The purpose of this study was to compare Registered Nurse (RN) current and future demand between Tennessee rural and urban licensed hospitals and nursing homes. Comparisons of Registered Nurse demand by principal duty or position and by educational level were also undertaken. The educational level of RNs was examined using the proportion of RNs at each of five educational levels: diploma, associate, baccalaureate, master's, and doctorate. The variables examined were 1988 and 1989 vacancy rates and proportion of budgeted positions, change in vacancy rates and proportions from 1988 to 1989, projected changes in positions and proportions from 1988 to 1992 and to 1995. Nurse administrators from one hundred fifty four hospitals (63% response rate) and two hundred twelve nursing homes (72% response rate) were surveyed for responses about current and future RN demand. This study is a secondary analysis of data that were collected as a part of a larger research project conducted by the Tennessee Board of Regents Task Force on Nurse Supply and Demand. The findings were that rural hospitals had significantly higher vacancy rates for total nurse positions in 1988 and general duty positions in 1989. Urban hospital administrators reported higher vacancy rates for RN positions at the diploma level and projected significantly greater changes in clinical specialist and master's level positions for 1992 and 1995. Rural hospitals had a higher proportion of associate degree nurses in 1989, and urban hospitals had a higher percentage of master's prepared RNs for 1988 and 1989. Urban hospitals projected a greater change in the proportion of RNs at the doctoral level for 1995. Rural nursing homes projected higher numbers of associate degree nurses for 1992 and 1995. The major conclusion was that the nursing shortage in Tennessee hospitals was more severe than that reported on the national level and greater in rural hospitals. The shortage in Tennessee nursing homes was reported to be much less acute than the national shortage, and the critical shortages were limited to a few facilities, both rural and urban.

Global climate change is anticipated to raise overall temperatures and has the potential to increase future mortality attributable to heat. Urban areas are particularly vulnerable to heat because of high concentrations of susceptible people. As the world's largest developing country, China has experienced noticeable changes in climate, partially evidenced by frequent occurrence of extreme heat in urban areas, which could expose millions of residents to summer heat stress that may result in increased health risk, including mortality. While there is a growing literature on future impacts of extreme temperatures on public health, projecting changes in future health outcomes associated with climate warming remains challenging and underexplored, particularly in developing countries. This is an exploratory study aimed at projecting future heat-related mortality risk in major urban areas in China. We focus on the 51 largest Chinese cities that include about one third of the total population in China, and project the potential changes in heat-related mortality based on 19 different global-scale climate models and three Representative Concentration Pathways (RCPs). City-specific risk estimates for high temperature and all-cause mortality were used to estimate annual heat-related mortality over two future twenty-year time periods. We estimated that for the 20-year period in Mid-21st century (2041-2060) relative to 1970-2000, incidence of excess heat-related mortality in the 51 cities to be approximately 37,800 (95% CI: 31,300-43,500), 31,700 (95% CI: 26,200-36,600) and 25,800 (95% CI: 21,300-29,800) deaths per year under RCP8.5, RCP4.5 and RCP2.6, respectively. Slowing climate change through the most stringent emission control scenario RCP2.6, relative to RCP8.5, was estimated to avoid 12,900 (95% CI: 10,800-14,800) deaths per year in the 51 cities in the 2050s, and 35,100 (95% CI: 29,200-40,100) deaths per year in the 2070s. The highest mortality risk is primarily in cities located in the North, East and Central regions of China. Population adaptation to heat is likely to reduce excess heat mortality, but the extent of adaptation is still unclear. Future heat mortality risk attributable to exposure to elevated warm season temperature is likely to be considerable in China's urban centers, with substantial geographic variations. Climate mitigation and heat risk management are needed to reduce such risk and produce substantial public health benefits.

Global climate change is anticipated to raise overall temperatures and is likely to increase future mortality attributable to heat. Urban areas are particularly vulnerable to heat because of high concentrations of susceptible people. As the world’s largest developing country and the largest carbon emitter, China has experienced noticeable changes in climate, partially evidenced by frequent occurrence of extreme heat in urban areas, which could expose millions of residents to summer heat stress that may result in increased health risk, including mortality. While there is a growing literature on future impacts of extreme temperatures on public health, projecting changes in future health outcomes associated with climate warming remains challenging, with the related health impacts in developing countries largely unexplored. This is an exploratory study aimed at projecting future heat-related mortality risk in major metropolitan areas in China. We focus on 50 large Chinese cities that cover about 1/3 of the total population in China, and propose to assess the potential changes in heat-related mortality under 19 different global-scale climate models and three Representative Concentration Pathways (RCPs) used in the latest Intergovernmental Panel on Climate Change Fifth Assessment Report (IPCC AR5). We project future changes in heat-related mortality in the 2050s and 2070s relative to the base period of 1950-2000. The projections are based on an integrated assessment framework that combines high-resolution climate model outputs, city-specific temperature-mortality relationships, population projections and baseline mortality rates. Future temperature changes in the study areas are estimated based on downscaled climate model outputs at a spatial resolution of about 1 square kilometer. City-specific historical temperature-mortality associations are obtained from the epidemiological literature. Population projections are based on the China census 2010 survey and projected population growth rates from the 2015 Revision of World Population Prospects by the United Nations. Baseline mortality rates are obtained from China’s national and local health statistics publications. Our findings suggest that future heat mortality risk attributable to elevated warm season temperature is likely to be significant in China’s urban areas, with substantial geographic variations, highlighting the significance of climate mitigation and local-level heat risk management.

No description available.

Thesis (M.B.A.)--University of Limpopo,2009. / The term “brain drain” became a reality in South Africa after doors opened for South Africans in overseas markets and the emphasis moved from hospital bed based care to total health for all South Africans. The lack of services in rural areas seems a problem with focus on migration of health professionals between rural and urban areas, and even overseas markets, leaving a possible imbalance. More allied health professionals from previously disadvantaged groups are trained but the need in specifically the rural areas continues to rise. Recruitment and retention strategies were implemented for scarce skilled health professionals in the Public Service but no proof is available whether it is successful or not for the allied health professional group. The vacancy rates for allied health professional posts are reportedly too high despite the fact that more candidates are recruited from rural areas to be trained as professionals, hoping they will return to work in rural areas. Allied health professionals seem to be constantly on the move despite the strategies already implemented, reasons for this are unknown. The purpose of this study is to explore and determine if there is an imbalance of allied health workers in rural and urban areas within Limpopo Province. Secondly, it was to determine what factors may influence and contribute to allied health professional‟s decision to consider migration and thirdly to establish if the current recruitment and retention strategies are having the desired outcome. A survey was conducted over a period of three months with respondents representing the dietetic, physiotherapy, radiography, occupational therapy and speech and language therapy professions. The sample population was randomly selected as well as cluster sampling from the different districts within the Limpopo Province. Data was collected from a total of 122 respondents. xv Because the type of data collected was mainly nominal data, graphical and tabular descriptive techniques like frequencies, relative frequencies, tables and graphs were used to provide information. Numerical descriptive techniques were also used to calculate sample statistics and the only statistical technique that involves nominal data, the Chi-Squared Test was also applied. The findings of the research survey enabled the researcher to make final conclusions as well as specific recommendations to the target groups that may benefit from this study in order to change the “brain drain” to a “brain gain” situation for allied health professionals within the Limpopo Province. / N/A

<p>The general aim of this essay is to situate the AIDS-epidemic in its socio-economic context, in order to see how HIV/AIDS affects households at a micro level. The material for the study was gathered during a minor field study conducted in Mwanza City, Tanzania.  The majority of the population in Tanzania is not part of the formal economic sector and does not enjoy the security of public health care, pension and other forms of support. Instead of being employed in the formal sector these people draw on different informal sources to secure their livelihoods. This has created a context where people are vulnerable in a situation of crisis. Since the 1980s - when the first cases of HIV were recorded in Tanzania - the epidemic has grown and HIV now constitutes one of the major threats to livelihood security.  But what impact does HIV/AIDS have on livelihood strategies in an urban setting? And how does the AIDS-epidemic affect society in general? Theses questions are investigated using qualitative methods and the data is analyzed by means of a livelihood framework.  From the gathered material I could conclude that HIV/AIDS indeed affects the livelihood strategies of afflicted households. Social capital – in the shape of support from family, friends and other networks – turned out to be an important resource. There is, however, an inequity in access to this resource. Stigmatisation has a negative impact on the social capital and increases the vulnerability of the afflicted households.  The essay deals with these issues in a wider perspective in relation to the role of the state and other actors and it is concluded with a discussion on the role of livelihood studies in the prevailing discourse on HIV/AIDS.</p>

<p>This study focuses on the impact on service provision arising from uncertainties in the UC Act. There are serious problems with the delivery of basic services in urban areas: including frequent interruptions in water supply, persistent power cuts, uncollected refuse, poor health services and dilapidated infrastructure. The purpose of this study is to highlight specific weaknesses in the UC Act and examine how these contribute to poor service delivery. The specific weaknesses to be examined are the unfettered powers of the minister, lack of legal certainty on powers and functions of UCs, limited revenue generating powers and lack of autonomy in recruiting senior council administration. First, UCs exercise delegated powers from central government. The minister has powers to give directions on matters of policy, suspend, reverse, or rescind council resolutions. There is no legal authority to check and balance the unfettered powers of the minister. Poor service delivery may be attributed in part to the unfettered powers of the minister. Secondly, UCs do not have devolved fiscal powers. As agents of central government, UCs can only levy those taxes and borrow money as authorised by the minister. The limited capacities of UCs to generate own revenue impacts negatively on the capacity of UCs to respond to the needs of the communities they serve.</p>

The general aim of this essay is to situate the AIDS-epidemic in its socio-economic context, in order to see how HIV/AIDS affects households at a micro level. The material for the study was gathered during a minor field study conducted in Mwanza City, Tanzania.  The majority of the population in Tanzania is not part of the formal economic sector and does not enjoy the security of public health care, pension and other forms of support. Instead of being employed in the formal sector these people draw on different informal sources to secure their livelihoods. This has created a context where people are vulnerable in a situation of crisis. Since the 1980s - when the first cases of HIV were recorded in Tanzania - the epidemic has grown and HIV now constitutes one of the major threats to livelihood security.  But what impact does HIV/AIDS have on livelihood strategies in an urban setting? And how does the AIDS-epidemic affect society in general? Theses questions are investigated using qualitative methods and the data is analyzed by means of a livelihood framework.  From the gathered material I could conclude that HIV/AIDS indeed affects the livelihood strategies of afflicted households. Social capital – in the shape of support from family, friends and other networks – turned out to be an important resource. There is, however, an inequity in access to this resource. Stigmatisation has a negative impact on the social capital and increases the vulnerability of the afflicted households.  The essay deals with these issues in a wider perspective in relation to the role of the state and other actors and it is concluded with a discussion on the role of livelihood studies in the prevailing discourse on HIV/AIDS.

Diss. Stockholm : Stockholms universitet, 2006.

Doktorafhandling. / Format: PDF. Bibl.