Toward an Expanded Focus for Occupational Safety and Health: A Commentary.

Powerful and ongoing changes in how people work, the workforce, and the workplace require a more holistic view of each of these. We argue that an expanded focus for occupational safety and health (OSH) is necessary to prepare for and respond rapidly to future changes in the world of work that will certainly challenge traditional OSH systems. The WHO Model for Action, various European efforts at well-being, and the Total Worker Health concept provide a foundation for addressing changes in the world of work. However, a paradigm expansion to include the recognition of worker and workforce well-being as an important outcome of OSH will be needed. It will also be vital to stimulate transdisciplinary efforts and find innovative ways to attract and train students into OSH professions as the paradigm expands. This will require active marketing of the OSH field as vibrant career choice, as a profession filled with meaningful, engaging responsibilities, and as a well-placed investment for industry and society. An expanded paradigm will result in the need for new disciplines and specialties in OSH, which may be useful in new market efforts to attract new professionals. Ultimately, to achieve worker and workforce well-being we must consider how to implement this expanded focus.

Maldistribution or scarcity of nurses? The devil is in the detail.

AIMS: The goal of this paper was to improve our understanding of nursing shortages across the variety of health care sectors and how this may affect the agenda for addressing nursing shortages. A health care sector comprises a number of health care services for one particular type of patient care, for example, the hospital care sector. BACKGROUND: Most Western countries are shifting health care services from hospital care towards community and home care, thus increasing nursing workforce challenges in home and community care. In order to implement appropriate policy responses to nursing workforce challenges, we need to know if these challenges are caused by maldistribution of nurses and/or the scarcity of nurses in general. EVALUATION: Focusing on the Netherlands, we reviewed articles based on data of a labour market research programme and/or data from the Dutch Employed Persons' Insurance Administration Agency. The data were analysed using a data synthesis approach. KEY ISSUES: Nursing shortages are unevenly distributed across the various health care sectors. Shortages of practical nurses are caused by maldistribution, with a long-term projected surplus of practical nurses in hospitals and projected shortages in nursing/convalescent homes and home care. Shortages of first-level registered nurses are caused by general scarcity in the long term, mainly in hospitals and home care. CONCLUSIONS: Nursing workforce challenges are caused by a maldistribution of nurses and the scarcity of nurses in general. To implement appropriate policy responses to nursing workforce challenges, integrated health care workforce planning is necessary. IMPLICATIONS FOR NURSING MANAGEMENT: Integrated workforce planning models could forecast the impact of health care transformation plans and guide national policy decisions on transitioning programmes. Effective transitioning programmes are required to address nursing shortages and to diminish maldistribution. In addition, increased recruitment and retention as well as new models of care are required to address the scarcity of nurses in general.

Human resources for health in Peru: recent trends (2007-2013) in the labour market for physicians, nurses and midwives.

BACKGROUND: Most analyses of gaps in human resources for health (HRH) do not consider training and the transition of graduates into the labour market. This study aims to explore the labour market for Peru's recent medical, nursing, and midwifery graduates as well as their transition into employment in the Ministry of Health's (MOH) system. METHODS: Data from four different datasets, covering 2007-2013, was used to characterize the patterns of recently trained physicians, nurses, midwives, and postgraduate-trained physicians that enter employment in the MOH system, and scenario analyses were used to describe how this rate of entry needs to adapt in order to fill current HRH shortages. RESULTS: HRH graduates have been increasing from 2007 to 2011, but the proportions that enter employment in the MOH system 2 years later range from 8 to 45% and less than 10% of newly trained medical specialists. Scenario analyses indicate that the gap for physicians and nurses will be met in 2027 and 2024, respectively, while midwives in 2017. However, if the number of HRH graduates entering the MOH system doubles, these gaps could be filled as early as 2020 for physicians and 2019 for nurses. In this latter scenario, the MOH system would still only utilize 56% of newly qualified physicians, 74% of nurses, and 66% of midwives available in the labour market. CONCLUSION: At 2013 training rates, Peru has the number of physicians, nurses, and midwives it needs to address HRH shortages and meet estimated HRH gaps in the national MOH system during the next decade. However, a significant number of newly qualified health professionals do not work for the MOH system within 2 years of graduation. These analyses highlight the importance of building adequate incentive structures to improve the entry and retention of HRH into the public sector.

The Informal Economy: Recent Trends, Future Directions.

Informal employment represents more than half of nonagricultural employment in most developing regions, contributes to the overall economy, and provides pathways to reduction of poverty and inequality. Support to the informal economy should include the expansion of occupational health and safety to include informal workers, based on an analysis of their work places and work risks. The paper presents main schools of thought and argues for a holistic understanding of the different segments of the informal work force and for policies and interventions tailored to the needs and constraints of these different segments. The paper recommends a policy approach which seeks to extend social protection, including occupational health and safety services, to informal workers, and to increase the productivity of informal enterprises and informal workers through an enabling environment and support services. The paper calls for a new paradigm of a hybrid economy which would value and integrate the informal economy alongside the formal economies.

An economy of scales: A selective review of obesity's economic causes, consequences, and solutions.

This paper reviews the economic research on obesity, covering topics such as the measurement of, and trends in, obesity, the economic causes of obesity (e.g. the monetary price and time cost of food, food assistance programs, income, education, macroeconomic conditions, and peer effects), and the economic consequences of obesity (e.g. lower wages, a lower probability of employment, and higher medical care costs). It also examines the extent to which obesity imposes negative externalities, and economic interventions that could potentially internalize such externalities, such as food taxes, subsidies for school-based physical activity programs, and financial rewards for weight loss. It discusses other economic rationales for government intervention with respect to obesity, such as imperfect information, time inconsistent preferences, and irrational behavior. It concludes by proposing a research agenda for the field. Overall, the evidence suggests that there is no single dominant economic cause of obesity; a wide variety of factors may contribute a modest amount to the risk. There is consistent evidence regarding the economic consequences of obesity, which are lower wages and higher medical care costs that impose negative externalities through health insurance. Studies of economic approaches to preventing obesity, such as menu labeling, taxes on energy-dense foods, and financial rewards for weight loss find only modest effects on weight and thus a range of policies may be necessary to have a substantial effect on the prevalence of obesity.

Migraciones profesionales la-UE. Oportunidades para el desarrollo compartido: revisión bibliográfica / Professional migration EU. Opportunities for shared development: bibliographic review

En este informe, se aborda en primer lugar, la crisis mundial de los sistemas de la salud y su relación con tres aspectos fundamentales: la escasez universal de los recursos humanos sanitarios, la mala distribución de los mismos y la movilidad del personal sanitario a las zonas más ricas, más cosmopolitas y con más oportunidades, incidiendo especialmente en este último punto a través del análisis de las tendencias en los flujos más frecuentes, los lugares más reconocidos como receptores o emisores o las motivaciones aludidas por el personal sanitario para migrar. En segundo lugar, se describen algunas consecuencias y problemáticas asociadas a este panorama, como la pérdida económica potencial y real, la reducción de la calidad de la atención sanitaria o el aumento de la intención de migrar. Por último, se realiza una exposición de las diferentes alternativas puestas en marcha o propuestas por los diferentes agentes implicados en el estudio y la solución de esta situación de crisis, junto con algunas valoraciones sobre su desarrollo y resultados. Las iniciativas encontradas en la revisión se destacan agrupándolas en las categorías relacionadas con la contratación, la planificación de recursos, la formación, y la política laboral; resaltando, por su relevancia, las iniciativas centradas en la cooperación y colaboración entre países como instrumentos de intervención. (AU)

The next 20 years: how customer and workforce attitudes will evolve.

Business projects with very long time horizons--such as those involving product R&D, workplace design, and total compensation planning--have to contend with a crucial question: What will be the needs, demands, and desires of consumers and employees decades from now? If you think the answer is "Just more of the same," you're in for a surprise. Howe and Strauss, the authors of Generations, The Fourth Turning, Millennials Rising, and other books, have studied the differences among generations for some 30 years. Their extensive research has revealed a fascinating pattern--one so strong that it supports a measure of predictability. On the basis of historical precedent, they say, we can foresee how the generations that are alive today will think and act in decades to come. Three of those generations will still be vital forces in American society 20 years from now: Boomers, Generation X, and Millennials. Their attitudes and behaviors will have profound effects on the economy, the workplace, and social institutions in general. For example, as aging Boomers eschew high-tech medicine in favor of holistic self-care, natural foods, and mind-body healing techniques, some hospitals are opening new wings featuring alternative medicine and spiritual counseling. Gen Xers, having grown up in an era of failing schools and marriages, will remain alienated, disaffected, and pragmatic as they enter midlife. Already the greatest entrepreneurial generation in U.S. history, they will be highly effective at pushing innovation, efficiency, and mass customization. In contrast, young adult Millennials will favor teamwork, close family relationships, job security, and a bland popular culture. Their unprecedented digital empowerment and talent for organizing will create a political powerhouse and may even revitalize the union movement.

Occupational health care for the 21st century: from health at work to workers' health.

A survey of relevant national and international legislation and recommendations on occupational health (OH) organization revealed two fundamental approaches to OH: 1) the historically older labor approach, essentially seeing OH care as an obligation of the employer derived from the labor contract, and 2) an emerging health approach, including all workers and all aspects of health, A draft decree on OH in Flanders seeks to integrate the two approaches. It extends the scope of OH to all workers (not only employees), introduces holistic health surveillance, rejects the incapacity concept, provides for strong integration of health and workplace surveillance, and stresses ethics. Workers' satisfaction is seen as the first criterion in quality control. Systematic data collection and analysis, and when necessary, scientific research are recommended. Additional resources for OH services should be provided by stakeholders other than employers.

[Older female employees in Germany - structures of employment and perspectives of the future]. / Altere Arbeitnehmerinnen in Deutschland - Erwerbsstrukturen und Zukunftsperspektiven.

This contribution presents an overview to the structures and conditions of employment of older female employees in Germany. Based on information about the labor force participation rates, rates of unemployment and occupational patterns the conditions of female employment beyond midlife are examined. Relating to the standard of living, the meaning of employment for older women is discussed. Furthermore, the effects of regulations of welfare state, i. e., pension systems, on future life of the employed women are highlighted. Further topics are the completion of working life and the transition to retirement of female employees, the issue of the future working conditions of older female employees related with demographic change und future reduction of the potential of labor force. Finally the contribution stresses the importance of a holistic approach to investigate the living and working conditions of older female employees.

Informe sobre la salud en el mundo 2006: colaboremos por la salud / World health report 2006: collaborate for health

El Informe sobre la salud en el mundo 2006 - Colaboremos por la salud presenta una evaluación realizada por expertos acerca de la crisis de personal sanitario que atraviesa el mundo, así como varias propuestas ambiciosas para abordar ese problema a lo largo de los próximos diez años, empezando a actuar de inmediato. El informe revela que, según las estimaciones, existe un déficit de casi 4,3 millones de médicos, parteras, enfermeras y trabajadores auxiliares en todo el mundo. Donde mayor gravedad reviste esa escasez es en los países más pobres, sobre todo en el África subsahariana, precisamente donde mayor es la necesidad de trabajadores sanitarios. Centrándose en todas las etapas del ciclo de vida laboral de los trabajadores de la salud, desde su incorporación a la formación sanitaria, pasando por su contratación, hasta la jubilación, el informe traza un plan de acción a diez años en cuyo marco los países pueden conformar su fuerza laboral sanitaria con el apoyo de los asociados mundiales. (AU)

[The underpaid nursing profession: myth or reality]. / La profession infirmière sous payée: mythe ou réalité.

The originality of this research lies in its object, nurses salaries, a subject that is often discussed amongst professionals, yet rarely broached in writing. The concepts of salaries and salaried workers are examined, then, through literature, a list of salary data from 1845 to 1945 is made. The study of nursing personnel salaries from 1945 to 2001 begins with a reconstruction of salary charts, continuing with an internal analysis of the private and semi-public sector, then alternatively with the teachers. This work provides objective information on the aspect of this profession's salaries and uncovers numerous questions on the origins of wage increases.

How much do kids count in corporate board rooms? Results from the first survey of Fortune 1000 companies.

OBJECTIVE: The objective of this study was to characterize the extent of the business community's commitment to children, particularly with respect to understanding its role in assuring children's health and development, by conducting a survey of the largest US companies. METHODS: A survey of year 2001 Fortune 1000 companies was performed to determine whether their mission statements, vision statements, or guiding principles include a commitment to children; whether they employ people under the age of 18 years in the United States; whether they encourage their employees to mentor children under the age of 18 years; whether they have an affiliated philanthropic foundation; whether their company's philanthropy focuses specifically on children; and whether they participate in any activities that particularly help disadvantaged children. The survey consisted of 2 mailings followed by phone calls to companies to obtain answers to the questions listed above and answers to additional questions that asked specifically about the company's financial expenditures for parental leave, child care, and healthcare for children of employees and about the company's specific philanthropic giving aimed at helping children. Descriptive information about some of the ways that companies impact the lives of children was also obtained to provide context for the responses. RESULTS: Data were obtained from 333 year 2001 Fortune 1000 companies (33%) between March 20, 2002 and March 20, 2003, with a good representation of all industry sectors. These data suggest that approximately 33% of the companies that responded have mission statements, vision statements, or guiding principles that specifically include a commitment to children. Employment opportunities for children under the age of 18 years in the United States exist at approximately 41% of these companies. These companies clearly see mentoring as a major theme, with 77% of them encouraging their employees to mentor children under the age of 18 years. Approximately 60% of the companies that responded support affiliated, independent philanthropic foundations, and approximately 55% of companies indicated that they focus their philanthropy specifically (although not exclusively) on children. Approximately 80% of these companies indicated that they participate in at least one activity that helps disadvantaged children. Many companies faced challenges in estimating their overall investments in children, particularly given their large and decentralized nature, but they were able to provide an overall sense of their commitment and they indicated that they could provide quantitative data prospectively if they knew it would be requested. CONCLUSION: Many companies that responded play a major role in supporting children's health and development in the United States both directly and indirectly. Further efforts to better quantify the business community's aggregate commitments to improving children's health and development should be sought to allow better estimation of the amount of resources expended and the impact of these investments on children.