Objective
Access to adequate oral health care is deficient in many parts of the world. Many countries are now using dental therapists to increase access, particularly for children. To inform the ...discussion on dental therapists in the workforce, particularly in the United States, the W.K. Kellogg Foundation funded a review of the global literature to identify as many documents as possible related to the practice of dental therapists since the establishment of the School Dental Service in New Zealand in 1921.
Methods
Consultants in each of the countries considered to have a substantive literature on dental therapists were asked to participate in the research; seventeen in total. In addition to identifying and reviewing published articles, a focus of the research was on identifying ‘gray’ documents. Standard databases were searched for key words associated with dental therapists. In addition, searches were conducted of the governmental and dental association websites of all countries known to have dental therapists in their oral health workforce.
Results
Fifty‐four countries, both developing and developed, were identified where dental therapists are members of the workforce. Eleven hundred documents were identified from 26 of these countries, with over 2/3 of them cited in the published monograph. Reliable evidence from the related literature and verbal communication confirmed the utilization of dental therapists in an additional 28 countries. Thirty‐three of the countries were members of the Commonwealth of Nations, suggesting a mechanism of spread from New Zealand.
Variable lengths of training/education existed for dental therapists with the tradition being 2 years postsecondary. In a few countries, the training of therapists and hygienists is now being combined in a three academic year program. Historically, dental therapists have been employed by government agencies caring for children, typically in school‐based programs. Initiatives in some countries allow limited care for adults by dental therapists with additional training.
Conclusions
The evidence indicates that dental therapists provide effective, quality, and safe care for children in an economical manner and are generally accepted both by the public and where their use is established, by the dental profession.
The Exercise is Medicine Canada (EIMC) initiative promotes physical activity counselling and exercise prescription within health care. The purpose of this study was to evaluate perceptions and ...practices around physical activity counselling and exercise prescription in health care professionals before and after EIMC training. Prior to and directly following EIMC workshops, 209 participants (physicians (n = 113); allied health professionals (AHPs) (n = 54), including primarily nurses (n = 36) and others; and exercise professionals (EPs) (n = 23), including kinesiologists (n = 16), physiotherapists (n = 5), and personal trainers (n = 2)) from 7 provinces completed self-reflection questionnaires. Compared with AHPs, physicians saw more patients (78% > 15 patients/day vs 93% < 15 patients/day; p < 0.001) and reported lower frequencies of exercise counselling during routine client encounters (48% vs 72% in most sessions; p < 0.001). EPs had higher confidence providing physical activity information (92 ± 11%) compared with both physicians (52 ± 25%; p < 0.001) and AHPs (56 ± 24%; p < 0.001). Physicians indicated that they experienced greater difficulty including physical activity and exercise counselling into sessions (2.74 ± 0.71, out of 5) compared with AHPs (2.17 ± 0.94; p = 0.001) and EPs (1.43 ± 0.66; p < 0.001). Physicians rated the most impactful barriers to exercise prescription as lack of patient interest (2.77 ± 0.85 out of 4), resources (2.65 ± 0.82 out of 4), and time (2.62 ± 0.71 out of 4). The majority of physicians (85%) provided a written prescription for exercise in <10% of appointments. Following the workshop, 87% of physician attendees proposed at least one change to practice; 47% intended on changing their practice by prescribing exercise routinely, and 33% planned on increasing physical activity and exercise counselling, measured through open-ended responses.
To reveal the equity of health workforce distribution in urban community health service (CHS), and to provide evidence for further development of community health service in China.
A community-based, ...cross-sectional study was conducted in China from September to December 2011. In the study, 190 CHS centers were selected from 10 provinces of China via stratified multistage cluster sampling. Human resources profiles and basic characteristics of each CHS centers were collected. Lorenz curves and Gini Coefficient were used to measure the inequality in the distribution of health workforce in community health service centers by population size and geographical area. Wilcoxon rank test for paired samples was used to analyze the differences in equity between different health indicators.
On average, there were 7.37 health workers, including 3.25 doctors and 2.32 nurses per 10,000 population ratio. Significant differences were found in all indicators across the samples, while Beijing, Shandong and Zhejiang ranked the highest among these provinces. The Gini coefficients for health workers, doctors and nurses per 10,000 population ratio were 0.39, 0.44, and 0.48, respectively. The equity of doctors per 10,000 population ratio (G = 0.39) was better than that of doctors per square kilometer (G = 0.44) (P = 0.005). Among the total 6,573 health workers, 1,755(26.7%) had undergraduate degree or above, 2,722(41.4%)had junior college degree and 215(3.3%) had high school education. Significant inequity was found in the distribution of workers with undergraduate degree or above (G = 0.52), which was worse than that of health works per 10000 population (P<0.001).
Health workforce inequity was found in this study, especially in quality and geographic distribution. These findings suggest a need for more innovative policies to improve health equity in Chinese urban CHS centers.
Context:
Many changes in health care delivery, health legislation, and the physician workforce that affect the supply and demand for endocrinology services have occurred since the first published ...workforce study of adult endocrinologists in 2003.
Objective:
The objective of the study was to assess the current adult endocrinology workforce data and provide the first analysis of the pediatric endocrinology workforce and to project the supply of and demand for endocrinologists through 2025.
Design:
A workforce model was developed from an analysis of proprietary and publicly available databases, consultation with a technical expert panel, and the results of an online survey of board-certified endocrinologists.
Participants:
The Endocrine Society commissioned The Lewin Group to estimate current supply and to project gaps between supply and demand for endocrinologists. A technical expert panel of senior endocrinologists provided context, clinical information, and direction.
Main Outcome Measures:
The following were measured: 1) the current adult and pediatric endocrinology workforce and the supply of and demand for endocrinologists through 2025 and 2) the number of additional entrants into the endocrinology work pool that would be required to close the gap between supply and demand.
Results:
Currently there is a shortage of approximately 1500 adult and 100 pediatric full-time equivalent endocrinologists. The gap for adult endocrinologists will expand to 2700 without an increase in the number of fellows trained. An increase in the prevalence of diabetes mellitus further expands the demand for adult endocrinologists. The gap can be closed in 5 and 10 years by increasing the number of fellowship positions by 14.4% and 5.5% per year, respectively. The gap between supply and demand for pediatric endocrinologists will close by 2016, and thereafter an excess supply over demand will develop at the current rate of new entrants into the work force.
Conclusions:
There are insufficient adult endocrinologists to satisfy current and future demand. A number of proactive strategies need to be instituted to mitigate this gap.
Why do some European welfare states protect unemployed and inadequately employed workers ("outsiders") from economic uncertainty better than others? Philip Rathgeb's study of labor market policy ...change in three somewhat-similar small states-Austria, Denmark, and Sweden-explores this fundamental question. He does so by examining the distribution of power between trade unions and political parties, attempting to bridge these two lines of research-trade unions and party politics-that, with few exceptions, have advanced without a mutual exchange.
Inclusive trade unions have high political stakes in the protection of outsiders, because they incorporate workers at risk of unemployment into their representational outlook. Yet, the impact of union preferences has declined over time, with a shift in the balance of class power from labor to capital across the Western world. National governments have accordingly prioritized flexibility for employers over the social protection of outsiders. As a result, organized labor can only protect outsiders when governments are reliant on union consent for successful consensus mobilization. When governments have a united majority of seats, on the other hand, they are strong enough to exclude unions.Strong Governments, Precarious Workerscalls into question the electoral responsiveness of national governments-and thus political parties-to the social needs of an increasingly numerous group of precarious workers. In the end, Rathgeb concludes that the weaker the government, the stronger the capacity of organized labor to enhance the social protection of precarious workers.
Women's Underrepresentation in Science Ceci, Stephen J; Williams, Wendy M; Barnett, Susan M
Psychological bulletin,
03/2009, Letnik:
135, Številka:
2
Journal Article
Recenzirano
The underrepresentation of women at the top of math-intensive fields is controversial, with competing claims of biological and sociocultural causation. The authors develop a framework to delineate ...possible causal pathways and evaluate evidence for each. Biological evidence is contradictory and inconclusive. Although cross-cultural and cross-cohort differences suggest a powerful effect of sociocultural context, evidence for specific factors is inconsistent and contradictory. Factors unique to underrepresentation in math-intensive fields include the following: (a) Math-proficient women disproportionately prefer careers in non-math-intensive fields and are more likely to leave math-intensive careers as they advance; (b) more men than women score in the extreme math-proficient range on gatekeeper tests, such as the SAT Mathematics and the Graduate Record Examinations Quantitative Reasoning sections; (c) women with high math competence are disproportionately more likely to have high verbal competence, allowing greater choice of professions; and (d) in some math-intensive fields, women with children are penalized in promotion rates. The evidence indicates that women's preferences, potentially representing both free and constrained choices, constitute the most powerful explanatory factor; a secondary factor is performance on gatekeeper tests, most likely resulting from sociocultural rather than biological causes.
The stagnation of the Japanese economy and the ageing of Japanese society has led to major changes in the labour market in Japan. This comprehensive study looks at how the Japanese employment system ...is adapting to its new economic environment. Using the latest statistical evidence, the book focusses on the growing use of part-time and other forms of atypical employment relationships and illustrates how this is expressed in several different parts of the labour market. Particular attention is given to the changing situation of women, the decline of the family enterprise, the problems faced by older workers and the poor prospects for recent high school graduates. The recent rise in unemployment, including hidden unemployment is analysed. Relations between management and employees in Japanese corporations are also becoming more individualistic with the introduction of performance-related pay and the declining importance of enterprise unions. As a result of these changes, the future may see rising levels of income inequality. The Japanese labour force is declining with the ageing of the population and Japan's ability to cope is examined with special attention given to immigration policy. This book will be of interest to anyone interested in what is happening today in Japan and what the possibilities are for the future. Available in OSO: http://www.oxfordscholarship.com/oso/public/content/economicsfinance/0199247242/toc.html
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