Nightmare Scenario Research Articles

Are HCAs the new nurses?

There has long been a view of future healthcare provision in which an army of unqualified healthcare assistants (HCAs) carries out all the hands-on 'menial' nursing care while a much smaller number of highly skilled qualified nurses occupies parts of the higher ground currently held by doctors. A nightmare scenario for some; utopia for others.

Global Warming: Nightmare Scenario

Africa Research Bulletin: Economic, Financial and Technical SeriesVolume 43, Issue 5 p. 16962C-16962C Global Warming: Nightmare Scenario First published: 11 July 2006 https://doi.org/10.1111/j.1467-6346.2006.00257.xRead the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Volume43, Issue5July 2006Pages 16962C-16962C RelatedInformation

Achieving the Dream: Autonomous Arbitration

DO YOU dream? When do you dream? What do you dream about? Do you dream about international arbitration? Is there a dream for international arbitration? Is the concept of delocalised arbitration, or arbitration not controlled by national law, a dream or nightmare? Is autonomous arbitration a reality, or is ‘every arbitration necessarily … a national arbitration, that is to say, subject to a specific system of national law’?1 As long ago as the mid-1950s, when participating in the drafting of the New York Convention, Frederic Eisemann, then Secretary-General of the ICC International Court of Arbitration, lobbied for a denationalised, international arbitration award.2 It was then too early for international arbitration to be detached from national law. Nonetheless, in many ways the New York Convention laid the seeds for autonomous international arbitration. The ideal and expectation is for international arbitration to be established and conducted according to internationally accepted practices, free from the controls of parochial national laws, and without the interference or review of national courts. Arbitration agreements and awards should be recognised and given effect, with little or no complication or review, by national courts. By corollary, the nightmare scenario exists in situations where national laws control a narrow right of access and the subject matters capable of being resolved in international arbitration. These nightmare scenarios undermine the international arbitration process. There can be no justification for national courts to intercede in the arbitration process or second-guess the determinations and analyses of an international arbitration tribunal. Courts which do so for parochial local law reasons, or because the court thinks its procedures and analyses are preferable and more reliable than those that exist in arbitration, ignore the intention and expectation of the parties and the autonomy of international arbitration. Nightmare scenarios include anti-arbitration injunctions. These can be …

How old is too old (or too young) to resuscitate?

The prospect of becoming ill and dependent in old age is a worrying factor in today's world. What was once hailed as a great achievement of the 20th century, i.e. adding 20 years to the average life expectancy of British people, has now become, for some, a nightmare scenario. Many doctors, nurses, health and social care professionals are becoming very concerned about the increasing gaps in service provision and the ability of the NHS to cope with the ever-increasing numbers of older people. It is estimated that about 40% of the NHS budget is spent caring for the elderly.

Communitas, Ritual, and Sustainability in Peter Senge’s Presence: Human Purpose and the Field of the Future

Presence suggests that adapting the experiences of leading innovators may address a nightmare scenario of environmental destruction, a growing divide between the rich and poor, and escalating violence around the world. Innovation occurs by transforming sensing to identify limitations in existing solution sets, transforming perception to envision an entire whole, and transforming action to realize the future seeking to emerge from the whole. This U sequence follows the rite-of-passage phases of separation, liminality, and reincorporation documented by Victor Turner. By ending in spontaneous communitas and avoiding a normative model, the U does not discuss how to mobilize resources and develop systems of social control. This omission, as well as depending on the constructive power of human ritual without recognition of its destructive potential, significantly limits the U ’s analytic validity. Despite these limitations, Presence is an encouraging set of stories of attempts within the industrial context to mitigate the nightmare scenario and work toward a sustainable future.

Demystifying Bioterrorism: Misinformation and Misperceptions

The true threat of bioterrorism remains mysterious and elusive to the common citizen. It principally has become the dominion of a few "experts", many of whom have limited apparent expertise, who have failed to effectively communicate the risks and realities to society, and have instead created an air of uncertainty surrounding the topic. Unlike the great classic deceptions of modern life (e.g., "the check is in the mail"), the misinformation and misperceptions associated with bioterrorism can be dangerous and are not merely humorous. Indeed, it is possible to grasp the facts as well as fallacies associated with bioterrorism, and, as a result, demystify this nightmare scenario and prepare for the "unthinkable".

Parallel universes

Parallel universes

Military technology: an historical perspective

Throughout history, nations have endeavored to develop new and more advanced technologies with the goal of achieving military advantage. New technologies resulted in new weapons and brought dramatic change in military tactics. The increase in the destructive power of soldiers in the Civil War and the resulting horror and futility of the frontal assault ushered in a change to trench warfare. The military aircraft, tanks, and the newly developed radio and radar made a new kind of dynamic warfare possible during World War II. World War II ended with a remarkable technological achievement: the development of the atomic bomb. In response, the Soviet Union detonated its first atomic bomb in 1949, followed by their successful test of a hydrogen bomb. By the early-1950s, missile programs were underway in both countries. In the absence of knowledge, the American threat assessments, and therefore the American response, were based on worst-case scenarios. The response of the Soviet Union was also based on their worst-case scenarios. Recognizing the dangers of this arms race in the dark, President Eisenhower authorized the secret development of a new generation of sensors and reconnaissance satellites, the successors of which are still vital to our security. Then, in response to the Soviet quantitative advantage in military forces, the US conceived a new “system of systems” of intelligence sensors, smart weapons and stealth aircraft. These new systems were developed during the late-1970s, produced in the early-1980s, and entered into the force in the late-1980s—just in time for Desert Storm. Today the threat of terrorism and the threat of proliferation are the greatest threats to our security. It seems likely that the American military will remain the dominant military force in the world for the foreseeable future, but this can have unintended consequences. It can lead to a nightmare scenario where a terror group may attack us with weapons of mass destruction. Advanced information technology is critical to countering this threat. There are technological opportunities in all the components of homeland security: intelligence, prevention, protection of infrastructure, detection of attacks, and consequence management. But these improvements will not evolve automatically. It is boldness and single-minded dedication that we must summon to respond to the threat of weapons of mass destruction in our cities. We must mobilize the scientific community as was done in World War II and in the Cold War.

Hot Wars in Cold War Africa

For years following the triumph of the Cuban revolution in 1959, a nightmare scenario haunted American leaders: Fidel Castro, having overthrown one government closely allied to the United States, would succeed in sparking radical movements elsewhere in the Western Hemisphere to do the same. By the early 1960s, the Kennedy administration believed that Havana was working hard at it. The Central Intelligence Agency reported in early 1963 that the Cuban government was training as many as 1,500 revolutionaries from across Latin America in techniques of political subversion and guerrilla warfare-lessons they were to take back to their home countries to ignite rebellion. Castro and his legendary collaborator, Che Guevara, seemed to take interest in the effort. The two men frequently appeared before the foreign trainees to give personal pep talks, the CIA noted.' American officials could have rested easy. Over the remainder of the Cold War, the Cuban government scored few successes in its bid to challenge U.S. hegemony in Latin America. Another failed to materialize, not least because the Castro government shied away from actions that would seriously challenge Washington. The threat of U.S. retaliation against Cuba, even an invasion of the island, was simply too great to risk anything forceful. During the 1960s, fewer than forty Cubans participated in guerrilla struggles elsewhere in Latin America, and Havana showed little enthusiasm about sending weapons to support rebel movements. When Cuba did act, the results were disastrous. Most famously, U.S.-backed paramilitary forces crushed Guevara's 1967 foray into Bolivia, killing him and demolishing his vision of spreading grassroots revolution across the continent. The story of Cuban efforts to promote revolution abroad does not, however, end in the Bolivian mountains. As Piero Gleijeses makes clear in his stunning book, Conflicting Missions: Havana, Washington, and Africa, 19591976, it was Africa, not Latin America, where Castro's Cuba acted boldly on its dream of supporting leftist liberation struggles against the United States

A career in medical informatics

Mohammad Al-Ubaydli explains how to have a career in medical informatics1 If you want to understand why I love technology, take a look at my hearing aid. Just before starting my house job, my nightmare scenario was of being deafened by the vacuum cleaner during the ward round while my consultant barked orders at me. So I invested in a funky, digital hearing aid. With the flick of a switch, the machine promptly filters out all noise, and homes in on the speech of the person I am facing. It is quite amusing to watch my (very nice) consultant needing to ask the cleaner (very nicely) to switch the vacuum off. Technology helps me to be a good clinician, despite my disability. Using information technology within the NHS enables the clinician to increase his or her abilities. Unfortunately, the NHS has been particularly slow in introducing computers into the system. But things are improving. This article is about steps you can take to improve your computing skills. The more useful this exercise becomes for you, the more you can delve into the area. If, like me, you become hooked, there is the possibility of focusing your career on the new specialty of medical informatics. But before I get that far, let me clear up a few myths on learning about computers. Firstly, you are never too old to learn, and computers are not the exclusive domain of your children and grandchildren. It was my father who taught me how to use a computer, and his skills were self taught. Secondly, you do …

Greater Albania?

The nightmare scenario of a violent push for a 'Greater Albania' has been much exaggerated. There is undoubtedly a nucleus of hardline nationalist whose goal is to unite a future independent Kosovo with Albania and carve off slices of Serbia proper, Montenegro and Macedonia. But no major Albanian political party in any of these places advocates a 'Greater Albanian' state. This would change only if Albanians felt that their rights were not being served in the countries in which they lived, or if they lost confidence that Kosovo would, one day, be independent. Of equal importance is that the region as a whole prosper, and that the borders which now divide the Albanians dissolve in the way they have dissolved between European Union states.

A vision of pig production in the UK

PreambleWhile preparing to write a vision of pig production in the UK, the fragility of crystal ball gazing became apparent, when in February 2001, the nightmare scenario of Foot and Mouth disease broke. The problem appears to have started on a pig farm using swill feed in Northumberland and within weeks, primarily associated with the farmer's failure to report a problem and legal but uncontrolled sheep movement, Foot and Mouth Disease spread throughout the West of England, Wales and the South West of Scotland as well as closing a major slaughterhouse for adult pigs. The disease then spread into continental Europe, causing instant havoc to export markets for the UK and then over the whole of the European Union. Had the problem prevented Denmark from exporting globally for any period, this would have resulted in severe price depression in pig production in Europe. And all this in the year following East Anglia's savaging with Classical Swine Fever.The Foot and Mouth epidemic in the UK is likely to have a long term impact on the country's export capabilities; already there are threats of five year bans from countries like the United States of America. Much will depend on whether natural wildlife, such as deer, have become infected and how effective we are at finding carrier animals.

The scope for rehabilitation in severely disabled stroke patients

A severe stroke is a distressing condition for the patient, their family and friends and for those involved in their care. Sudden deprivation of ability to communicate, move independently, dress, feed and toilet oneself is a nightmare scenario which is thought by some to be a state worse than death. The nihilistic approach to severe stroke is long- standing. Hippocrates stated thatto get over a strong attack of apoplexy is impossible' and in 1892 William Osler, a leadingphysician,felt thatthe friends should be told frankly at the onset that chances of recovery are slighto and when hemiplegia persist for more than three months and contractures have developed, that the condition is past relief and there is no possible hope of cure'. Are these views pessimistic or realistic and is re- habilitation appropriate for severely disabled stroke patients? Gladman and Sackley eloquentlyaddress these issues by seeking evidence to support frequently cited negative views regarding the rehabilitation and care of this group of stroke patients. They ask pertinent questions whether: (1) patients with severe stroke do not recover; (2) thisgroupare tooillto receiverehabilitation; (3) rehabilitation is ineŒective even when possible; and whether (4) aspects of rehabilitation which may be eŒective are not cost eŒective. At the 1990 meeting of the British Stroke Research Group a leader in the ® eld was asked to address an expectant audience on the topicwhat is new in stroke research?' The speaker saidnothing' and then sat down. Fortunately the situation has changed dramati- cally since then. The importance of stroke as a major cause of morbidity and mortality in the UK has been recognized by the Department of Health, many health districts have developed dedicated stroke services along with service speci® cations and the evidence base for the care of stroke patients has expanded enormously.# One of the cornerstones to stroke rehabilitation * e-mail: helen.rodgers! newcastle.ac.uk research was a meta-analysis of randomized controlled trials which compared organized in-patient stroke care with conventional care on general medical wards. While it was not surprising that organized strokecare improved outcome the size of the treatment eŒect was remark- able.$ ±

Predestination: A Scottish Perspective

In contemporary Scottish culture the subject of predestination is guaranteed to evoke a variety of reactions ranging from horror and disgust on the one hand to laughter and ridicule on the other. It is viewed by some as a nightmare scenario devised by Christian theologians in their worst moments, while for odiers it is a ludicrous aberration of the medieval and Reformation mind. It is perceived frequently as the trademark of a theological mindset which is marked by harshness, legalism and a fatalistic attitude towards life. A clear example of this is Edwin Muir's biography of Knox which writes vitriolically of the oppression and tyranny of the predestinarian religion that was imported from Calvin's Geneva.

Retreat from Africa

reforms that promised to bring back foreign capital investment have thus far only deepened Africa's dependency on foreign aid. The pace of political transition that saw no less than nine leaders toppled by gun or ballot in the nine months following the fall of 1990 has slowed to a crawl, as many incumbent regimes have managed to maintain military control while outmaneuvering splintered oppositions. But the greatest failure of reform?both economic and polit ical?may be that it is overwhelmingly urban, while Africa is not. Structural adjustment programs have succeeded in getting import prices right, but fertilizer, for instance, is now beyond the reach of the average farmer. In most countries the creation of new political parties has not directly involved those outside the existing urban political class and has neglected the majority rural poor. Moreover, many of the most prominent new-breed politicians are simply refashioned opportunists of Cold War vintage. Thus while a majority of the one-party sys tems that dominated Africa's landscape since independence have collapsed under a combination of internal and external economic and political pressures, the narrow concentration of power within most states remains unchanged. It is becoming all too apparent that political freedom will not address Africa's appalling economic condition. In many countries, in fact, the result is just the opposite: the civil disor der accompanying political reform has only reduced foreign capital inflows and racked the rural poor. A nightmare sce nario may be building: a two-tiered Africa where existing political and economic elites reintegrate with the global econo my via Western-sponsored reform, while increasingly isolat ed rural populations are integrated internationally as perpetual recipients of humanitarian aid.

Foreign Capital Investment in Member States of the Gulf Cooperation Council Considerations, Issues and Concerns for Investors

Particularly in light of the Iraqi invasion of Kuwait and the subsequent damage and loss to the economies of both those countries, it is self evident that the successful attraction of venture capital into any country, or investment area, requires, in this day and age, the existence of a range of conditions and satisfaction of criteria designed to provide comfort to potential investors. The extent of investors' losses in those countries since August 1990 is still being quantified but the early estimates are staggering. It is unclear to what extent insurers will meet claims submitted under war risk coverage clauses and then, very much later, seek reimbursement from the proposed United Nations Compensation Commission (the Commission). Any such recourse to the Commission either by insurers or investor principals will have to be submitted through their respective domiciliary governments and cannot be expected to be satisfactory or even minimally effective in providing fair and prompt compensation. Charles Brower, a judge of the Iran-United States Claims Tribunal at the Hape since 1984, writing in the Financial Times of 11 April 1991, stated his belief that any attempt to establish a similar tribunal to handle the hundreds ofthousands of individual claims against Iraq would be wholly unworkable. He wrote that nearly eight years after beginning to review claims the Iran-US Tribunal and its panel of nine judges were still at work on the last of the nearly 4,000 claims filed and that it would have been worse had the US and Iran not settled 2,500 small claims as a group. Consequently, it is essential for each investor contemplating participation in any project, joint venture enterprise, or even lending acovity in a Gulf Cooperation Council (GCC) state to prepare for the kind of nightmare scenario which occurred in Kuwait and Iraq betwen August 1990 and April 1991. These concerns and this preparation are relevant to all investments but should now have special meaning to the hundreds of Western contractors, service organisations

Applications of molecular orbital-valence bond theory in chemistry

Abstract

Nuclear Proliferation and World Politics

Varying technical deficiencies are likely to characterize the nuclear forces of many new proliferators. Regional interactions within a proliferated world probably would include increased nuclear arms racing, inadvertant or calculated nuclear-weapon use, and outside involvement in domestic nuclear coups d'état. In turn, the possible global repercussions of local proliferation are likely to include: a partial erosion of existing alliances, or, to the degree that present superpower ties remain unchanged, the risk of escalating conflict; growing nuclear "black and gray marketeering"; the spread of nuclear terrorism; a corrosion of political authority and legitimacy; and, ulti mately, even growing global anarchy. Whether or not this initial assessment proves accurate will depend upon the difficulties of designing and implementing a proliferation- management strategy. Such a strategy might attempt, on the one hand, to affect which proliferated world emerged and, on the other, to influence Nth countries' nuclear postures, contribute to regional stability, and circumscribe the global repercussions of local proliferation. The gap between the gravity of a proliferated world's varied threats and the probable effectiveness of politically acceptable policy responses supports the fear that the initial depiction may be more than a nightmare scenario.