208 research outputs found
Size, composition and distribution of health workforce in India: why, and where to invest?
BACKGROUND: Investment in human resources for health not only strengthens the health system, but also generates employment and contributes to economic growth. India can gain from enhanced investment in health workforce in multiple ways. This study in addition to presenting updated estimates on size and composition of health workforce, identifies areas of investment in health workforce in India. METHODS: We analyzed two sources of data: (i) National Health Workforce Account (NHWA) 2018 and (ii) Periodic Labour Force Survey 2017-2018 of the National Sample Survey Office (NSSO). Using the two sources, we collated comparable estimates of different categories of health workers in India, density of health workforce and skill-mix at the all India and state levels. RESULTS: The study estimated (from NHWA 2018) a total stock of 5.76 million health workers which included allopathic doctors (1.16 million), nurses/midwives (2.34 million), pharmacist (1.20 million), dentists (0.27 million), and traditional medical practitioner (AYUSH 0.79 million). However, the active health workforce size estimated (NSSO 2017-2018) is much lower (3.12 million) with allopathic doctors and nurses/midwives estimated as 0.80 million and 1.40 million, respectively. Stock density of doctor and nurses/midwives are 8.8 and 17.7, respectively, per 10,000 persons as per NHWA. However, active health workers' density (estimated from NSSO) of doctor and nurses/midwives are estimated to be 6.1 and 10.6, respectively. The numbers further drop to 5.0 and 6.0, respectively, after accounting for the adequate qualifications. All these estimates are well below the WHO threshold of 44.5 doctor, nurses and midwives per 10,000 population. The results reflected highly skewed distribution of health workforce across states, rural-urban and public-private sectors. A substantial proportion of active health worker were found not adequately qualified on the one hand and on the other more than 20% of qualified health professionals are not active in labor markets. CONCLUSION: India needs to invest in HRH for increasing the number of active health workers and also improve the skill-mix which requires investment in professional colleges and technical education. India also needs encouraging qualified health professionals to join the labor markets and additional trainings and skill building for already working but inadequately qualified health workers
Stellar Rotation in Young Clusters. II. Evolution of Stellar Rotation and Surface Helium Abundance
We derive the effective temperatures and gravities of 461 OB stars in 19
young clusters by fitting the H-gamma profile in their spectra. We use
synthetic model profiles for rotating stars to develop a method to estimate the
polar gravity for these stars, which we argue is a useful indicator of their
evolutionary status. We combine these results with projected rotational
velocity measurements obtained in a previous paper on these same open clusters.
We find that the more massive B-stars experience a spin down as predicted by
the theories for the evolution of rotating stars. Furthermore, we find that the
members of binary stars also experience a marked spin down with advanced
evolutionary state due to tidal interactions. We also derive non-LTE-corrected
helium abundances for most of the sample by fitting the He I 4026, 4387, 4471
lines. A large number of helium peculiar stars are found among cooler stars
with Teff < 23000 K. The analysis of the high mass stars (8.5 solar masses < M
< 16 solar masses) shows that the helium enrichment process progresses through
the main sequence (MS) phase and is greater among the faster rotators. This
discovery supports the theoretical claim that rotationally induced internal
mixing is the main cause of surface chemical anomalies that appear during the
MS phase. The lower mass stars appear to have slower rotation rates among the
low gravity objects, and they have a large proportion of helium peculiar stars.
We suggest that both properties are due to their youth. The low gravity stars
are probably pre-main sequence objects that will spin up as they contract.
These young objects very likely host a remnant magnetic field from their natal
cloud, and these strong fields sculpt out surface regions with unusual chemical
abundances.Comment: 50 pages 18 figures, accepted by Ap
Equity in health care financing: The case of Malaysia
Background: Equitable financing is a key objective of health care systems. Its importance is
evidenced in policy documents, policy statements, the work of health economists and policy
analysts. The conventional categorisations of finance sources for health care are taxation, social
health insurance, private health insurance and out-of-pocket payments. There are nonetheless
increasing variations in the finance sources used to fund health care. An understanding of the equity
implications would help policy makers in achieving equitable financing.
Objective: The primary purpose of this paper was to comprehensively assess the equity of health
care financing in Malaysia, which represents a new country context for the quantitative techniques
used. The paper evaluated each of the five financing sources (direct taxes, indirect taxes,
contributions to Employee Provident Fund and Social Security Organization, private insurance and
out-of-pocket payments) independently, and subsequently by combined the financing sources to
evaluate the whole financing system.
Methods: Cross-sectional analyses were performed on the Household Expenditure Survey
Malaysia 1998/99, using Stata statistical software package. In order to assess inequality,
progressivity of each finance sources and the whole financing system was measured by Kakwani's
progressivity index.
Results: Results showed that Malaysia's predominantly tax-financed system was slightly
progressive with a Kakwani's progressivity index of 0.186. The net progressive effect was produced
by four progressive finance sources (in the decreasing order of direct taxes, private insurance
premiums, out-of-pocket payments, contributions to EPF and SOCSO) and a regressive finance
source (indirect taxes).
Conclusion: Malaysia's two tier health system, of a heavily subsidised public sector and a user
charged private sector, has produced a progressive health financing system. The case of Malaysia
exemplifies that policy makers can gain an in depth understanding of the equity impact, in order to
help shape health financing strategies for the nation
Corrosion challenges towards a sustainable society
A global transition towards more sustainable, affordable and reliable energy systems is being stimulated by the Paris Agreement and the United Nation's 2030 Agenda for Sustainable Development. This poses a challenge for the corrosion industry, as building climate-resilient energy systems and infrastructures brings with it a long-term direction, so as a result the long-term behaviour of structural materials (mainly metals and alloys) becomes a major prospect. With this in mind "Corrosion Challenges Towards a Sustainable Society" presents a series of cases showing the importance of corrosion protection of metals and alloys in the development of energy production to further understand the science of corrosion, and bring the need for research and the consequences of corrosion into public and political focus. This includes emphasis on the limitation of greenhouse gas emissions, on the lifetime of infrastructures, implants, cultural heritage artefacts, and a variety of other topics
Stylized (Arte) Facts on Sectoral Inflation
Research on disaggregate price indices has found that sectoral shocks generate the bulk of sectoral inflation variance, but no persistence. Aggregate shocks, by contrast, are the root of sectoral inflation persistence, but have negligible relative variance. We argue that these findings are largely an artefact of using overly simple factor models to characterize inflation. Sectoral inflation series are subject to particular features such as sales and item substitutions. In factor models, these blow up the variance of sectoral shocks, while reducing their persistence. Controlling for such effects, we find that inflation variance is driven by both aggregate and sectoral shocks. Sectoral shocks, too, generate substantial inflation persistence. Both findings contrast sharply with earlier evidence from factor models. However, these results align well with recent micro evidence. This has implications for the foundations of price stickiness, and provide quantitative inputs for calibrating models with sectoral heterogeneity
The genomes of two key bumblebee species with primitive eusocial organization
Background: The shift from solitary to social behavior is one of the major evolutionary transitions. Primitively eusocial bumblebees are uniquely placed to illuminate the evolution of highly eusocial insect societies. Bumblebees are also invaluable natural and agricultural pollinators, and there is widespread concern over recent population declines in some species. High-quality genomic data will inform key aspects of bumblebee biology, including susceptibility to implicated population viability threats. Results: We report the high quality draft genome sequences of Bombus terrestris and Bombus impatiens, two ecologically dominant bumblebees and widely utilized study species. Comparing these new genomes to those of the highly eusocial honeybee Apis mellifera and other Hymenoptera, we identify deeply conserved similarities, as well as novelties key to the biology of these organisms. Some honeybee genome features thought to underpin advanced eusociality are also present in bumblebees, indicating an earlier evolution in the bee lineage. Xenobiotic detoxification and immune genes are similarly depauperate in bumblebees and honeybees, and multiple categories of genes linked to social organization, including development and behavior, show high conservation. Key differences identified include a bias in bumblebee chemoreception towards gustation from olfaction, and striking differences in microRNAs, potentially responsible for gene regulation underlying social and other traits. Conclusions: These two bumblebee genomes provide a foundation for post-genomic research on these key pollinators and insect societies. Overall, gene repertoires suggest that the route to advanced eusociality in bees was mediated by many small changes in many genes and processes, and not by notable expansion or depauperation
Central Bank Policy Paths and Market Forward Rates: A Simple Model
Increasingly many central banks announce likely paths for future policy rates. Recent experience suggest that market forward rates can differ substantially from those announced. Models commonly adopted in policy analysis ignore such differences. This paper studies a simple model that can capture deviations between announced paths and market forward rates. We detail the macroeconomic transmission of such deviations both in the model and in the data and show how the model can inform policy deliberations
Post Genome-Wide Association Studies of Novel Genes Associated with Type 2 Diabetes Show Gene-Gene Interaction and High Predictive Value
Recently, several Genome Wide Association (GWA) studies in populations of European descent have identified and validated novel single nucleotide polymorphisms (SNPs), highly associated with type 2 diabetes (T2D). Our aims were to validate these markers in other European and non-European populations, then to assess their combined effect in a large French study comparing T2D and normal glucose tolerant (NGT) individuals. rs7903146 SNP, were combined (8.68-fold for the 14% of French individuals carrying 18 to 30 risk alleles with an allelic OR of 1.24). With an area under the ROC curve of 0.86, only 15 novel loci were necessary to discriminate French individuals susceptible to develop T2D. strongly associate with T2D in French individuals, and mostly in populations of Central European descent but not in Moroccan subjects. Genes expressed in the pancreas interact together and their combined effect dramatically increases the risk for T2D, opening avenues for the development of genetic prediction tests
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