Mylene Lagarde and Anthony Scott
This chapter reviews the evidence on the role of physicians in shaping inequalities in access to and utilisation of healthcare. The authors examine three types of physician…
Abstract
This chapter reviews the evidence on the role of physicians in shaping inequalities in access to and utilisation of healthcare. The authors examine three types of physician decisions that can influence inequalities in access and utilisation: location decisions, decisions to work in the public and/or private sector, and decisions or behaviours in the doctor–patient encounter. For each, the authors summarise the issues and empirical evidence on possible policies to help reduce inequalities in access. Future research to reduce inequalities should focus on changes to health systems that influence physician decisions, such as health insurance expansions, the public–private mix and financial incentives, as well as physician training and policies for a more diverse physician workforce.
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Software tools are an essential part of any IC design system but there are dangers associated with the introduction of CAD systems. This paper attempts to lift the software cloak…
Abstract
Software tools are an essential part of any IC design system but there are dangers associated with the introduction of CAD systems. This paper attempts to lift the software cloak which, along with the ubiquitous workstation, tends to cover the finer points of CMOS design. This paper should help to make the designer or user of gate arrays more aware of the important features such as power dissipation, the use of transmission gates, latch‐up prevention, the pitfalls of using circuit simulators, and the importance of selecting the correct package.
Eileen J. Porter, Melinda S. Markham, Edward L. Kinman and Lawrence H. Ganong
Health care services are typically viewed as institutions or agencies offering professional care or care supervised by professionals. The concept of availability of health care…
Abstract
Health care services are typically viewed as institutions or agencies offering professional care or care supervised by professionals. The concept of availability of health care services involves the degree to which persons can readily find professional care. Few scholars have considered the relevance of these notions to life-circumstances of older homebound women who experience emergent situations (ES) at home such as falls, unintentional injuries, or health problems. During a larger descriptive phenomenological study of the experience of reaching help quickly, 33 of 40 homebound women, aged 85–98 years, who were living alone, reported 57 situations of interest during open-ended interviews over 18 months. The purposes of this facet of the study were (a) to describe the life-world of women who had fortuitous help with ES at home, (b) to categorize helpers involved, and (c) to elaborate the reported influence of such situations on recognizing the risk of being unable to reach help quickly in the future. Life-world was featured by having help right now from someone on the scene. We categorized involved helpers into six types, including four previously identified types of home care helpers as well as (a) “on-the-spot” helpers, acquaintances not among the woman's home care helpers and (b) “at-this-scene-only” helpers, who were not likely to encounter the woman afterwards. In these ES, the home – not the health care institution – was the setting. On-the-scene helpers served as critical health care resources. In contrast to the typical focus on availability of health care services in a public space, availability of on-the-scene helpers in the home, a private space, was critical to the well-being of these old homebound women. This work raises new notions about availability of health care services for older homebound women and offers new perspectives on the key support network concepts of proximity and frequency of contact.
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Richard Colbran, Robyn Ramsden, Michael Edwards, Emer O'Callaghan and Dave Karlson
While Australia has continued to invest in polices and strategies aimed at improving rural health service provision, many communities still confront a disproportionate share of…
Abstract
Purpose
While Australia has continued to invest in polices and strategies aimed at improving rural health service provision, many communities still confront a disproportionate share of the rural workforce shortage. The NSW Rural Doctors Network (RDN) contributes its perspectives about the importance of a whole of life career and the meandering stream concept to support the retention of health professionals rurally. We unpack these concepts and examine how they bring to light a new and useful approach to addressing rural workforce challenges and potentially contribute to building a stronger integrated care approach.
Design/methodology/approach
The approach used involved tapping into RDN's 30-years of experience in recruitment and retention of remote and rural health professionals, combined with insights from relevant existing and emerging evidence.
Findings
We suggest that reframing retention to consider a life stage approach to career will guide more effective targeting of rural health policies, workforce planning, collaborative approaches and allocation of incentives. We posit that an understanding and acceptance of modern lifestyles and career pathways, and a celebration of career commitment to serving rural communities, is necessary for successful recruitment and retention of Australia's future rural health workforce beyond the training pipeline.
Originality/value
We outline and visually represent RDN's meandering stream approach to building and retaining a capable rural health workforce through addressing life cycle and workforce level needs. This perspective paper draws on RDN's direct experience in the field.
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Nazim Habibov, Alena Auchynnikava and Yunhong Lyu
The purpose of this study is to investigate the determinants of job retention intention among healthcare workers (HCWs) in Canada during the COVID-19 pandemic.
Abstract
Purpose
The purpose of this study is to investigate the determinants of job retention intention among healthcare workers (HCWs) in Canada during the COVID-19 pandemic.
Design/methodology/approach
Data are from a large nationally representative cross-sectional survey conducted by the Canadian National Statistics Agency. Ordered logistic regression is estimated to find an association between job retention and its main determinants as gleaned from the literature while controlling for a wide range of pertinent covariates. Odds and standardized odds are reported and discussed.
Findings
The results suggest that worsening working conditions, changes in health and well-being and lack of organizational support weaken intentions regarding job retention. Being employed rather than self-employed and working as a nurse also weakens job retention.
Originality/value
This is the first research on the determinants of intentions regarding job retention in Canada using nationally representative data. It allows us to test and confirm the results of previous studies on a large sample of Canadian HCWs. The paper also discusses the implications of the findings for health management and administration.
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Spam emails classification using data mining and machine learning approaches has enticed the researchers' attention duo to its obvious positive impact in protecting internet…
Abstract
Spam emails classification using data mining and machine learning approaches has enticed the researchers' attention duo to its obvious positive impact in protecting internet users. Several features can be used for creating data mining and machine learning based spam classification models. Yet, spammers know that the longer they will use the same set of features for tricking email users the more probably the anti-spam parties might develop tools for combating this kind of annoying email messages. Spammers, so, adapt by continuously reforming the group of features utilized for composing spam emails. For that reason, even though traditional classification methods possess sound classification results, they were ineffective for lifelong classification of spam emails duo to the fact that they might be prone to the so-called “Concept Drift”. In the current study, an enhanced model is proposed for ensuring lifelong spam classification model. For the evaluation purposes, the overall performance of the suggested model is contrasted against various other stream mining classification techniques. The results proved the success of the suggested model as a lifelong spam emails classification method.
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Leigh-ann Onnis and Tahalani Hunter
The aim of this study was to conduct a scoping review of a global body of scholarly and industry (grey) literature for evidence of implemented and evaluated interventions to…
Abstract
Purpose
The aim of this study was to conduct a scoping review of a global body of scholarly and industry (grey) literature for evidence of implemented and evaluated interventions to identify best practice workforce retention strategies for organisations providing health services in rural and remote areas.
Design/methodology/approach
A scoping review was conducted of the scholarly and grey literature by two independent researchers. This comprised a search of four scholarly databases, and a Google and website search for grey literature. Quality checks were conducted, and a total of 15 documents were included in the literature review. Using the World Health Organisation’s categories of workforce intervention (regulatory, education, financial incentives, personal and professional support), the documents were analysed to identify effective workforce interventions.
Findings
The literature review found evidence of regulatory impacts as well as organisation-level evaluated workforce interventions for education-to-employment pathways (education), remuneration programs (financial incentives) and working and living conditions (personal and professional support) but seldom provided insight into how successful interventions were implemented or evaluated at the organisational level. Further, there was an absence of scholarship contributing to the development of empirical evidence to inform organisations about designing, implementing and evaluating workforce strategies to improve health workforce retention in rural and remote communities.
Originality/value
Few studies have focused on evidence-based organisation-level interventions to improve rural and remote workforce sustainability. This article offers insights to shape future intervention implementation and evaluation research for rural and remote health workforce sustainability.
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Omid Khosravizadeh, Bahman Ahadinezhad, Sima Rafiei, Rohollah Kalhor and Aisa Maleki
In the time of the COVID-19 crisis, many physical, psychological and spiritual difficulties are imposed on the front line staff and overshadow their rights, resilience and…
Abstract
Purpose
In the time of the COVID-19 crisis, many physical, psychological and spiritual difficulties are imposed on the front line staff and overshadow their rights, resilience and retention. In addition, the loss of this important organizational resource imposes huge costs on the system. The purpose of this study is systemic review of the influential factors, policies and strategies applied to defend the rights of health-care staff and improve the resilience and retention of health system human resources in the COVID-19 crisis.
Design/methodology/approach
This systematic review was conducted in 2021. Data were collected by keyword search in Google Scholar, PubMed, Scopus, Web of Science, Science Direct, Magiran, SID and Irandoc databases until December 2021. In addition, the quality of the studies was evaluated by three experts using the Strobe checklist. The analysis used in this study to categorize the results was thematic analysis.
Findings
Factors that cause tension and injustice to employees and also strategies to overcome it and increase their resilience were classified into general categories according to their nature. Factors included factors related to safety, economic and financial, staff characteristics, crisis management characteristics, organizational climate and working conditions. Existing strategies also fall into four categories of physical, psychological and spiritual health promotion strategies; organizational climate and work environment; education and empowerment and economic and financial.
Originality/value
This study is a systematic review of the factors that affect the health workforce rights and resilience of health-care personnel during the COVID-19 crisis. On the other hand, the policies and strategies used in different countries to overcome the difficulties and increase the resilience and retention of health workers have been summarized and can be used in other crises.
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Ewa McGrail, J. Patrick McGrail and Alicja Rieger
To explore the potential of conversations with an authentic audience through blogging for enriching in young writers the understanding of the communicative function of writing…
Abstract
Purpose
To explore the potential of conversations with an authentic audience through blogging for enriching in young writers the understanding of the communicative function of writing, specifically language and vocabulary use.
Design/methodology/approach
We situate our work in the language acquisition model of language learning, in which learners develop linguistic competence in the process of speaking and using language (Krashen, 1988; Tomasello, 2005). We also believe that language learning benefits from formal instruction (Krashen, 1988). As such, in our work, we likened engaging in blogging to learning a language (here, more broadly conceived as learning to write) through both natural communication (acquisition) and prescription (instruction), and we looked at these forms of learning in our study.
We were interested in the communicative function of language learning (Halliday, 1973; 1975; Penrod, 2005) among young blog writers, because we see language learning as socially constructed through interaction with other speakers of a language (Tomasello, 2005; Vygotsky, 1978).
Findings
The readers and commenters in this study supported young writers in their language study by modeling good writing and effective language use in their communication with these writers. Young writers also benefited from direct instruction through interactions with adults beyond classroom teachers, in our case some of the readers and commenters.
Practical implications
Blogging can extend conversations to audiences far beyond the classroom and make writing a more authentic endeavor for young writers. Teachers should take advantage of such a powerful tool in their writing classrooms to support their students’ language study and vocabulary development.
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The purpose of this paper is to identify the operational and management challenges in a globally budgeted, regionalized healthcare system and their implications for public service.
Abstract
Purpose
The purpose of this paper is to identify the operational and management challenges in a globally budgeted, regionalized healthcare system and their implications for public service.
Design/methodology/approach
Concentrating on British Columbia’s regional health authorities (RHAs) and hospitals, this study utilized data from interviews of key informants, documents (histories, legislation, agreements between RHAs and provincial government, and RHA organizational charts), news reports, and participant observation at board meetings.
Findings
Challenges encountered by the managers include accommodating powerful stakeholders (elected officials, providers, and organized publics), adhering to fixed budgets, obtaining capital from public sources, and adjusting to government turnover. In response, the managers engage in balancing priorities of stakeholders, shifting of resources within and across sites and operating units, and working strategically with the capital allocation process. Responses of managers to these challenges have promoted stability but raise concerns about attaining the system’s goals.
Practical implications
Management challenges and potential patterns of response should be considered in assessing the options for health system reforms. Many countries periodically reorganize their healthcare systems, and recognition of potential management challenges can contribute to the achievement of objectives sought in these reforms.
Originality/value
Although studies have demonstrated that management affects the implementation of public programs in several areas, little research has focused on the relationships between features of health systems, management responses, and potential outcomes.