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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.

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 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]

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]

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]

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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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]

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]

Background: The COVID-19 pandemic has impacted nursing theatre staff, departmental activity, and delivery of services to patients. This work-based project aimed to investigate the challenges of nursing leadership in an elective orthopaedic department at current times. Methods: The study collected qualitative data exploring theatre staff's expectations from leadership, offering insight on how the pandemic has influenced the way of working and exploring how the future in this unit may look. The answers from 20 practitioners to an anonymised open-ended survey were examined using thematic analysis. Results: The participants described a leader as a good communicator who focuses on empowering others and supporting the team, identified by the majority as a senior team member. From the findings, three topics were identified: immediate changes, delayed changes, and pre-existing conditions. The answers painted a reality that is complex and multifaceted, where numerous variables play a part in the physical and mental health of each candidate, impacting their performance as well as their work/life balance. Overall, the strongest subjects recurring in the findings were the need for nursing leadership to focus on supporting staff with training opportunities, to actively plan for a reduction in staffing shortages, and to be constantly mindful of staff well-being. Conclusions: This study pointed out that the need for constant communication with their staff, building honest relationships, and being a reliable leader, focused on empowering others and supporting the team were important factors for the nursing management during the COVID-19 pandemic and post-COVID-19 era. [ABSTRACT FROM AUTHOR]

In semi-arid southern Kenya, climate change is putting rainfed agriculture at risk with major implications for food security. The zai pit, a Climate-Smart Agriculture (CSA) technique, has proven to enhance yields in arid regions, but its labor demands have limited adoption rates. This study assessed how the zai pit depth and manure application within zai pits influenced maize (Zea mays) success (i.e., growth, development, and productivity). Three zai pit treatments were prepared at the Wildlife Works Research Center in southeastern Kenya: (1) deep (50 cm) with manure; (2) shallow (25 cm) with manure; and (3) deep (50 cm) without manure, and all were compared to a non-zai pit control (surface planting). Maize growth/development (e.g., height, stage, roots) and productivity (e.g., yield) measurements were taken over two growing periods. For most measures, shallow zai pits performed equally as well as deep zai pits, with both performing better than the control. Zai pits without manure performed significantly worse than zai pits with manure, oftentimes not differing from the control. Results suggest that maize success is influenced more by manure than the depth of the pit. Kenyan farmers are encouraged to dig shallower, manure-enriched zai pits to enhance food security in response to climate change. [ABSTRACT FROM AUTHOR]

Aim: To explore the experiences and needs of postgraduate nursing students within the Nigerian context. Design: This qualitative study was conducted using a descriptive phenomenological approach. Method: Data were collected between February and April 2022 using a purposive sampling method and telephone semi‐structured interviews. Colaizzi's method of Qualitative data Analysis was utilized. Twenty‐two Nigerian postgraduate nursing students were interviewed. Results: Three themes emerged: challenges of Nigerian postgraduate students before the pandemic, the impact of the pandemic on postgraduate education, and innovations to improve postgraduate education in Nigeria. The challenges include the burden of physical lectures, lack of infrastructure, and poor mentorship of postgraduate nursing students. The impact of the pandemic on postgraduate education includes abrupt disruption of the academic program, a prolonged academic calendar, and a communication gap between students and their research supervisors. Innovations to improve postgraduate nursing education in Nigeria also include adoption and sustainability of e‐learning, upgrading post‐basic to postgraduate nursing programmes, proper structuring of postgraduate nursing education, commencement of postgraduate nursing programmes in more universities and provision of financial aid for students. Our primary finding is that funding, mentorship and infrastructure were issues peculiar to all the respondents. Conclusion: This study concludes that efforts should be made to maintain a seamless educational program by ensuring an uninterrupted flow of learning through virtual means, thereby enhancing effective teaching and learning. Implications: Graduate nursing studies is one of the suggested solutions in the WHO strategic direction for nursing and midwifery globally to achieve Universal Health Coverage. The reason is that nurses can practice with more and better skills in any work setting, thus improving the quality of health care services. Our study provides insights into the experiences of postgraduate students and how these could discourage other nurses who might have thought about furthering their studies. Efforts should be made to provide all the support that these students need, using evidence from this study and similar studies to ensure they have a good learning experience and others can be motivated to learn at the graduate level as well. This will increase the proportion of nurses and midwives honed with better skills to provide more standard quality services that will improve patient care outcomes. [ABSTRACT FROM AUTHOR]

Mounting research has revealed how the labor of caregiving and parenting in the United States fell disproportionately to mothers during the COVID-19 pandemic, with negative impacts on mothers' personal and professional well-being. Here, we advance this growing body of work by examining how mothers' pandemicrelated parenting and caregiving experiences differed across socioeconomic status. We ask the degree to which mothers' class-based parenting approaches persisted or dissipated in the wake of the pandemic. Drawing on in-depth interviews conducted with 130 mothers caring for children under eighteen in 2020-2021, we find that these parenting patterns largely continued into the pandemic, with mothers' socioeconomic and employment status shaping how they experienced and navigated this disruption and particularly how they managed competing paid and unpaid labor demands. [ABSTRACT FROM AUTHOR]

Introduction: Behavioral and mental health conditions present significant challenges in the United States where access to care is limited. Family medicine physicians play a crucial role in addressing these challenges, often serving as frontline clinicians for behavioral and mental health conditions. Methods: This study examined the current behavioral and mental health system in a predominantly rural 10-county region in the Southeastern United States through gap analysis in addition to a survey of preparedness and barriers among family medicine physicians in the region. Results: Gap analysis results indicated that (1) stigma and lack of accessible education about behavioral and mental health, (2) fragmented resources, (3) inaccessible care, and (4) workforce shortage and burnout were primary drivers of poor outcomes in the region. Survey results indicated that physicians feel prepared to treat anxiety and depression but feel less prepared to manage bipolar disorder, schizophrenia, and substance use disorders. Respondents disagreed that there are adequate local resources and referral options for patients with behavioral and mental health conditions. Lack of timely access, distance, cost/insurance status, were all cited by respondents as barriers to appropriate care. Conclusion and Recommendations: Findings underscore the importance of supporting family medicine physicians to enhance behavioral and mental healthcare outcomes. Behavioral health integration in primary care settings is a promising strategy to improve care accessibility and clinician preparedness. Bridging gaps in health care outcomes requires collaborative efforts, enhanced training, and policy advocacy within the family medicine community to ensure comprehensive and equitable behavioral and mental healthcare delivery. [ABSTRACT FROM AUTHOR]

Background: The need for palliative care is ever-increasing globally. However, it is least developed or not available in most low-and-middle-income-countries including Bhutan. Objective: This study was aimed at exploring the perspectives of Bhutanese healthcare professionals on the need for palliative care in the country. Design: This is a cross-sectional, mixed-method study. Setting/subjects: The study sites included all levels of healthcare in Bhutan and involved doctors, nurses, physiotherapists, pharmacists, health assistants and Drungtshos (traditional physicians). Data were collected through surveys, focus group discussions and in-depth interviews. Results: While the majority of the participants were directly involved in taking care of terminally ill and dying patients, only 14% had received some form of palliative care training for a duration ranging from 1 day to 6 weeks. Ninety-five percent of the participants reported that they faced challenges related to lack of palliative care knowledge and skills; limited resources including analgesics; shortage of doctors and nurses and lack of a palliative care team; issues with low illiteracy and financial challenges among patients; and policies and other systemic issues. The qualitative data generated four major themes: past adverse experiences; unique and complex needs for palliative care; challenges faced while caring for terminally ill and dying patients; and the urgent need for palliative care in Bhutan. Conclusion: Bhutanese healthcare professionals had very limited exposure to palliative care. This study identified a crucial need for palliative care and informs the development of an appropriate palliative care model for Bhutan. Plain language summary: 'There is no such word as palliative care for us at the moment': A study exploring the perceptions of healthcare professionals on the need for palliative care in Bhutan Palliative care is least developed in most low-and-middle-income-countries. This study was aimed at exploring the perspectives of healthcare professionals on the need for palliative care in Bhutan. Utilising both quantitative and qualitative approaches, the study sites included all levels of healthcare in Bhutan and involved doctors, nurses, physiotherapists, pharmacists, health assistants and Drungtshos (traditional physicians). Data were collected through surveys, focus group discussions and in-depth interviews. While the majority of the participants were directly involved in taking care of terminally ill and dying patients, only 14% had received some form of palliative care training for a duration ranging from one day to six weeks. Ninety five percent of the participants reported that they faced challenges related to lack of palliative care knowledge and skills; limited resources including analgesics; shortage of doctors and nurses and lack of a palliative care team; issues with low illiteracy and financial challenges among patients; and policies and other systemic issues. The qualitative data generated four major themes: past adverse experiences; unique and complex needs for palliative care; challenges faced while caring for terminally ill and dying patients; and the urgent need for palliative care in Bhutan. Bhutanese healthcare professionals had very limited exposure to palliative care. This study identified a crucial need for palliative care and informs the development of an appropriate palliative care model for Bhutan. [ABSTRACT FROM AUTHOR]

The article views that digital and computational pathology are pathologists' physician extenders. It recognizes the benefits of digital and computational pathology through whole slide imaging and integration of artificial intelligence for pathologists, that include making primary diagnoses, flexibility of pathology practice and workforce, mitigation of office space capacity limits, practice efficiency, alleviation of rote tasks and improved diagnostic accuracy and clinical decision-making.

With reference to the film Inside Out, we show how Christian eschatology helps us understand the personal experience of grieving loss, generated by capital's demands for labor hypermobility and its resultant disjunctures in a person's biography. Inside Out cinematically portrays, in seemingly unremarkable moments, an inbreaking of a redemptive eschatological moment. We organize our case around two eschatological themes, those of judgement and death. The first section links a person's affective experience, the structures that generate those experiences, and the last things; we make our case using Merleau-Ponty's account of the intervolved body and Affect Theory's relationship to Foucauldian power. The second section investigates what becomes of loss and restoration when they are refracted eschatologically, using Guardini's idea of biographical death, Critical Theory's conception of the Messianic, and Bonaventure's conception of the convergence of opposites. We ultimately propose that, seen in the light of the last things, grieving over loss and its opposite, the restoration of what was lost, converge into one and the same thing. A third section will circle back to Inside Out and highlight the contours of the restoration of that which was lost in light of the two eschatological themes above. [ABSTRACT FROM AUTHOR]

We analyze the labor market effects of oil palm cultivation among smallholder farmers in Indonesia. Oil palm requires less labor per unit of land than alternative crops, especially less female labor. Microlevel data and nationally representative regency-level data show that oil palm adoption, on average, led to an expansion of total cropland at the expense of forestland, resulting in higher agricultural labor demand for men. At the same time, women's employment rates declined due to a substantial decrease in agricultural family labor, which was most evident in regions with high initial land scarcity and thus limited options for cropland expansion. [ABSTRACT FROM AUTHOR]

We answer three core questions about the hypothesized role of newly emerging job categories ("new work") in counterbalancing the erosive effect of task-displacing automation on labor demand: what is the substantive content of new work, where does it come from, and what effect does it have on labor demand? We construct a novel database spanning eight decades of new job titles linked to U.S. Census microdata and to patent-based measures of occupations' exposure to labor-augmenting and labor-automating innovations. The majority of current employment is in new job specialties introduced since 1940, but the locus of new-work creation has shifted from middle-paid production and clerical occupations over 1940–1980 to high-paid professional occupations and secondarily to low-paid services since 1980. New work emerges in response to technological innovations that complement the outputs of occupations and demand shocks that raise occupational demand. Innovations that automate tasks or reduce occupational demand slow new-work emergence. Although the flow of augmentation and automation innovations is positively correlated across occupations, the former boosts occupational labor demand while the latter depresses it. The demand-eroding effects of automation innovations have intensified in the past four decades while the demand-increasing effects of augmentation innovations have not. [ABSTRACT FROM AUTHOR]

Background: Extending working lives due to labour market and pension regulations makes maintaining and promoting work ability necessary. The coronavirus pandemic has shown that employees in low-skilled jobs (no qualification required) contribute significantly to society and the economy. Research on these employees has been neglected in Germany for many decades despite demanding working conditions. Therefore, we investigate the relationship between low-skilled jobs and work ability. Moreover, we explore this relationship's variation by psychosocial work demands and resources. Methods: We use two waves of the German Study on Mental Health at Work (S-MGA). We calculate Ordinary-Least-Squares (OLS) regression models with pooled data (n = 6,050) to analyse the relationship between job requirement level and work ability. We also explore the contribution of job demands and resources on this relationship with interaction models. We use the Copenhagen Psychosocial Questionnaire (COPSOQ), to assess psychosocial work demands and resources. Results: Employees performing low-skilled jobs report significantly less work ability than those in medium- or high-skilled jobs. Interaction models show significantly greater work ability for employees in medium- and high-skilled jobs with high influence on their work (amount or tasks). Unexpectedly, employees in low-skilled jobs have lower work ability with more influence on their work. Furthermore, high role clarity, describing responsibility, authority and work goals, is associated with lower levels of work ability among employees in low-skilled jobs. Conclusions: The moderating effect of role clarity on the work ability of employees in low-skilled jobs can possibly be attributed to skills mismatch and limited responsibility, as well as a lack of self-perceived collective purpose of the job. The moderation of the influence on work dimension supports results of previous studies. Too much job autonomy can have negative effects under certain circumstances and is therefore perceived as a job demand in some studies. Consequently, mechanisms concerning psychosocial work demands and resources must be investigated in further studies with different theoretical approaches. The imbalance of job demands and resources shows that employers should invest in preserving the work ability to prevent early exit from the labour market in an aging society. [ABSTRACT FROM AUTHOR]

To address the low efficiency and high labor demands of manual Codonopsis pilosula cultivation, as well as the limitations of existing flat-type transplanting machines that create trenches of inconsistent depth hindering root growth and seedling emergence, a C. pilosula film-covered outcrop tilted transplanting machine was developed. Based on theoretical analysis of the prototype's key components and agronomic requirements for oblique C. pilosula transplanting, the structure and working parameters of the rotary tiller soil throwing device, soil lifting device, track-type soil conveying device, seedling throwing device, and film covering device were determined. The core components' working principles were analyzed, and the soil throwing process of the rotary tiller device was simulated using the discrete element method (DEM). A calculation domain was established, and the results showed that the average mass of the rotary tiller device was 49.44 kg, while the required soil lifting amount for the scraper-type soil lifting device was 21.84 kg, meeting the soil throwing requirements. Field experiments in 10 test areas demonstrated an average qualified rate of 89.50% for planting depth, 84.00% for planting posture, 90% for exposed plant spacing, 4.51 cm for plant spacing, and 8.67% coefficient of variation for planting spacing. These results meet industry standards for planting depth and planting spacing, confirming the machine's effectiveness in achieving high-quality tilted transplanting of C. pilosula seedlings. [ABSTRACT FROM AUTHOR]

Background: The maternal mortality and perinatal mortality rate in Cameroon are among the highest worldwide. To improve these outcomes, we conducted a formative qualitative assessment to inform the adaptation of a mobile provider-to-provider intervention in Cameroon. We explored the complex interplay of structural barriers on maternity care in this low-resourced nation. The study aimed to identify structural barriers to maternal care during the early adaptation of the mobile Medical Information Service via Telephone (mMIST) program in Cameroon. Methods: We conducted in-depth interviews and focus groups with 56 key stakeholders including previously and currently pregnant women, primary healthcare providers, administrators, and representatives of the Ministry of Health, recruited by purposive sampling. Thematic coding and analysis via modified grounded theory approach were conducted using NVivo12 software. Results: Three main structural barriers emerged: (1) civil unrest (conflict between Ambazonian militant groups and the Cameroonian government in the Northwest), (2) limitations of the healthcare system, (3) inadequate physical infrastructure. Civil unrest impacted personal security, transportation safety, and disrupted medical transport system. Limitations of healthcare system involved critical shortages of skilled personnel and medical equipment, low commitment to evidence-based care, poor reputation, ineffective health system communication, incentives affecting care, and inadequate data collection. Inadequate physical infrastructure included frequent power outages and geographic distribution of healthcare facilities leading to logistical challenges. Conclusion: Dynamic inter-relations among structural level factors create barriers to maternity care in Cameroon. Implementation of policies and intervention programs addressing structural barriers are necessary to facilitate timely access and utilization of high-quality maternity care. [ABSTRACT FROM AUTHOR]

This perspective is focused on the evidence on human resources for health (HRH) solutions for immunization, as a part of a primary health care (PHC) approach.. In the wake of the COVID-19 pandemic and 50 years since the Expanded Program on Immunization (EPI) clocks 50 years since its inception. was initiated, evidence and experience demonstrate the significant HRH gaps in many countries and globally, and how countries are seeking innovative ways of closing them with limited resources. The aim of this perspective article is to highlight the growing gap between the needs and the realities related to health workforce for PHC, including immunization, and to call for increasing the visibility of HRH within global and national immunization agendas. This perspective highlights key guidelines and tools to improve HRH, such as integrating immunization and primary health care, addressing the mental health needs of the health workforce, addressing gender-related issues, rationalizing the roles and composition of PHC workforce teams, and meeting the surge requirements related to health emergencies. [ABSTRACT FROM AUTHOR]

In the face of formidable healthcare challenges, such as staffing shortages and rising costs, technology has emerged as a crucial ally in enhancing patient care. UCHealth, Colorado's largest health system, has pioneered the integration of technology into patient care through its Virtual Health Center (VHC). In this Comment, we explore UCHealth's journey in creating a centralized hub that harnesses innovative digital health solutions to address patient care needs across its 12 hospitals, spanning over 600,000 emergency department visits and nearly 150,000 inpatient and observation encounters annually. The VHC has proven to be a transformative force, providing high-quality care at scale, reducing staff burden, and establishing new career pathways in virtual health. The transformation process involved multiple steps: (a) identifying a need, (b) vetting within health system solutions, (c) searching for industry solutions, and scrutinizing these through meetings with our innovations center, (d) piloting the solution, and (e) sustaining the solution by integrating them within the electronic health record (EHR). [ABSTRACT FROM AUTHOR]

Aim and objectives: To analyse the levels of anxiety, depression, post-traumatic stress, and burnout among nursing professionals working in the Imbabura region of Ecuador during the COVID-19 pandemic and identify the contributing socio-occupational factors. Background: The high demand for care of COVID-19 patients led to increased work pressure on nurses, owing to increased demands for care and shortages of medical supplies and protective equipment. Design: A cross-sectional study was conducted from September to December 2022 using a self-administered questionnaire addressed to nursing professionals who cared for COVID-19 patients. Methods: The questionnaire included socio-demographic characteristics, the Spanish adaptation of Hospital Anxiety and Depression Scale (HADS-Spanish), Impact of Event Scale–Revised (IES-R) for the evaluation of post-traumatic stress disorder (PTSD), and the Spanish adaptation of the Maslach Burnout Inventory–Human Services Survey (MBI-HSS-Spanish) for burnout assessment. Univariate and multivariate analyses were performed. Results: Of the 782 participants, 88.6% had a high level of burnout (MBI-HSS-Spanish scale score > 27). Female nurses, nurses with eight-hour work shifts, and older professionals exhibited high levels of anxiety and depression. Prolonged working hours in COVID-19 patient care services were found to be a risk factor for burnout and post-traumatic stress. Conclusions: Participating nurses presented with a high level of chronic work stress and exhibited signs of anxiety and depression during the period under consideration. Providing nurses with psychological support measures and performing liaison consultations will alleviate the psychological burden on nurses. Relevance to clinical practice: The study has shown that accounting for the environments where the emotional impact is greatest and how to reduce it would not only reduce anxiety, depression, and burnout in nurses but also improve the quality of care, not only in pandemic. Patient or public contribution: Nurses contributed to the conduct of the study by participating in the data collection via questionaries. [ABSTRACT FROM AUTHOR]

This Editorial addresses the critical need for developing a healthy ageing society in Malaysia by 2030. With the country's elderly population projected to increase significantly, the article explores current challenges, including healthcare disparities, a shortage of geriatric specialists and malnutrition. It evaluates existing policies and highlights successful international and local initiatives, suggesting specific recommendations to improve healthcare infrastructure, healthy ageing support and technological integration. Emphasising the importance of engaging private sectors, non-governmental organisations (NGOs) and community groups, this Editorial calls for a collaborative approach to address the economic and cultural aspects of ageing. This comprehensive strategy aims to ensure a resilient, healthy and inclusive environment for Malaysia's ageing population by 2030. [ABSTRACT FROM AUTHOR]

Securing employment is a primary objective for many individuals, particularly among the youth, after completing their education. Nevertheless, with the growing number of graduates, organizations seek additional qualities beyond academic qualifications. In this regard, soft skills have gained prominence in the contemporary workforce as they facilitate achievement in the workplace, and are a pivotal component of academic and professional triumph. Therefore, the goal of this study was to ascertain how soft skills can improve postgraduate employability at Taif University. The significance of the findings can be seen in investigating the nature of the connection between soft skills and improving employability for postgraduate students at Taif University may also be helpful to universities in creating their plans to enhance and develop students' abilities to find employment. Both qualitative and quantitative data were analyzed using descriptive statistics, and the questionnaire's validity and dependability were confirmed. The study found that postgraduate students possess a notable level of networking abilities, anger-management skills, and understanding of employability. These individuals also exhibit a moderate degree of proficiency in negotiating and engaging in self-promotion. Furthermore, the study established a direct and statistically significant correlation between soft skills and employability. As such, the research recommended an expansion of soft skills development initiatives for postgraduate students to enhance their self-sufficiency and equip them with appropriate soft skills that align with the demands of the labor market. [ABSTRACT FROM AUTHOR]

AIM The purpose of this qualitative study was twofold: 1) explore factors contributing to the shortage of academic nurse educators (ANEs) and 2) identify opportunities to address these factors from the perspectives of nursing education institutions. BACKGROUND The nurse faculty shortage is a major national concern, with inadequate recruitment and retention. Addressing the nursing faculty shortage is important to maintain a sustained nursing workforce. METHOD Using a nominal group technique (NGT), a group of 45 diverse nurse educators from across the United States formed a virtual workgroup. RESULTS Findings led to an action plan formulated to guide educational institutions with ways to decrease the ANE shortage through recruitment and retention. CONCLUSION The evidence demonstrates the need for educational institutions to concentrate efforts on recruiting and retaining ANEs to combat the nursing shortage. The analysis offers recommendations to institutions to increase the number of qualified ANEs. [ABSTRACT FROM AUTHOR]

Copyright of Exacta is the property of Exacta - Engenharia de Producao and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Cultural challenges in clinical practice can directly affect the quality and effectiveness of care for patients from different cultures. Aim: To find out and compare Czech and Slovak nurses' cultural challenges in their clinical practice. Methods: This cross-sectional comparative study used a non-standard questionnaire to explore cultural challenges in nurses' clinical practice in the Czech Republic and Slovakia. This study followed the guidelines provided by the STROBE checklist. The statistical analysis was conducted using SASD 1.5.8 and IBM SPSS Statistics version 28.0.0. Results: The study sample comprised 202 nurses from the Czech Republic and 222 nurses from Slovakia. The findings suggest that the most significant cultural challenge identified by nurses in both countries is the language barrier, which is compounded by staff shortages. It was found that nurses who are proficient in multiple languages demonstrated increased sensitivity to cultural challenges, which may indicate a correlation between multilingual ability and the perception of cultural barriers. The results suggest that factors such as gender, role within the healthcare setting, years of experience, and educational level may have an impact on the perception of cultural challenges. Conclusion: As a result, it may be important to develop targeted interventions to improve cultural competence. Interventions such as education about cultures, training, and policy adjustments could be considered to create a more equitable and effective care environment for patients from diverse cultural backgrounds. This approach may lead to improved healthcare outcomes and increased patient satisfaction. [ABSTRACT FROM AUTHOR]

This study examines the impact of foreign direct investment (FDI) on women's labor force participation in 14 Arab countries from 1991 to 2021. Theoretically, FDI supports gender equality by creating more jobs for women, providing them with better working conditions, and increasing their wages relative to those provided by local firms. It also does this via increasing the demand for labor and technological spillovers. Unlike previous studies, we utilize likelihood-based panel cointegration and multivariate analysis to examine cointegration between the variables, considering cross-sectional dependence and slope heterogeneity. The results demonstrate that FDI inflows boost women's participation in the labor force in nearly half of the sample countries. Policywise, the findings imply that FDI inflows can assist central governments in achieving better gender development and equality through either higher female labor demand or sustainable labor practices and gender-equal norms. [ABSTRACT FROM AUTHOR]

Background: The Deep End network in the North East and North Cumbria (NENC) was set up to tackle health inequalities in general practice. One aim is to address the inverse care law and improve recruitment of GPs, which is known to be especially challenging in areas of socioeconomic deprivation. Aim: To explore GP trainees’ experiences and perceptions of working in Deep End or Deprived Area Practices (DE/DAPs) to identify how GP recruitment can be improved. Design & setting: Qualitative study recruiting 13 doctors training to be GPs from the Northumbria training programme. Method: Audio-recorded, online, semi-structured interviews and discussion groups were undertaken, transcribed verbatim, and analysed with a grounded theory approach, using a process of thematic analysis. Results: Overall, seven interviews and two discussion groups (13 participants in total) were conducted. Three themes were identified. The first theme was working in areas of socioeconomic deprivation is challenging but has many advantages. The challenges of working in DE/DAPs were not deterring factors for GP trainees wanting to work in areas of socioeconomic deprivation. The second theme was trainees are willing to work in areas of socioeconomic deprivation but clinical experience is important. Training in DE/DAPs gives trainees the confidence to work in areas of deprivation. Familiarity with a practice also makes them more likely to stay post-training. The third theme was financial incentives are not an important attracting factor but support and development opportunities are. Non-pecuniary measures, such as clinical support and protected time for continuing professional development (CPD), were found to be important. Conclusion: To improve recruitment to DE/DAPs, investments should be made to increase the opportunities to train in these environments. This can be achieved by supporting more DE/DAPs to become training practices, and providing clinical support and protected time for CPD. [ABSTRACT FROM AUTHOR]

Background: The DAWN antivirals trial was a multicentric, randomised placebo-controlled trial evaluating antiviral medication for COVID-19 in general practice. The trial was prematurely terminated because of insufficient recruitment. Aim: To explore which factors contributed to the premature termination. Design & setting: General practice in Belgium. Method: Patients were randomised to camostat or placebo (patients and physicians blinded) between June 2021 and July 2022; a third arm evaluating molnupiravir (open label) was opened in March 2022. The outcome assessor was blinded for all comparisons except for the patient reported outcomes in case of molnupiravir. The authors analysed available trial data and evaluated trial context, implementation, and mechanisms of impact based on semi-structured interviews with trial stakeholders. Results: The trial recruited 44 participants; 19 were allocated to camostat (median age 55 years), 8 to molnupiravir (median age 60 years), and 17 to placebo (median age 56 years). There were no serious adverse events in either group. Most difficulties were related to the pandemic context: disruption to routine clinical services; multiple changes to the service model for COVID-19 patients; overwhelmed clinical staff; delays of trial medication; and staff shortages in the sponsor and clinical team. In addition, regulatory approval processes were lengthy and led to additional study procedures. It was felt that the trial started too late, when vaccinations had already begun. Conclusion: The DAWN antivirals trial was stopped prematurely. Although many barriers were related to the pandemic itself, hurdles such as a small and inexperienced sponsor and clinical teams, delays in regulatory processes, and research capacity in routine settings could be overcome by established research infrastructure and standardisation of processes. [ABSTRACT FROM AUTHOR]

Copyright of Space & Society / Tér és Társadalom is the property of Centre for Economic & Regional Studies, Hungarian Academy of Sciences and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The massive increase in labor migration to the Middle East during the past three decades has rivaled its historical trends bound to the West. This paper assesses how this growing trend of migration may have helped shape the economic structure and performance across the member countries of the Gulf Cooperation Council. Findings from a descriptive and time series regression analysis of the limited cross-country data show that the experience with labor migration and its linkage with other aspects of the economy are varied. The migration trend coinciding with increasing personal remittances attests to the competitive demand for foreign labor. While labor migration shows mixed association with the key aspects of the economy, the stock of migrant population is negatively associated with economic growth. Albeit seemingly contradictory, the insights from this six-country analysis covering the periods since 1990 are useful to understand the complex nature of relationship between labor migration and economic structure and performance in the region. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic has prompted a re-evaluation of infection prevention and control (IPC) in general practices, highlighting the need for comprehensive IPC implementation. This study aimed to evaluate healthcare workers' (HCWs) experiences and perspectives regarding IPC in general practices before and during the COVID-19 pandemic, and its implications for post-pandemic IPC implementation. Methods: This qualitative study involved semi-structured, in-depth interviews during two time periods: (1) prior to the COVID-19 pandemic (July 2019-February 2020), involving 14 general practitioners (GPs) and medical assistants; and (2) during the COVID-19 pandemic (July 2022-February 2023), including 22 GPs and medical assistants. Data analysis included thematic analysis that addressed multiple system levels. Results: Findings indicated a shift towards comprehensive IPC implementation and organisation during the pandemic compared to the pre-pandemic period. Since the Omicron variant, some general practices maintained a broad set of IPC measures, while others released most measures. HCWs' future expectations on post-pandemic IPC implementation varied: some anticipated reduced implementation due to the desire to return to the pre-pandemic standard, while others expected IPC to be structurally scaled up during seasonal respiratory epidemics. Main contextual challenges included patient cooperation, staff shortages (due to infection), shortages of IPC materials/equipment, and frequently changing and ambiguous guidelines. Key lessons learned were enhanced preparedness (e.g., personal protective equipment supply), and a new perspective on care organisation (e.g., digital care). Main recommendations reported by HCWs were to strengthen regional collaboration within primary care, and between primary care, public health, and secondary care. Conclusion: HCWs' experiences, perspectives and recommendations provide insights to enhance preparedness for future epidemics and pandemics, and sustain IPC in general practices. For IPC improvement strategies, adopting an integrated system-based approach that encompasses actions across multiple levels and engages multiple stakeholders is recommended. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic has highlighted the importance of intensive care units (ICUs) and their organization in healthcare systems. However, ICU capacity and availability are ongoing concerns beyond the pandemic, particularly due to an aging population and increasing complexity of care. This study aimed to assess the current and future shortage of ICU physicians in France, ten years after a previous evaluation. A national e-survey was conducted among French ICUs in January 2022 to collect data on ICU characteristics, medical staffing, individual physician characteristics, and education and training capacities. Results: Among 290 ICUs contacted, 242 responded (response rate: 83%), representing 4943 ICU beds. The survey revealed an overall of 300 full time equivalent (FTE) ICU physician vacancies in the country. Nearly two-thirds of the participating ICUs reported at least one physician vacancy and 35% relied on traveling physicians to cover shifts. The ICUs most affected by physician vacancies were the ICUs of non-university affiliated public hospitals. The retirements expected in the next five years represented around 10% of the workforce. The median number of physicians per ICU was 7.0, corresponding to a ratio of 0.36 physician (FTE) per ICU bed. In addition, 27% of ICUs were at risk of critical dysfunction or closure due to vacancies and impending retirements. Conclusion: The findings highlight the urgent need to address the shortage of ICU physicians in France. Compared to a similar study conducted in 2012, the inadequacy between ICU physician supply and demand has increased, resulting in a higher number of vacancies. Our study suggests that, among others, increasing the number of ICM residents trained each year could be a crucial step in addressing this issue. Failure to take appropriate measures may lead to further closures of ICUs and increased risks to patients in this healthcare system. [ABSTRACT FROM AUTHOR]

Background: Physician assistants/associates (PAs) provide services in diverse medical specialties globally, including psychiatry. While health professionals in psychiatry have been described for many years, little is known about PAs practicing in this discipline. Methods: We describe US PAs practicing in psychiatry using robust national data from the National Commission on Certification of Physician Assistants (NCCPA). Analyses included descriptive and inferential statistics comparing PAs in psychiatry to PAs in all other medical and surgical specialties. Results: The percentage of PAs practicing in psychiatry has increased from 1.1% (n = 630) in 2013 to 2.0% (n = 2 262) in 2021. PAs in psychiatry differed from PAs practicing in all other specialties in the following: they identified predominately as female (71.4% vs. 69.1%; p = 0.016), were more racially diverse (Asian [6.6% vs. 6.0%], Black/African American [5.5% vs. 3.4%], multi-race [2.8% vs. 2.1%], and other races [Native Hawaiian/Pacific Islander, American Indian/Alaska Native, or other; 3.7% vs. 3.6%]; p < 0.001), and resided in the South (43.8% vs. 34.1%; p < 0.001). PAs in psychiatry vs. all other specialties were more likely to work in office-based private practice settings (41.6% vs. 37.3%; p < 0.001) and nearly twice as likely to provide telemedicine services for their patients (62.7% vs. 32.9%; p < 0.001). While one-third (31.9%) of PAs in psychiatry experienced one or more burnout symptoms, and 8.1% considered changing their current position, the vast majority of PAs in psychiatry (86.0%) were satisfied with their position. Conclusions: Understanding the attributes of PAs in psychiatry is essential in medical labor supply and demand research. Our findings suggest that the number of PAs working in psychiatry is steadily increasing. These PAs were predominantly female, exhibited greater racial diversity, and were primarily located in the South and Midwest regions of the US. A striking difference was that PAs in psychiatry were almost twice as likely to provide telemedicine services for their patients. Although nearly a third of PAs in psychiatry acknowledged having one or more symptoms of burnout, few were considering changing their employment, and the vast majority reported high job satisfaction. [ABSTRACT FROM AUTHOR]

This paper aims to explore the impact of China's value-added tax (VAT) credit refunds policy on the enterprises' labor demand through a paradigm combining ex-ante analysis and ex-post test. By introducing the VAT credit refunds into the production-decision model of the enterprise, calibrating the parameters and conducting the dynamic effects tests using the data of Chinese A-share listed enterprises, this paper finds that the labor employment of the pilot enterprises exhibits a V-shaped fluctuation trend. In the initial implementation of the policy, due to the existence of layoff costs, iso-cost line of the enterprise bends, which results in that the enterprise with a capital-labor substitution elasticity greater than 1 will not reduce labor hiring, as it has already deployed labor force before the implementation of the policy. When the enterprise enter the next production cycle where the labor force can be freely allocated, the labor employment of the enterprise with a capital-labor elasticity of substitution greater than 1 will decline compared to that without the policy. In the long run, as output increases, the labor demand will recover. The results of ex-post test are consistent with that of the ex-ante analysis. Additionally, heterogeneity test reveals that the greater the elasticity of capital-labor substitution of the sub-industry is, the more severe the degree of the V-shaped fluctuation is. Following the implementation of the policy, the continuous increase in enterprise output and capital stock verifies the relevant transmission mechanism. This study provides a more detailed perspective for comprehensively understanding the impact of VAT credit refunds policy on employment. [ABSTRACT FROM AUTHOR]

Introduction. Shifting care from hospitals into community‐based settings is a major policy goal internationally. Community health services in England currently face the greatest workforce shortages of all sectors, threatening the feasibility of this policy. Moreover, little is known about the extent of variation in community workforce provision regionally and how this relates to determinants of need. Aim. To analyse regional variation in the community services workforce in England between 2010 and 2021. Methods. We obtained NHS workforce statistics data on the number of nurses and nursing support staff providing community services at each NHS organisation in England, from March 2010 to November 2021. We aggregated the organisation‐level data to both regional and national levels, which enabled us to maintain consistent units of analysis across the decade. To examine longitudinal trends and regional variation in workforce provision, we calculated the number of staff per 100,000 population aged 65+ in each region and each period. We then graphed and summarised the variation and examined the correlations with levels of deprivation and rurality. Results. There was a twofold variation in community services workforce provision between English regions. In November 2021, the number of staff per 100,000 people aged over 64 ranged from 300 in the South West to 697 in the North West. Most regions experienced a reduction in provision between 2010 and 2021, with a 21.2% reduction nationally. East of England experienced the largest reduction of 39.3%, whilst London experienced a 2.1% increase. In November 2021, regions with more deprived populations had higher workforce provision and regions with a larger proportion of residents living in rural areas had lower workforce provision. Conclusions. The size of the community services workforce has fallen relative to population needs, contradictory to the policy priority to enhance care in the community. There was substantial regional variation in the size of the workforce, which has persisted throughout the decade. Workforce provision was higher in more deprived areas but lower in rural areas, potentially impacting equitable access in rural areas. [ABSTRACT FROM AUTHOR]

Background: Canada's immigrants and refugees have often settled in large Canadian cities, but this is changing with rising costs of living and rural settlement initiatives. However, little consideration is made regarding systemic changes needed to accommodate this distribution, particularly in healthcare in medium-sized cities or smaller communities. For most Canadians, primary care is an entry point into the healthcare system but immigrants and refugees face unique barriers to accessing care compared to the general Canadian population. This project aimed to better understand the barriers to accessing primary care among newcomers in Peterborough, Ontario from the perspective of newcomer service providers. Methodology: Participants were recruited from community organizations identified by the local settlement agency, the New Canadians Centre, as having regular interactions with newcomer clients including clinics, not-for-profit organizations, and volunteer groups. Four focus groups were completed, each with three participants (n=12). A coding grid was deductively developed to guide thematic analysis by adapting Levesque et al.'s conceptual framework defining access to healthcare with five specific dimensions: approachability, acceptability, availability and accommodation, affordability, and appropriateness. Results: Participants identified lack of awareness of the healthcare system, stigma, competing priorities, and direct costs as some of the barriers for newcomers. Participants highlighted barriers unique to Peterborough including proximity to services, social isolation, and a shortage of family physicians. The results also highlighted strengths in the community such as its maternal-child health programming. Conclusion: The results provide a glimpse of the challenges to accessing primary care among newcomers in medium-sized communities and identify opportunities to prepare for changing settlement patterns. [ABSTRACT FROM AUTHOR]

This article aims to analyze the development and management of local cultural policies, with a specific focus on the Public Libraries network in Barcelona. This new look at cultural policies seeks to integrate local culture and mobilize communities, driven by the prioritization of the governance of the cultural system. Within this context, among the initiatives that embrace this new perspective, the role of libraries as privileged spaces for fostering a "common culture", strengthening social cohesion, and generating value in the social sphere stands out. The challenge for these institutions to adapt to new roles, such as being centers of "culture makers" and promoters of digital consumption, is essential. For the analysis, two main approaches are considered. First, the social value of libraries is examined from the perspective of their management, exploring how this concept is integrated into their day-to-day work and their relevance as community meeting points in Barcelona. Second, it assesses the impact of institutional policies and labor demands on the functioning of these libraries, considering their application in the specific context of these cultural institutions. In order to carry out this analysis, a qualitative perspective is used. As a result, it has been possible to conclude that the public policy of libraries in Barcelona must have an active and real citizen participation to be effective, understanding that cultural democratization implies not only physical access, but also an active commitment of the community. It is observed that the public administration implements a very marked "top down" policy, contrasting with the daily work of library management. Despite efforts to strengthen the social value of these facilities, challenges arise, such as the precariousness of the budget and human resources, which limit the effective development of the policy. Librarians play a vital role as cultural mediators, but the gap between public projection and operational reality highlights the need to address the labor and social challenges faced by libraries in their daily operations. [ABSTRACT FROM AUTHOR]

The article examines the solutions to Aotearoa New Zealand's general practitioner (GP) workforce crisis. Topics discussed include the current government's initiatives to increase the number of graduating doctors, the implementation of financial incentives for GPs in underserved areas, and the proposal for a bonding scheme to ensure long-term workforce distribution in high-need regions.

Introduction. New Zealand's health care system faces significant shortages in health care workers. To address workforce challenges and meet the population's health needs, health care systems around the world have introduced new clinical roles, such as physician associates/assistants (PAs) into existing health care teams. Aim. This article aims to examine the benefits, challenges, and broader implications of regulating PAs in the context of New Zealand's primary care sector, with a specific emphasis on how it may impact general practice. Methods. A range of literature surrounding the role, impact, and perception of PAs were selected and included in this article. Results. The PA profession can significantly strengthen New Zealand's primary care workforce, improving patient access and continuity of care. However, the global deployment of PAs has faced scrutiny due to concerns about its potential risks to patient safety and the overall viability of such a role. Discussion. If regulated, the PA profession can reshape New Zealand's primary care, offering a partial solution to current medical staff shortages. Trained under a generalised medical model similar to doctors, PAs possess the necessary skills to perform both routine and non-routine medical tasks. This dual capability can significantly improve primary care service provision, reduce existing workloads, and allow for a more efficient deployment of doctor expertise. However, medico-legal issues and the supervisory burden can impede widespread integration into general practice. Despite challenges, the success of the PA role relies on mutual trust, respect, and support from other clinical team members within primary health care. [ABSTRACT FROM AUTHOR]

In sub-Saharan Africa (SSA), 63% of new human immunodeficiency virus (HIV) infections in 2021 were among women, particularly adolescent girls, and young women. There is a high incidence of HIV among pregnant and lactating women (PLW) in SSA. It is estimated that the risk of HIV-acquisition during pregnancy and the postpartum period more than doubles. In this article, we discuss the safety and effectiveness of drugs used for oral HIV pre-exposure prophylaxis (PrEP), considerations for initiating PrEP in PLW, the barriers to initiating and adhering to PrEP among them and suggest recommendations to address these barriers. Tenofovir/emtricitabine, the most widely used combination in SSA, is safe, clinically effective, and cost-effective among PLW. Any PLW who requests PrEP and has no medical contraindications should receive it. PrEP users who are pregnant or lactating may experience barriers to starting and adhering for a variety of reasons, including personal, pill-related, and healthcare facility-related issues. To address the barriers, we recommend an increased provision of information on PrEP to the women and the communities, increasing and/or facilitating access to PrEP among the PLW, and developing strategies to increase adherence. [ABSTRACT FROM AUTHOR]