Hearing loss and paid employment: Australian population survey findings

This paper provides an analysis of participation in paid employment for people with a hearing loss over the full span of adult ages. The paper is based on original analysis of the 2003 Australian survey of disability, aging and carers (SDAC). This analysis shows that hearing loss was associated with an increased rate of non-participation in employment of between 11.3% and 16.6%. Advancing age and the existence of co-morbidities contribute significantly to reduced participation in employment. A disproportionate impact is evident for women and for those having low education and communication difficulties. Controlling for co-morbidities, hearing loss was associated with a 2.1% increase of non-participation in employment, a proportional difference of 1.4 times the population. People with hearing loss were less likely to be found in highly skilled jobs and were over-represented among low income earners. The SDAC data set provides self-report findings on the experience of disability rather than hearing impairment. As such, these findings serve as a conservative estimate of the impact of hearing loss on accessing well-paid employment.     

CLINICIAN BELIEFS AND PRACTICES RELATED TO INCREASING RESPONSIVITY TO THE NEEDS OF MAORI WITH ALCOHOL AND DRUG PROBLEMS

Culturally responsive treatments are often cited as essential for successfully addressing substance use-associated problems in indigenous and other ethnicgroups. However, there has been little investigation of the support for this assertion among alcohol and drug-user treatment workers, or how it might translate into clinical practice. The current paper reports on the results of a survey of the New Zealand alcohol and drug-user treatment field, which canvassed these issues. Eighty-six percent of respondents advocated adjustment of clinical practice when working with Maori. Two key strategies were referral to specialist Maori groups or individuals and/or contacting/meeting with whanau (family). Comparisons were made between respondents who referred clients on and those who provided intervention themselves. Implications of results, limitations and future research are discussed.     

The specialty of oral and maxillofacial surgery (OMFS) in Europe – Part 1: service configuration,regulation, and provision

Oral and maxillofacial surgical (OMFS) practice and training in Europe is supported by the OMFS Section of the Union of European Medical Specialists (UEMS). Across Europe the number of OMFS specialists per 100,000 varies from 3.0 (Switzerland) to 0.28 (Ireland). The two types of OMFS within the European Union (EU) under Directive 2005/36 and European Free Trade Association (EFTA) treaties are dual degree dental, oral and maxillofacial surgery (DOMFS) and single medical degree maxillofacial surgery (MFS). Automatic recognition of OMFS specialist qualifications is possible only between nations which have the same (or both) types of medical OMFS. Otherwise, individual specialists must apply for a Certificate of Eligibility for Specialist Registration (CESR). DOMFS: 20 European nations have dual degree OMFS. Of these, 12 EU nations are DOMFS in Annex V, 3 are DOMFS in the European Free Trade Association (EFTA) Treaty, and one has mandated dual degree OMFS but is a dental specialty. The United Kingdom has dual degree OMFS. Two MFS nations have had mandated dual degree training for more than 10 years and one has both DOMFS and MFS training, with DOMFS recommended. Although no nation with dual degree DOMFS has transitioned back to single degree MFS, there are pressures to do so within Finland and Norway. MFS: 11 EU nations have single medical degree MFS (and 4 DOMFS nations also have MFS as a legacy specialty). Four nations in the EU/EFTA do not yet have a medical specialty of OMFS: Sweden, Iceland, Denmark, and Estonia.     

Realigning Global Health Realities Towards Children's Surgery: Progress and Possibilities

Despite the high population of children, increasing surgical disease burden and shortage of pediatric surgeons, as well as limited infrastructure, children's surgical care in low- and middle-income countries (LMICs) has been neglected for decades. This has contributed to unacceptably high morbidity and mortality, long term disabilities and economic loss to families. The work of the global initiative for children's surgery (GICS) has raised the profile and visibility of children's surgery in the global health space. This has been achieved a philosophy of inclusiveness, LMIC participation, focus on LMIC needs and high income country (HIC) support, and driven by implementation to change on the ground situations. Children's operating rooms are being installed to strengthen infrastructure and children's surgery is being gradually included in national surgical plans to provide the policy framework to support children's surgical care. In Nigeria, pediatric surgery workforce has increased from 35 in 2003 to 127 in 2002, but the density remains low at 0.14 per 100,000 population <15 years. Education and training have been strengthened with the publication of a pediatric surgery textbook for Africa and creation of a Pan Africa pediatric surgery e-learning platform. However, financing children's surgery in LMICs remains a barrier as many families are at risk of catastrophic healthcare expenditure. The success of these efforts provides encouraging examples of what can be collectively achieve by appropriate and mutually beneficial global north-south collaborations. Pediatric surgeons need to commit their time, knowledge and skills, as well as experience and voices to strengthen children's surgery globally to impact more lives, for the overall good of more.     

The people factor: An analysis of the human resources landscape for immunization supply chain management

Human resources is the backbone of any system and the key enabler for all other functions to effectively perform. This is no different with the Immunization Supply Chain, more so in todays’ complex operating environment with the increasing strain caused by new vaccines and expanding immunization programmes (Source: WHO, UNICEF).In order to drive the change that is required for sustainability and continuous improvement, every immunization supply chain needs an effective leader. A dedicated and competent immunization supply chain leader with adequate numbers of skilled, accountable, motivated and empowered personnel at all levels of the health system to overcome existing and emerging immunization supply chain (ISC) challenges. Without an effective supply chain leader supported by capable and motivated staff, none of the interventions designed to strengthen the supply chain can be effective or sustainable (Source: Gavi Alliance SC Strategy 2014).This landscape analysis was preceded by an HR Evidence Review (March 2014) and has served to inform global partner strategies and country activities, as well as highlight where most support is required. The study also aimed to define the status quo in order to create some form of baseline against which to measure the impact of interventions related to HR going forward.The analysis was comprised of a comprehensive desk review, a survey of 40 respondents from 32 countries and consultations with ISC practitioners in several forums.The findings highlight key areas that should inform the pillars of a HR capacity development plan. At the same time, it revealed that there are some positive examples of where countries are actively addressing some of the issues identified and putting in place mechanisms and structures to optimize the SC function.     

ACCCN Workforce Standards for Intensive Care Nursing: Systematic and evidence review,development, and appraisal

Background

The intensive care nursing workforce plays an essential role in the achievement of positive healthcare outcomes. A growing body of evidence indicates that inadequate nurse staffing and poor skill mix are associated with negative outcomes for patients, and potentially compromises nurses’ ability to maintain the safety of those in their care. In Australia, the Australian College of Critical Care Nurses (ACCCN) has previously published a position statement on intensive care staffing. There was a need for a stronger more evidence based document to support the intensive nursing workforce.

Prevalence of overweight and obesity among nurses in Scotland: A cross-sectional study using the Scottish Health Survey

BackgroundIncreasing prevalence of overweight and obesity represents a global pandemic. As the largest occupational group in international healthcare systems nurses are at the forefront of health promotion to address this pandemic. However, nurses own health behaviours are known to influence the extent to which they engage in health promotion and the public's confidence in advice offered. Estimating the prevalence of overweight and obesity among nurses is therefore important. However, to date, prevalence estimates have been based on non-representative samples and internationally no studies have compared prevalence of overweight and obesity among nurses to other healthcare professionals using representative data.ObjectivesTo estimate overweight and obesity prevalence among nurses in Scotland, and compare to other healthcare professionals and those working in non-heath related occupations.DesignCross-sectional study using a nationally representative sample of five aggregated annual rounds (2008–2012) of the Scottish Health Survey.SettingScotland.Participants13,483 adults aged 17–65 indicating they had worked in the past 4 weeks, classified in four occupational groups: nurses (n = 411), other healthcare professionals (n = 320), unqualified care staff (n = 685), and individuals employed in non-health related occupations (n = 12,067).Main outcome measuresPrevalence of overweight and obesity defined as Body Mass Index ≥ 25.0.MethodsEstimates of overweight and obesity prevalence in each occupational group were calculated with 95% confidence intervals (CI). A logistic regression model was then built to compare the odds of being overweight or obese with not being overweight or obese for nurses in comparison to the other occupational categories. Data were analysed using SAS 9.1.3.Results69.1% (95% CI 64.6, 73.6) of Scottish nurses were overweight or obese. Prevalence of overweight and obesity was higher in nurses than other healthcare professionals (51.3%, CI 45.8, 56.7), unqualified care staff (68.5%, CI 65.0, 72.0) and those in non-health related occupations (68.9%, CI 68.1, 69.7). A logistic regression model adjusted for socio-demographic composition indicated that, compared to nurses, the odds of being overweight or obese was statistically significantly lower for other healthcare professionals (Odds Ratio [OR] 0.45, CI 0.33, 0.61) and those in non-health related occupations (OR 0.78, CI 0.62, 0.97).ConclusionsPrevalence of overweight and obesity among Scottish nurses is worryingly high, and significantly higher than those in other healthcare professionals and non-health related occupations. High prevalence of overweight and obesity potentially harms nurses’ own health and hampers the effectiveness of nurses’ health promotion role. Interventions are therefore urgently required to address overweight and obesity among the Scottish nursing workforce.