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Increased Demand (increased + demand)
Selected AbstractsWorkforce Characteristics of Mohs Surgery FellowsDERMATOLOGIC SURGERY, Issue 2 2004Josephine C. Nguyen BS Background. Anecdotal evidence from program directors and Mohs surgeons suggests that Mohs fellowships are becoming increasingly popular and competitive among dermatology trainees. Objective. To assess the characteristics and investigate the motivating factors of those pursuing Mohs fellowships. Methods. Anonymous surveys were distributed to recent dermatology residency graduates taking a board exam review course in years 1999,2002. Results. In 2002, 2001, and 1999, the percentages of recently trained dermatologists pursuing Mohs fellowships were 9.4%, 8.5%, and 8.8%, respectively. There were no significant differences between Mohs fellows and the rest of the recently graduated dermatologists in terms of debt levels, marital status, parenting status, and spousal employment status. The Mohs fellows were slightly more likely to be male than their non-Mohs counterparts. The factor considered the most important by both groups when choosing a job was location. Conclusions. Further research is needed to discover potential factors that may be playing a role in the increased popularity of Mohs surgery. The number of Mohs surgeons is increasing and is likely to expand over time. It remains to be seen what effect the growth will have on the supply of Mohs surgery and whether it will outpace the increased demand for services. [source] Studies of the Ala/Val98 polymorphism of the hepatocyte nuclear factor-1, gene and the relationship to ,-cell function during an OGTT in glucose-tolerant women with and without previous gestational diabetes mellitusDIABETIC MEDICINE, Issue 12 2004J. Lauenborg Abstract Aims In pregnancies complicated by gestational diabetes mellitus (GDM) an increased demand for insulin is not met due to ,-cell dysfunction. An Ala/Val polymorphism at codon 98 of the hepatocyte nuclear factor-1, (HNF-1,) gene has been associated with decreased serum insulin and C-peptide responses during an oral glucose tolerance test (OGTT) in glucose-tolerant subjects. The aims of the present study were to evaluate the influence of the polymorphism on the serum insulin and C-peptide responses to an OGTT in glucose-tolerant women with and without previous GDM and to investigate if this polymorphism is associated with GDM. Methods The Ala/Val98 polymorphism was measured in 376 women of Danish origin with previous GDM, and in 724 age-matched and 310 middle-aged glucose tolerant women using polymerase chain reaction-restriction fragment length polymorphism. Results The allelic frequency of the Ala/Val98 polymorphism was 0.043 [95% confidence interval (CI) 0.028, 0.057] in women with previous GDM vs. 0.037 (95% CI 0.028, 0.047) in age-matched and 0.039 (95% CI 0.024, 0.054) in middle-age women. Among 117 glucose-tolerant women with previous GDM, 10 carriers of the Ala/Val98 polymorphism had a non-significant 27% and 22% reduction in serum C-peptide and insulin levels, respectively, at 30 min during an OGTT. Seventy-eight control subjects carrying the Ala/Val98 polymorphism had a 10% (P = 0.001) and 16% (P = 0.004) reduction in serum C-peptide and insulin levels, respectively, compared with 956 Ala/Ala control subjects. Conclusions The Ala/Val polymorphism at codon98 of HNF-1, is not associated with GDM in Danish women. However, the codon 98 variant is associated with a significant impairment of serum insulin and C-peptide responses during an OGTT in glucose-tolerant women without previous GDM. [source] THE IMPACT OF CONTINUING EDUCATION TRAINING ON LAW GUARDIAN KNOWLEDGE, EFFICACY, AND PRACTICE BEHAVIORSFAMILY COURT REVIEW, Issue 1 2007Wendi Cross There is an increased demand for law guardians in domestic violence cases, especially those involving child witnesses. Training is required for law guardians to meet child clients' needs. While workshops and conferences are typical venues for continuing education training, their effectiveness is unknown. This pilot study compared law guardians who attended a conference on community violence and children to nonattendees on several training outcomes. Results showed a positive impact on attendees' feelings of efficacy and intentions to carry out new practice behaviors post-conference; differences were maintained at follow-up. Limitations and implications of this pilot study are discussed. [source] Accessibility and equity of health and social care services: exploring the views and experiences of Bangladeshi carers in South Wales, UKHEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 3 2006HV Tut Cert, Joy Merrell BSc (Hons) Abstract There is a paucity of information regarding the extent and nature of caring provided by minority ethnic communities. The proportion of older people from these communities will dramatically increase in the next 20 years, which will be accompanied by increasing health and social care needs and an increased demand for carers. A qualitative, exploratory study was conducted to identify the health and social care needs of informal carers, who were caring for a dependent adult from a Bangladeshi community in South Wales, UK. This paper focuses on Bangladeshi carers' access to formal support services provided by the statutory, private and voluntary sectors to assist them with their caring responsibilities. The findings are based on data collected using face-to-face, focused interviews with 20 Bangladeshi carers. Purposive and snowball sampling were used to recruit the sample. The data were analysed using thematic content analysis. The dimensions of accessibility and equity of quality of care were drawn upon to aid understanding of the findings. Bangladeshi carers faced a number of barriers in accessing health and social service provision, which impeded uptake of these services. Additionally, there was evidence of inequity in service provision. Recommendations for improving the accessibility of health and social care services are proposed, which may assist in promoting more equitable services for carers from the Bangladeshi community. [source] Relation between external audit fees, audit committee characteristics and internal auditACCOUNTING & FINANCE, Issue 3 2006Jenny Goodwin-Stewart M42; G34 Abstract This study examines whether the existence of an audit committee, audit committee characteristics and the use of internal audit are associated with higher external audit fees. Higher audit fees imply increased audit testing and higher audit quality. We find that the existence of an audit committee, more frequent committee meetings and increased use of internal audit are related to higher audit fees. The expertise of audit committee members is associated with higher audit fees when meeting frequency and independence are low. These findings are consistent with an increased demand for higher quality auditing by audit committees, and by firms that make greater use of internal audit. [source] Impact of irrigation on malaria in Africa: paddies paradoxMEDICAL AND VETERINARY ENTOMOLOGY, Issue 1 2001J. N. Ijumba Summary The high population growth rate of the African continent has led to an increased demand for food and is in danger of outstripping agricultural production. In order to meet this need, many governments have sought ways of improving food production by initiating large-scale irrigation projects, involving reclamation of arid and semi-arid areas for the cultivation of crops. Although crop irrigation promises one solution to alleviating hunger and encourages economic growth, irrigation has often been blamed for aggravating disease in local communities. Malaria is one of the major tropical diseases associated with irrigation schemes, and changes in the transmission pattern of this disease following irrigation development have been a perennial subject of debate. It has often been assumed that high numbers of malaria vector Anopheles mosquitoes (Diptera: Culicidae) resulting from irrigation schemes lead inevitably to increased malaria in local communities. However, recent studies in Africa have revealed a more complex picture. Increased numbers of vectors following irrigation can lead to increased malaria in areas of unstable transmission, where people have little or no immunity to malaria parasites, such as the African highlands and desert fringes. But for most of sub-Saharan Africa, where malaria is stable, the introduction of crop irrigation has little impact on malaria transmission. Indeed, there is growing evidence that for many sites there is less malaria in irrigated communities than surrounding areas. The explanation for this finding is still unresolved but, in some cases at least, can be attributed to displacement of the most endophilic and anthropophilic malaria vector Anopheles funestus Giles by An. arabiensis Patton with lower vectorial capacity, as the latter thrives more than the former in ricefields. Similarly, among members of the An. gambiae complex, some cytotypes of An. gambiae sensu stricto are more vectorial than others. For example, the Mopti form has high vectorial capacity and breeds perennially in irrigated sites, whereas the savanna form is often sympatric but more seasonal. Also we suggest that many communities near irrigation schemes benefit from the greater wealth created by these schemes. Consequently irrigation communities often have greater use of bednets, better access to improved healthcare and receive fewer infective bites compared with those outside such development schemes. Thus, in most cases, irrigation schemes in Africa do not appear to increase malaria risk, except in areas of unstable transmission. However, developers should take the opportunity to improve health-care facilities for local communities when planning irrigation schemes wherever they occur. [source] Participation of the subthalamic nucleus in executive functions: An intracerebral recording studyMOVEMENT DISORDERS, Issue 4 2008Marek Balá Abstract The objective of our work was to find whether the subthalamic nucleus (STN) is directly involved in cognitive activities, specifically in executive functions. Ten patients with idiopathic Parkinson's disease had P3 potentials recorded by externalized deep brain electrodes that were implanted in the STN or in its immediate vicinity. Two contacts of each electrode were positioned inside the STN according to clinical effect, perioperative microrecording, and stimulation. The P3 waves were recorded following the auditory stimulus in a standard oddball paradigm. They were compared with the P3 waves elicited from a protocol modified by a dual task with an increased demand on executive functions. The P3 potentials with a steep amplitude gradient evoked by the modified protocol were detected by the contacts in 8 of the 14 available electrodes, located either inside the STN or in its immediate vicinity. The modified protocol led to an increased latency of the P3 potential in 8 of 14 electrodes. No local field potentials of the standard P3 potentials were recorded. The P3 potentials related to the increased demand on executive functions were detected by the STN contacts known to have the best effect on Parkinsonian motor signs. This could suggest that the STN takes part in the executive function processing. © 2007 Movement Disorder Society [source] The Emergency Informatics Transition Course: A Flexible, Online Course in Health Informatics for Emergency Medicine Clinicians and TraineesACADEMIC EMERGENCY MEDICINE, Issue 2009Michael Wadman Increasing emphasis on health information technology (HIT) as a mechanism to control costs and increase quality in health care is accelerating the diffusion of more advanced health information systems into emergency medicine. This has created an increased demand for informatics-trained emergency physicians to provide clinical input. In response to this need we partnered with the American College of Emergency Physicians (ACEP) to adapt an existing informatics educational program to emergency medicine. The American Medical Informatics Association (AMIA) 10X10 program is an effort to provide formal informatics training to 10,000 clinicians by 2010. Our first AMIA-ACEP 10X10 Emergency Informatics Transition Course matriculated 37 emergency physicians this fall. This 12 week online course is an adaption of the Oregon Health & Science University (OHSU) introductory informatics 10X10 course where students complete weekly assignments and participate in online discussions. At the end of the course they meet face-to-face at the ACEP Scientific Assembly where they present their projects and discuss common themes. The online design of the course proved adaptable for a widely varied enrollment. The first class contained students from the United States and four other countries, both large urban and small rural hospitals, and both new and experienced clinicians. Extensive input from the students will assist us in further refining this annual course to better meet the needs of emergency clinicians. We will demonstrate the design of this course, which we believe offers interested residents and fellows in emergency medicine a flexible opportunity to advance their informatics training. [source] ESTIMATING THE RELATIONSHIP BETWEEN IMMIGRANT AND NATIVE WORKERS IN AUSTRALIA: A PRODUCTION THEORY APPROACHAUSTRALIAN ECONOMIC PAPERS, Issue 1 2010JAAI PARASNIS The impact of immigration on labour markets depends, among other factors, on the substitutability or complementarity between immigrants and natives. This relationship is examined by treating migrant and native labour, along with capital, as inputs in production process. Estimated price elasticities of substitution between immigrants and native labour suggest that in Australian context, an increase in the wage rate of one group of workers leads to an increased demand for the other. The estimated elasticities of substitution between immigrant and native workers and the complementary relationship between immigrants and capital provide an insight into the complex effects of immigration. [source] Advanced IMS client supporting secure signalingBELL LABS TECHNICAL JOURNAL, Issue 4 2008Ramana Isukapalli With recent advances in core and access networks and the availability of increased bandwidth and sophisticated devices for end users, there is an increased demand for client applications running on mobile devices, such as laptops and handheld devices, to support real time applications like Voice over Internet Protocol (VoIP) and streaming video, apart from traditional applications like web browsing. This paper presents a prototype IP Multimedia Subsystem (IMS) client, which serves as a VoIP client to set up calls between Internet Protocol (IP) devices and interworks with circuit-switched networks to deliver calls to public switched telephone network (PSTN) phones. It implements supplementary services (including call waiting, call transfer, and call forwarding); supports multimedia ringing, short message service/multimedia messaging service (SMS/MMS), audio/video conferencing, and peer-to-peer video; and it can deliver a call to a user (as opposed to a device) by simultaneously ringing multiple devices registered by the user. Further, to address various security concerns, the client supports Hypertext Transfer Protocol (HTTP) digest authentication using Message Digest 5 (MD5) cryptographic function authentication and key agreement (AKA) and can create secure tunnels to the core network using IP security (IPsec). © 2008 Alcatel-Lucent. [source] Feedstock handling and processing effects on biochemical conversion to biofuelsBIOFUELS, BIOPRODUCTS AND BIOREFINING, Issue 5 2010Daniel Inman Abstract Abating the dependence of the United States on foreign oil by reducing oil consumption and increasing biofuels usage will have far-reaching global effects. These include reduced greenhouse gas emissions and an increased demand for biofuel feedstocks. To support this increased demand, cellulosic feedstock production and conversion to biofuels (e.g. ethanol, butanol) is being aggressively researched. Thus far, research has primarily focused on optimizing feedstock production and ethanol conversion, with less attention given to the feedstock supply chain required to meet cost, quality, and quantity goals. This supply chain comprises a series of unit operations from feedstock harvest to feeding the conversion process. Our objectives in this review are (i) to summarize the peer-reviewed literature on harvest-to-reactor throat variables affecting feedstock composition and conversion to ethanol; (ii) to identify knowledge gaps; and (iii) to recommend future steps. © 2010 Society of Chemical Industry and John Wiley & Sons, Ltd [source] Extracorporeal membrane oxygenation as a rescue therapy for leukaemic children with pulmonary failureBRITISH JOURNAL OF HAEMATOLOGY, Issue 1 2010Bernhard Meister Summary In patients with leukaemia, acute respiratory distress syndrome (ARDS) secondary to intensified chemotherapy-induced immunosuppression is a devastating disorder resulting in high morbidity and mortality. Compared to standard indications for extracorporeal membrane oxygenation (ECMO), cytopenia further increases the risks of infection and bleeding. We describe the use of ECMO in four children with ARDS and leukaemia. Two patients (50%) survived, pulmonary function recovered and they are in prolonged first remission. The two other patients died from ARDS and pulmonary leukaemic infiltration. Although ECMO support is a high-risk setup for nosocomial infection we observed no additional septic episodes. All patients had a highly increased demand for packed platelet and red blood cell transfusions. This increased demand and unmanageable chronic bleeding into both lungs in one patient were probably caused by a combination of coagulopathy from the primary illness, the use of anticoagulants, chemotherapy-induced cytopenia, and a reduced survival rate of platelets and red cells due to permanent contact to foreign surface. We concluded that ECMO is a supportive tool to reduce the incidence of early death, treatment-related mortality and, ultimately, to improve overall survival in childhood leukaemia. [source] The Creation of a Vocational Sector in Swiss Higher Education: balancing trends of system differentiation and integrationEUROPEAN JOURNAL OF EDUCATION, Issue 4 2003Juan-Francisco Perellon The article discusses the establishment of a vocational sector in Swiss higher education as a complement to the existing two-tier system of cantonal Universities and federal Institutes of technology. The origins of this new player, its missions and organisational features are discussed. This overall discussion is placed into the context of changing landscape of Swiss higher education policy characterised by increasing pressures for geographical reorganisation of the higher education sector under the auspices of a more direct role of the federal government. The article makes two points. First, it argues that the creation of a vocational sector in Swiss higher education combines two contradictory trends. On the one hand, this new sector tends to provide differentiation at the system level, through the creation of a new, more marked-oriented sector of higher education. On the other hand, system differentiation at the system level is threatened by increased demands for greater inter-institutional cooperation and system integration, emanating principally from the federal level. Second, the article also argues that the distinction between ,academic/scientific' vs. ,vocational/professional' education generally referred to when studying the emergence of non-university sectors in higher education, is not pertinent for the analysis of the Swiss case. Two reasons are brought forward to sustain this argument. First, this distinction reinforces an artificial binary divide, no longer relevant to assess the evolution of higher education institutions placed in a context of academic and vocational drifts. Second, the ,academic' vs. ,professional' opposition does not take into consideration the political organisation of the country and how this impacts on policy making in higher education; a crucial element in the Swiss context. [source] The Veterans Health Administration: An American Success Story?THE MILBANK QUARTERLY, Issue 1 2007ADAM OLIVER The Veterans Health Administration (VHA) provides health care for U.S. military veterans. By the early 1990s, the VHA had a reputation for delivering limited, poor-quality care, which led to health care reforms. By 2000, the VHA had substantially improved in terms of numerous indicators of process quality, and some evidence shows that its overall performance now exceeds that of the rest of U.S. health care. Recently, however, the VHA has started to become a victim of its own success, with increased demands on the system raising concerns from some that access is becoming overly restricted and from others that its annual budget appropriations are becoming excessive. Nonetheless, the apparent turnaround in the VHA's performance offers encouragement that health care that is both financed and provided by the public sector can be an effective organizational form. [source] | |||||||||||||