Showing papers on "Workforce published in 2009"
TL;DR: To prepare for the growing chronic disease burden, a larger interdisciplinary primary care workforce is needed, and payment for primary care should reward practices that incorporate multidisciplinary teams.
Abstract: The U.S. chronic illness burden is increasing and is felt more strongly in minority and low-income populations: in 2005, 133 million Americans had at least one chronic condition. Prevention and management of chronic disease are best performed by multidisciplinary teams in primary care and public health. However, the future health care work-force is not projected to include an appropriate mix of personnel capable of staffing such teams. To prepare for the growing chronic disease burden, a larger interdisciplinary primary care workforce is needed, and payment for primary care should reward practices that incorporate multidisciplinary teams.
575 citations
TL;DR: These findings identified widespread prescriber shortage and poor distribution of nonprescribers at the county level across the United States.
Abstract: Objective: This study examined shortages of mental health professionals at the county level across the United States. A goal was to motivate discussion of the data improvements and practice standards required to develop an adequate mental health professional workforce. Methods: Shortage of mental health professionals was conceptualized as the percentage of need for mental health visits that is unmet within a county. County-level need was measured by estimating the prevalence of serious mental illness, then combining separate estimates of provider time needed by individuals with and without serious mental illness derived from National Comorbidity Survey Replication, U.S. Census, and Medical Panel Expenditure Survey data. County-level supply data were compiled from professional associations, state licensure boards, and national certification boards. Shortage was measured for prescribers, nonprescribers, and a combination of both groups in the nation’s 3,140 counties. Ordinary least-squares regression identified county characteristics associated with shortage. Results: Nearly one in five counties (18%) in the nation had unmet need for nonprescribers. Nearly every county (96%) had unmet need for prescribers and therefore some level of unmet need overall. Rural counties and those with low per capita income had higher levels of unmet need. Conclusions: These findings identified widespread prescriber shortage and poor distribution of nonprescribers. A caveat is that these estimates of need were extrapolated from current provider treatment patterns rather than from a normative standard of how much care should be provided and by whom. Better data would improve these estimates, but future work needs to move beyond simply describing shortages to resolving them. (Psychiatric Services 60:1323–1328, 2009)
500 citations
TL;DR: Registered nurse (RN) employment has increased during the current recession, and the recent increase in employment is improving projections of the future supply of RNs, yet large shortages are still expected in the next decade.
Abstract: Registered nurse (RN) employment has increased during the current recession, and we may soon see an end to the decade-long nurse shortage. This would give hospitals welcome relief and an opportunity to strengthen the nurse workforce by addressing issues associated with an increasingly older and foreign-born workforce. The recent increase in employment is also improving projections of the future supply of RNs, yet large shortages are still expected in the next decade. Until nursing education capacity is increased, future imbalances in the nurse labor market will be unavoidable.
486 citations
TL;DR: In the past four decades, the number of U.S. households with a stay-at-home parent has sharply declined as women have increasingly entered the paid workforce and more women raise children as discussed by the authors.
Abstract: In the past four decades, the number of U.S. American households with a stay-at-home parent has sharply declined as women have increasingly entered the paid workforce and more women raise children ...
464 citations
TL;DR: The results suggest that the health workforce shortage in Africa is even more critical than previously estimated and pre-service training needs to be expanded as well as combined with other measures to increase health worker inflow and reduce the rate of outflow.
Abstract: OBJECTIVE: To estimate systematically the inflow and outflow of health workers in Africa and examine whether current levels of pre-service training in the region suffice to address this serious problem, taking into account population increases and attrition of health workers due to premature death, retirement, resignation and dismissal. METHODS: Data on the current numbers and types of health workers and outputs from training programmes are from the 2005 WHO health workforce and training institutions' surveys. Supplementary information on population estimates and mortality is from the United Nations Population Division and WHO databases, respectively, and information on worker attrition was obtained from the published literature. Because of shortages of data in some settings, the study was restricted to 12 countries in sub-Saharan Africa. FINDINGS: Our results suggest that the health workforce shortage in Africa is even more critical than previously estimated. In 10 of the 12 countries studied, current pre-service training is insufficient to maintain the existing density of health workers once all causes of attrition are taken into account. Even if attrition were limited to involuntary factors such as premature mortality, with current workforce training patterns it would take 36 years for physicians and 29 years for nurses and midwives to reach WHO's recent target of 2.28 professionals per 1000 population for the countries taken as a whole - and some countries would never reach it. CONCLUSION: Pre-service training needs to be expanded as well as combined with other measures to increase health worker inflow and reduce the rate of outflow.
275 citations
TL;DR: In this article, an equilibrium search and matching model of an economy with an informal sector is proposed to analyse the effects of labour market policy on informal-sector and formal-sector output, on the division of the workforce into unemployment, informal sector employment and formal sector employment, and on wages.
Abstract: In this article, we build an equilibrium search and matching model of an economy with an informal sector. Our model extends Mortensen and Pissarides (1994) by allowing for ex ante worker heterogeneity with respect to formal-sector productivity. We use the model to analyse the effects of labour market policy on informal-sector and formal-sector output, on the division of the workforce into unemployment, informal-sector employment and formal-sector employment, and on wages. Finally, we examine the distributional implications of labour market policy; specifically, we analyse how labour market policy affects the distributions of wages and productivities across formal-sector matches. In this article we construct a search and matching model that we use to analyse the effects of labour market policies in an economy with a significant informal sector. What we mean by an informal sector is a sector that is unregulated and hence not directly affected by labour market policies such as severance or payroll taxes. We find that labour market policies that apply only to the formal sector nonetheless affect the size and the composition of employment in the informal sector. This is important since there is substantial economic activity in the informal sector in many economies, particularly in developing countries. Estimates for some Latin American countries put the informal sector at more than 50% of the urban work force.1 The informal sector is also important in many transition countries as well as in some developed economies.2 Although much of the literature treats the informal sector as a disadvantaged sector in a segmented labour market framework, this interpretation is not consistent with recent empirical evidence from Latin America. Under a segmented or dual labour market interpretation, one would expect jobs to be rationed in the primary sector and workers to be in the secondary or informal sector involuntarily and to be queuing for formal-sector jobs. Maloney (2004) presents evidence for several Latin American countries that challenges this view and instead interprets the informal sector as an unregulated micro-entrepreneurial sector. Similarly, using data from the Argentinian household survey, Pratap and Quintin (2006) reject the notion that labour markets are segmented in the greater Buenos Aires area, concluding that there is no evidence of a formal-sector wage premium after controlling for individual and establishment * We thank Mauricio Santamaria for stimulating conversations that inspired our interest in this topic. We also thank Bob Hussey and Fabien Postel-Vinay as well as our editor, Steve Pischke, and two anonymous
272 citations
TL;DR: This article reviewed the empirical literature on the effects of offshoring and foreign activities of multinational enterprises on developed countries' labour markets and found that material off-shoring worsens wage inequality between skilled and unskilled workers; it also seems to make employment more volatile, by raising the elasticity of labour demand and the risk of job losses.
Abstract: omica, CSIC Abstract. This paper reviews the empirical literature on the effects of offshoring and foreign activities of multinational enterprises on developed countries' labour markets. Results suggest that material offshoring worsens wage inequality between skilled and unskilled workers; it also seems to make employment more volatile, by raising the elasticity of labour demand and the risk of job losses. Service offshoring exerts at most small negative effects on total employment, and changes the composition of the workforce in favour of high-skilled white- collar employees. Multinationals tend to substitute domestic and foreign labour in response to changes in relative wages across countries; substitutability is weak, however, and mainly driven by horizontal, market-seeking foreign direct investments.
256 citations
TL;DR: Hofstede et al. as mentioned in this paper reviewed published literature on cross-cultural differences in attitudes, perceptions and beliefs regarding safety and presented details of a study examining the relationship between Hofstede's [Hofstadede, G., 1984. Culture's Consequences; International Differences in Work-Related Values, Abridged edition.
225 citations
TL;DR: In the context of ageing societies, the importance of long-term care is growing in all OECD countries as discussed by the authors and this is projected to reach between 2% and 4% of GDP by 2050.
Abstract: This working paper offers an overview of the LTC workforce and reviews country responses to a
growing demand for LTC workers. In the context of ageing societies, the importance of long-term care is growing in all OECD
countries. In 2005, long-term care expenditure accounted for slightly over 1% of GDP across OECD
countries (OECD Health Data 2008), but this is projected to reach between 2% and 4% of GDP by 2050
(Oliveira Martins et al., 2006). Spending on long-term care as a share of GDP rises with the share of the
population that is over 80 years old, which is expected to triple from 4 per cent to 11-12 per cent between
2005 and 2050. In addition to ageing, there are other factors likely to affect future spending. Trends in severe
disability among elderly populations across 12 OECD countries for which data are available do not show a
consistent sign of decline (Lafortune and Balestat, 2007), while the number of elderly that need assistance
in carrying out activities of daily living is also growing. Meanwhile, societal changes – notably possible
reductions in the importance of informal care due to rising labour market participation by women and
declining family size, as well as growing expectations for more responsive, quality health and social-care
systems – are creating pressures to improve value for money in long-term care systems. These factors add
pressures on the workforce of this highly labour-intensive sector. Adding to this are the difficulties in
attracting and retaining caregivers to a physically and mentally gruelling profession.
215 citations
TL;DR: It is concluded that in order to use human resources most effectively, health care organisations must consider a more systemic approach - one that accounts for factors beyond narrowly defined human resources management practices and includes organisational and institutional conditions.
Abstract: Throughout the world, countries are experiencing shortages of health care workers Policy-makers and system managers have developed a range of methods and initiatives to optimise the available workforce and achieve the right number and mix of personnel needed to provide high-quality care Our literature review found that such initiatives often focus more on staff types than on staff members' skills and the effective use of those skills Our review describes evidence about the benefits and pitfalls of current approaches to human resources optimisation in health care We conclude that in order to use human resources most effectively, health care organisations must consider a more systemic approach - one that accounts for factors beyond narrowly defined human resources management practices and includes organisational and institutional conditions
206 citations
TL;DR: Giesecke et al. as mentioned in this paper discussed the possible trade-offs between various mechanisms of flexibility in different labour market assets, such as numerical and functional flexibility, for re-equilibrium, and showed that some mechanisms may introduce insecurity in individuals' labour market careers, while others play a crucial role in upskilling the workforce.
Abstract: for re-equilibrium. As a matter of fact, flexibility is a multi-dimensional term. Following Atkinson (1984) we can briefly recall the four different types of labour market flexibility, indicating opposite goals and purposes. Numerical flexibility and functional flexibility do not need further explanation here (see Giesecke in this session). The two other forms are temporal flexibility, that is the possibility to adjust working time and working hours according to the needs of the employer or in theory also the employees, and finally wage flexibility that is a firm's possibility to adjust wage levels. Yet, these flexibility types are not seen as equally leading to insecurity; rather, some may introduce insecurity in individuals' labour market careers, while others may play a crucial role in upskilling the workforce. While temporal flexibility has been mainly addressed in terms of part-time diffusion, the lion's share has been done by the trade off between numerical and functional flexibility (that is, external and internal forms of flexibility). If the mainstream labour economics debate since the early 1980s has assumed numerical flexibility as proxy for labour market efficiency, the European socio-economic literature has pointed out that diversified quality production in small and medium size, highly innovative firms requires functional forms of flexibility to their skilled workforce [the reference here is to Piore and Sabel (1984) and the north-Italian district economy as well as the 'Rhine model of capitalism' as opposed to mass, 'neo-Fordist' low-quality production]. These four alternative scenarios within the same term 'flexibility' illustrate quite well the possible trade-offs between various mechanisms of flexibility in different labour market assets.
TL;DR: In this paper, a comparative survey among employers from four European countries ( Greece, Spain, Netherlands and the United Kingdom) is used to examine their expectations with respect to the ageing of the workforce, the productivity of older workers and their recruitment and retention behaviour regarding this cohort.
Abstract: This article addresses employers' attitudes and actions regarding the position of older workers. A comparative survey among employers from four European countries — Greece, Spain, the Netherlands and the United Kingdom — is used to examine their expectations with respect to the ageing of the workforce, the productivity of older workers and their recruitment and retention behaviour regarding this cohort. The results show that in spite of the perceived challenges ahead (including the ageing workforce), employers take no substantial measures to retain and recruit older workers or improve their productivity. Only employers in the United Kingdom seem to recognize older workers as a valuable source of labour supply and act accordingly.
TL;DR: This paper summarizes the constraining barriers and issues for the psychiatric workforce according to policy and management; interagency collaboration; worker attitude, skill and knowledge; the parent-consumer; and the consumer's family, including children.
Abstract: Many consumers of psychiatric services are parents, making these services the opportunistic point for supporting consumers' children. While evidence suggests that assisting such children improves their mental health, there is a large gulf between what psychiatric services should (or could) provide and what they do in practice. This paper summarizes the constraining barriers and issues for the psychiatric workforce according to: (1) policy and management; (2) interagency collaboration; (3) worker attitude,skill and knowledge; (4) the parent-consumer; and (5) the consumer's family, including children. Potential solutions are presented, with a particular focus on the hierarchical nature of these barriers. Recommendations are made, including organizational audits to identify the most pressing barriers that impede family sensitive practice.
TL;DR: Engagement is an important mechanism by which empowerment affects nurses feelings of effectiveness but less important to new graduates' feelings of work effectiveness than empowerment, and differential effects on new graduates and more seasoned nurses.
Abstract: The nursing profession is currently experiencing asevere nursing shortage. With a large cohort of nursesabout to retire, every effort must be made to retainnurses currently within the system and to ensure thatnursing work environments are attractive to newcomersto the profession. High-quality patient care depends ona nursing workforce that is empowered to provide careaccording to professional nursing standards. Numerous
Book•
20 Apr 2009
TL;DR: Becker, Huselid, and Beatty as discussed by the authors presented the Differentiated Workforce, which recommends that a company should manage its workforce like a portfolio, with disproportionate investments in the jobs that create the most wealth.
Abstract: Do you think of your company's talent as an investment to be managed like a portfolio? You should, according to authors Becker, Huselid, and Beatty, if you're interested in strategy execution. Many companies fall into the trap of spending too much time and money on low performers, while high performers aren't getting the necessary resources, development opportunities, or rewards. In The Differentiated Workforce, the authors expand on their previous books, The HR Scorecard and The Workforce Scorecard, and recommend that you manage your workforce like a portfolio - with disproportionate investments in the jobs that create the most wealth. You'll learn to: Rise above talent management "best practice" and instead create a differentiated workforce that can't be easily copied by competitors Differentiate those capabilities in your company that are truly strategic Identify your wealth-creating "A" positions Create a new relationship between HR and line managers, and articulate the role each plays in a differentiated workforce strategy Develop the right measures for your organization Based on two decades of academic research and experience working with hundreds of executives, The Differentiated Workforce gives you the tools to translate your talent into strategic impact.
Book•
01 Jan 2009
TL;DR: Fitz-enz et al. as discussed by the authors present a system of metrics that describe and predict the cost and productivity curves of its workforce, and it needs qualitative measures that focus on value and human reactions.
Abstract: Chapter One: Human Capital—the Profit Lever of a Knowledge Economy In the current knowledge economy, people, not money, facilities, or equipment, are the critical differentiators of a business enterprise. People are the profit levers; all other assets are passive resources that require human application to generate value. Thus, the key to sustaining a profitable company or a healthy economy is the productivity of the workforce. Given this reality, there is no chance of competing effectively, without hard data on human capital activity and productivity. Management needs a system of metrics that describes and predicts the cost and productivity curves of its workforce, and it needs qualitative measures that focus on value and human reactions. Whereas, quantitative measures describe what happened in terms of cost, capacity, and time, qualitative measures tell why it happened. Together, they offer insights into causes and effects, and they allow management to: • communicate specific performance expectations; • know what is going on inside the organization; Jac Fitz-enz
TL;DR: This paper considers the experience of newly instituted general practitioners with a special interest (GPSIs) in genetics, introduced to improve genetics knowledge and practice in primary care, and shows how claims to knowledge of geneticists and GPSIs interacted with wider policy pressures to produce a rather more conservative redistribution of power and responsibility across the intra-professional boundary.
TL;DR: Winslow et al. as mentioned in this paper examined what accounts for the increase in the sense of work-family conflict among employed parents between 1977 and 1997 using data from two national surveys (N = 2,050).
Abstract: Using data from two national surveys (N = 2,050), this paper examines what accounts for the increase in the sense of work-family conflict among employed parents between 1977 and 1997. Decomposition analysis indicates that the increases in women's labor force participation, college education, time pressure in completing one's job, and the decline in free time were related to the increase. Fathers in dual-earner marriages experienced a particular increase in work-family conflict. With the same amount of time spent with children, parents felt greater work-family conflict in 1997 than in 1977. Although masked by the overall increase, some trends, such as the increases in intrinsic job rewards, time with children, and egalitarian gender attitudes, contributed to a decline in work-family conflict. Key Words: decomposition analysis, gender, parenthood, sociohistorical change, time use, work-family balance. Since the 1970s, the United States has undergone a variety of demographic, economic, and cultural changes, such as the increase in women's labor force participation, the changing nature of employment, and the changing ideas toward gender and parenting. Work-family researchers tend to agree that these social changes have resulted in dramatic changes in how U.S. adults integrate work and family and how they feel about it (e.g., Jacobs & Gerson, 2004). One notable change is the increasing sense of conflict between paid work and family life. Using data from the 1977 Quality of Employment Survey (QES) and the 1997 National Study of the Changing Workforce (NSCW), Winslow (2005) reported that between 1977 and 1997, employed adults who felt mat their job and family life interfere with each other increased substantially. Empirical evidence what accounts for the link between social change and the increasing sense of work-family conflict has been limited, however. The purpose of this paper is to address this gap in the literature. Using data from the 1977 QES and the 1997 NSCW, I conducted decomposition analysis to examine how changes in various characteristics of employed parents between 1977 and 1997 - demographic and socioeconomic characteristics, time commitments, and attitudes toward gender - were related to the change in the sense of work-family conflict in the population. I focused on parents living with children under age 18 because they tend to experience higher work-family conflict man those without minor children at home (Winslow, 2005). Because the 1977 QES did not collect data from those who worked fewer hours, mis study focuses on parents who worked 20 or more hours per week. SOCIAL CHANGE AND WORK-FAMILY CONFLICT Work-family conflict is a form of inter-role conflict that involves the extent to which individuals feel that the demands of paid work and family roles are incompatible so that participation in either role is difficult because of the other role (Greenhaus & Beutell, 1985). The demandresource perspective (Voydanoff , 2004) suggests that people feel greater work-family conflict when (a) demands of paid work and family responsibilities are higher, (b) resources that help them manage those demands are fewer, or (c) perceptions of demands that they feel they must fulfill are higher. Below, guided by this perspective, I discuss how demographic and socioeconomic characteristics, time commitments, and attitudes toward gender may be related to the level of work-family conflict and how changes in those characteristics between 1977 and 1997 may have led to change in work-family conflict among employed parents. Following Firebaugh's (1997) suggestion, I pay attention to two different ways through which change in each characteristic may be related to change in work-family conflict. One is change in the prevalence or mean level of the characteristic among employed parents. The other is change in the effect of the characteristic on work-family conflict. Demographic Characteristics Gender and family structure. …
TL;DR: The findings show that both research and interventions directed at increasing the retention of women must be flexible enough to respond to the variation that exists among women and within IT workplaces.
Abstract: The challenge of meeting the demand for information technology (IT) workers is addressed by examining three important organizational factors that affect women's retention in the IT field. Much of t...
TL;DR: Results support a focus on recruitment of both rural-raised and community-oriented applicants to medical school, residency, and rural practice, and local mentorship and "place-specific education" can support the integration of new rural physicians by promoting self-actualization, community integration, sense of place, and resilience.
TL;DR: In this paper, a review of the certificates granted in seven surgical specialties was conducted to estimate the workforce needed by 2030 in 7 specialties to serve a population of 364 million people and quantify the cost associated with training additional surgeons.
Abstract: Objectives: To estimate the workforce needed by 2030 in 7 surgical specialties to serve a population of 364 million people and to quantify the cost associated with training additional surgeons. Materials and Methods: A review of the certificates granted in otolaryngology, orthopedic surgery, thoracic surgery, obstetrics and gynecology, neurosurgery, urology, and general surgery was conducted. Using a population-based algorithm, we extended the results of Richard Cooper's pioneering work to these fields of surgery. The assumptions were unchanged physician to population ratio, 30 years in practice from completion of residency to retirement, and no revision of the Balanced Budget Act of 1997, and therefore no additional residency positions offered. Per resident expenses were estimated annually at $80,000, including salaries, benefits, and other direct medical education costs. Results/Conclusions: (1) There will not be enough surgeons in the 7 surgical specialties studied. (2) We will have to train more than 100,000 surgeons by 2030 to maintain access for our citizens at an annual cost of almost $2 Billion and total cost of about $37 billion. (3) To train the extra needed surgical workforce will cost an additional $10 Billion. (4) To do this, the Balanced Budget Act of 1997 must be revised to permit more residents to be trained in the United States or other alternatives explored.
01 Jan 2009
TL;DR: A major shift in the balance of generational dominance is currently occurring, with the 'Baby Boomer' generation exiting the leadership roles in the workforce and the Y Generation dramatically entering, both in workforce and as visitors.
Abstract: The profile of the tourism industry is characterized by multigenerational visitors and a multigenerational workforce. A major shift in the balance of generational dominance is currently occurring, with the 'Baby Boomer' generation exiting the leadership roles in the workforce and the Y Generation dramatically entering, both in the workforce and as visitors. According to generational theory, each generation brings with them somewhat predictable traits, values and beliefs, along with skills, attributes, capacities, interests, expectations and preferred modus operandi directly attributable to their generational location. For the tourism industry, insights gained through the lens of generational theory has the potential to guide the incentives, the motivators, the leadership models and the overall culture of the profession to better connect with the Y Generation as the most recent members of the tourism workforce and as the current and future visitor market. This chapter sets out to provide some foundations around the concept of generations, discuss the demography and unique character traits of members of the Y Generation by drawing on a renowned generational theorist, and begin to consider this cohort as tourism, consumers. This chapter will thus serve as a platform for the following chapters in the book.
TL;DR: To gain a deeper understanding of the process of making the transition from student to graduate nurse, discussion groups were held across Alberta with 14 new graduates and 133 staff nurses, employers, and educators.
Abstract: Reports that new nurse graduates are not sufficiently prepared to enter the workforce are of concern to educators, employers, and other stakeholders. Often, this lack of 'practice readiness' is defined in relation to an inability to 'hit the ground running' and is attributed to a 'gap' between theory and practice and the nature of current work environments. To gain a deeper understanding of the process of making the transition from student to graduate nurse, discussion groups were held across Alberta with 14 new graduates and 133 staff nurses, employers, and educators. Five additional new graduates and 34 staff nurses, employers, and educators provided input by fax or e-mail. The findings of this initiative speak to the need to examine assumptions underlying 'practice readiness' and what constitutes an effective transition to the workplace. The problems to be addressed are complex and a wide range of sustainable, evidence-based approaches are required to resolve them.
TL;DR: In this article, a number of issues and challenges confronting individuals with a disability making the transition from school to the post-school environment are reviewed, along with a deep-seated prejudice towards people with disabilities in the market place.
Abstract: Australian research has demonstrated that students with a disability are more likely to remain out of the full-time workforce. These research findings have been the catalyst for a call for a comprehensive career development and transition planning approach for all students with disabilities in schools as well as for employers to rethink the role of people with disabilities in the workforce. In the Australian context the transition from school for individuals with a disability is complicated by a disparate and fragmented group of service agencies providing a range of services, including employment, supported accommodation, recreation and leisure pursuits, as well as training and placement, along with, at times, a deep-seated prejudice towards people with disabilities in the market place. This paper reviews a number of issues and challenges confronting individuals with a disability making the transition from school to the post-school environment.
01 Jan 2009
TL;DR: In this paper, a study aimed to examine the expectations of employers with respect to the graduates they employed and to evaluate their perceptions of the quality of graduates produced by South Africa's higher education institutions.
Abstract: This study aimed to examine the expectations of employers with respect to the graduates they employed and to evaluate their perceptions of the quality of graduates produced by South Africa’s higher education institutions. It was hoped that the study would provide information for debate and engagement with industry, and serve as a baseline for future reviews. The study was based on the assumptions that the attributes developed by higher education may be out of step with the needs and expectations of employers and that ‘skills’ may need to be redefined to match higher education with new and changing forms of labour and the application of knowledge. A questionnaire was produced for employers focusing on the attributes that employers consider important and expect graduates should possess upon entering the workforce and the degree to which graduates in South Africa demonstrate these skills. Statistics are provided to illustrate the results. It was found that there is a real need to address the gaps between employers’ expectations and higher education outcomes, but that employers did value some of the attributes currently produced by higher education. The role of higher education cannot be treated in isolation and must take its place in producing thinking, responsive and intellectually well-grounded individuals who are flexible and can readily adapt to new demands and challenges in a changing work environment.
TL;DR: An efficient and quick hybrid genetic algorithm that combines local searches with genetic population management techniques is presented to manage the Skilled Workforce Project Scheduling Problem.
TL;DR: The measure of inequality in the distribution of the health workforce may depend strongly on the underlying measure of health care needs, and other measures ofhealth care needs than population levels may have to be developed in order to ensure a more meaningful measurement of distributional inequalities of thehealth workforce.
Abstract: The overall human resource shortages and the distributional inequalities in the health workforce in many developing countries are well acknowledged. However, little has been done to measure the degree of inequality systematically. Moreover, few attempts have been made to analyse the implications of using alternative measures of health care needs in the measurement of health workforce distributional inequalities. Most studies have implicitly relied on population levels as the only criterion for measuring health care needs. This paper attempts to achieve two objectives. First, it describes and measures health worker distributional inequalities in Tanzania on a per capita basis; second, it suggests and applies additional health care needs indicators in the measurement of distributional inequalities. We plotted Lorenz and concentration curves to illustrate graphically the distribution of the total health workforce and the cadre-specific (skill mix) distributions. Alternative indicators of health care needs were illustrated by concentration curves. Inequalities were measured by calculating Gini and concentration indices. There are significant inequalities in the distribution of health workers per capita. Overall, the population quintile with the fewest health workers per capita accounts for only 8% of all health workers, while the quintile with the most health workers accounts for 46%. Inequality is perceptible across both urban and rural districts. Skill mix inequalities are also large. Districts with a small share of the health workforce (relative to their population levels have an even smaller share of highly trained medical personnel. A small share of highly trained personnel is compensated by a larger share of clinical officers (a middle-level cadre) but not by a larger share of untrained health workers. Clinical officers are relatively equally distributed. Distributional inequalities tend to be more pronounced when under-five deaths are used as an indicator of health care needs. Conversely, if health care needs are measured by HIV prevalence, the distributional inequalities appear to decline. The measure of inequality in the distribution of the health workforce may depend strongly on the underlying measure of health care needs. In cases of a non-uniform distribution of health care needs across geographical areas, other measures of health care needs than population levels may have to be developed in order to ensure a more meaningful measurement of distributional inequalities of the health workforce.
01 Jan 2009
TL;DR: There is provided a shutter type digital clock which comprises generally a display block, a light source block disposed behind the display block and a mechanical block disposedbehind the light sourceBlock.
TL;DR: There is a need for addressing the looming workforce shortage as behavioral health services in primary care become more widely implemented and new initiatives have emerged which attempt to provide training for the preexisting mental health workforce to enable their successful integration into primary care settings.
Abstract: Training and education in integrated primary care is limited. We see a need for addressing the looming workforce shortage as behavioral health services in primary care become more widely implemented. Bringing mental health clinicians straight from specialty mental health settings into primary care often results in program failure due to poor skills fit, assumptions about services needed, and routines of practice these clinicians bring from their specialty settings. Health psychology graduate programs tend to prepare graduates for specialty research and practice in medical settings rather than preparing them for the pace, culture and broad spectrum of needs in primary care. Family medicine residency programs provide an underutilized resource for training primary care psychologists and family physicians together. Even if comprehensive graduate training programs in integrated primary care were developed, they could not begin to meet the need for behavioral health clinicians in primary care that the present expansion will require. In response to the demand for mental health providers in primary care, new initiatives have emerged which attempt to provide training for the preexisting mental health workforce to enable their successful integration into primary care settings.