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PubMed2004

The provider system for children's mental health: workforce capacity and effective treatment.

This issue brief examines two issues that are key to meeting children's unmet needs for mental health care: ensuring that the provider supply is adequate and that the care delivered is effective. It describes the shortage of qualified providers to address children's mental disorders, as well its possible causes; it describes how managed care, to a certain extent, drives practice patterns; and it discusses the gray areas in deciding which providers are most qualified to deliver what care. In addition, this paper introduces what is known about evidence-based care in children's mental health, the extent to which it is being taught and practiced, the extent to which health plans are adopting such practices, and the effect such strategies may have on the makeup of the children's mental health provider field.

Antidepressive Agents↗
PubMed2000

A threat to the public health workforce: evidence from trends in preventive medicine certification and training.

Evidence of a growing need for preventive medicine specialists is the congruence between needed competencies for practice in the current health care environment, as identified by the Council on Graduate Medical Education (COGME) and in other national reports, and the core competencies of preventive medicine residents. The total number of certified specialists in preventive medicine is 6091. The proportion of self-designated preventive medicine specialists among all U.S. physicians is on the decline and the greatest decline has been among those in public health (PH) and general preventive medicine (GPM). In addition, the total number of preventive medicine residents is on the decline, and the decline has been greatest among those training in PH and combined PH/GPM. One of the reasons for this decline has been inadequate funding due to the absence of Medicare graduate medical education (GME) financing for population-based vs. individual patient care services and meager and diminishing Title VII support. A paucity of faculty is apparent in medical schools with residency training and board certification in preventive medicine. Several actions may help reverse this trend and assure adequate numbers of preventive medicine specialists: expansion of Title VII to increase the number of residents receiving stipends and tuition, adding infrastructure support for faculty development and funding of demonstration projects in distance learning and in joint generalist/ preventive medicine residency training. Medicare GME reform should include recognition of population-based services and inclusion of preventive medicine residencies in provisions for "nonhospital-based" training and in up-weighting methodologies for primary care training. Expansion of Veterans Affairs, National Institute for Occupational Safety and Health, and Department of Defense support is also needed as is attention to resident debt reduction.

Aerospace Medicine↗
PubMedDate not supplied

[Health workforce forecasting carried out by the C.S.D.M. (1964-2004)].

During the last 4 decades, the Centre has performed 16 pieces of forecast on the various health professions in France, the majority being devoted to medical doctors. During the 60's, information were scarce, and calculations on both the inflows of future new graduates and the outflows of future deaths and retirements could not reach an acceptable level of relevance. In 1972, a numerus clausus system was established at the beginning of medical training. Moreover, efforts were deployed to collect better data and improve projection techniques. All these factors contributed to raise strongly the quality of the forecasting work. The discrepancies between the projected and actual trends were narrowing, as showed below: [table: see text] The forecasts were based on the demographic projection techniques and the results obtained showed not only the total number of active physicians in the country but equally the distribution by age groups of this total number. The latter element allows the predictions of the aging process of the medical profession as an impact of the present-day policies concerning medical student intake (numerus clausus).

Female↗
PubMed2002

A hospital-level analysis of the work environment and workforce health indicators for registered nurses in Ontario's acute-care hospitals.

The purpose of this study was to explore the relationship between hospital-level indicators of the work environment and aggregated indicators of health and well-being amongst registered nurses working in acute-care hospitals in Ontario, Canada. This ecological analysis used data from a self-reported survey instrument randomly allocated to nurses using a stratified sampling approach. Multivariable linear regression models were used to examine hospital-level associations for burnout, musculoskeletal pain, self-rated general health, and absence due to illness. The unit of analysis was the hospital (n = 160), with individual nurse responses (n = 6,609) aggregated within hospitals. After controlling for basic differences in nurse workforces, including mean age and education, higher (better) work-environment scores were found to be generally associated with higher health-indicator scores, while a larger proportion of full-time than part-time nurses was found to be associated with lower (poorer) health scores. This study may provide direction for policy-makers in coping with the recruitment and retention of nursing staff in light of the current nursing shortage.

Health Facility Environment↗
PubMed2004

Training the veterinary public health workforce: a review of educational opportunities in US veterinary schools.

This article presents the results of an Internet-based review conducted in January and February 2003 to assess the educational opportunities available in veterinary public health, epidemiology, and preventive medicine at the 27 veterinary schools in the United States. Most professional veterinary curricula are designed to train students for careers as highly qualified private practitioners, although there is an increased need for veterinary perspectives and contributions in the public health sector. The future of veterinary public health relies on the opportunities available in education to teach and encourage students to pursue a career of public service. The results of this review indicate the availability of a wide variety of required courses, electives, and post-graduate training programs to veterinary students in the United States. Veterinary students are exposed to a median of 60 hours of public health, epidemiology, and preventive medicine in required stand-alone courses in these areas. Four veterinary schools also have required rotations for senior students in public health, preventive medicine, or population medicine. Contact time for required public health, epidemiology, and preventive medicine courses ranges from 30 to 150 contact hours. Advanced training was available in these subjects at 79% of the 27 schools. Greater collaboration between veterinary schools, schools of public health, and the professional public health community will increase exposure to and opportunities in public health to all future veterinarians.

Curriculum↗
PubMed1998

University performance, gender and the rural health workforce: an analysis of nursing students.

The relationship between student gender and performance was examined in first year students enrolled in the Bachelor of Nursing course at Charles Sturt University from 1991 to 1995. A greater proportion of female students achieved passing grades in subjects studied when compared to male students, irrespective of the subject discipline area. Furthermore, a significantly greater proportion of female than male students passed nursing subjects; however, no statistically significant differences in performance were detected in the proportion of male or female students in either science or humanities subjects.

Education, Nursing, Baccalaureate↗
PubMedDate not supplied

Correlates of public health workforce acceptance of smallpox immunization in Virginia.

OBJECTIVE: By October 24, 2003, 38,577 of 500,000 targeted civilians received smallpox vaccine in the Pre-Event Smallpox Vaccination Campaign, Phase I. We investigated reasons for the low vaccination uptake. DESIGN: Cross-sectional survey, conducted in May 2004. SAMPLE: We surveyed 225 health care personnel, potential members of smallpox response teams in Virginia, who were offered vaccination. We assessed respondents' acceptance of vaccination and its association with factors potentially influencing vaccination: perceptions of vaccine safety, contraindications, concerns about bioterrorism, and workplace influences. RESULTS: Among nonvaccinees (n=44), 70% had a contraindication to the vaccine compared with 8% among vaccinees (n=132). The desire to prepare America for potential bioterrorist attack was associated with acceptance of smallpox vaccination (odds ratio [OR]: 17.7, 95% confidence interval [CI]: 3.6-85.9). Among respondents with contraindications, vaccinees reported more often than nonvaccinees having been asked by their supervisors to be vaccinated (OR: 5; 95% CI: 1.1-22.1) and to have been concerned that their vaccination choice would affect positively their job evaluation (OR: 11; 95% CI: 1.6-81.1). CONCLUSION: Concerns about bioterrorism and willingness to help in the preparedness effort were motivations for vaccination. Continued vigilance to avoid vaccination of those with contraindications is needed.

Adult↗