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We measure the impact of two main signals of tertiary-level human capital accumulation, college quality and certification, on the first stage of the hiring process in India. As part of a correspondence experiment, we send 16,944 resumes to 1412 job postings for recent engineering graduates at small and medium firms in eight major cities. In precisely estimated results, we find that these employers do not respond to signals of tertiary education quality. Specifically, there is no impact on callbacks of having graduated from a mid-tier college ranked in the top 300 relative to one outside of the top 1000. There is also no impact of scoring in the highest as opposed to the lowest quartile of a widely-used post-tertiary certification test. We also examine gender, since employers have often used this as a signal in evaluating workers. There is evidence that women modestly benefit in the first stage of hiring in this market, with this effect concentrated in some regions.

The authors estimate the effects of an increase in the youth minimum wage in the Netherlands on low-paid workers' employment and earnings, using a difference-in-differences approach with detailed administrative data. Findings show that the increase does not have a negative effect on the number of jobs or hours worked, hence raising overall earnings for affected workers. Further, the minimum wage increase has substantial spillover effects, accounting for close to 70% of the average wage increase experienced by workers. While employment grows in fixed-term and temporary help agency contracts, the authors do not find evidence of declines in employment in other types of work arrangements, nor of labor-labor substitution. Labor market outcomes evolve most favorably for full-time incumbent workers who are not enrolled in education and are thus less likely to be transient occupants of minimum wage jobs. [ABSTRACT FROM AUTHOR]

Background/Aims: Personalised care is associated with high-quality, safe maternity care. Limited evidence exists on midwives' perception of personalised care and potential barriers and facilitators associated with implementing it in practice. The aim of this study was to explore midwives' perspectives of personalised care. Methods: An online mixed-methods survey was conducted exploring the perspectives of 46 NHS midwives. Data were analysed using descriptive statistics and thematic analysis. Results: Assessing individual needs was perceived as a key facilitator and time restrictions were considered a significant barrier to providing personalised care in practice. Conclusions: Providing personalised care is associated with increased job satisfaction for midwives, and key barriers include inflexible healthcare systems and limited resources. Implications for practice: The findings contribute to an understanding of the factors that influence the provision of personalised care and have the potential to inform improvements in maternity services. [ABSTRACT FROM AUTHOR]

Background: Maintaining optimal hearing health and preventing ear infections is crucial across all life stages, spanning from before birth and infancy to middle age and beyond. The primary aim of the research was to evaluate and compare the effectiveness of the telemedicine-enabled otoscope (TEO) in diagnosing ear diseases with that of the conventional otoscope. Materials and Methods: The databases PubMed, Cochrane, and Embase were thoroughly searched to find original studies on TEO at the community as well as hospital levels along with meta-analysis for comparison with standard diagnostic methods using traditional otoscopes. Results: The telemedicine-equipped otoscope displays a sensitivity of 82% (confidence interval 0.78-0.95) and a specificity of 95% (confidence interval 0.93-0.96). When employed by physicians, the combined sensitivity and specificity become 84% (confidence interval 0.79-0.88) and 91% (confidence interval 0.87-0.94), respectively. Community Health Workers (CHWs) using telemedicine-enabled otoscopes exhibit a collective sensitivity of 80% (confidence interval 0.72-0.87) and a collective specificity of 97% (confidence interval 0.95-0.98). Snapping multiple photographs and removal of cerumen where necessary in increasing the quality of the photographs for diagnosis. Conclusions: The TEO holds the promise of substantially enhancing the accessibility of audiology services, encompassing evaluation, public outreach, and fundamental care. Its implementation has the potential to fortify primary health care environments, contributing to the prevention of ear diseases and assisting in mitigating the shortage of skilled ear care professionals. [ABSTRACT FROM AUTHOR]

AIM The aimof this study was to analyze nursing student level of knowledge and understanding of current experiences of Indigenous people within the Canadian health care system to identify curricular gaps that need to be addressed. BACKGROUND In response to the 2015 Truth and Reconciliation Commission of Canada, nursing schools have begun incorporating Indigenous health content into curricula. However, few studies about the implementation and effectiveness of this education exist. METHOD Students wrote a reflection and engaged with colleagues' reflections after watching a video from the Aboriginal Peoples Television Network. Fifteen reflections were selected using systematic, random sampling to undergo thematic analysis. RESULTS Two themes were identified: 1) students' understanding of barriers Indigenous populations face when accessing the health care system and 2) students' perceptions of strategies to ensure culturally safe care for Indigenous populations. CONCLUSION Analysis of students' learning through a reflection activity can improve the Indigenous health content curriculum. [ABSTRACT FROM AUTHOR]

The healthcare sector is ubiquitously plagued by workforce shortages in economies around the globe. The fragility of this structural shortage becomes apparent when external shocks, such as the COVID-19 pandemic, exacerbate the lack of workers in clinical practice. In this article, we summarize current trends in healthcare workforce development across the globe, review theoretical concepts of workforce shortages, and discuss policies to address them. In practice, developed countries often address workforce shortages with targeted migration policies. However, targeted workforce migration policies only intensify workforce shortages in low-and middle-income countries. Theoretical macroeconomic models suggest that supply shortages may result from too low wages, supply lagging behind demand, and social perception. Changes in the wage rate cannot sufficiently increase the supply of health professionals as scholars find inelastic wages for physicians and nurses. Nonpecuniary factors such as working conditions, job satisfaction, and intrinsic motivation are at least equally important as financial incentives. In conclusion, increased wages can only be part of a heterogeneous policy plan to address shortages. Migration and retirement levels of health professionals can temporarily mitigate workforce shortages but rarely change the underlying systemic issues. Increasing the number of places available in medical and nursing schools while also improving, both, financial and nonfinancial incentives for employees are long-term structural policy options. [ABSTRACT FROM AUTHOR]

The success of healthcare reform hinges on policymaker, regulator, and administrator actions that shape policies at various levels. These policies can either facilitate or hinder the practice of healthcare professionals and collaborative work environments. It is imperative for all healthcare professionals to fully utilize their education and certification, as fostering an equitable workplace culture is vital for retaining staff and improving access to care. Using nurse practitioners (NPs) as an exemplar, this article aims to specify systemic barriers to healthcare reform and call for policymakers, regulators, and clinical agency administrators to enact change. Barriers to NP practice include restrictive oversight by external stakeholders, financial incentives for indirect billing, and hierarchical constraints that limit NP contributions to the healthcare system. The growing healthcare provider shortage disproportionately impacts primary care and rural settings. NPs are increasingly more likely to fill these roles than medical doctors and have documented positive patient health outcomes. Removing systemic obstacles for NP practice increases access to care. Nursing—the largest healthcare workforce with diverse roles—operates under complex oversight from multiple organizations for licensure, accreditation, certification, and education. The recent trend of external stakeholders influencing and requiring additional oversight has created barriers to nursing practice. Despite national education, accreditation, and certification standards, nursing licensure and practice are increasingly negotiated with external stakeholders and supervised at the state and institutional levels. Supporting all healthcare professionals to practice according to their education and certification can advance healthcare reform, address workforce shortages, increase access to care, and improve health. [ABSTRACT FROM AUTHOR]

Through an intersectional analysis of gender, class, and migration, this article reveals how a hegemonic culture of workplace masculinity, embodied by a group of 'gurus,' is constructed in China's tech companies. The guru masculinity is characterized by proactivity and aggressiveness at work, 'putting work first' and overwork, and the ability to navigate boundaryless careers and settle down in first‐tier cities. It translates hegemonic masculine norms of material success, enjoying urban life, and men's breadwinner position in contemporary China on the one hand, and responds to a labor regime of precarious employment relations and prevalent overwork norm on the other hand. The article contributes to the literature on hegemonic masculinity in work organizations by showcasing how a hegemonic masculinity in China's tech workplace is constructed at the conjuncture of hegemonic gender norms at a societal level and the distinct labor regime in the tech sector. It also reveals that many male workers fail to conform to this cultural ideal, experiencing masculine frustration rooted in the nature of the 'workplace masculinity contest,' uneven urban development, and the demanding labor regime. It thus opens further discussions on how men resist hegemonic gender norms and construct alternative masculinities. [ABSTRACT FROM AUTHOR]

The integration of Information and Communications Technologies (ICT) in the education of future systems engineers has generated a significant impact that deserves to be analyzed from multiple perspectives. This article explores these repercussions using the neutrosophic PEST-SWOT approach, a methodology that combines political, economic, social and technological (PEST) analysis with strengths, weaknesses, opportunities and threats (SWOT) within a framework of neutrosophic indeterminacy and complexity. The adoption of ICT in educational curricula has transformed not only the way in which students access information and knowledge, but also the way in which they interact and collaborate, promoting a more dynamic and adaptive education to contemporary market demands. labor. This analysis reveals both the benefits and challenges associated with this transformation, offering a comprehensive vision that ranges from opportunities for educational innovation to the structural barriers that still persist. In this context, profound changes are observed in pedagogy and teaching strategies, where ICT acts as catalysts for more active and personalized learning. The PEST-SWOT neutrosophic approach allows us to unravel the complexity of these changes, highlighting how political and economic forces influence the implementation of new technologies, while social and technological variables outline the horizon of possibilities and challenges. Thus, the article not only presents a detailed overview of the repercussions of ICT in the training of systems engineers, but also offers a critical reflection on the future implications of these technologies in the educational field. Ultimately, this research highlights the need for adaptive educational policies and a robust technological infrastructure to maximize the benefits of ICT, fostering a resilient and cutting-edge learning environment. [ABSTRACT FROM AUTHOR]

Purpose: The Purpose of the study was to investigate the construct validity and internal consistency of the LaMI among staff in the context of elderly care in Sweden. Design/methodology/approach: Questionnaire data from a longitudinal study of staff working in elderly care were used. Data were collected using the Leadership and Management Inventory. First data collection was for explorative factor analysis (n = 1,149), and the second collection, one year later, was for confirmatory factor analysis (n = 1,061). Findings: The explorative factor analysis resulted in a two-factor solution that explained 70.2% of the total variance. Different models were tested in the confirmatory factor analysis. The final model, a two-factor solution where three items were omitted, showed acceptable results. Originality/value: The instrument measures both leadership and management performance and can be used to continually measure managers' performances as perceived by staff to identify areas for development. [ABSTRACT FROM AUTHOR]

Background: With the evolution of disease patterns and the continuous pursuit of persons for high-quality nursing services, new nurses are the reserve talents of the nursing team and shoulder a major mission. However, due to their low work performance and high turnover rate, this is not conducive to the stable development of nursing teams, and it is urgent to solve this problem. The purpose of this study was to explore the effect of work readiness on the work performance of new nurses, focusing on the mediating role of organizational justice and professional identity. Method: A cross-sectional design was employed. Using convenience sampling methods, 607 new nurses were surveyed in 5 hospitals in Henan Province, China, from January to February 2023. Data were collected using demographic characteristics questionnaire, the Work Performance Scale, the Work Readiness Scale for Graduate Nurses, the Organizational Justice Scale, and the Professional Identity Rating Scale for Nurses. AMOS 26.0 was used for model drawing and mediation path testing, and SPSS 25.0 was used for data analysis. Results: The mediation model shows a good fit (χ2 /df = 2.747, CFI = 0.987, GFI = 0.948, AGFI = 0.926, TLI = 0.984, IFI = 0.987, and RMSEA = 0.054). In this study, we found professional identity is a mediating variable between work readiness and the work performance of new nurses (β = 0.113, P<0.01), organizational justice is a mediating variable between work readiness and the work performance of new nurses (β = 0.269, P<0.01) and Organizational justice and professional identity play a chain mediating role in work readiness and work performance (β = 0.066, P<0.01). Conclusions: The study highlights the importance of improving the work performance of new nurses. To improve work performance, managers should create a fair atmosphere, formulate transparent policies, improve the organizational justice of new nurses, and promote the professional identity and work readiness of new nurses by holding activities or conducting lectures. This will help stabilize the nursing team, improve the medical environment, stimulate the work enthusiasm of new nurses, and contribute to the development of the hospital. [ABSTRACT FROM AUTHOR]

One of the anticipated benefits for senior high school graduates is employment upon completion of their studies. Transitioning from school to work is challenging for senior high school graduates due to difficulties entering the labor market with only their credentials. Despite this, there is limited research on their specific employment challenges. This study explored the challenges and identified the strategic interventions employed by graduates to overcome them. Utilizing a qualitative research design, data were collected through in-depth interviews. The results revealed three themes for existing challenges, and they are: lack of experience to meet job qualifications, lack of backer to speed up qualifications, and experienced discrimination from companies applied. Regarding the strategic interventions employed by graduates, three themes emerged which are: increasing qualifications and skills, building connections, and seeking companies that accept senior high school graduates. Additionally, graduates proposed recommendations to improve the senior high school curriculum and instruction to better align with labor market demands. These include providing laboratories and facilities, improving work immersion, and hiring skilled SHS teachers. This study can serve as a model for other researchers and educational institutions aiming to improve senior high school curricula to better prepare graduates for the workforce. [ABSTRACT FROM AUTHOR]

Background: Pediatric residency in Italy has undergone significant changes in recent years, with a notable increase in the number of pediatric residents. Exploring the implications of this increase, highlighting disparities in training opportunities, and discussing the broader socio-economic impacts on pediatric healthcare, represent a crucial consideration for the healthcare system in the future. Main Body: The Italian National Association of Pediatric Residents ("Osservatorio Nazionale Specializzandi in Pediatria", ONSP) conducted an extensive survey among pediatric residents to assess the current state of pediatric residency. Key findings indicate that 50% of respondents believe the number of residents is excessive for the available training opportunities, leading to concerns about the quality of education and hands-on experience. Despite the increased number of residents, the workload has increased, but up to one-third of residents feel that the autonomy provided by their programs is insufficient. Significant disparities in training quality were found across different regions, with notable shortages in neonatology and pediatric emergency departments. Research opportunities are also limited, with only 17% of residents finding the time allocated to research satisfactory, especially in central and southern Italy. Conclusion: The increase in pediatric residents presents both challenges and opportunities. Addressing these challenges through strategic reforms, such as implementing standardized national curricula, investing in training resources and mobility programs, and enhancing research opportunities, is crucial for the future of pediatric residency in Italy. Ensuring high-quality training for all residents is an ethical and practical obligation that will significantly impact pediatric healthcare. [ABSTRACT FROM AUTHOR]

Introduction: The Coronavirus Disease 2019 (COVID-19) pandemic placed enormous pressure on healthcare systems around the world, but it also provided valuable insights for healthcare organizations during this challenging period. Objective: This study aimed to explore nurses' lived experiences of vulnerability in hospital nursing management during the COVID-19 pandemic, and reflect on the lessons learned. Methods: In this phenomenological study, 14 participants, including nurse managers at different levels and staff nurses, were selected by purposive sampling from one center university hospital. Data collection was done through in-depth individual semistructured interviews with participants and a review of weekly reports of crisis management meetings at the university hospital. Interviews were analyzed using Colaizzi's method in seven phases by MAXQDA software Version 10. Results: One overarching theme, four themes, and 15 subthemes were obtained from analyses of interviews. Four themes of "nurses' attrition," "distrust of society to the organization," "fragility in the organization's performance," and "intensified inequalities" were extracted as threats to nursing management at the hospital. Subsequently, the weekly reports of crisis management meetings at the university hospital were analyzed to extract the solutions and lessons. Conclusion: The unpreparedness of the healthcare system against a crisis can led to the loss of organizational assets, including medical staff and the credibility of the healthcare system. Limitations of the infrastructure at hospital became more obvious during the pandemic and caused serious threats to the healthcare system. Despite severe challenges along with the pandemic, it offered four valuable lessons in nursing management. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this scoping review was to summarize the literature pertaining to burnout and chiropractic. Methods: A literature review was performed in accordance with Preferred Reporting of Systematic Reviews and Meta-Analysis Extension for Scoping Reviews (PRISMA-ScR). A literature review was performed by combining the term "chiropractic" with terms relevant to professional burnout (e.g., "work-related stress," "emotional exhaustion"). We included all publications addressing burnout within the chiropractic profession, including all study designs in only peer-reviewed literature. Results: Our search yielded 126 citations and 10 met the inclusion criteria. The studies identified consisted of eight surveys and two narrative reviews published from 2011 to 2024. Six of the studies utilized the Maslach Burnout Inventory to assess burnout. Chiropractic students reported greater burnout than the general population. Factors reported to increase burnout risk include higher workload, insurance mandates, and physical demands of daily practice. Factors reported to be protective against burnout included longer duration in clinical practice and philosophy-based practices. Conclusions: Research on burnout within the chiropractic profession is limited and may not be generalizable. However, the reported factors contributing to burnout are well-documented. Future research should be conducted to improve understanding of the prevalence and causes of burnout in chiropractic. [ABSTRACT FROM AUTHOR]

Higher education plays a critical role in driving an innovative economy by equipping students with knowledge and skills demanded by the workforce. While researchers and practitioners have developed data systems to track detailed occupational skills, such as those established by the U.S. Department of Labor (DOL), much less effort has been made to document which of these skills are being developed in higher education at a similar granularity. Here, we fill this gap by presenting Course-Skill Atlas – a longitudinal dataset of skills inferred from over three million course syllabi taught at nearly three thousand U.S. higher education institutions. To construct Course-Skill Atlas, we apply natural language processing to quantify the alignment between course syllabi and detailed workplace activities (DWAs) used by the DOL to describe occupations. We then aggregate these alignment scores to create skill profiles for institutions and academic majors. Our dataset offers a large-scale representation of college education's role in preparing students for the labor market. Overall, Course-Skill Atlas can enable new research on the source of skills in the context of workforce development and provide actionable insights for shaping the future of higher education to meet evolving labor demands, especially in the face of new technologies. [ABSTRACT FROM AUTHOR]

Nurses play a vital role in providing high-quality primary healthcare and health promotion services. The state of research highlights their often complex operational realities and shows the need for an evidence-based understanding of nurses' perspectives on health promotion practices, especially in low-resource settings. This study focuses on how community health nurses in rural primary healthcare centers in Nigeria perceive their health promotion role and the opportunities and challenges of, and potential entry points for strengthening, their practice. A sample of 10 nurses from eight rural primary healthcare centers in eight local government areas of Anambra state, Nigeria, was purposively selected. Data were collected via semistructured telephone and written interviews and analyzed by qualitative content analysis using a deductive–inductive approach. Nurses emphasized their commitment to supporting patients and communities to develop skills and take control of their own lives. Nurses described their role as facilitators of behavioral and environmental change, individual and community empowerment facilitators as well as social activists. Factors that enhance the health promotion practice of nurses include adequate skills, sufficient human and material resources and community support and participation. Inhibiting factors included insufficient funding, poor working conditions, staff shortages, high workload, lack of training opportunities and low participation of community members. Overcoming challenges and facilitating health promotion activities in rural communities require bolstering nurses by providing further training opportunities for enhancing their health promotion competencies and creating supportive environments. Future research should focus on how to strengthen nurses' health promotion efforts through interprofessional and intersectoral collaboration. [ABSTRACT FROM AUTHOR]

The article focuses on the ongoing shortage of trained occupational and environmental medicine (OEM) physicians, despite a high demand for the specialty. Topics include the funding challenges faced by OEM training programs, the limited visibility of the specialty among medical students and residents, and a historical perspective on the persistent issues affecting OEM residency education over the past decades.

Purpose: Young graduates in Morocco are encountering an increasingly challenging labor market environment. Confronted with intense competition, job insecurity, and unclear career trajectories, many find themselves in low-skilled positions despite possessing relevant qualifications. This issue is particularly pronounced among vocational training graduates, who experience professional downgrading at a rate three times higher (33.6%) compared to their peers from general education (11.6%) (HCP, 2018). Our study aims to investigate professional downgrading among young vocational training graduates in Morocco, focusing on the factors contributing to this phenomenon and identifying potential solutions to address it. Design/methodology/approach: Our study is based on the insertion and career path survey conducted by the Department of Professional Training with graduates of professional training programs in Morocco. For this edition, the survey was conducted in 2020, encompassing all 31,498 graduates of the 2016 professional training programs. The Heckman self-selection model is employed to analyze and explore various dimensions of downgrading. Factors such as gender, age, marital status, parental education, and the choice of vocational training field are scrutinized to understand their influence on downgrading. Findings: The study reveals several key findings: Women exhibit a lower probability of professional downgrading compared to men. Young graduates are more vulnerable to downgrading, emphasizing the necessity for career guidance and mentorship programs to facilitate their entry into the job market. Marital status plays a role, with married individuals having a higher likelihood of downgrading. Parental education, particularly that of mothers, proves critical in preventing subjective downgrading of vocational training graduates, highlighting the need for adult literacy and education programs. The effectiveness of the National Agency for the Promotion of Employment and Competencies (ANAPEC) programs in preventing downgrading among vocational training graduates is questioned, suggesting the need for program revisions tailored to this population. The choice of vocational training field significantly impacts downgrading, with graduates of technical training programs experiencing advantages. This emphasizes the importance of diversifying training fields and aligning them with market demands. Originality/value: This study provides valuable insights into the phenomenon of professional downgrading among young vocational training graduates in Morocco. The findings emphasize the need for targeted policy interventions. Recommendations include supporting young graduates, reassessing programs offered by the ANAPEC, and enhancing technical training to better align with the evolving demands of the labor market. [ABSTRACT FROM AUTHOR]

The article discusses the strategies employed by a community hospital in Pennsylvania with designated with the American Nurses Credentialing Center Magnet Recognition Program in helping foster and increase nurse satisfaction. Cited are the benefits of having a shared governance structure at the hospital, the effectiveness of clinical ladder programs (CLP) in increasing nurse engagement, and career advancement opportunities that the hospital provides to its employees.

Collectively, Ethiopians and Eritreans represent one of the largest African immigrant groups in the US, yet no research to date exists on families from these communities raising autistic children. The purpose of our study was to examine the experiences of Ethiopian and Eritrean families of autistic children including experiences (1) receiving the autism diagnosis and interacting with healthcare providers, (2) obtaining services and supports for children (including satisfaction with services and barriers to care), and (3) accessing services and supports for caregivers and families (including needs and barriers to care). Ethiopian and Eritrean parents (N = 51) raising autistic children in the US completed an online survey. Parents reported limited prior knowledge of autism within their communities and had varied experiences with healthcare providers through the diagnostic process. They endorsed barriers to accessing care for their child and family supports (such as provider shortages and cost of services), service needs, and dissatisfaction with school-based and behavioral supports. Many parents reported a negative impact on workforce participation in order to meet their child's needs. Parents identified needs that would benefit their autistic children and families, such as accessible support groups to obtain relevant information. To our knowledge, this is the first systematic study exploring the experiences of Ethiopian and Eritrean families raising autistic children in the US. We discuss implications of our findings and recommendations for culturally responsive care. [ABSTRACT FROM AUTHOR]

Background: Efforts to increase transparency and accountability of nursing homes, and thus improve quality, now include information about changes in nursing home ownership. However, little is known about how change in ownership affects nursing home quality. Methods: We conducted a retrospective cohort study of 15,471 U.S. nursing homes between January 2016 and December 2022, identifying all changes in ownership during that period. We used logistic regression to measure the association between nursing home characteristics and the odds of a change in ownership. A difference‐in‐differences model with multiple time periods was used to examine the impact of a change in ownership on the Medicare Nursing Home Compare 5‐star ratings. Results: One in five (23%) facilities changed ownership between 2016 and 2022. Nursing homes that were urban, for‐profit, part of a chain, located in the South, had >50 beds, lower occupancy, higher percentage of stays covered by Medicaid, higher percentage of residents with non‐white race, or a 1‐star (poor) rating were more likely to undergo a change in ownership. There was a small statistically significant decrease in 5‐star ratings after a change in ownership (−0.09 points on a 5‐point scale; 95% CI −0.13 to −0.04; p < 0.001), driven primarily by a decrease in staffing ratings (−0.19 points; 95% CI −0.24 to −0.14; p < 0.001), and health inspections ratings (−0.07 points; 95% CI −0.11 to −0.03; p = 0.001). This was mitigated by an increase in quality measure ratings (0.15 points; 95% CI 0.10–0.20; p < 0.001). Conclusion: Nursing Home Compare ratings decreased slightly after a change in facility ownership, driven by lower staffing and health inspection ratings and mitigated somewhat by higher quality measure ratings. These conflicting trends underscore the need for transparency around changes in facility ownership and a better understanding of consequences of changes in ownership that are salient to patients and families. [ABSTRACT FROM AUTHOR]

Biomechanical stress may exacerbate inflammation in psoriatic arthritis (PsA). This study aimed to investigate disease activity, work disability, and drug response/retention rates in PsA patients among two different occupation's types: blue-collar workers (BCol) with manual labor versus white-collar workers (WCol) with sedentary occupations. PsA patients registered in the Swiss cohort (SCQM) were classified as BCol or WCol workers and assessed at the initiation of a biologic or targeted synthetic disease-modifying anti-rheumatic drug (b-/tsDMARD). We compared the baseline characteristics at treatment start and the DAS28-CRP for the 1-year remission. Treatment retention was investigated using Kaplan–Meier curves and Cox regression analysis. Multivariable models were adjusted for potential confounders. Of 564 patients, 29% were BCol, and 71% were WCol workers. Baseline disease activity was comparable between both groups. BCol workers were predominantly male (79.8%) and more work disabled at baseline (84.0% vs. 27.9%; p < 0.01). One hundred seventy-four treatment courses (TCs) of 165 PsA patients were included for longitudinal analysis. Occupation did not significantly influence the achievement of DAS28-CRP remission at 1 year. Kaplan–Meier analysis (n = 671) indicated longer retention for BCol workers (mean retention duration: 3.15 years vs. 2.15 years, (p = 0.006). However, adjusted Cox regression analysis did not corroborate these findings. This study indicates that physically demanding occupations correlate with increased rates of work disability among PsA patients, while treatment response seems to be unaffected by the patients' occupation type. Additional research is required to thoroughly comprehend the relationship between physical workload, disease activity, and treatment outcomes. Key Points • This study indicates that physically demanding occupations correlate with increased rates of work disability among PsA patients. • The treatment response among of PsA patients seems unaffected by the patients' occupation type. [ABSTRACT FROM AUTHOR]

The article focuses on the growing use of telemedicine in developmental pediatrics, driven by the rapid adoption of telehealth technologies, especially during the COVID-19 pandemic. Topics include the role of telemedicine in enhancing healthcare access, the challenges posed by the scarcity of pediatric subspecialists, and the difficulties that individuals with developmental disabilities face in obtaining adequate care.

Purpose: Rehabilitation can positively affect quality of life, functional status, and physiological status for patients with head and neck or lung cancer. However, barriers and facilitators regarding access, referral, and participation in rehabilitation have not been outlined in the literature either from a healthcare professional or from a structural perspective. Therefore, the objective of this paper was to identify and map barriers and facilitators from structural and healthcare professionals' perspectives in relation to access, referral, and participation in rehabilitation for patients with head and neck or lung cancer. Materials and methods: Two systematic searches were conducted in five databases mapping peer-reviewed research literature. Results: In total, 17 studies of 3918 potential sources were included. Seven themes were identified. Four themes concerned access: Understanding Patients' Resources; Collaboration Determining Access; Education, Knowledge, and Evidence Impact Access to Rehabilitation; and Resources Affecting Availability to Rehabilitation Services. Two themes concerned referral: Referral Criteria; and Elements Affecting Referral Pathway. One theme concerned participation: Factors Influencing Participation. Conclusion: From structural and healthcare professionals' perspectives, barriers and facilitators impact access, referral and participation in rehabilitation. However, the findings on facilitators were limited; only one theme addressed participation and two findings concerned patients with low socioeconomic status. IMPLICATIONS FOR REHABILITATION: Healthcare professionals should be mindful that a diverse array of barriers and facilitators may impact the rehabilitation pathway for patients with head, neck, and lung cancer. Engagement by healthcare professionals and structural initiatives are needed to ensure comprehensive access to information concerning rehabilitation options. Local guidelines should be developed to prescribe methods for informing and guiding patients towards suitable rehabilitation options. It is important that healthcare professionals take the individual patient's resources into account when navigating aspects of access, referral, and participation in rehabilitation. [ABSTRACT FROM AUTHOR]

Purpose: Patient navigation is a recommended practice to improve cancer screenings among underserved populations including those residing in rural areas with care access barriers. We report on patient navigation programme adaptations to increase follow‐up colonoscopy rates after abnormal fecal testing in rural primary care practices. Methods: Participating clinics delivered a patient navigation programme to eligible patients from 28 affiliated clinics serving rural communities in Oregon clustered within 3 Medicaid health plans. Patient navigation adaptations were tracked using data sources including patient navigation training programme reflections, qualitative interviews, clinic meetings, and periodic reflections with practice facilitators. Findings: Initial, planned (proactive) adaptations were made to address the rural context; later, unplanned (reactive) adaptations were implemented to address the impact of the COVID‐19 global pandemic. Initial planned adaptations to the patient navigation programme were made before the main trial to address the needs of the rural context, including provider shortages and geographic dispersion limiting both patient access to care and training opportunities for providers. Later unplanned adaptations were made primarily in response to COVID‐19 care suspension and staff redeployments and shortages that occurred during implementation. Conclusion: While unplanned adaptations were implemented to address the contextual impact of the COVID‐19 pandemic on care access patterns and staffing, the changes to training content and context were beneficial to the rural setting overall and should be sustained. Our findings can guide future efforts to optimise the success of such programmes in other rural settings and highlight the important role of adaptations in implementation projects. [ABSTRACT FROM AUTHOR]

Background: People experiencing socio‐economic disadvantage face significantly higher rates of diet‐related health inequities. This study aimed to explore barriers, opportunities and potential solutions in providing food and nutrition services to people experiencing socio‐economic disadvantage from the perspective of services providers. The present study is part of a broad co‐design model to improve service provision for people experiencing socio‐economic disadvantage. Methods: A cross‐sectional online survey involving 33 open and closed‐ended questions was distributed to Australian governmental and non‐governmental organisations providing nutrition‐related support to people experiencing socio‐economic disadvantage aged 16 years and over. Data were analysed using frequency distributions and conceptual content analyses. Results: Sixty‐eight responses were analysed. Services are predominantly offered by charitable organisations (90%), funded through private donations (66%) and reliant on volunteers (100%). Barriers to supporting clients' nutrition needs include financial constraints, limited community engagement, understaffing, insufficient resources and knowledge gaps. Opportunities and solutions for enhancing support include increasing government funding, advocacy initiatives, stronger community collaboration and more holistic, customised services. Proposed recommendations include establishing purpose‐built facilities or wrap‐around services to expand access to health services, life skills, training and educational programs. Conclusions: Services face challenges including volunteer reliance, limited resources and inadequate government support, hindering food provision. Client barriers include transportation costs and lack of social support. With dedicated financial support, services can offer comprehensive assistance, including community spaces, staffing, health and social services and training. Community partnerships can maximise funding impact. Solutions must address overall well‐being and broader social determinants such as income inequality and housing. Highlights: People experiencing socio‐economic disadvantage face significantly higher rates of diet‐related health inequities, which are a major contributor to the global public health burden, resulting in substantial direct financial costs for societies and governments.Charitable services involved in food and nutrition‐related support have the potential to extend their services beyond food provision by offering comprehensive assistance tailored to the specific needs of their clients.Dedicated financial support from government funding or grants can provide community‐specific spaces, staff, health and social services, resources and training.Collaborations with the community and higher education sector can enhance the effectiveness of this funding and political and policy interventions are essential to support these initiatives. [ABSTRACT FROM AUTHOR]

Context: The objective of this article is to explain the political factors determining the relatively weak performance of the Polish health care (HC) sector. This can be treated as a critical case for several reasons. First, the Poles are among the most unsatisfied patients in the European Union, with one of the lowest life expectancy levels. Second, Poland spends one of the lowest shares of gross domestic product on HC-related expenditures among OECD countries. Third, the country is facing medical personnel shortages. Methods: The analysis is based on the mixed-methods approach. The authors rely on quantitative data outsourced from a survey, which is supplemented by the semistructured, in-depth interviews with selected key HC stakeholders representing patients' advocacy groups, medical personnel organizations, and high-level decision-makers. Findings: The Polish HC system remains weak due to the postcommunist legacy in terms of organization, a short-term approach by politicians, and weak decision-making processes. Conclusions: The HC policy inertia in Poland is determined by a group of interrelated political factors that effectively block the development of any positive reform. [ABSTRACT FROM AUTHOR]

The relationship between environmental regulation and labor demand has been mixed. Few research studies have considered the impact of cross-regional environmental regulations on the labor market, even though this is notable. We adopted a geographic regression discontinuity (RD) approach to investigate the labor market impact of the cross-regional environmental regulation "2 + 26" Cities Special Emission Limit Program for Air Pollutants. We found that the policy significantly boosts the labor demand of polluting firms rather than a simple inter-industry transfer, mainly through increasing investment in fixed assets and cost offset mechanisms. Further analysis of the structure of labor demand shows that the increasing workforce is primarily low-quality labor accompanied by wage loss. The government should recognize the risks of welfare loss from low-quality work due to environmental regulation and direct polluting firms to innovate rather than reduce costs by increasing demand for low-quality labor. This facilitates a better understanding of the labor market response to environmental policy from the perspective of cross-regional environmental regulation. [ABSTRACT FROM AUTHOR]

Background: New graduate nurses are traditionally not recruited for home health care (HHC). Local Problem: Due to staffing shortages, a HHC agency was interested in hiring graduate nurses, but there was concern about associated risks. Methods: The purpose of this quality improvement project was to develop a nurse residency program to safely transition graduate nurses to the HHC setting. After initial program design, analysis using a failure mode effects analysis (FMEA) was conducted, and risk mitigation strategies were applied. Results: The overall risk of onboarding graduate nurses in HHC was reduced by 42% after applying harm reduction tactics identified from the FMEA. Conclusion: The FMEA was found to be a useful tool to prospectively identify areas of concern and apply harm reduction tactics prior to nurse residency implementation. [ABSTRACT FROM AUTHOR]

How much can employers in low- and middle-income countries suppress wages below marginal productivity? Using plant and customs data from Colombia, we exploit predetermined variation across plants in sales export destinations combined with variation in exchange rates to generate plant-specific shocks to marginal revenue productivity and labor demand. We estimate a firm-level labor supply elasticity of around 2.5, implying that workers produce about 40% more than their wage level. This result is driven by plants that account for a large share of local employment, consistent with an oligopsonistic labor market model. [ABSTRACT FROM AUTHOR]

In the UK, student nurses, nursing associates and midwives are supervised by practice supervisors and practice assessors while completing the placement-based component of their training. Because of increased clinical commitments, staff shortages and rising student numbers, demands for the supervision and assessment of student nurses have increased in recent years and this was exacerbated by COVID-19. The Nursing and Midwifery Council's Standards for Student Supervision and Assessment separated the roles of practice supervisor and assessor, giving rise to opportunities to assess students in a different way. Some integrated care systems are exploring the new role of roaming assessor. Roaming assessors can fulfil the role of practice assessors while providing additional support for student nurses. This role could be expanded to other health professions. This article explores the use of practice learning facilitators as roaming assessors for student nurses in the UK and evaluates the potential benefits and limitations of this approach. Roaming assessors may provide a useful service to deliver practice assessments, increasing the reliability and availability of assessments. [ABSTRACT FROM AUTHOR]

Background: The HIV epidemic in sub-Saharan Africa has a disproportionate gender impact, with women bearing the brunt of the epidemic. South Africa carries the largest share of the global HIV burden, with similar trends seen for women due to unequal socio-cultural and economic status. Objectives: This study aims to understand 30–49 year-old women's barriers and facilitators to accessing HIV services in order to maximize health in resource limited settings and reach women missing from HIV care. Design: Employing a convenience sampling strategy, we recruited, informed, and consented participants at clinics and public areas. Interviews were conducted in respondent's preferred languages, transcribed verbatim, translated into English if needed, and thematically analyzed using grounded theory. Methods: We conducted 81 interviews with women aged 30–49 either missing from care (n = 21), having unknown HIV status (n = 30) or linked to care (n = 30) within two sites: City of Johannesburg district, Gauteng Province and Mopani district, Limpopo Province. Results: Participants missing from care reported negative staff attitudes, queues, family rejection, medication side effects, and painful blood tests as key deterrents. Participants with an unknown status were deterred by fear of being diagnosed as HIV positive and family rejection, which was similar to women missing from care who often dropped out from care due to actual family rejection. Participants linked to care reported that long queues and staff shortages were challenges but stayed in care due to a will to live for themselves and their children, in addition to counselling and feeling emotionally supported. Interestingly, participants missing from care often accessed medication from friends but, similarly to those with unknown status, noted that they would access care if attended to by supportive nurses and by having non-clinical HIV services. Conclusions: The accounts of women in this research highlight significant improvements needed to address inequities in the fight against HIV in South Africa. Additionally, the healthcare service access preferences of women aged 30–49 need to be further explored quantitatively in order to design policy relevant interventions. Plain language summary: Understanding HIV service preferences of South African women 30–49 years old missing from or linked to care: An exploratory study of Gauteng and Limpopo provinces The HIV epidemic in sub-Saharan Africa harms women more than men. South Africa carries the largest share of the global HIV burden, with similar trends seen for women. This study aims to understand 30–49 year-old women's ability to access HIV services in order to reach women missing from HIV care. We conducted 81 interviews with women aged 30–49 either missing from care (n = 21), having unknown status (n = 30) or linked to care (n = 30) within two sites: City of Johannesburg district, Gauteng Province and Mopani district, Limpopo Province. We recruited, informed, and consented participants at clinics and public areas. Interviews were conducted in respondent's preferred languages, transcribed, and translated into English for analysis. Participants missing from care reported negative staff attitudes, queues, family rejection, medication side effects and painful blood tests as key deterrents. Participants with an unknown status were deterred by fear of being diagnosed as HIV positive and family rejection, which was similar to women missing from care who often dropped out from care due to family rejection. Participants linked to care reported that long queues and staff shortages were challenges but stayed in care due to a will to live for themselves and their children, in addition to counselling and feeling emotionally supported. Interestingly, participants missing from care often accessed medication from friends but, similarly to those with unknown status, noted that they would access care if attended to by supportive nurses and by having non-clinical HIV services. The healthcare service access preferences of women aged 30–49 needs to be further explored in order to improve interventions. [ABSTRACT FROM AUTHOR]

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In their daily practice, health care workers (HCWs) experience the effects of tensions between professional ethos and work realities, which can lead to ethical dilemmas. We aim to explore the ethical dilemmas that affected HCWs in Germany during the COVID-19 pandemic and to understand these in the context of the German health system. Between April and December 2022, we interviewed HCWs from various levels of care and key informants responsible for decisions related to HCWs in Germany. Three themes were identified in the data analyzed from 78 participants. The first highlighted the potency of pre-existing health system problems during the COVID-19 pandemic. The second captured the ethical dilemmas that were described as having arisen due to the tension between professional ethos and structural constraints. The third included factors related to increasing or diminishing the implications of ethical dilemmas. A lack of opportunities for HCWs to participate in political and managerial decisions was suggested to result in policies that do not meet the needs of HCWs and patients. Positive interpersonal interactions were described as helpful when coping with dilemmatic decision-making situations. In order to avoid negative consequences caused by unresolved ethical dilemmas, including moral distress, among HCWs, staff shortages and decision-making in the German health system urgently need to be addressed. HCWs' working conditions regularly evoke ethical dilemmas, particularly during public health emergencies. Together with HCWs, decision-makers must develop new models for working in health care settings that are in line with HCWs' professional ethos. [ABSTRACT FROM AUTHOR]

The global agriculture industry is encountering challenges due to labor shortages and the demand for increased efficiency. Currently, fruit yield estimation in guava orchards primarily depends on manual counting. Machine vision is an essential technology for enabling automatic yield estimation in guava production. To address the detection of guava in complex natural environments, this paper proposes an improved lightweight and efficient detection model, V-YOLO (VanillaNet-YOLO). By utilizing the more lightweight and efficient VanillaNet as the backbone network and modifying the head part of the model, we enhance detection accuracy, reduce the number of model parameters, and improve detection speed. Experimental results demonstrate that V-YOLO and YOLOv10n achieve the same mean average precision (mAP) of 95.0%, but V-YOLO uses only 43.2% of the parameters required by YOLOv10n, performs calculations at 41.4% of the computational cost, and exhibits a detection speed that is 2.67 times that of YOLOv10n. These findings indicate that V-YOLO can be employed for rapid detection and counting of guava, providing an effective method for visually estimating fruit yield in guava orchards. [ABSTRACT FROM AUTHOR]

Background: eHealth was widely used during the COVID-19 pandemic. Much attention was given to the technical aspects of eHealth, such as infrastructure and cost, while the soft skill of compassion remained underexplored. The wide belief in compassionate care is more compatible with in-person interactions but difficult to deliver via e-platforms where personal and environmental clues were lacking urges studying this topic. Purpose: to explore the experience of delivering compassionate care via an eHealth platform among healthcare professionals working to contain the COVID-19 pandemic. Methods: A qualitative study design with an interpretative phenomenological analysis approach was used. Twenty healthcare professionals (fifteen nurses and five physicians) who provided care using technology platforms, such as telephone hotlines, mobile apps, and social media, were interviewed individually. Ethical considerations: Permission to conduct the study was obtained from the Institutional Review Board. Results: Participants stated that "eHealth enabled compassionate care during the pandemic" by ensuring patient care availability and accessibility. They shared experiences of "communicating compassionate care via eHealth" with suggestions of addressing patients' needs with empathy, adopting a structured protocol to guide eHealth communication, and using more advanced visual-media methods to promote human-to-human interaction. They recommended "setting realistic mutual expectations" considering the limitations of eHealth in handling complex health situations and staffing shortages. Participants considered "low eHealth literacy hinders compassion." Additionally, they recommended the need for "institutional/system-level support to foster compassionate care." Conclusion: Participants recognized the importance of integrating compassion into eHealth services. Promotion of compassionate care requires standardization of eHealth services with institutional and system-level support. This also includes preparing adequate staffing who can communicate compassionate care via eHealth, set realistic expectation, and adjust communication to eHealth literacy level while meeting the needs of their patients. [ABSTRACT FROM AUTHOR]

Background: Patients with multiple chronic conditions often have many care plans, polypharmacy, and unrelieved symptoms that contribute to high emergency department and hospital use. High-quality primary care delivered in practices that employ nurse practitioners can help prevent the need for such acute care services. However, such practices located in primary care health professional shortage areas face challenges caring for these patients because of higher workloads and fewer resources. Objective: We examined differences in hospitalization and emergency department use among patients with multiple chronic conditions who receive care from practices that employ nurse practitioners in health professional shortage areas compared to practices that employ nurse practitioners in non-health professional shortage areas. Methods: We performed an analysis of Medicare claims, merged with Health Resources and Services Administration data on health professional shortage area status in five states. Our sample included 394,424 community-dwelling Medicare beneficiaries aged ≥65 years, with at least two of 15 common chronic conditions who received care in 779 practices that employ nurse practitioners. We used logistic regression to assess the relationship between health professional shortage area status and emergency department visits or hospitalizations. Results: We found a higher likelihood of emergency department visits among patients in health professional shortage areas compared to those in non-health professional shortage areas and no difference in the likelihood of hospitalization. Discussion: Emergency department use differences exist among older adults with multiple chronic conditions receiving care in practices that employ nurse practitioners in health professional shortage areas, compared to those in non-health professional shortage areas. To address this disparity, the health professional shortage area program should invest in recruiting and retaining nurse practitioners to health professional shortage areas to ease workforce shortages. [ABSTRACT FROM AUTHOR]

The article introduces the Leadership and Education for Advanced Practice Provider (LEAPP) fellowship, an innovative postgraduate program designed to address the shortage of qualified cystic fibrosis (CF) providers by offering specialized training across various CF care centers. Topics include the program's unique blended learning approach, its focus on leadership and quality improvement, and its potential application to other complex conditions requiring specialized care.

Since the Doctor of Nursing Practice (DNP) was implemented, there has been ongoing discussion about whether or not DNP-prepared faculty are eligible for promotion and tenure. This column updates that discussion through input from two DNP-prepared faculty key informants. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The aims of this study were to describe burnout, mental health, and healthy lifestyle behaviors of nurses in a managerial role and assess associations among workplace culture factors (perceived culture, mattering, support, and staff shortages) with burnout, mental health outcomes, and healthy lifestyle behaviors. BACKGROUND: Nurse managers foster unit-based wellness cultures, yet burnout and mental health problems adversely impact the culture and well-being of staff. METHODS: A cross-sectional, descriptive correlational design was used. The Florida Organization forNursing Leadership enabled distribution of a wellness survey to nurse managers. RESULTS: There were 125 participants. Healthy lifestyle behaviors were infrequently practiced. Analysis revealed significant correlations among workplace culture factors, burnout, and mental health outcomes. When compared with nurse managers with staff shortages, those without staff shortages were 6.11 times more likely to not screen positive for burnout. CONCLUSIONS: Health systems should address workplace culture factors and staff shortages to reduce burnout, improve mental health, and enhance healthy behaviors in nurse managers. [ABSTRACT FROM AUTHOR]

Due to the current status of English as a lingua franca in numerous domains, increasing attention has been directed toward the economic potential of English. However, research on languages other than English from an economic perspective remains limited. This study aims to address this gap by examining the labor market demand for Japanese language skills in the Pearl River Delta (PRD) region of China. Drawing on data from the job advertisements published on two prominent job websites in mainland China in 2019 and 2022, this study suggests an increasing overall demand for Japanese language skills, as well as a request for higher proficiency in Japanese in the PRD labor market between 2019 and 2022, despite variations observed across different economic sectors. Furthermore, the results also indicate a growing tendency to interweave Japanese and global English in the PRD labor market. The findings provide implications for language instructors, job applicants, and educational institutions. [ABSTRACT FROM AUTHOR]

The article evaluates medical therapies in the nursing home (NH) population in 2024. Topics covered include concerns on the issues of inadequately trained and insufficient staff, high staff turnover, and lack of accountability and transparency, the need for clinical trials in NHs and their possible filling of gaps therein, the challenges in conducting trials, and addressing them through interventions and trial design. Also noted is a framework for realizing a NH clinical trials network.

Objective: A severe staff shortage and a dearth of professionals from underrepresented backgrounds in the public health workforce are contributing to poor health outcomes in the United States. Schools and programs can mitigate these problems by admitting more graduate public health students overall and from underrepresented backgrounds. We identified predictors of foundational graduate public health course grades and graduate grade point average (GPA), sharing evidence to remove application factors that are admission barriers and do not predict student outcomes. Methods: We conducted a linear regression analysis on demographic and academic factors from 564 graduate public health applications for students at the University at Buffalo who received their degree from January 1, 2016, to February 1, 2021, analyzing age, race and ethnicity, sex, income, undergraduate degree, verbal and quantitative Graduate Record Examination (GRE) percentiles, and undergraduate GPA. Outcomes were grades in foundational public health courses and cumulative graduate GPA. Results: Undergraduate GPA was the best predictor of graduate public health student success, explaining nearly 7% of foundational public health course grades and 29% of graduate GPA. Higher undergraduate GPA contributed to higher course grades and graduate GPA. GRE scores explained <1% of student outcomes. Conclusions: Our findings add to the growing body of research showing that standardized test scores may not predict graduate student outcomes and provide further evidence for the field of public health to consider removing this admission barrier. By doing so, institutions could admit more students to graduate public health programs who can bring needed skills to the market, further diversifying the workforce and public health faculty, to better meet population health needs. [ABSTRACT FROM AUTHOR]

Background: Family‐centered care (FCC) approach in neonatal intensive care units (NICUs) has been shown to improve family satisfaction and quality of care. However, several contextual barriers influence its use in NICUs, and these barriers are understudied in Ghana. Aim: To describe FCC practice in Ghanaian NICUs in order to understand the contextual barriers. Study Design: The study employed a descriptive qualitative design. The researchers used a structured interview guide to collect the data in 24 interviews and 12 focus group discussions. We engaged families (n = 42), nurses and midwives (n = 33), and doctors (n = 9) to describe their perspectives on the barriers to FCC in two public tertiary hospital NICUs. The data were mapped, triangulated, and aggregated to inform the findings. Thematic analysis and MAXQDA qualitative software version 2020 were employed to analyse the data. This qualitative study followed the COREQ guidelines and checklist. Results: Perceived family barriers and perceived facility barriers to FCC were the two main themes. The perceived family barriers include family stress and anxiety, inadequate information sharing and education, culture and religion. The perceived facility barriers are inadequate space and logistics, workload and inadequate staff, restricted entry, and negative staff attitudes. Conclusion: The findings of this study shed light on the barriers to FCC practice in neonatal care in Ghanaian NICUs. Family stress and anxiety, a lack of information sharing, cultures and religious beliefs, NICU workload and staffing shortages, restrictions on family entry into NICUs, and staff attitudes towards families are all contextual barriers to FCC practice. Relevance to Clinical Practice: Health facility managers and NICU staff may consider addressing these barriers to implement FCC in the NICU in order to enhance family satisfaction and quality neonatal care. The design of future NICUs should consider family comfort zones and subunits to accommodate families and their sick infants for optimal health care outcomes. The development of communication models and guidelines for respectful NICU care may aid in integrating families into ICUs and promoting quality health care outcomes. [ABSTRACT FROM AUTHOR]

Engaging in export activities is a key factor influencing firm performance. This paper explores the export-productivity and export-capital intensity relationship using firm-level data from the Brazilian manufacturing industry over the period 2007–2014. The empirical strategy combines Propensity Score Matching (PSM) and Differences in Differences (DD) methods and explores the fact that firms enter the external market at different moments, generating a variation in the period and permanence in international trade. We find static and dynamic effects on labor productivity, total factor productivity, and capital intensity. Firms that start exports experience an average productivity growth of about 5% and a 2% decrease in capital intensity compared to non-exporting firms. The permanence in the activity magnifies these impacts. After three periods, the growth (reduction) in productivity (capital intensity) is around 10.5% (4.7%). We identify heterogeneous effects, leading to variations in magnitude across dimensions such as technological intensity, size, age, ex-ante levels of productivity and capital intensity, and intensive margin of trade. We also show that firms become more labor intensive by demanding more skilled workers. • Engaging in export activities is a key factor influencing firm performance. • We explore the export-productivity and export-capital intensity relationship using firm-level data from Brazilian manufacturing industry over the period 2007-2014. • We find static and dynamic effects on labor productivity, total factor productivity, and capital intensity. • Firms that start export experience an average productivity growth of about 5% and a 2% decrease in capital intensity compared to non-exporting firms. • Firms become more labor intensive by demanding more skilled workers. [ABSTRACT FROM AUTHOR]

Introduction: Global workforce shortages in medical specialties strain healthcare systems, jeopardising patient outcomes. Enhancing recruitment strategies by supporting professional identity (PI) development may be one way to address this workforce gap—yet little research has explored this topic. The goal of the current study was to explore specialty‐specific recruitment through considering PI. As proposed causes of workforce shortages in anatomical pathology (AP) bear similarities to many other specialties, this study uses the field of AP as a model for specialist PI development and asks: (1)why, how and when do doctors choose to pursue AP trainingand (2) what can be learned from this for recruitment to AP and other specialties? Methods: A qualitative research approach was undertaken using narrative inquiry. Interviews with junior doctors interested in AP, AP registrars and AP consultants from Australia and New Zealand were interpreted as stories via 're‐storying'. Narrative synthesis of participants' collective stories identified chronological key events (i.e. 'turning points') in choosing AP. Results: Narrative synthesis resulted in identification of three portraits entering medical specialist training: (1) die‐hards, deciding upon initial exposure; (2) negotiators, choosing after comparing specialties; and (3) migrants, seeking to move away from non‐pathology specialties. The negotiators and migrants cemented their decision to pursue AP as a postgraduate doctor, whereas the die‐hards made this decision during medical school. Conclusions: Given the similarities in portrait traits between AP and other specialties across the literature, our results suggest ways to support specialty recruitment using PI development. We propose a medical specialist recruitment framework to support the PI development of doctors with die‐hard, negotiator and migrant traits. Use of this framework could enhance current specialty‐specific recruitment approaches, particularly in fields challenged by workforce shortages. Want to know more about doctors' decision‐making processes when choosing a specialty? Check out this article! [ABSTRACT FROM AUTHOR]

This study aims to develop and evaluate a mobile-based intelligent measurement system as a tool to assess work readiness and identify work readiness patterns among vocational students in facing the challenges of Industry 4.0. Through the development of this innovative system, we have successfully created a tool that can provide more accurate and efficient evaluations of students' work readiness. The results of the study indicate that adapting to technological advancements and current labor market demands is crucial in preparing vocational graduates to succeed in an increasingly competitive workforce. It is hoped that these findings will contribute to improving the quality of vocational education and ensuring that graduates possess the relevant skills needed by the industry. In conclusion, this study not only offers practical solutions to enhance the work readiness of vocational students but also contributes to our understanding of vocational education in the Industry 4.0 era. [ABSTRACT FROM AUTHOR]

Faced with high unemployment and labor mismatches, many countries have mainly focused on stimulating labor demand through job creation policies. However, empirical evidence regarding their effectiveness is mixed, while the impact of labor supply-side policies remains underexplored. This study fills the gap by assessing the effectiveness of a labor supply-side policy—the Job Creation Income Tax Credit in Korea—which provides tax incentives for workers under 35 employed in small and medium-sized enterprises (SMEs). Using event-study and difference-in-differences models with national survey data from 2016 to 2019, we find insignificant effects on overall SME employment among individuals aged 32–34. While no significant effects are observed on regular workers, only low-educated male SME workers ineligible for the credit transition to eligible temporary SME jobs. These findings highlight that modest tax credits are ineffective in promoting employment for highly educated young individuals due to their high reservation wages and inelastic labor supply. [ABSTRACT FROM AUTHOR]