Brachytherapy practice across Canada: A survey of workforce and barriers

PurposeTo determine the current use of brachytherapy, characteristics of the brachytherapy workforce, and barriers to development and maintenance of brachytherapy programs across Canada.Methods and MaterialsA survey was designed to inquire about the use of brachytherapy and was sent to all Canadian radiation oncologists.ResultsOf the 116 respondents, we identified 80 radiation oncologists from 33 of 41 responding centers who currently or in the past have practiced brachytherapy. Responses were received from 30% overall and 80% of provinces. Approximately 58% of the respondents treat in one site with brachytherapy, whereas 12% treat in three or more sites. Gynecologic (GYN) and genitourinary are the most commonly treated sites (49% of respondents). For all sites, there was a large range in the number of patients treated with brachytherapy by each radiation oncologist per year (i.e., cervix: 1–50). Approximately 49% of the respondents have discontinued practicing brachytherapy for a certain site, most commonly head and neck (28%), GYN (25%), and bronchus (24%). The most common reasons include reassignment or lack of a local program. The most common reasons why brachytherapy is not used for sites other than GYN and prostate include lack of infrastructure and insufficient training of radiation oncologists rather than insufficient patient numbers or lack of evidence for a benefit of brachytherapy.ConclusionsWithin its limitations, our study suggests a mismatch between demand and availability of brachytherapy programs across Canada. In light of finite resources, a rational approach to investment in brachytherapy is needed and this must be based on a formal audit of brachytherapy demand and use.     

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.     

A critical review of the nursing shortage in Malaysia

BARNETT T., NAMASIVAYAM P. & NARUDIN D.A.A. (2010) A critical review of the nursing shortage in Malaysia. International Nursing Review 57 , 32–39
Objective:  This paper describes and critically reviews steps taken to address the nursing workforce shortage in Malaysia.
Background:  To address the shortage and to build health care capacity, Malaysia has more than doubled its nursing workforce over the past decade, primarily through an increase in the domestic supply of new graduates.
Methods:  Government reports, policy documents and ministerial statements were sourced from the Ministry of Health Malaysia website and reviewed and analysed in the context of the scholarly literature published about the health care workforce in Malaysia and more generally about the global nursing shortage.
Results:  An escalation in student numbers and the unprecedented number of new graduates entering the workforce has been associated with other impacts that have been responded to symptomatically rather than through workplace reform. Whilst growing the domestic supply of nurses is a critical key strategy to address workforce shortages, steps should also be taken to address structural and other problems of the workplace to support both new graduates and the retention of more experienced staff.
Conclusion:  Nursing shortages should not be tackled by increasing the supply of new graduates alone. The creation of a safe and supportive work environment is important to the long-term success of current measures taken to grow the workforce and retain nurses within the Malaysian health care system.     

Associations between work schedule characteristics and occupational injury and illness

DE CASTRO A.B., FUJISHIRO K., RUE T., TAGALOG E.A., SAMACO‐PAQUIZ L.P.G. & GEE G.C. (2010) Associations between work schedule characteristics and occupational injury and illness. International Nursing Review 57 , 188–194 Background: Nurses often endure working irregular day, night and evening shifts as well as mandatory overtime (i.e. employer‐imposed work time in excess of one's assigned schedule). While these work characteristics are examined as potential risks for nurses' safety and health, it is not clear whether negative health impacts occur simply because of working long hours or in combination with other mechanisms. Aim: This study investigates how these work characteristics are associated with nurses' work‐related injury and illness over and above long work hours. Methods: In this cross‐sectional study, questionnaire data were collected from a sample of 655 registered nurses in the Philippines. Multiple logistic regression was used to assess associations of shift work and mandatory overtime with four work‐related health outcomes. Results: After weekly work hours, shift length and demographic variables were accounted for, non‐day shifts were associated with work‐related injury [odds ratio (OR) = 1.54; 95% confidence interval (CI): 1.07, 2.24] and work‐related illness (OR = 1.48; 95% CI: 1.02, 2.16). Also, frequency of working mandatory overtime was associated with work‐related injury (OR = 1.22; 95% CI: 1.06, 1.41), work‐related illness (OR = 1.19; 95% CI: 1.04, 1.37) and missing more than 2 days of work because of a work‐related injury or illness (OR = 1.25; 95% CI: 1.08, 1.44). Conclusions: These findings suggest that non‐day shifts and mandatory overtime may negatively impact nurses' health independent of working long hours. Mechanisms through which these work characteristics affect health, such as circadian rhythm disturbance, nurse‐to‐patient ratios and work–family conflict, should be examined in future studies.     

Gestión de los recursos humanos y estrategias de vacunación en atención primaria en Europa en la pandemia COVID-19

This article describes the management of human resource and the vaccination strategies in primary care in twelve European countries in relation to the COVID-19 pandemic. All the countries have found solutions to increase their workforce in primary care. Other healthcare professionals were incorporated to support family doctors assuming their tasks, under their supervision and coordination. The European Commission had a crucial role in the production, purchase and distribution of the vaccines. The engagement of primary care in the vaccination campaign has had an unequal participation in the different countries, although the greatest burden has been managed from the government's public health departments.     

International Medical Graduates in Nephrology: A Guide for Trainees and Programs

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Surge capacity for critical care specialised allied health professionals in Australia during COVID-19

Significant investment in planning and training has occurred across the Australian healthcare sector in response to the COVID-19 pandemic, with a primary focus on the medical and nursing workforce. We provide a short summary of a recently published article titled “Surge capacity of Australian intensive care units associated with COVID-19 admissions” in the Medical Journal of Australia and, importantly, highlight a knowledge gap regarding critical care specialised allied health professional (AHP) workforce planning in Australia. The unique skill set provided by critical care specialised AHPs contributes to patient recovery long after the patient leaves the intensive care unit, with management targeted at reducing disability and improving function, activities of daily living, and quality of life. Allied health workforce planning and preparation during COVID-19 must be considered when planning comprehensive and evidence-based patient care. The work by Litton et al. has highlighted the significant lack of available data in relation to staffing of critical care specialised AHPs in Australia, and this needs to be urgently addressed.