articulated concepts of "health as shortage" and "communication as shortage," community members put forth alternative rationalities of health that highlight structural resources at the heart of health. These local articulations of shortage offer an alternative rationality for organizing health promotion efforts in the rural margins of Bengal through the foregrounding of discourses of shortage.

Establishing a new medical school: Botswana's experience.

PubMed

Mokone, Gaonyadiwe G; Kebaetse, Maikutlo; Wright, John; Kebaetse, Masego B; Makgabana-Dintwa, Oarabile; Kebaabetswe, Poloko; Badlangana, Ludo; Mogodi, Mpho; Bryant, Katie; Nkomazana, Oathokwa

2014-08-01

Having adequate numbers of qualified human resources for health is essential for any effective health care system. However, there is a global shortage of skilled health care workers, especially in Sub-Saharan African countries. This shortage is exacerbated by a disproportionately high rate of infectious diseases, the burden of emerging chronic, noncommunicable diseases, and the emigration of medical doctors. Botswana has also experienced this critical shortage of doctors for many years. To address the shortage, the country in the 1990 s embarked on an aggressive program to train its students at foreign medical schools. Despite intensified training, many graduates have not returned. As a result, the country decided to establish a medical school within Botswana. The newly established school was awarded a grant from the Medical Education Partnership Initiative, which has helped to accelerate the school's development. This paper describes the authors' experiences, highlighting curriculum, staffing, infrastructure approaches, key successes, and challenges encountered. The paper concludes by proposing solutions. The authors' experiences and the lessons learned can inform colleagues in other countries considering similar endeavors.

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.

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.

7 CFR 3431.8 - Purpose and scope.

Code of Federal Regulations, 2012 CFR

2012-01-01

... veterinarians in shortage situations and provide USDA with a pool of veterinary specialists to assist in the... service agreements with veterinarians to pay principal and interest on education loans of veterinarians who agree to work in veterinary shortage situations for a prescribed period of time. In addition...

7 CFR 3431.8 - Purpose and scope.

Code of Federal Regulations, 2014 CFR

2014-01-01

... veterinarians in shortage situations and provide USDA with a pool of veterinary specialists to assist in the... service agreements with veterinarians to pay principal and interest on education loans of veterinarians who agree to work in veterinary shortage situations for a prescribed period of time. In addition...

7 CFR 3431.8 - Purpose and scope.

Code of Federal Regulations, 2013 CFR

2013-01-01

... veterinarians in shortage situations and provide USDA with a pool of veterinary specialists to assist in the... service agreements with veterinarians to pay principal and interest on education loans of veterinarians who agree to work in veterinary shortage situations for a prescribed period of time. In addition...

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...

7 CFR 1778.21 - Application processing.

Code of Federal Regulations, 2011 CFR

2011-01-01

... AGRICULTURE (CONTINUED) EMERGENCY AND IMMINENT COMMUNITY WATER ASSISTANCE GRANTS § 1778.21 Application... acute shortage of potable water, or that such a decline or shortage is imminent, and that the proposed... 7 Agriculture 12 2011-01-01 2011-01-01 false Application processing. 1778.21 Section 1778.21...

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...

Where Are the Accounting Professors?

ERIC Educational Resources Information Center

Chang, Jui-Chin; Sun, Huey-Lian

2008-01-01

Accounting education is facing a crisis of shortage of accounting faculty. This study discusses the reasons behind the shortage and offers suggestions to increase the supply of accounting faculty. Our suggestions are as followings. First, educators should begin promoting accounting academia as one of the career choices to undergraduate and…

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...

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...

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.

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.

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…

Perspectives on Rural Health Workforce Issues: Illinois-Arkansas Comparison

ERIC Educational Resources Information Center

MacDowell, Martin; Glasser, Michael; Fitts, Michael; Fratzke, Mel; Peters, Karen

2009-01-01

Context: Past research has documented rural physician and health care professional shortages. Purpose: Rural hospital chief executive officers' (CEOs') reported shortages of health professionals and perceptions about recruiting and retention are compared in Illinois and Arkansas. Methods: A survey, previously developed and sent to 28 CEOs in…

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...

Executive Leadership: Preparation Is Paramount to Success

ERIC Educational Resources Information Center

Miller, Tina Lee

2012-01-01

A review of current research clearly points to a shortage of highly qualified principal candidates to fill vacancies as "baby boomer" principals reach retirement age. In many school districts across the nation, the principal shortage is already being realized. Principal preparatory programs as well as school districts are working…

Stories of Exemplary Hospital Registered Nurses: A Narrative Analysis

ERIC Educational Resources Information Center

Snelson, Donna Ayers

2010-01-01

Today the multidimensional global shortage of nurses is negatively impacting the work environment of hospital nurses and causing, in a cyclical fashion, decreasing work satisfaction, increasing nurse turnover, and decreasing patient outcomes. While strategies aimed at causation of the nursing shortage must be addressed, to support nursing until…

High Stakes Supervision: We Must Do More

ERIC Educational Resources Information Center

Zepeda, Sally J.

2006-01-01

The characteristics of the emerging and existing teaching force are explored in relation to supervision Key trends that exacerbate teacher shortages include out-of-field teaching, increases in student population, critical subject-area shortages, attrition, and retirement. This paper calls for a high-stakes form of supervision as a long-term…

"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)

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...

Opting for Science and Technology!

ERIC Educational Resources Information Center

Biermans, Maarten; De Jong, Uulkje; Van Leeuwen, Marko; Roeleveld, Jaap

2005-01-01

This study focuses on the shortage of graduates in science/technology in the Netherlands. First, the potential reserves of students in science/technology are mapped. Second, the effects of measures to mobilise the reserves are investigated in terms of size and cost effectiveness. Efforts aimed at solving the enormous shortage of higher education…

The Competitive Disadvantage: Teacher Compensation in Rural America. Policy Brief.

ERIC Educational Resources Information Center

Jimerson, Lorna

Three components of the teacher shortage are the recruitment challenge, the retention problem, and the demand for teacher quality. Although the teacher shortage problem involves many factors, any solution must address salaries. Rural districts face a threefold disadvantage: teachers are not compensated as well as other rural professionals; rural…

The Future of Education and the Future of Work.

ERIC Educational Resources Information Center

Bruce, Michael G.

1984-01-01

Observing that there is no shortage of work to be done, but rather a shortage of employment, this essay analyzes aspects of youth unemployment in Europe including school effectiveness; alienation and the work ethic; remedies, which include European Community's "social guarantee"; and some considerations for future change. (MJL)

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,…

Professional Development Needs of Beginning Agricultural Education Teachers in Idaho

ERIC Educational Resources Information Center

Touchstone, Allison J. L.

2015-01-01

The continuing shortage of agricultural education instructors has been documented across the state and nation. Secondary instructor retention may help reduce the shortage and position changes each year. Identifying the challenges facing beginning teachers as perceived by beginning teachers, veteran teachers, and building administrators can help…

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

ERIC Educational Resources Information Center

Berry, Barnett; Shields, Patrick M.

2017-01-01

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

Industry into Teaching: An Alternative Model

ERIC Educational Resources Information Center

Green, Annette; Randall, Rachael; Francis, Rod

2004-01-01

Teacher shortages have encouraged initiatives to tailor training programs to meet the demand in both past, current and future contexts. Such programs have been streamlined to ensure a rapid response to shortages, in addition to also drawing participants from non-traditional groups as a source of potential educators. More broadly in teacher…

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.…

Promoting Scholarship during Child and Adolescent Psychiatry Residency

ERIC Educational Resources Information Center

Mezzacappa, Enrico; Hamoda, Hesham M.; DeMaso, David R.

2012-01-01

Background: In 2003, the Institute of Medicine (IOM) drew attention to the critical national shortage of psychiatrist-researchers and the need for competency-based curricula to promote research training during psychiatry residency as one way to address this shortage at the institutional level. Here, the authors report on the adaptation,…

76 FR 54996 - Negotiated Rulemaking Committee on Designation of Medically Underserved Populations and Health...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-06

... Designation of Medically Underserved Populations and Health Professional Shortage Areas; Notice of Meeting... of Medically Underserved Populations and Health Professional Shortage Areas on September 20, 21, and 22, 2011. The dates of the meeting and contact information were incorrect. Correction In the Federal...

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...

19 CFR 19.12 - Inventory control and recordkeeping system.

Code of Federal Regulations, 2010 CFR

2010-04-01

... invoice with any discrepancy reported to the port director as provided in § 19.6(a). (3) Recordation... discovery. The responsible party must pay the applicable duties, taxes and interest on thefts and shortages... discovery. The responsible party must pay the applicable duties, taxes and interest on thefts and shortages...

Special Education Faculty Needs Assessment Study Implications

ERIC Educational Resources Information Center

Smith, D.D.; Tyler, N.; Montrosse, B.E.; Young, C.; Robb, S.M.

2011-01-01

This paper presents the highlights of the Special Education Faculty Needs Assessment Study (SEFNA). Actions taken after the release of The 2001 Faculty Shortage Study demonstrate that supply-and-demand imbalances can be improved. The projected shortage of special education faculty will directly and negatively affect students with disabilities and…

Infrared thermometry for deficit irrigation of peach trees

USDA-ARS?s Scientific Manuscript database

Water shortage has been a major concern for crop production in the western states of the USA and other arid regions in the world. Deficit irrigation can be used in some cropping systems as a potential water saving strategy to alleviate water shortage, however, the margin of error in irrigation manag...

Influencing Technology Education Teachers to Accept Teaching Positions

ERIC Educational Resources Information Center

Steinke, Luke Joseph; Putnam, Alvin Robert

2008-01-01

Technology education is facing a significant teacher shortage. The purpose of this study was to address the technology education teacher shortage by examining the factors that influence technology education teachers to accept teaching positions. The population for the study consisted of technology education teachers and administrators. A survey…

Preparing Early Childhood Special Educators in Appalachian Kentucky

ERIC Educational Resources Information Center

McLaren, Elizabeth; Rutland, Julie Harp

2013-01-01

National shortages of qualified personnel in the field of early childhood special education are well documented, with shortages magnified in regions characterized by poverty and rural geography. This article provides an overview of the challenges faced and innovations implemented by an alternate-track, personnel preparation program in Appalachian…

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...

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...

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…

A Jobs Mismatch. Commentary

ERIC Educational Resources Information Center

Marina, Brenda L. H.

2011-01-01

In the article "A Jobs Mismatch", Jaschik has compiled the findings of a new report that was released by the Georgetown University Center on Education and the Workforce. The Georgetown University report claims that there is a severe shortage of college graduates in America, and that this shortage has the United States on a…

42 CFR 491.5 - Location of clinic.

Code of Federal Regulations, 2010 CFR

2010-10-01

... or urban area that is designated as either a shortage area or an area that has a medically... specifically designated by the Census Bureau as urban. (3) Included in the rural area classification are those... below the poverty level. (2) The criteria for determination of shortage of primary medical care manpower...

Six-part series on the state of the RN workforce in the United States.

PubMed

Buerhaus, Peter I

2005-01-01

This series on the state of the nursing workforce focuses on describing the results of the national surveys of RNs. The series begins with an analysis of RNs' perceptions of the current nursing shortage and whether they perceive the shortage has gotten better or worse over the past few years. Future topics will include RNs' perceptions of being a nurse and how they perceive certain aspects of their jobs; RNs' awareness of the J&J Campaign and whether they think it has been effective; RNs' perceptions of the impact of the shortage on the quality of patient care in hospitals; and various issues related to the age and diversity of the nursing profession.

Impacting Student Perceptions about Careers in Information Systems

ERIC Educational Resources Information Center

Walstrom, Kent A.; Schambach, Thomas P.

2012-01-01

A shortage of graduates prepared to fill the available jobs in Information Systems remains. Previous studies have verified the shortage and attempted to explain why students do not major in Information Technology related fields. Since prior studies identified lack of awareness regarding the discipline as a major reason in ignoring the major, the…

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…

Perceptions of Novice Clinical Adjunct Nursing Faculty

ERIC Educational Resources Information Center

Himmelberg, Layna

2011-01-01

The anticipated nursing shortage in the United States is well documented and continues to be a topic of discussion. A nationwide solution has been for nursing programs to increase their enrollment of nursing students. This could be difficult for many nursing schools; as many have a shortage of qualified nursing faculty with which to instruct…

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…

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.

Egg fertilisation in a freshwater mussel: effects of distance, flow and male density

Treesearch

Tyler L. Mosley; Wendell R. Haag; James A. Stoeckel

2014-01-01

1. Small or sparse populations can experience Allee effects if egg fertilisation is reduced because of a shortage of sperm. 2. Freshwater mussels are spermcasters that often occur as sparse, patchy populations. Previous studies suggested that sperm shortage limits these populations unless facultative hermaphroditism and selffertilisation occur at low density...

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…

Voices of Black Women Superintendents' Experiences

ERIC Educational Resources Information Center

Cox, Gloria

2017-01-01

The shortage of African American leadership in business, science, law, medicine or just in public school districts can be directly linked to several factors, including a shortage of African American teachers who will enter the leadership pipeline in both urban and suburban settings. This study uses a narrative approach to explore the experiences…

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...

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...

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…

Motivational and Adaptational Factors of Successful Women Engineers

ERIC Educational Resources Information Center

Bornsen, Susan Edith

2012-01-01

It is no surprise that there is a shortage of women engineers. The reasons for the shortage have been researched and discussed in myriad papers, and suggestions for improvement continue to evolve. However, there are few studies that have specifically identified the positive aspects that attract women to engineering and keep them actively engaged…

7 CFR 3431.13 - Terms of loan repayment and length of service requirements.

Code of Federal Regulations, 2013 CFR

2013-01-01

... requirements. (a) Loan repayment. For each year of obligated service in a veterinary shortage situation, as..., provided the shortage situation in which the participant has agreed to serve has been designated as... qualified veterinarians to participate in the VMLRP, the Secretary may establish a loan repayment cap that...

7 CFR 3431.13 - Terms of loan repayment and length of service requirements.

Code of Federal Regulations, 2014 CFR

2014-01-01

... requirements. (a) Loan repayment. For each year of obligated service in a veterinary shortage situation, as..., provided the shortage situation in which the participant has agreed to serve has been designated as... qualified veterinarians to participate in the VMLRP, the Secretary may establish a loan repayment cap that...

7 CFR 3431.13 - Terms of loan repayment and length of service requirements.

Code of Federal Regulations, 2012 CFR

2012-01-01

... requirements. (a) Loan repayment. For each year of obligated service in a veterinary shortage situation, as..., provided the shortage situation in which the participant has agreed to serve has been designated as... qualified veterinarians to participate in the VMLRP, the Secretary may establish a loan repayment cap that...

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…

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…

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…

Compass and Prerequisite Course Scores as Predictors of Success in Practical Nursing School

ERIC Educational Resources Information Center

Pritchard, Toni L. Early

2010-01-01

The nursing shortage is compounded by nursing student attrition. Schools of nursing have limited enrollment, making the admission process an important factor in resolving the ongoing nursing shortage. The purpose of this study was to identify preadmission criteria that accurately identify applicants to practical/vocational nursing (P/VN) schools…

Organizational Approaches to Managing Tacit Knowledge Loss of Legacy System Information Technology Professionals

ERIC Educational Resources Information Center

Bitner, Michael

2012-01-01

Information Technology (IT) employment shortages may be related to employee retirement or normal attrition. Within IT job shortages, tacit knowledge is lost when employees retire or leave organizations. Tacit knowledge is unwritten or unspoken knowledge that is not easily articulated, and exists only with the individuals who obtain the knowledge…

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…

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…

Pros and Cons; New Roles for Non-Professionals in Corrections.

ERIC Educational Resources Information Center

Benjamin, Judith G.; And Others

Ways in which correctional institutions could make the most effective use of the available manpower supply were studied in response to the awareness of widespread unemployment during a period of economic prosperity, a shortage of service workers, and, particularly, an acute shortage of professional personnel in corrections work. The study's…

Targeted Teacher Recruitment: What Is the Issue and Why Does It Matter? Policy Snapshot

ERIC Educational Resources Information Center

Aragon, Stephanie

2018-01-01

Districts across the country are facing severe shortages of teachers--especially in certain subjects (math, science, special education, career and technical education, and bilingual education) and in specific schools (urban, rural, high-poverty, high-minority, and low-achieving). The severity of the teacher shortage problem varies significantly by…

7 CFR 1778.7 - Project priority.

Code of Federal Regulations, 2011 CFR

2011-01-01

... shortage. Grants made in accordance with § 1778.11(b) of this part to assist an established water system remedy an acute shortage of quality water or correct a significant decline in the quantity or quality of... 7 Agriculture 12 2011-01-01 2011-01-01 false Project priority. 1778.7 Section 1778.7 Agriculture...

Spreadsheet Modeling of (Q,R) Inventory Policies

ERIC Educational Resources Information Center

Cobb, Barry R.

2013-01-01

This teaching brief describes a method for finding an approximately optimal combination of order quantity and reorder point in a continuous review inventory model using a discrete expected shortage calculation. The technique is an alternative to a model where expected shortage is calculated by integration, and can allow students who have not had a…

Predicting Success in Nursing Programs

ERIC Educational Resources Information Center

Herrera, Cheryl; Blair, Jennifer

2015-01-01

As the U.S. population ages and policy changes emerge, such as the Patient Protection and Affordable Care Act of 2010, the U.S. will experience a significant shortage of Registered Nurses (RNs). Many colleges and universities are attempting to increase the size of nursing cohorts to respond to this imminent shortage. Notwithstanding a 2.6%…

Promising Practices: Building the Next Generation of School Leaders

ERIC Educational Resources Information Center

Bryant, Jennifer Edic; Escalante, Karen; Selva, Ashley

2017-01-01

This study applies transformational leadership theory practices to examine the purposeful ways in which principals work to build the next generation of teacher leaders in response to the shortage of K-12 principals. Given the impact principals have on student development and the shortage of those applying for the principalship, the purpose of this…

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…

Education-Job Mismatch among Canadian University Graduates: Implications for Employers and Educators.

ERIC Educational Resources Information Center

Redpath, Lindsay

1994-01-01

A recent study of education-job mismatch among 487 Canadian university graduates are analyzed, and the implications in the debate over shortages of skilled employees are considered. It is suggested that the perceived skills shortage is rather a problem of inadequate skill utilization, implying greater employer responsibility. (MSE)

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…

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…

Corporations' Resistance to Innovation: The Adoption of the Internet Protocol Version 6

ERIC Educational Resources Information Center

Pazdrowski, Tomasz

2013-01-01

Computer networks that brought unprecedented growth in global communication have been using Internet Protocol version 4 (IPv4) as a standard for routing. The exponential increase in the use of the networks caused an acute shortage of available identification numbers (IP addresses). The shortage and other network communication issues are…

Availability of Special Education Teachers: Trends and Tests.

ERIC Educational Resources Information Center

Katsiyannis, Antonis; Zhang, Dalun; Conroy, Maureen A.

2003-01-01

A study examined trends in teacher availability in special education by analyzing data from annual reports to Congress from 1988-1989 to 1998- 1999. Findings indicate a nationwide shortage of teacher qualified to teach across all disabilities and a dramatic decrease in the teacher shortage rate beginning in the 1993-1994 year. (Contains…

What Makes Them Stay? A Study of Nursing Faculty Persistence

ERIC Educational Resources Information Center

Greer, Tiffany D.

2017-01-01

There is a nursing faculty shortage contributing to the nursing shortage that necessitates more than just standard recruitment and retention efforts. The purpose of this study was to understand faculty persistence by asking nurse faculty members why they persist in their educating role, what factors influence their persistence, and what obstacles…

Preparing Community College Leaders: The AACC Core Competencies for Effective Leadership & Doctoral Education

ERIC Educational Resources Information Center

McNair, Delores E.

2010-01-01

Community colleges in the United States face shortages of leaders prepared to assume administrative positions in the 21st century. To respond to this shortage, graduate programs are emerging with a specific emphasis on community college leadership; other graduate programs offer broader curricula focused on educational leadership, policy, or higher…

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…

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…

Community Health Crisis: Solving the Nurse Shortage.

ERIC Educational Resources Information Center

Vitiello, Erie

2003-01-01

Describes how Los Rios Community College District (LRCCD), California, the major provider of nursing graduates to the Sacramento area, addressed the issue of the nursing shortage crisis. LRCCD faced the dual issues of student/faculty ratio restrictions of 10/1 and funding that accommodated a 40/1 ratio. Describes LRCCD's new off-campus,…

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…

Staffing the Principalship: Finding, Coaching, and Mentoring School Leaders

ERIC Educational Resources Information Center

Lovely, Suzette

2004-01-01

"Help Wanted" signs are springing up outside schools. The shortage of school administrators is not coming, it is here. To thwart the shortage and keep schools on the cutting edge, diligence in cultivating, training, and inspiring a new generation of school leaders--especially for the principalship, must be exercised. Staffing the Principalship…

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…

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...

Expanding Your Parking Paradigm To Meet Diverse Needs.

ERIC Educational Resources Information Center

Kirkpatrick, Susan A.

1998-01-01

Explores the parking shortage on college campuses in the 1990s and examines an expanding-parking model as planned and developed by the University of Michigan. The model is designed to address the perceived parking shortage, customer perceptions of high parking costs, increasing costs to operate and maintain facilities, and customer dissatisfaction…

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.

Combined top-down and bottom-up climate change impact assessment for the hydrological system in the Vu Gia- Thu Bon River Basin.

PubMed

Tra, Tran Van; Thinh, Nguyen Xuan; Greiving, Stefan

2018-07-15

Vu Gia- Thu Bon (VGTB) River Basin, located in the Central Coastal zone of Viet Nam currently faces water shortage. Climate change is expected to exacerbate the challenge. Therefore, there is a need to study the impacts of climate change on water shortage in the river basin. The study adopts a combined top-down and bottom-up climate change impact assessment to address the impacts of climate change on water shortage in the VGTB River Basin. A MIKE BASIN water balance model for the river basin was established to simulate the response of the hydrological system. Simulations were performed through parametrically varying temperature and precipitation to determine the vulnerability space of water shortage. General Circulation Models (GCMs) were then utilized to provide climate projections for the river basin. The output from GCMs was then mapped onto the vulnerability space determined earlier. In total, 9 out of 55 water demand nodes in the simulation are expected to face problematic conditions as future climate changes. Copyright © 2018 Elsevier B.V. All rights reserved.

Economic benefits of less restrictive regulation of advanced practice nurses in North Carolina.

PubMed

Conover, Chris; Richards, Robert

2015-01-01

With looming provider shortages and increased demand for health care, many states are looking for low-cost ways to alleviate the shortages. The purpose of this study was to assess the economic impact of less restrictive regulations for advanced practice registered nurses (APRNs) in North Carolina. We use economic impact analysis to demonstrate the economic impacts of making state scope-of-practice regulations on APRNs less restrictive in North Carolina. Outcomes include economic output, value-added, payroll compensation, employment, and tax revenue for North Carolina and for various subregions. If North Carolina adopted the same approach to APRN regulation as the least restrictive states, its economy will benefit from substantial increases in economic output and employment. The state will also see increases in tax revenue. In addition to substantially shrinking the size of projected physician shortages, allowing full scope-of-practice for APRNs will bring significant economic benefits to the state of North Carolina. Our analysis should be helpful to policy makers considering ways to deal with provider shortages. Copyright © 2015 Elsevier Inc. All rights reserved.

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

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.

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.

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

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.

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.

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.

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.

A news media analysis of economic sanction effects on access to medicine in Iran

PubMed Central

Kheirandish, Mehrnaz; Rashidian, Arash; Bigdeli, Maryam

2015-01-01

Objective: In the past decades economic sanctions have been used by different countries or international organizations in order to deprive target countries of some transactions. While the sanctions do not target health care systems or public health structures, they may, in fact, affect the availability of health care in target countries. In this study, we used media analysis to assess the impacts of recent sanctions imposed by the Central Bank of Iran in 2012 on access to medicines in Iran. Methods: We searched different sources of written news media including a database of nonspecialized weeklies and magazines, online news sources, web pages of daily newspapers and healthcare oriented weeklies from 2011 to 2013. We searched the sources using the general term “medicine” to reduce the chances of missing relevant items. The identified news media were read, and categorized under three groups of items announcing “shortage of medicines,” “medicines related issues” and “no shortage.” We conducted trend analyzes to see whether the news media related to access to medicines were affected by the economic sanctions. Findings: A total number of 371 relevant news media were collected. The number of news media related to medicines substantially increased in the study period: 30 (8%), 161 (43%) and 180 (49%) were published in 2011, 2012 and 2013, respectively. While 145 (39%) of media items referred to the shortage of medicines, 97 (26%) reported no shortage or alleviating of concerns. Conclusion: Media analysis suggests a clear increase in the number of news media reporting a shortage in Iran after the sanctions. In 2013, there were accompanying increases in the number of news media reporting alleviation of the shortages of medicines. Our analysis provides evidence of negative effects of the sanctions on access to medicines in Iran. PMID:26645026

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 managers, who shoulder the burden of protecting food security and rural livelihoods in the world's poor dry communities.

[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 edge enough,well preserved organ function, comparatively low incidence about the laryngeal stenosis, the short-term and long-term repair effect are all exact.

What caused the recent reduction in heroin supply in Australia?

PubMed

Wodak, Alex

2008-08-01

Heroin availability and purity decreased and prices increased in Australia suddenly in early 2001. The heroin market in Australia has still not returned to the status quo ante after more than six years. Benefits of the heroin shortage, including a substantial reduction in drug overdose deaths and property crime, are generally considered to have outweighed adverse effects which included increased use of other drugs, especially stimulants, with a subsequent increase in aggression, violence and mental illness. Some commentators attributed the heroin shortage to a combination of factors, while an influential study highlighted the importance of supply control asserting that increased funding and improved effectiveness of domestic drug law enforcement produced critical heroin seizures which disrupted major syndicates, thereby producing the heroin shortage. Evidence to support a critical role for drug law enforcement in the heroin shortage is weak with some recent evidence contradicting key assertions used to support the supply control hypothesis. Although the most likely interpretation is still a combination of multiple factors, the most important factors appear to have been a substantial recent reduction in source opium cultivation and heroin production in Burma, but probably also increased heroin consumption en route through China and a switch from heroin to amphetamine production in Burma. This interpretation is consistent with the international experience of several recent decades in numerous countries where national heroin shortages have occurred rarely and generally only briefly, notwithstanding vigorous and very well resourced supply control efforts. The recent reduction in heroin supply in Australia, the most severe, longest lasting and best-documented heroin shortage in the world, cannot be confidently attributed, solely or largely, to improved domestic drug law enforcement. At best, domestic law enforcement may have made a small contribution compared to several other factors. Evaluation of supply, demand and harm reduction should be held to the same standards.

Evaluating Teacher-Leaders for Careers as Administrators: Effects of Job Attributes, Teacher Leader Role, and Teaching Assignment Area

ERIC Educational Resources Information Center

Shumate, Brian T.; Munoz, Marco A.; Winter, Paul A.

2005-01-01

Recruitment of public school administrators is an important issue due to the shortage of qualified job applicants nationwide. The shortage of applicants requires school districts to evaluate their internal pools of potential applicants for administrative vacancies. This evaluation research addressed the recruitment of teacher-leaders to serve as…

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,…

Personnel Supply and Demand: A Context for Special Education. Information on Personnel Supply and Demand.

ERIC Educational Resources Information Center

National Clearinghouse for Professions in Special Education, Reston, VA.

Annual surveys by the Association for School, College, and University Staffing show that various categories of special education are among the major areas of personnel shortage in all of education. Especially severe areas of shortage occur in the areas of emotional disturbance/behavior disorders, learning disabilities, and multiple/severe…

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…

Manpower Projections, Recruitment Needs and Training Requirements for Commercial Airline Pilots in the United States 1968-1979.

ERIC Educational Resources Information Center

Simons, Robert Marchand

This study evaluated the reported airline pilot shortage in relation to certified air carriers; recruitment needs for qualified applicants; training requirements as recommended by air carriers, airline captains, and flight officers; and airline pilot supply and demand during 1968-79. A literature review on foreign and domestic pilot shortages was…

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…

A Model Retention Program for Science and Engineering Students: Contributions of the Institutional Research Office.

ERIC Educational Resources Information Center

Andrade, Sally J.; Stigall, Sam; Kappus, Sheryl S.; Ruddock, Maryann; Oburn, Martha

This paper asserts that the continuing decline in admissions to science and engineering graduate programs may lead to a shortage of skilled professionals that undermines the U.S. economy and to a shortage in higher education faculty. The Louis Stokes Alliance for Minority Participation (LSAMP) provides academic activities and retention services to…

Closing the Gap: Education Requirements of the 21st Century Production Workforce

ERIC Educational Resources Information Center

Stone, Kyle B.; Kaminski, Karen; Gloeckner, Gene

2009-01-01

Due to the large number of individuals retiring over the next ten years a critical shortage of people available to work within the manufacturing industry is looming (Dychtwald, Erickson, & Morison, 2006). This shortage is exacerbated by the lack of a properly educated workforce that meets the demands of the 21st century manufacturer (Judy…

A Bridging Approach to Boost Doctoral Enrollment in a HBCU: An Exploratory Qualitative Study

ERIC Educational Resources Information Center

Birore, Charles M. S.; Wu, Liyun

2017-01-01

A declining enrollment in doctoral social work programs not only affects the sustainability of the programs, but also impacts the knowledge-based economy in the long run. The shortage of doctoral-prepared faculty, interwoven with the current national shortage of social workers, will limit effective service delivery, and generation of knowledge…

TEXAS MIGRANT LABOR, THE 1965 MIGRATION.

ERIC Educational Resources Information Center

Good Neighbor Commission of Texas, Austin.

THE CALENDAR YEAR 1965 WAS THE FIRST FULL YEAR IN WHICH NO BRACEROS WERE IMPORTED FROM MEXICO. CROP LOSSES OCCURRED IN SOME AREAS OF THE COUNTRY DUE TO LABOR SHORTAGES, HOWEVER, GOVERNMENT OFFICIALS STATE THAT THESE SHORTAGES CAN BE AVOIDED IN THE FUTURE. THE MAJORITY OF TEXAS MIGRANTS LIVE IN SOUTH TEXAS AND APPROXIMATELY 95 PERCENT OF THEM ARE…

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

Code of Federal Regulations, 2012 CFR

2012-10-01

... number of FTE podiatrists) will be computed as follows: Podiatrist shortage = adjusted population/28,000... will be assigned to groups, based on the ratio (R) of adjusted population to number of foot care... for the delivery of podiatric services. 2. The area's ratio of population to foot care practitioners...

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

Code of Federal Regulations, 2014 CFR

2014-10-01

... number of FTE podiatrists) will be computed as follows: Podiatrist shortage = adjusted population / 28... will be assigned to groups, based on the ratio (R) of adjusted population to number of foot care... for the delivery of podiatric services. 2. The area's ratio of population to foot care practitioners...

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

Code of Federal Regulations, 2013 CFR

2013-10-01

... number of FTE podiatrists) will be computed as follows: Podiatrist shortage = adjusted population / 28... will be assigned to groups, based on the ratio (R) of adjusted population to number of foot care... for the delivery of podiatric services. 2. The area's ratio of population to foot care practitioners...

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…

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…

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...

STEM Development: A Study of 6th-12th Grade Girls' Interest and Confidence in Mathematics and Science

ERIC Educational Resources Information Center

Heaverlo, Carol Ann

2011-01-01

Researchers, policymakers, business, and industry have indicated that the United States will experience a shortage of professionals in the Science, Technology, Engineering, and Mathematics (STEM) fields. Several strategies have been suggested to address this shortage, one of which includes increasing the representation of girls and women in the…

Regional Economic and Workforce Strategies: A Focus on the Mature Workforce--New Opportunities for Meeting Skill Needs

ERIC Educational Resources Information Center

Council for Adult and Experiential Learning (NJ1), 2009

2009-01-01

Regions around the country are grappling with current and anticipated skills shortages and, in some cases, labor shortages. Economic prosperity depends heavily on the quality of the workforce, and yet far too few regions have recognized their best underutilized asset: the mature workforce. Because mature workers are nearing traditional retirement…

42 CFR Appendix A to Part 5 - Criteria for Designation of Areas Having Shortages of Primary Medical Care Professional(s)

Code of Federal Regulations, 2010 CFR

2010-10-01

... above.) 2. Determination of Degree of Shortage. Designated correctional institutions will be assigned to... metropolitan areas which display a strong self-identity (as indicated by a homogeneous socioeconomic or... population for the differing health service requirements of various age-sex population groups will be...

Service Delivery to Young Handicapped Children in Rural Areas: A Review of Issues and Practices.

ERIC Educational Resources Information Center

Nash, Tina Eaton; And Others

The paper examines barriers faced by educators and administrators in serving young handicapped children in rural areas and suggests approaches to overcoming these barriers. Among problems identified are transportation; funding shortages due to a lower tax base and higher levels of poverty; unemployment, and seasonal employment; staff shortages;…

Meeting the Need for Special Education Teachers for Culturally Linguistically Diverse Students with Disabilities

ERIC Educational Resources Information Center

Peterson, Patricia; Showalter, Stephen

2010-01-01

Significant personnel shortages in special education have been noted in the 23rd Annual Report to Congress on the Implementation of IDEA Act (USDE, 2002). With predictions of even more serious teacher shortages, there is an especially critical need for additional special education teachers for students with disabilities from culturally and…

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…

A Job Too Big for One: Multiple Principals and Other Nontraditional Approaches to School Leadership

ERIC Educational Resources Information Center

Grubb, Norton W.; Flessa, Joseph J.

2006-01-01

Background: Current federal, state, and local school accountability measures as well as policy initiatives that call for improved leadership have placed increasing demands on principals. Many districts face shortages of appropriate candidates for the job; popularly, this shortage is explained by the fact that simply too few hero-principals exist…

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…

Factors Influencing the Recruitment and Retention of Special Education Teachers: An Evaluation of Teacher Retention in a Southeastern Metropolitan School District

ERIC Educational Resources Information Center

Kagler, Fiesta T.

2011-01-01

The national shortage of certified special education teachers has reached crisis proportions. This shortage has been exacerbated by increases in special education populations and high attrition rates of special education teachers. This study examined the factors influencing the recruitment and retention of special education teachers. Several…

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...

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…

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…

The Impact of Alcohol and Other Drugs on the Child Welfare System.

ERIC Educational Resources Information Center

Curtis, Patrick A.; McCullough, Charlotte

1993-01-01

Surveyed Child Welfare League of America member agencies about the impact of alcohol and other drugs (AOD) on child welfare services delivery. Agencies reported that AOD adversely affected the system by compounding problems, such as personnel shortages and shortages in available foster homes, which existed before AOD was identified as a major…

Exploring Student Perceptions of Retention Issues in a 3-Year Baccalaureate-Level Nursing Program

ERIC Educational Resources Information Center

Taulbee, Rebecca

2017-01-01

The nursing shortage, a major concern for the United States, has a multitude of causative factors. Nursing education has been tasked with helping to decrease the shortage of qualified registered nurses. Poor retention of nursing students in higher education is impacting the number of qualified nurses entering the workforce. Nursing education has…

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.

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.

International medical graduates and the cardiology workforce.

PubMed

Kostis, John B; Ahmad, Busharat

2004-09-15

Recent publications have expressed the view that there is a shortage of cardiologists and it is growing worse. Both an increasing demand and a diminishing supply of cardiologists have been projected. An increase in the number of international medical graduates (IMGs) who enter cardiology practice has been proposed as a remedy for a projected shortage. The IMGs have to overcome challenges including clinical practice, language proficiency, and cultural differences before they are incorporated into the fabric of U.S. cardiology. With hard work, perseverance, excellence,compassionate care and support and mentoring, many have contributed to scientific and clinical cardiology in the U.S. Whether in the absence of a present crisis the projected shortage of cardiologists necessitates change in U.S. immigration policy is an open question.

A Shortage of Medical Residency Positions: Parallels with Psychology.

PubMed

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

2015-12-01

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

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.

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.

Tracking the Career Paths of Physics Teachers in Texas

ERIC Educational Resources Information Center

Mount, Jennifer; Marshall, Jill; Fuller, Edward

2013-01-01

In Texas, and some other states, there is a documented shortage of physics teachers, in terms of both number and qualifications. The shortage in Texas is due as much to teachers leaving the field (attrition) as to a lack of teachers entering. There are efforts under way to prepare more and better-qualified physics teachers who will stay in the…

An Investigation of the Efficacy of Speech and Language Interventions with Students with ASD Using Telepractice

ERIC Educational Resources Information Center

Boisvert, Michelle K.

2012-01-01

There is a national shortage of school-based Speech Language Pathologists (SLP). Schools located in rural and geographically remote areas are often impacted by the shortage, and as a result students with an autism spectrum disorder may not receive services that are mandated by their Individual Education Plan. This study examined the use of…

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

Code of Federal Regulations, 2012 CFR

2012-10-01

... for the delivery of pharmacy services. 2. The number of pharmacists serving the area is less than the estimated requirement for pharmacists in the area, and the computed pharmacist shortage is at least 0.5. 3. Pharmacists in contiguous areas are overutilized or excessively distant from the population of the area under...

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

Code of Federal Regulations, 2014 CFR

2014-10-01

... for the delivery of pharmacy services. 2. The number of pharmacists serving the area is less than the estimated requirement for pharmacists in the area, and the computed pharmacist shortage is at least 0.5. 3. Pharmacists in contiguous areas are overutilized or excessively distant from the population of the area under...

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

Code of Federal Regulations, 2010 CFR

2010-10-01

... for the delivery of pharmacy services. 2. The number of pharmacists serving the area is less than the estimated requirement for pharmacists in the area, and the computed pharmacist shortage is at least 0.5. 3. Pharmacists in contiguous areas are overutilized or excessively distant from the population of the area under...

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

Code of Federal Regulations, 2011 CFR

2011-10-01

... for the delivery of pharmacy services. 2. The number of pharmacists serving the area is less than the estimated requirement for pharmacists in the area, and the computed pharmacist shortage is at least 0.5. 3. Pharmacists in contiguous areas are overutilized or excessively distant from the population of the area under...

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

Code of Federal Regulations, 2013 CFR

2013-10-01

... for the delivery of pharmacy services. 2. The number of pharmacists serving the area is less than the estimated requirement for pharmacists in the area, and the computed pharmacist shortage is at least 0.5. 3. Pharmacists in contiguous areas are overutilized or excessively distant from the population of the area under...

The Future of Work. A Report by the AFL-CIO Committee on the Evolution of Work.

ERIC Educational Resources Information Center

American Federation of Labor and Congress of Industrial Organizations, Washington, DC.

The United States is a labor surplus society, one with a persistent shortage of jobs. This labor surplus--manifested in excessively and persistently high unemployment--will continue through the 1980s. The existence of a persistent job shortage, resulting in a labor surplus of four to six million unemployed workers without a constructive economic…

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…

Pressing Problems of Professional Education in Russia

ERIC Educational Resources Information Center

Neshchadin, A.; Neshchadina, O.; Tsareva, I.

2007-01-01

In the near future, the factor that may become the greatest hindrance to both industrial growth and to economic growth as a whole is the shortage of labor resources, a shortage that even now is keenly felt in the sphere of production. For this reason, the structure and quality of the labor capital that is being turned out by the system of…

Assessing the Relationship of Teacher Self-Efficacy, Job Satisfaction, and Perception of Work-Life Balance of Louisiana Agriculture Teachers

ERIC Educational Resources Information Center

Blackburn, J. Joey; Bunchm, J. C.; Haynes, J. Chris

2017-01-01

Agricultural education has faced a national shortage of qualified teachers since 1965. Initiatives, such as NAAE's TeachAg Campaign, seek to alleviate this shortage through recruitment of new agriculture teachers. However, turnover in the teaching profession remains a problem, with attrition rates approaching 60% reported in some research studies.…

Michigan Technician Need Study. The Present and Projected Demand for Technically Trained People in Michigan.

ERIC Educational Resources Information Center

Ferris State Coll., Big Rapids, MI. Office of Administrative Studies.

This study undertakes to determine (1) the extent of crucial manpower shortages in Michigan by technical area and skill, by the areas of occupation or industry, and whether these shortages will decrease or increase over the next few years, and (2) the opportunities for technical education now available or necessary to assure Michigan industry and…

A Study of Variables That Influence Teacher Turnover in the Little Municipal School District

ERIC Educational Resources Information Center

Stokes, Paula Hollingsworth

2013-01-01

A teacher shortage is a recognized problem in research on public schools. Schools across the United States must hire and retain highly qualified teachers, but the literature indicates teachers with fewer than 3 years of experience are often leaving teaching, creating a possible teacher shortage of 4.2 million teachers by the year of 2016.…

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…

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…

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

PubMed Central

2016-01-01

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

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

ERIC Educational Resources Information Center

Twalo, T.

2010-01-01

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

Georgia Hospital Association leads long-term staff recruiting effort. Reaches wide target audience through innovative media use.

PubMed

Botvin, Judith D

2003-01-01

The Georgia Hospital Association (GHA), faced with a critical healthcare workforce shortage, created a long-term response to the problem by creating a Workforce Shortage Media Campaign. Its single purpose was to encourage Georgians to pursue careers in healthcare. The four-week campaign took six months to develop and included print, radio and television.

Local Workforce Rx: Training Students to Meet the Needs of a Changing Health Care Job Market

ERIC Educational Resources Information Center

Murray, Corey; Ullman, Ellen

2011-01-01

Those following recent employment trends have heard about the nursing shortage. A combination of increased demand and impending retirements means 1 million nurses will be needed in hospitals, homes, and medical facilities by 2018. That's good news for job seekers. But it is not just shortages in nursing. Allied health careers, including…

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...

Technology Teacher Education: Alternative Pathways Established in Response to Issues of Supply and Demand in NSW

ERIC Educational Resources Information Center

Cornius-Randall, Rachael

2004-01-01

Teacher shortages have encouraged initiatives to tailor training programs to meet the demand in both past, current and future contexts. Such programs have been streamlined to ensure a rapid response to shortages, in addition to also drawing participants from non-traditional groups as a source of potential educators. Within teacher education,…

The Impact of Teacher Preparation on Student Achievement in Algebra in a "Hard-to-Staff" Urban PreK-12-University Partnership

ERIC Educational Resources Information Center

Gimbert, Belinda G.; Cristol, Dean; Sene, Abdou Marty

2007-01-01

Debate about teacher supply, demand, retention, and attrition has been renewed in recent years by an increased concern about the reduced numbers of prospective teachers entering teacher education programs, the high attrition rate of beginning teachers, and the resulting teacher shortages. U.S. schools are experiencing teacher shortages, especially…

Physician Supply: A Review of the Literature and an Analysis of Physician Supply Functions.

ERIC Educational Resources Information Center

Johnson, Pierce Jarvis

The first section of this thesis is a review of previous studies and analyses of physician supply. Then, comparing the present physician shortage with the shortage of engineers and scientists during the 1950's, the author examines the present policies of the American Medical Association which, in effect, restrict the entry of physicians into the…

Defining Administrative Support and Its Relationship to the Attrition of Teachers of Students with Emotional and Behavioral Disorders

ERIC Educational Resources Information Center

Cancio, Edward J.; Albrecht, Susan Fread; Johns, Beverley H.

2013-01-01

Special education faces serious shortages of teachers, and the area of special education teaching with the greatest shortage is in the field emotional and behavioral disorders (EBD). This study was conducted to identify the perceptions of current teachers of students with EBD on the definition of and the extent and importance of administrative…

Strategies for Estimating Teacher Supply and Demand Using Student and Teacher Data. REL 2017-197

ERIC Educational Resources Information Center

Lindsay, Jim; Wan, Yinmei; Berg-Jacobson, Alexander; Walston, Jill; Redford, Jeremy

2016-01-01

Every year the U.S. Department of Education reports for each state in the country the grade levels, subject areas, and geographic areas that have experienced teacher shortages (U.S. Department of Education, Office of Postsecondary Education, 2015). A teacher shortage occurs when the number of teachers available in a specific grade, subject matter…

Special Education Teacher Perception of Administrative Supports That Encourage, Decrease Burnout, and Reduce Attrition

ERIC Educational Resources Information Center

Beebe, Jay

2017-01-01

The field of special education is facing a shortage of teachers. A shortage of special education teachers is an example of a pressing issue within education. The problem is that teacher attrition rates are among the highest within special education. Many special education teachers are leaving the profession after a few years of teaching for varied…

The Future Labor Force and Workplace and the Scientific and Engineering Workforce: Implications for Society and Business and Potential Solutions.

ERIC Educational Resources Information Center

Lightle, Juliana

This report examines the future shortages of scientists and engineers and suggests potential solutions to the shortage. The first section presents general demographic data and trends and interprets what this information suggests for the future economy and business in general. The second section considers the supply of physical scientists and…

Marketing low-grade hardwoods for furniture stock - a new approach

Treesearch

Hugh W. Reynolds; Charles J. Gatchell

1979-01-01

A hardwood shortage of high-grade lumber exists while there is a surplus of low-grade hardwood timber. Two things are needed for the surplus to correct the shortage: a new manufacturing system and a new marketing technique. Utilization research at the Princeton Forestry Sciences Laboratory has developed the new system for converting low-grade hardwood for furniture use...

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"…

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…

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…

A Longitudinal Investigation of the Relationship between Teacher Preparation and Teacher Retention

ERIC Educational Resources Information Center

Zhang, Guili; Zeller, Nancy

2016-01-01

Few issues in education threaten the nation as seriously as the present and growing shortage of teachers. Teacher attrition is high among teachers across the nation and is one of the most serious causes of teacher shortage (Ingersoll, 2004). As policy makers rush to address this problem, research is needed to examine the retention effects of…

Water--Problems and Solutions. A Report Concerning the Problems and Solutions of Negative Water Balance.

ERIC Educational Resources Information Center

Ewert, Alan

Outdoor leaders constantly face problems created by water shortage and, to act effectively, must thoroughly understand the body's use of water and the ways to delay dehydration when water shortage occurs. Dehydration begins when there is a negative water balance, or more water lost than ingested, and progresses from the stage of dryness, to the…

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…

Identification of Anticipated Job Stressors of Registered Nurse Refresher Students as They Prepare to Reenter the Work Force Following a Career Break

ERIC Educational Resources Information Center

Peterson, Carol A.

2013-01-01

Multifactorial reasons have produced a growing nursing shortage. One possible group that could reverse this shortage is inactive nurses. Many stakeholders wonder about allocating scarce resources to identify, locate, educate, and redeploy this group into active practice. The purpose of this one-phase embedded validating quantitative mixed…

Nurse Migration: A Canadian Case Study

PubMed Central

Little, Lisa

2007-01-01

Objective To synthesize information about nurse migration in and out of Canada and analyze its role as a policy lever to address the Canadian nursing shortage. Principal Findings Canada is both a source and a destination country for international nurse migration with an estimated net loss of nurses. The United States is the major beneficiary of Canadian nurse emigration resulting from the reduction of full-time jobs for nurses in Canada due to health system reforms. Canada faces a significant projected shortage of nurses that is too large to be ameliorated by ethical international nurse recruitment and immigration. Conclusions The current and projected shortage of nurses in Canada is a product of health care cost containment policies that failed to take into account long-term consequences for nurse workforce adequacy. An aging nurse workforce, exacerbated by layoffs of younger nurses with less seniority, and increasing demand for nurses contribute to a projection of nurse shortage that is too great to be solved ethically through international nurse recruitment. National policies to increase domestic nurse production and retention are recommended in addition to international collaboration among developed countries to move toward greater national nurse workforce self sufficiency. PMID:17489918

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.

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.

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.

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

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 duration in the 2 years before and after voluntary approval or UDI action increased from 31 days (IQR = 0-339) to 217 days (IQR = 0-406; P = 0.053). The UDI was associated with higher drug prices and more frequent drug shortages when compared with the period before UDI action, while the approval process for these drugs did not necessarily require new clinical evidence to establish safety or efficacy. This project was not supported by any external grants or funds. Gupta was supported by the Yale University School of Medicine Office of Student Research at the time of this study. Dhruva is supported by the Department of Veterans Affairs as part of the Robert Wood Johnson Foundation Clinical Scholars program. Ross reports receiving research support through Yale University from Johnson and Johnson to develop methods of clinical trial data sharing; from Medtronic and the FDA to develop methods for postmarket surveillance of medical devices; from the FDA to establish the Yale-Mayo Clinic Center of Excellence in Regulatory Science and Innovation; from the Blue Cross Blue Shield Association to better understand medical technology evidence generation; from the Centers for Medicare & Medicaid Services to develop and maintain performance measures that are used for public reporting; and from the Laura and John Arnold Foundation to support the Collaboration on Research Integrity and Transparency at Yale. Fox reports travel support from Oklahoma Society of Health System Pharmacists, Premier Oncology Hematology Management Society, and SEHA-United Arab Emirates. Vizient provides some financial support to the University of Utah Drug Information Service to provide summaries of drug shortage information. Gupta and Ross were responsible for the conception and design of this work, drafted the manuscript, and conducted the statistical analysis. Gupta and Fox were responsible for acquisition of data. Ross provided supervision. All authors participated in the analysis and interpretation of the data and critically revised the manuscript for important intellectual content.

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.

Will there be a good general surgeon when you need one? (Part II) Solutions and taking back general surgery.

PubMed

Smith, Richard; Stain, Steven C; McFadden, David W; Finlayson, Samuel R G; Jones, Daniel B; Reid-Lombardo, K Marie

2014-07-01

Multiple reports have cited the looming shortage of physicians over the next decades related to increasing demand, an aging of the population, and a stagnant level in the production of new physicians. General surgery shares in this problem, and the specialty is "stressed" by a declining workforce related to increasing specialization that leaves gaps in emergency, trauma, and rural surgical care. The Society of Surgery of the Alimentary Tract (SSAT) Public Policy and Advocacy Committee sponsored panel discussions regarding the general surgery workforce shortage at the Digestive Disease Week 2012 and 2013 meetings. The 2012 panel focused on defining the problem. This is the summation of the series with the solutions to the general surgery workforce shortage as offered by the 2013 panel.

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

ERIC Educational Resources Information Center

Bondarenko, Natal'ia

2015-01-01

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

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

Treesearch

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

2012-01-01

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

Who Is Going to Build the Wall? A Building Trades Crisis in the U.S.A.

ERIC Educational Resources Information Center

Toppin, Ian N.

2017-01-01

A significant workforce shortage exists in most skilled trades areas in the U.S., but this is especially true in building and construction trades. The number of jobs in the construction industry is expected to grow by almost 20% between 2008 to 2018, while only growing by 11% for all other industries. With the prospect of significant shortages in…

The Association between a Community College's Teacher Education Program and the 4-Year Graduation Rates of Black and Hispanic Teacher Education Students

ERIC Educational Resources Information Center

Perkins, Britine; Arvidson, Cody

2017-01-01

In response to a shortage of qualified Black and Hispanic teachers, community colleges (CC) have developed certificate programs and Associate of Arts degrees in teacher education to address shortages of minority teachers in the nation's classrooms. We examined one CC's effectiveness in transferring Black and Hispanic students to university teacher…

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.

An Investigation of the Phenomenon of Shortages of Indian Teachers as Described by Tribal College Leaders in Teacher Preparation

ERIC Educational Resources Information Center

O'Dell, Cynthia Best

2010-01-01

In Montana, less than 3% of K-12 teachers are American Indian (Montana Office of Public Instruction, 2009). The lack of Indian teachers, which was the problem identified for this dissertation, is of great concern to educational leaders. The shortage of Native American teachers can be correlated to problems in the education of K-12 students…

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...

Comparative Perspectives of Direct Support Professionals Working with Adults with Intellectual Disabilities Regarding Standard Competencies

ERIC Educational Resources Information Center

Bayes, Cynthia Anne

2010-01-01

There is a growing shortage of Direct Support Professionals (DSPs) in the field of intellectual and developmental disabilities. This shortage is at a crisis now and will continue to become more of a crisis unless changes are made. This is a crisis for many community employers and even more of a crisis for the people with disabilities who are faced…

What Prevents Nurses from Entering Faculty Positions Early in Their Professional Career: A Qualitative Study

ERIC Educational Resources Information Center

Moreland, Jack E.

2011-01-01

There is a nursing faculty shortage in the United States today and projections are that over the next decade nurses will retire at a rate faster than they are being replaced. The projected shortage at a time when the largest part of the population will begin to retire and enter the ranks of the elderly could potentially cause serious problems…

Change in the southern U.S. water demand and supply over the next forty years

Treesearch

Steven C. McNulty; Ge Sun; Erika C. Cohen; Jennifer A. Moore Myers

2008-01-01

Water shortages are often considered a problem in the western United States, where water supply is limited compared to the eastern half of the country. However, periodic water shortages are also common in the southeastern United States due to high water demand and periodic drought. Southeastern U.S. municipalities spend billions of dollars to develop water storage...

Responding to Health Skills Shortages: Innovative Directions from Vocational Education and Training. A National Vocational Education and Training Research and Evaluation Program Report

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…

JPRS Report, Science & Technology, USSR: Science & Technology Policy

DTIC Science & Technology

1990-02-28

Biliary, Post-Operative, and Chronic Pancreatites ." 12. Doctor of Technical Sciences Oleg Nikolayevich Kukushkin and Candidate of Technical...Motorygin: What is amazing here: established production in case of the absence of a market and in case of a chronic shortage does not like innovations...tremendous losses due to chronic shortages of serviceable equipment. Dozens of original technological processes are aimed at solving this problem

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

Code of Federal Regulations, 2010 CFR

2010-10-01

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

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

Code of Federal Regulations, 2011 CFR

2011-10-01

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

Perceptions of Teaching Effectiveness of Part-Time and Full-Time Clinical Nursing Faculty of BSN Education

ERIC Educational Resources Information Center

DeSantis, Kimberly L.

2012-01-01

The United States faces a critical shortage of full-time registered nurses, which is . directly affected by the shortage of nurse educators. Many schools of nursing are already seeing the impact as qualified program applicants are being turned away due to the lack of qualified educators available to teach them. The trend has become to employ…

Organization and startup of The Gambia's new community-based medical programme.

PubMed

Chávez, José A; Suárez, Lázaro V; Del Rosario, Odalis; Hechavarría, Suiberto; Quiñones, Judith

2012-01-01

The shortage of health professionals in developing countries and especially in their poorest regions imperils the vision of health for all. New training policies and strategies are needed urgently to address these shortages. The Gambia's new Community-Based Medical Programme is one such strategy. KEYWORDS Medical education, access to health care, healthcare disparities, health manpower, rural health, developing countries, The Gambia.

The Day Care Challenge: The Unmet Needs of Mothers and Children.

ERIC Educational Resources Information Center

Keyserling, Mary Dublin

An overview of the present shortage of day care facilities in the United States is presented in this speech. Statistics cited on the number of working mothers with children under the age of 6 and the number of day care licensed homes and centers show that the shortage of licensed day care facilities is much more acute than it was five years ago.…

Teachers at Heart: A Case Study Exploration of the Role Transition from Clinical Nurse to Community College Adjunct Clinical Nursing Instructor

ERIC Educational Resources Information Center

Wilson, Deborah S.

2017-01-01

The shortage of nursing faculty is limiting the number of students community colleges are able to enroll (National League for Nursing, 2014). The use of adjunct clinical nursing instructors may help lessen the impact of this shortage, while allowing nurses to gain valuable academic experience. An understanding of the process these nurses go…

Nursing Workforce: Emerging Nurse Shortages Due to Multiple Factors. Report to the Chairman, Subcommittee on Health, Committee on Ways and Means, House of Representatives.

ERIC Educational Resources Information Center

Heinrich, Janet

Current evidence suggests emerging shortages of nurses available or willing to fill some vacant positions in hospitals, nursing homes, and home care. Total employment of registered nurses (RNs) per capita and the national unemployment rate for RNs have declined, and providers from around the country report growing difficulty recruiting and…

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…

Policy Options for Use of Media Directed to Increase the Supply of Bachelors Educated Nurses in the U.S.A.

ERIC Educational Resources Information Center

Kloc, Michelle L.

2010-01-01

The national nursing shortage poses health risks to patients and the community. One approach used to mitigate the shortage is increasing interest in nursing as a desirable career among high school and college-age individuals. One method used to promote nursing as a career is via promotional advertisements in media (i.e. television, internet,…

Math and Science Scholars (MASS) Program: A Model Program for the Recruitment and Retention of Preservice Mathematics and Science Teachers

ERIC Educational Resources Information Center

Scott, Timothy P.; Milam, Jennifer L.; Stuessy, Carol L.; Blount, Kit Price; Bentz, Adrienne

2006-01-01

The shortage of certified teachers in mathematics and science in Texas classrooms is a major concern and mirrors national tends. Dramatic increases in shortages of teachers have stimulated the design of new certification programs that recruit and place teachers in classrooms as quickly as possible (Texas Center for Educational Research, 1999).…

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?

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.

Lebensraum: paradoxically, population growth may eventually end wars.

PubMed

Simon, J L

1989-03-01

Population growth may progressively reduce 1 of the motives for making war. Namely, population growth threatens shortages of resources, and especially land. Impending shortages cause a search for ways to mitigate the shortages. The discoveries eventually produce greater availability of resources than if population growth and pressure on resources had never occurred. The argument runs as follows: 1) Rhetoric about resources scarcity induced by population density has often contributed to international conflict, even if economics has not been the main motive in making war. 2) In the pre-modern era, war to obtain land and other resources may sometimes have been an economically sound policy. 3) Politicians and others in industrially developed nations believe resources may still be a casus belli. 4) Land and other productive resources are no longer worth acquiring at the cost of war.

"One man's trash is another man's treasure": exploring economic and moral subtexts of the "organ shortage" problem in public views on organ donation.

PubMed

Schicktanz, S; Schweda, M

2009-08-01

The debate over financial incentives and market models for organ procurement represents a key trend in recent bioethics. In this paper, we wish to reassess one of its central premises-the idea of organ shortage. While the problem is often presented as an objective statistical fact that can be taken for granted, we will take a closer look at the underlying framework expressed in the common rhetoric of "scarcity", "shortage" or "unfulfilled demand". On the basis of theoretical considerations as well as a socioempirical examination of public attitudes, we will argue that this rhetoric has an economic subtext that imbues the debate with normative premises that have far-reaching social and ethical consequences and need to be made explicit and discussed.

Marketing or strategy? Defining the best approach to expand the anesthesiology workforce in Israel.

PubMed

Lewis, Michael C; Grant, Gilbert J

2015-01-01

There is a chronic shortage of anesthesiologists in Israel. The study by Cohen et al. suggests that a marketing campaign may be one method of addressing this shortage. This commentary argues for a more comprehensive strategy based on the US experience. This would not only involve marketing as suggested by Cohen et al. but would also involve a fundamental change in the Israel anesthesia care model, as well as providing substantial financial incentives to young physicians. We believe that a combination of these approaches will help to alleviate the shortage of anesthesia providers in Israel. Creating a new class of physician extenders, namely, anesthesiologist assistants, would also provide an employment pathway for the skilled medical technicians trained by the Israel Defense Forces, and other non-physicians with an interest in anesthesiology.

Sustaining Unconventional Warfare

DTIC Science & Technology

2013-05-23

unavailable or infrequent, resulting in a shortfall of the OSS’ ability to provide agents the radio. To overcome the shortage Donovan ordered all individuals...deploying to theaters accompanied with an SSTR-1. This simple system enabled the OSS to overcome the shortage and cease the practice. The other...to the invasion. It took both the OSS and SOE to overcome these setbacks. They were both placed under SHAEF that fall and were designated Special

Predicting Persistence in Practical Nursing and Success on the NCLEX-PN: Examining Demographic, Non-Academic, and Academic Variables

ERIC Educational Resources Information Center

Davis, Alicia Debra

2015-01-01

The United States is now in the midst of a major nursing shortage that is predicted to get worse over the next ten years (Kurzen, 2005). The Health Resources and Services Administration reports that all 50 states will suffer from a nursing shortage by 2020 (U.S. Department of Health and Human Services, 2004). This means that there will be a…

Components of US Associate Degree Nursing Programs and Their Relationship to the National Council Licensure Examination for Registered Nurses Graduate Pass Rates

ERIC Educational Resources Information Center

Popescu, Caroline A.

2011-01-01

The nursing shortage has accelerated the need for nursing programs to discover program components related to success on the NCLEX-RN. As the demand for nurses is growing, nursing programs have been called upon to help find solutions to the problem. This study attempted to contribute to the resolution of the shortage and provide nursing educators…

A house divided: cooperative and competitive recruitment in vital industries.

PubMed

Willis, William K; Muslin, Ivan; Timko, Karlyn N

2016-03-01

To propose a theoretical based model approach to address the nursing shortage problem of recruiting qualified applicants. Vital industries such as nursing and trucking face a large labour shortage. A literature review focusing on recruitment and realistic job previews examines relevant theories and an indication of the focus of similar research. Game theory illustrates cooperative and competitive recruitment strategies in vital industries. Proposition and model development where cooperative or competitive strategies for recruitment can either increase or decrease the employee applicant pool. Institutional theory states that firms within a population become isomorphic in nature. Firms employing cooperative or competitive strategies for recruitment can change organisational practices through isomorphic processes. Industries facing a labour market shortage using cooperative strategy will use realistic job previews accurately to disseminate information about industry jobs. Realistic job previews will increase the applicant pool through individuals self-selecting into, rather than out of, the applicant pool. Recruitment in the nursing industry has been examined at the individual applicant and organisational level, yet the overall industry has been ignored. As nursing shortages continue, viewing recruitment at the macro level (the overall industry) is appropriate. Game theory as proposed provides opportunities for current research at the industry level. © 2015 John Wiley & Sons Ltd.

Torpor use during gestation and lactation in a primate

NASA Astrophysics Data System (ADS)

Canale, Cindy I.; Perret, Martine; Henry, Pierre-Yves

2012-02-01

Torpor is an energy-saving mechanism that allows endotherms to overcome energetic challenges. Torpor should be avoided during reproduction because of potential incompatibility with offspring growth. To test if torpor can be used during gestation and lactation to compensate for food shortage, we exposed reproductive female grey mouse lemurs ( Microcebus murinus), a heterothermic primate, to different levels of food availability. Torpor use was characterised by daily skin temperature profiles, and its energetic outcome was assessed from changes in body mass. Food shortage triggered torpor during the end of the gestation period ( n = 1), ranging from shallow in response to 40% food restriction to deep daily torpor in response to 80% restriction. During the early period of lactation, females fed ad libitum ( n = 2) or exposed to a 40% restriction ( n = 4) remained normothermic; but 80% food restricted females ( n = 5) gave priority to energy saving, increasing the frequency and depth of torpor bouts. The use of torpor was insufficient to compensate for 80% energetic shortage during lactation resulting in loss of mass from the mother and delayed growth in the pups. This study provides the first evidence that a heterothermic primate can use torpor to compensate for food shortages even during reproduction. This physiological flexibility likely evolved as a response to climate-driven fluctuations in food availability in Madagascar.

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

The demand for doctorally prepared public health personnel in institutions of higher education.

PubMed

Scutchfield, F D; Quimson, S; Williams, S J; Hofstetter, R

1988-01-01

We examined the demand for doctorally prepared public health personnel in academia. We developed an unduplicated list of positions advertised during 1983 in several of the nation's public health journals. Based on this, we identified a total of 217 available positions. We surveyed the persons who placed the advertisements regarding their perceptions of the applicant pool, their experiences in filling the positions, and their perceptions of the future supply of doctorally prepared public health personnel. Of the respondents, 93% were in institutions of higher education. Based on their response, it appears that the current supply of doctorally prepared public health personnel is short and is likely to continue to be limited. Respondents had difficulty filling the advertised positions, based on the amount of time necessary to fill the position, and a number of positions had to be modified in order to be filled. Thirty-two percent of the respondents replied that the pool of applicants was low or poor. Thirty-four percent felt there was a shortage of such personnel, and a similar percentage felt there would be a future shortage. Based on our data, we believe that there is now a shortage of doctorally educated public health personnel for academic positions and that this shortage is likely to continue.

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.

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

PubMed

Ge, Weiqing

2018-01-01

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

A Case for Enlisted Unmanned Aerial System Operators

DTIC Science & Technology

2009-02-25

operational units with the young pilots that are coming in.”27 This is not a new phenomenon, as the Air Force has experienced on and off pilot shortages...underpinning for the increasingly complex leadership and managerial tasks expected from Senior Officers. But as previously discussed, history has definitively...the pilot shortage and economic incentives such as Aviaiton Continuation Pay designed to encourage pilots to stay in the Air Force. When three

The Use of Gamma-H2AX as a Biodosimeter for Total-Body Radiation Exposure in Non-Human Primates

DTIC Science & Technology

2010-11-23

Services University, Bethesda, Maryland, United States of America Abstract Background: There is a crucial shortage of methods capable of determining the...Approved for public release; distribution unlimited 13. SUPPLEMENTARY NOTES 14. ABSTRACT Background: There is a crucial shortage of methods capable of... Veterinarian , Dr. Jennifer Mitchell, and her colleagues in AFRRI’s Veterinary Science Department, radiation exposure and dosimetry support from AFRRI’s

Feeding the Devil Dogs of War

DTIC Science & Technology

2013-03-03

to produce more food than required by her citizens, not every country is as fortunate. Food shortages have affected countries of all sizes, and... veterinarians in 1900 to conduct meat inspections, but the Meat Inspection Act of 1906 had a 17 direct impact on the way that the Army approached the...escalation of force (as evidenced by the shortage of certain types of grenades during AL FAJR) that exceeds distribution center capacity. However, food

Button Pushers and Ribbon Cutters: Observations on Skill and Practice in a Hospital Laboratory and Their Implications for the Shortage of Skilled Technicians. EQW Working Papers.

ERIC Educational Resources Information Center

Scarselletta, Mario

Employers and policymakers have traditionally sought to manage skill shortages in technical and other occupations through initiatives predicted in one of two broad definitions of skill: skill-as-input and skill-as-artifact. A weakness of both these perspectives is that focusing on the inputs and outcomes of a labor process obscures or ignores the…

Environmental Security: A Strategy for the Mitigation of Regional Instabilities?

DTIC Science & Technology

2003-04-07

Fungal infections and intestinal roundworms are common, particularly in the refugee camps. A cholera outbreak was reported in November of 1994 in Gaza...Saharan Africa is noted for its recurring food shortages. All three types of environmental scarcity have been present in Angola, Ethiopia , Eritrea...approximately 11 million people in Ethiopia alone are facing serious food shortages in 2003.58 A historical perspective of the distribution of the world’s

Missan Surgical Hospital Under the Economic Support Fund Al Amarah, Iraq

DTIC Science & Technology

2009-07-16

budget shortages resulting from the reduction in crude oil prices will continue to impact the GOI’s ability to adequately equip, operate, and maintain...staff to operate and maintain the hospital. However, the reduction in oil prices resulted in budget shortages, which delayed the Iraqi funding...operating budget.” The recent fluctuation in oil prices has resulted in budget uncertainty for the GOI, including the funding of projects for the

A Study of School Without Schools: The Columbus, Ohio Public Schools During the Natural Gas Shortage, Winter, 1977. Volume I and Volume II, Appendices.

ERIC Educational Resources Information Center

Sanders, James R.; Stufflebeam, Daniel L.

The energy crisis, specifically a shortage of natural gas, caused by the unusually cold winter of 1977, resulted in the Columbus, Ohio, schools being closed for a month. Schools heated with gas were closed, but students met one day a week in school buildings that used coal, oil, or electricity. The educational program continued with school…

The Politics of Student Housing: Student Activism and Representation in the Determination of the User-Price of a Public-Private Partnership Residence on a Public University Campus in South Africa

ERIC Educational Resources Information Center

Mugume, Taabo; Luescher, Thierry M.

2015-01-01

South African universities have been facing a critical shortage in the provision of student housing for several years now, and the establishment of public--private partnerships (PPPs) is seen as part of the solution to address the shortage (Rensburg, 2011). This article investigates the effectiveness of the Students' Representative Council (SRC)…

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

ERIC Educational Resources Information Center

Alebous, Tahani

2016-01-01

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

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 South Korean Model of Political and Economic Development: Economic Aspects.

DTIC Science & Technology

1983-10-01

controls, future wage negotiations are likely to prove difficult as workers push to make up for earlier losses. Negotiations may even by destabilizing if 6... workers and reports of labor shortage during seasons of veak farm activity. Traditional labor abundance has evidently given way to shortage, and to...new entrants and more fully employ established workers . The dramatic reversal in output growth of 1979-80, sub- sequent industrial stagnation, and a

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.

The Problem and Goals Are Global, the Solutions Are Local: Revisiting Quality Measurements and the Role of the Private Sector in Global Health Professions Education.

PubMed

Hamdy, Hossam

2017-08-01

The shortage of a competent health workforce is a global challenge. However, its manifestations and proposed solutions are very much context related (i.e., local). In addition to the shortage of health professionals, the quality of health professions education programs, institutions, and graduates, and how to measure quality, are also problematic. Commonly used metrics like the Credit Hours System and the European Credit Transfer and Accumulation System have limitations (e.g., being more focused on quantity than quality).In this Invited Commentary, the author discusses the need to revisit quality measurements in health professions education and the issue of whether the private sector has a role to play in narrowing the ever-increasing gap between the demand for health care professionals and the health care workforce shortage.

A statewide strategy for nursing workforce development through partnerships in Texas.

PubMed

Kishi, Aileen; Green, Alexia

2008-08-01

Statewide efforts and partnerships were used for nursing workforce development to address the nursing shortage in Texas. A statewide strategic action plan was developed where partnerships and collaboration were the key components. One of the most important outcomes of these statewide partnerships was the passage of the Nursing Shortage Reduction Act 2001. Through this legislation, the Texas Center for Nursing Workforce Studies and its advisory committee were established. This article describes how a statewide infrastructure for nursing workforce policy and legislative and regulatory processes were further developed. An overview is provided on the contributions made by the organizations involved with these strategic partnerships. The ingredients for establishing successful, strategic partnerships are also identified. It is hoped that nursing and health care leaders striving to address the nursing shortage could consider statewide efforts such as those used in Texas to develop nursing workforce policy and legislation.