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PubMed2006

Economic, neurobiological, and behavioral perspectives on building America's future workforce.

A growing proportion of the U.S. workforce will have been raised in disadvantaged environments that are associated with relatively high proportions of individuals with diminished cognitive and social skills. A cross-disciplinary examination of research in economics, developmental psychology, and neurobiology reveals a striking convergence on a set of common principles that account for the potent effects of early environment on the capacity for human skill development. Central to these principles are the findings that early experiences have a uniquely powerful influence on the development of cognitive and social skills and on brain architecture and neurochemistry, that both skill development and brain maturation are hierarchical processes in which higher level functions depend on, and build on, lower level functions, and that the capacity for change in the foundations of human skill development and neural circuitry is highest earlier in life and decreases over time. These findings lead to the conclusion that the most efficient strategy for strengthening the future workforce, both economically and neurobiologically, and improving its quality of life is to invest in the environments of disadvantaged children during the early childhood years.

Adult↗

PubMedDate not supplied

Prioritizing ergonomic research in aging for the 21st century American workforce.

The Bureau of Labor Statistics predicts that by 2008 Americans aged 55 and over will represent the greatest annual growth rate and will occupy 30% of the American population. Additionally, by 2008 civilian labor force participation rates for the 55 and older group will grow to 36.8%, a 6.5% increase over the participation rates for this group for 1996, with the 55 to 64 age group expected to add 7.3 million workers. The predicted median age of the labor force for 2008 is estimated at 40.7 years, an age not approached because the median age peaked at 40.5 years in 1962. Coupled with this aging profile, employment in professional specialty occupations will increase the fastest and add the most jobs in the decade leading to 2008. Within the professional specialty professions, the majority of the employment increases are expected to occur in the service industry division. The purpose of this paper is to merge demographic data with ergonomic and human factors data and predictions to explore areas of ergonomic research that will aid in keeping the aging workforce, and those with whom they interact, healthy in their jobs and keep the companies for whom they are employed competitive. Although some ergonomics research has been conducted in all the listed areas of expected growth, the paper reexamines the job demands in each sector, with a focus on the needs of the aging workforce.

Aging↗

PubMed2005

The general practitioner pharmacotherapy prescribing workforce: examining sustainability from a systems perspective.

As prescribers of opioid pharmacotherapies, general practitioners (GPs) are pivotal to the sustainability of opioid pharmacotherapy treatment services. The goal of this study was to examine the nature and sustainability of the Australian GP prescriber workforce in order to inform future programmes and policy development in this area. Data were collected from four Australian states: South Australia, Queensland, Victoria and New South Wales. Key features of the available data were: a heavy client load carried by a small number of prescribers, a high proportion of trained but inactive prescribers, and a high proportion (one-third to two-thirds) of medical practitioners who undertake training but do not take up prescribing, i.e. a high attrition rate. Available data indicate significant shortfalls in the number of prescribers available in each state to service this patient population. Across all states a relatively small number of prescribers were providing services for the majority of methadone clients. In order to achieve sustainable, high quality prescriber service provision, workforce development strategies are needed which focus on recruitment of new prescribers, and the support and retention of existing and inactive prescribers. Establishment of systematic and detailed data collection systems should also be considered a priority.

Adult↗

PubMed2006

Seroprevalence survey of varicella, measles, rubella, and hepatitis A and B viruses in a multinational healthcare workforce in Saudi Arabia.

OBJECTIVE: To determine the prevalence of the vaccine-preventable diseases caused by varicella, measles, rubella, and hepatitis A and B viruses in a multinational healthcare workforce. DESIGN: Prospective cohort study. SETTING: A 750-bed tertiary care center located in Riyadh, Saudi Arabia. METHODS: In compliance with hospital policy, newly recruited healthcare workers (HCWs) were enrolled in the study from September 2001 to March 2005. Serum samples were collected from all HCWs during the initial hiring process and tested for IgG antibodies against each of the 5 viral agents. Nonimmune HCWs were subsequently vaccinated at the earliest opportunity. RESULTS: A total of 4,006 newly hired (international and local) employees were included in the study. All underwent serologic testing for IgG antibodies against varicella, measles, rubella, hepatitis A, and hepatitis B viruses. Of the total, 63% were female and 37% were male. Middle Eastern employees comprised 47% of the total, followed by employees from the Far East (35%), the West (10%), and Africa (8%). Forty-two percent were nurses, 27% were in administration, 18% were medical technicians, and 13% were physicians. Among the 4,006 newly hired HCWs, 14% had negative IgG antibody test results for varicella virus, 13% for measles virus, 10% for rubella virus, 33% for hepatitis A virus, and 43% for hepatitis B virus. More women than men were susceptible to hepatitis A (40% vs. 24%; P<.001), whereas more men were susceptible to hepatitis B (55% vs. 35%; P<.001). Varicella susceptibility was more common among HCWs from the Far East (19%), whereas susceptibility to measles, rubella, hepatitis A, and hepatitis B was highest among HCWs from the Middle East. Both relative youth and male sex were associated with lack of antibodies against hepatitis B virus and rubella virus. In contrast, female sex and younger age were associated with lack of antibodies against hepatitis A virus (P<.001). CONCLUSION: Seroprevalence surveys of vaccine-preventable diseases among HCWs, although labor intensive, are invaluable in caring for a multinational workforce.

Adult↗

PubMed2000

Effect of HIV-1 infection on tuberculosis and fertility in a large workforce in Kinshasa, Democratic Republic of the Congo.

To determine the effect of an HIV counseling service on the incidence of HIV and tuberculosis infection and on the fertility rate in a large workforce cohort of adult men and women from Kinshasa, Democratic Republic of Congo (formerly Zaire), we conducted a 2-year prospective longitudinal cohort study, two large Kinshasa businesses (a commercial bank and a textile factory). We determined baseline HIV-1 seroprevalence, HIV-1 and tuberculosis mortality/morbidity, and fertility rates during 24 months of follow-up on 8866 employees and 6411 wives of male employees. The baseline HIV-1 seroprevalence was 2.8% in male employees (n = 6657), 8.4% in female employees (n = 417), and 2.4% in the wives of male employees (n = 4692). The HIV-1 seroincidence per 100 person-years of follow-up in these three groups was 0.9, 0.5 and 0.8, respectively. The incidence of tuberculosis was 2.4/100 person years in persistently seropositive individuals compared with a 0.38 rate in persistently seronegative individuals (p < 0.01). The annual fertility rate in persistently seronegative women was 250.0/1000 women compared with a rate of 140/1000 in persistently seropositive women (p < 0.001). Forty-eight (44%) of 105 male employees and 17 (26%) of 60 wives of male workers who died during follow-up were HIV-1 seropositive. HIV infection was responsible for nearly one half of all deaths in this large workforce. Tuberculosis incidence was six times higher in HIV-1-infected compared with uninfected individuals. Counseling of HIV-infected women and their husbands appeared to be effective as their cumulative fertility rate was 44% lower than the rate in similarly aged uninfected women.

AIDS-Related Opportunistic Infections↗

PubMed2000

Gender differences in musculoskeletal health of computer and mouse users in the Swedish workforce.

The objectives of the study were to explore the musculoskeletal health of computer users in the Swedish workforce with regard to gender and psychosocial factors, and to describe gender differences between the occupational groups. A subset was chosen from a large survey of 12,462 individuals representing the workforce of Sweden, performed by Statistics Sweden. Included in the subset were 2044 subjects who worked for at least half their working hours with personal computers, or an equivalent device, and also used a computer mouse. All occupational groups had prevalence ratios (women/men) > 1. When using regression models, the variables 'learn and develop' and 'involved in planning your work' were health factors, and 'too much to do' was a risk factor for upper body symptoms for both women and men. For women 'PC duration 100' was a risk factor and 'support from superiors' was a health factor. Age seemed to be a stronger risk factor for men than for women.

Adult↗

PubMed2000

Workforce cultural factors in TQM/CQI implementation in hospitals.

One of the major obstacles to successful implementation of TQM/CQI in hospitals has been management's failure to consider the workforce cultural situation. This quasi-qualitative study investigates eight workforce cultural factors in seven midwestern hospitals. Results reveal only one of the seven hospitals successfully implementing TQM/CQI.

Employee Performance Appraisal↗

PubMed2002

Private practicing endodontists: production of endodontic services and implications for workforce policy.

The methods and techniques used by private practicing endodontists to provide patient care are at the core of endodontic workforce policy. Productivity influences both the amount of care provided and the required number of practicing endodontists in the future. Data was collected from practicing endodontists in order to characterize the technical methods of producing endodontic services. This data was then used to develop a statistical model for use in assessing the national endodontic workforce conditions in the United States. A survey was mailed to a random sample of 2,075 private practicing endodontists in the United States based on membership files from the American Association of Endodontists and the American Dental Association. The overall survey consisted of three means of data collection: (1) a survey about the endodontic practice as a whole; (2) a survey about the endodontist; and (3) patient encounter forms used when collecting detailed endodontic procedure data for a single day in the practice. The model was used to obtain a projection of 4,016 endodontists in the year 2005 and 4,671 practicing endodontists in 2010 required to meet the projected demand for endodontic care. The model and survey data provide valuable information to practicing endodontists for use in identifying critical elements used to render care, how the elements are combined in the practice of endodontics, and the minimum number of endodontists required to provide a given volume of endodontic care.

Adult↗

PubMed2003

Nursing workforce management: using benchmarking for planning and outcomes monitoring.

The goal of maintaining the balance between demand for nursing care and the supply of nurses is the basis for state and regional planning to meet future nursing workforce needs. Projecting nursing supply needs solely on the basis of historical registered nurse to population ratios does not specifically consider the healthcare needs of the population. The authors present a model in which state population data and nursing resource data are compared with national data to assist state planning groups in developing an effective workforce management plan. Integrating population demographic data, healthcare needs of citizens, and nurse resource factors at the state level can improve the accuracy of projection statistics.

Adult↗

PubMedDate not supplied

Strategic state-level nursing workforce initiatives: taking the long view.

This article reviews long-range, strategic nursing workforce initiatives developing in 5 states. It also summarizes progress in establishing a national network of state nursing centers for sharing workforce data, and new education, workplace, and policy initiatives being undertaken by and on behalf of the nursing profession.

Data Collection↗

PubMed1998

Occupational upper extremity disorders in the federal workforce. Prevalence, health care expenditures, and patterns of work disability.

Upper extremity disorders (UEDs) account for a significant number of work-related illnesses in the US workforce. Little information exists on the distribution of UEDs, their associated health care and indemnity costs, or patterns of work disability. The study presented is an analysis of upper extremity claims within the federal workforce. In this study, the universe consisted of all claims accepted by the US Department of Labor, Office of Workers' Compensation Programs (OWCP), from October 1, 1993, through September 30, 1994. A total of 185,927 claims of notices of injury were processed during the study period, and of these, 8,147 or 4.4% had an UED diagnosis coded according to the International Classification of Diseases, Clinical Modification (ICD-9-CM). 5,844 claims involved a single UED diagnosis and were the only claims field by these employees between October 1, 1990, and September 30, 1994. These single claims with single diagnoses comprised the sample for further analysis. Mononeuritis and enthesopathies of the upper limb were the most common diagnoses, accounting for 43% and 31% of the claims, respectively. Women had a higher proportion of carpal tunnel syndrome, "unspecified" mononeuritis, and "unspecified" enthesopathies. The majority of claimants for both the mononeuritis- and enthesopathy-related diagnoses were between 31 and 50 years of age, received only health care benefits, and did not incur wage loss. Health care costs for mononeuritis and enthesopathy claims were $12,228,755 (M = $2,849). Carpal tunnel syndrome (CTS) and enthesopathy of the elbow were the most costly diagnoses, accounting for 57% and 16% of the total, respectively. Surgical services represented the highest expenditures in CTS claims. Physical therapy accounted for the majority of health care costs for enthesopathy cases. The mean number of workdays lost for CTS and enthesopathy claims were 84 and 79, and the average indemnity costs were $4,941 and $4,477, respectively. These findings indicate that while UEDs represent a relatively small percentage of all workers' compensation cases, the health care and indemnity costs are considerable. Also mean duration and pattern of work disability revealed that these disorders can result in chronic work disability similar to that observed in low back pain. The results highlight the need to determine whether interventions that account for the majority of costs significantly impact long-term outcomes. There is also a need to identify risk factors for prolonged disability in those who experience problems with delayed recovery.

Adolescent↗

PubMedDate not supplied

A model for public health workforce development using the National Public Health Performance Standards Program.

Workforce development programs in public health should link improvements in workers' performance with improvements in their agencies' performance. The "ten essential services" of public health provide criteria for measuring both individual worker training (as in workforce competency standards) and agency performance (as in the Centers for Disease Control and Prevention's National Public Health Performance Standards Program). This shared foundation was the basis for a model strategic training program developed for use in a 500-employee urban county health department. Full implementation of this model as a foundation for assessment, curriculum development, and evaluation requires careful attention to management issues, confidentiality of employee records, and evaluation methodologies.

Efficiency, Organizational↗

PubMed2006

Meeting the needs of regional minority groups: the University of Washington's programs to increase the American Indian and Alaskan native physician workforce.

Minority populations in the United States are growing rapidly, but physician workforce diversity has not kept pace with the needs of underserved communities. Minorities comprised 26.4% of the population in 1995; by 2050, these groups will comprise nearly half. Medical schools must enlist greater numbers of minority physicians and train all physicians to provide culturally responsive care. The University of Washington School of Medicine (UWSOM) is the nation's only medical school that serves a five-state region (Washington, Wyoming, Alaska, Montana, and Idaho). Its mission addresses the need to serve the region, rectify primary care shortages, and meet increasing regional demands for underserved populations. The UWSOM Native American Center of Excellence (NACOE) was established as one important way to respond to this charge. The authors describe pipeline and minority recruitment programs at UWSOM, focusing on the NACOE and other activities to recruit American Indian/Alaskan Native (AI/AN) applicants to medical schools. These programs have increased the numbers of AI/AN medical students; developed the Indian Health Pathway; worked to prepare students to provide culturally responsive care for AI/AN communities; researched health disparities specific to AI/AN populations; provided retention programs and services to ensure successful completion of medical training; developed mentorship networks; and provided faculty-development programs to increase entry of AI/AN physicians into academia. Challenges lie ahead. Barriers to the pipeline will continue to plague students, and inadequate federal funding will have a significant and negative impact on achieving needed physician-workforce diversity. Medical schools must play a larger role in resolving these, and continue to provide pipeline programs, retention programs, and minority faculty development that can make a difference.

Alaska↗

PubMed2004

The impact of diabetes on workforce participation: results from a national household sample.

OBJECTIVE: Diabetes is a highly prevalent condition that results in substantial morbidity and premature mortality. We investigated how diabetes-associated mortality, disability, early retirement, and work absenteeism impacts workforce participation. DATA SOURCE: We used the Health and Retirement Study (HRS), a national household sample of adults aged 51-61 in 1992, as a data source. STUDY DESIGN: We conducted cross-sectional analyses on the baseline HRS data, and longitudinal analyses using data from eight years of follow-up. We used two-part regression models to estimate the adjusted impact of diabetes on workforce participation, and then estimated the economic impact of diabetes-related losses in productivity. PRINCIPAL FINDINGS: Diabetes is a significant predictor of lost productivity. The incremental lost income due to diabetes by 1992 was 60.0 billion US dollars over an average diabetes duration of 9.7 years. From 1992 to 2000, diabetes was responsible for 4.4 billion US dollars in lost income due to early retirement, 0.5 billion US dollars due to increased sick days, 31.7 billion US dollars due to disability, and 22.0 US dollars billion in lost income due to premature mortality, for a total of 58.6 billion dollars in lost productivity, or 7.3 billion US dollars per year. CONCLUSIONS: In the U.S. population of adults born between 1931 and 1941, diabetes is associated with a profound negative impact on economic productivity. By 1992, an estimated 60 billion US dollars in lost productivity was associated with diabetes; additional annual losses averaged 7.3 billion US dollars over the next eight years, totaling about 120 billion US dollars by the year 2000. Given the rising prevalence of diabetes, these costs are likely to increase substantially unless countered by better public health or medical interventions.

Chronic Disease↗

PubMed2002

What the emerging workforce wants in its leaders.

PURPOSE: To describe desired traits as perceived by emerging and entrenched workforce members. DESIGN AND METHODS: A national sample of nursing students (n = 108) and a sample of Midwestern American hospital managers (n = 126) were categorized by age and asked to rank the traits desired in their leaders. Participants ranked the most desired and least desired traits of leaders. Rankings were compared between groups as well as with desired traits from leadership studies in the 1990s. FINDINGS: A high degree of congruency was found between emerging and entrenched health care workforce respondents. However, these findings showed little congruence with previous studies. CONCLUSIONS: Congruence of expectations facilitates mentoring relationships, so finding no difference between the older and younger groups bodes well for the mentoring of young nurse leaders. The key implication is the challenge to recruit and retain such leaders in the nursing profession in a systematic, logical, and generation-friendly way.

Adolescent↗

PubMedDate not supplied

Returning nurses to the workforce: developing a fast track back program.

TOPIC: Fast Track Back: Re-entry into Nursing Practice program. PURPOSE AND SOURCES OF INFORMATION: Describes the development, implementation, and evaluation of a state-of-the-art re-entry program facilitating the return of licensed nonpracticing RNs to the workforce through a quality education program that retools them for the workforce in the areas of pharmacology, skill development using the latest technology, practice standards, and nursing issues. The program consists of didactic content taught via classroom, Internet, skills laboratory, and high fidelity human simulated technology and a clinical component. CONCLUSIONS: The program is a mechanism that enables re-entry nurses to improve skills and competencies necessary to practice in today's healthcare environment.

Academic Medical Centers↗

PubMed2004

Construction safety research in the United States: targeting the Hispanic workforce.

While it is known that Hispanics have a continuous growing participation in the construction workforce and that their fatal and non-fatal occupational injuries are higher than any other ethnic group, very little construction safety and health research has been conducted in the United States. Research that focuses on safety and health of Hispanic workers employed in the construction industry might prove beneficial in reducing injuries and promoting safe and decent workplaces for all. The purpose of this article was twofold. First, to propose a research agenda where topics such as surveillance, intervention research on high risk occupations, intervention effectiveness evaluation, design and development of effective and appropriate safety training and educational materials, and the socioeconomic impact of injuries and illnesses, are investigated among the Hispanic construction workforce. Second, to present relevant aspects inherent to this particular population that need to be incorporated into the design and development stages of any safety and health research initiative. They include the occupational, social, economic, and cultural background of Hispanic workers; use of a participatory approach, proper selection and use of translation methods; and conducting collaborative research. Certain limitations and challenges related to the availability of resources for conducting safety and health research on Hispanic workers are further discussed.

Accidents, Occupational↗

PubMed1994

A respiratory survey in a black Johannesburg workforce.

BACKGROUND: The burden and determinants of airway disease in the population of southern Africa, which is currently undergoing rapid, often uncontrolled, urbanisation and industrialisation, are unknown. Previous surveys have focused on specific occupational groups and few have included women. This paper describes the respiratory status in a 30% probability sample of 206 men and 203 women drawn from an urban black Johannesburg workforce of almost 1500, all working for an educational institution. METHODS: Subjects answered a respiratory questionnaire and performed spirometric tests. Symptom rates and age and height standardised forced vital capacity (FVC), forced expiratory volume in one second (FEV1), FEV1/FVC%, and forced expiratory flow (FEF25-75) were analysed by gender in relation to smoking, past work exposures, past and recent respiratory conditions, and socioeconomic indicators. RESULTS: Symptom prevalence was high, bronchitic symptoms in men being related to smoking and previous occupational exposure, and in women to smoking despite the low intensity of their habit. Phlegm and wheezing were related to childhood respiratory illness in both men and women. FVC and FEV1, based on all subjects including smokers, were higher than previously reported for black residents of southern Africa. FVC was also positively related to education and job category. Higher values for ever smokers than for never smokers suggested health selection into the habit, while significant negative smoking effects were seen only on FEV1/FVC% and only in women. CONCLUSIONS: Despite the high prevalence of symptoms--some smoking related--in this urban workforce, lung function levels were higher than previously reported in African blacks, and may reflect improving socioeconomic conditions.

Adult↗