Presence of management, entrepreneurship, leadership and marketing topics in the dental school curriculum in Brazil.

INTRODUCTION: To analyse the presence and characteristics of curricular components related to management, entrepreneurship, leadership and marketing as part of the structure and teaching methods of undergraduate courses in dentistry in Brazil. MATERIALS AND METHODS: This is an observational study that used the Ministry of Education's Undergraduate Course Accreditation Platform, which included 424 undergraduate courses in Dentistry on the last date of collection (August 31 2019). The following items were analysed as follows: the existence of curricular components in relation to the proposed themes, the most recurring denominations of curricular components, minimum and maximum workload, mandatory/optional classification, theoretical/practical teaching condition and in which year the curricular components were inserted. RESULTS: 367/424 (86.6%) of dentistry courses in Brazil included at least one of the topics: management, entrepreneurship, leadership and marketing curricular components in their curriculum, whilst 57/424 (13.4%) did not have these curricular components in their curricular structure. The most frequent names were "Management" 99 (45.21%) and "Entrepreneurship" 80 (36.5%). There was a predominance of the "theoretical method" and the number of hours varied considerably, with the most common course hours between 40 and 60 h. The majority of curricular components were inserted in the third to fifth year and offered on a compulsory basis. CONCLUSION: Most curricular matrices of dentistry courses in Brazil had components related to the topics studied. However, due to the variety of curricular components' names, hours, periods of courses and different teaching methodologies, there is a need to redesign the teaching and learning process, defining educational and evaluation models with common curricular components.

The private healthcare market and the sustainability of an innovative community nurses programme based on social entrepreneurship - CoNSENSo project.

BACKGROUND: CoNSENSo is a project funded by the European Union, which is aimed at developing an innovative care model based on community nurses to support active ageing in mountain areas. The planned sustainability of this innovative approach relies on social entrepreneurship on the healthcare market, and this work highlights the necessary conditions for the successful implementation of these entrepreneurial initiatives. METHODS: Considering municipalities in the Piedmont Region and those aged 65 or older as target population, the authors propose several negative binomial regression models to estimate the effectiveness of current private healthcare services in supporting the active aging process. Such effectiveness may represent the ex-ante (positive) reputation of these new social entrepreneurial initiatives on the market. RESULTS: According to our results, the private supply of healthcare services can effectively support the aging process. Indeed, given that the other predictor variables in the model are held constant, there are statistically significant negative relations between the number of hip fractures and the private supply of healthcare services by dental practitioners and psychologists (p-value < 0.05), as well as the private supply of opportunities for social interaction by coffee bars (p-value < 0.05). CONCLUSIONS: The authors expect a favourable environment for the entrepreneurial initiatives of community nurses in mountain areas. Accordingly, policy makers cannot reject the hypothesis that the goals reached by the CoNSENSo project may be maintained for the sake of the future generations, avoiding its collapse as soon as public funding shifts to new programmes.

Can bioenergy act as an entrepreneurial opportunity for the sustainable economic development of an emerging economy? A socio-technical approach.

Challenges in adopting renewable energy have become significant roadblocks to the country's sustainable progress. There is a shortage of studies examining how adopting biogas energy plants affects entrepreneurship in Pakistan's off-grid areas. This study aims to address this gap in the literature by investigating bioenergy as an entrepreneurial opportunity for the sustainable economic development of an emerging economy. Primary data comprising 305 respondents was used in Punjab Province by employing an inclusive questionnaire survey. The partial least square structural equation modeling (PLS-SEM) technique validates the model and analyzes the designated hypotheses. Empirical outcomes reveal that enhanced social and entrepreneurial prosperity adopting biogas plants, sustainable economic development of entrepreneurial businesses adopting biogas plants, and adoption in entrepreneurship improve the standard of living positively and significantly associated with intention to enhance entrepreneurship performance through biogas energy adoption. On the contrary, the production-cost reduction of adopting biogas plants in entrepreneurial businesses had no significant effect on intention to improve entrepreneurship performance through biogas energy adoption. Meanwhile, the intention to enhance entrepreneurship performance through biogas energy adoption positively mediates the relationship among enhanced social and entrepreneurial prosperity adopting biogas plants, sustainable economic development of entrepreneurial businesses adopting biogas plants, biogas plant adoption in entrepreneurship improves the standard of living, and economic development of entrepreneurial activities adopting biogas technology. Correspondingly, social media and word of mouth significantly moderate the relationships between the intention to enhance entrepreneurship performance through biogas energy adoption and the economic development of entrepreneurial activities adopting biogas energy. The results of this study show how crucial it is to change societal norms surrounding entrepreneurship, raise entrepreneurs' awareness of these issues, reform regulatory systems, and emphasize the benefits of entrepreneurial activities offered by biogas energy plants that grow entrepreneurs' standard of living. Finally, the study's limitations and recommendations for additional studies are highlighted.

Creating and promoting a sports performance service offering.

Many private hospitals and physician groups are exploring the possibility of expanding their facilities to include advanced ancillary services. Services such as a sports performance center provide additional opportunities for quality patient care and at the same time augment the bottom line. By offering additional ancillary services, healthcare organizations such as an orthopaedics practice can become a full-service center enabling clinicians to more fully provide care to their patients. Marketing and promotion play a crucial role in this type of service. These activities must be designed and carried out in a way that encourages productive results and collaboration as the organization strives to position itself as a full-service center and as a sports specialist in its community.

Policy entrepreneurship and policy networks in healthcare systems - the case of Israel's pediatric dentistry reform.

BACKGROUND: Can the entry of a policy entrepreneur challenge the equilibrium of a policy network and promote changes that might clash with the goals of powerful civil-servants and/or interest groups and, if so, why and how? Our goal is to examine two sides of the same coin: how does an in-depth analysis of Israel's dental care reform enrich our understanding of policy networks and policy entrepreneurship? Second, how does the literature on policy networks and policy entrepreneurship help us understand this reform? Based on a theoretical framework that appears in the literature of policy entrepreneurship and policy networks, we analyze the motivations, goals and strategies of the main actors involved in the process of reforming pediatric dental care in Israel. We demonstrate how a policy entrepreneur navigated within a policy network and managed to promote a reform that, until his appearance, no one else in that network had succeeded in enacting. METHODS: Our goals are advanced through a case study of a reform in pediatric dentistry implemented in Israel in 2010. It rests on textual analyses of the literature, reports, committee minutes, parliamentary proceedings, print and online media, and updates in relevant legislation and case law between 2009 and 2015. In addition, the case study draws on the insights of one of the authors (TH), who played a role in the reform process. RESULTS: Historical circumstances and the Israeli public's longstanding lack of interest in changing the existing model as well as interest groups that preferred the dominance of the private sector in the dental healthcare system kept that area out of the services supplied, universally, under the National Health Insurance Law. This situation changed significantly following the publication in 2007 of a policy analysis that contributed to shifts in the motivations and balance of power within the policy network, which in turn prepared the ground for a policy change. In this environment a determined policy entrepreneur, who identified a window of opportunity, took the lead and instituted an innovative and far-reaching reform. CONCLUSIONS: A policy entrepreneur can leverage external factors as well as the previous activities of a policy network that has already matured to create a policy change. Such entrepreneurial activity includes maneuvering around opponents and overcoming resistance from various stakeholders.

Policy entrepreneurship in the reform of pediatric dentistry.

In a recently published IJHPR article, Cohen and Horev ask whether an individual who holds rightful governmental power is able to effectively "challenge the equilibrium" in ways that might "clash with the goals" of an influential group". This question is raised within the context of a shift in governmental policy that imposed the potential for cost management by HMOs acting as financial intermediaries for pediatric dental care in an effort to provide Israeli children better access to affordable dental care. The influential group referred to consists of Israel's private dentists and the individual seeking to challenge the equilibrium was an Israeli Minister of Health whom the authors consider to be a policy entrepreneur.The Israeli health care system is similar to that of the United States in that private benefit plans and self-pay financing dominate in dental care. This is in contrast to the substantial role of government in the financing and regulation of medical care in both countries (with Israel having universal coverage financed by government and the US having government financing the care of the elderly and the poor as well as providing subsidies through the tax system for the care of most other Americans).Efforts to expand governmental involvement in dental care in both countries have either been opposed by organized dentistry or have suffered from ineffective advocacy for increased public investment in dental care.In the U.S., philanthropic foundations have acted as or have supported health policy entrepreneurs. The recent movement to introduce the dental therapist, a type of allied dental professional trained to provide a narrow set of commonly-needed procedures, to the U.S. is discussed as an example of a successful challenge to the equilibrium by groups supported by these foundations. This is a somewhat different, and complementary, model of policy entrepreneurship from the individual policy entrepreneur highlighted in the Cohen-Horev paper.The political traction gained to change the equilibrium favored by organized dentistry - in both Israel and the U.S. - may reflect aspirations for care that is more accessible, patient-centered, accountable and equitable. Evolving aspirations may lead to policy changes to systematize the disparate, disaggregated dental care delivery system in both counties. A change in payment incentives to provide more value is being explored for medical care, and its expansion to dental care can be anticipated to be among the policies considered in the future.

Job resources in Dutch dental practice.

AIM: To develop an instrument measuring job resources among dentists, and to assess the relative importance of these resources and relate them to job satisfaction. METHODS: 848 Dutch general dental practitioners (GDPs) received a questionnaire to monitor work experiences, including the Dentists' Experienced Job Resources Scale (DEJRS, 46 items, score range: 1 (not satisfying) to 5 (very satisfying), and the Dentist Job Satisfaction Scale (DJSS, 5 items, Cronbach's alpha = 0.85). RESULTS: A total of 497 (58.6%) dentists responded. Factor analysis (PCA) on the DEJRS resulted in 8 factors (Cronbach's alpha: 0.75 > alpha < 0.89), representing distinguishable categories of job resources. In rank order: Immediate Results / Aesthetics (M = 4.04, sd = 0.5); (Long-term) Patient Results (M = 4.03, sd = 0.6); Patient Care (M = 3.90, sd = 0.6); Craftmanship (M = 3.77, sd = 0.7); Idealism / Pride (M = 3.65, sd= 0.6); Entrepreneurship (M = 3.55, sd = 0.9); Material Benefits (M = 3.05, sd = 0.7); and Professional Contacts (M = 3.03, sd = 0.7). MANOVA indicated gender differences on: (Long-term) Patient Results (F(1,548) = 10.428, p = .001), and Patient Care (F(1,548) = 11.036, p < .001). Subscale correlations with the total DEJRS are: 0.57 > r < 0.88. All subscales show a positive correlation with the DJSS. DISCUSSION: The DEJRS is a valuable and psychometrically sound instrument to monitor job resources as experienced by GDPs. Dentists report immediate results and aesthetics, and long-term results of working with patients to be the most rewarding aspects. All job resources showed a positive correlation with job satisfaction. The discussion includes conjecture that stimulating a greater awareness of job resources serves a major role in burnout prevention.

Empreender para inovar: oportunidades para atuação na ciência / Entrepreneurship to innovate: opportunities for action in science

Empreender para inovar abre novas possibilidades de aplicação dos conhecimentos adquiridos na academia para o desenvolvimento econômico e social no país. Para isso, é importante que todos os atores do ecossistema relacionados com a Tríplice Hélice da Inovação se integrem para a criação de um ambiente de inovação com mecanismos que auxiliem e acelerem o desenvolvimento sustentável do Brasil. O presente comentário pretende divulgar políticas e iniciativas relevantes dos setores públicos e privados para sua interlocução com vistas a fomentar o empreendedorismo e a inovação; bem como contribuir para a ampliação do conhecimento acerca das oportunidades para a atuação de cientistas nesse contexto.

Entrepreneurship to innovate opens new possibilities for applying knowledge acquired in academia for economic and social development in the country. For this, it is important that all actors in the ecosystem related to the Triple Helix of Innovation integrate to create an innovation environment with mechanisms that help and accelerate the sustainable development of Brazil. This commentary intends to disseminate relevant policies and initiatives from the public and private sectors for their dialogue with a view to fostering entrepreneurship and innovation; as well as contributing to the expansion of knowledge about the opportunities for the work of scientists in this context.

Practice progress.

This column is not based on wishful thinking about how things should be, but rather is a candid look at the reality of everyday practice. Prioritization is critical. Each dentist should select three to five major initiatives that he or she would like to achieve and prioritize these accordingly. The best approach for most practices is to deal with each of these only one or two at a time. Consider scoring each priority on a scale of one to 10 (one being the lowest, 10 the highest), gauging its overall importance, its potential effect on the practice and whether it helps achieve preset practice goals.

Entrepreneurialism in dentistry: commercialism versus opportunity.

The school of dentistry at Nova Southeastern University was founded eight years ago at a time when other dental schools were closing. Efficiencies of structure with the Health Professions Division of the university have been important in making this possible. The applicant pool is large and diverse and the educational program is modern. Collaborative relationships are being developed with industry.

Will Large DSO-Managed Group Practices Be the Predominant Setting for Oral Health Care by 2025? Two Viewpoints: Viewpoint 1: Large DSO-Managed Group Practices Will Be the Setting in Which the Majority of Oral Health Care Is Delivered by 2025 and Viewpoint 2: Increases in DSO-Managed Group Practices Will Be Offset by Models Allowing Dentists to Retain the Independence and Freedom of a Traditional Practice.

This Point/Counterpoint article discusses the transformation of dental practice from the traditional solo/small-group (partnership) model of the 1900s to large Dental Support Organizations (DSO) that support affiliated dental practices by providing nonclinical functions such as, but not limited to, accounting, human resources, marketing, and legal and practice management. Many feel that DSO-managed group practices (DMGPs) with employed providers will become the setting in which the majority of oral health care will be delivered in the future. Viewpoint 1 asserts that the traditional dental practice patterns of the past are shifting as many younger dentists gravitate toward employed positions in large group practices or the public sector. Although educational debt is relevant in predicting graduates' practice choices, other variables such as gender, race, and work-life balance play critical roles as well. Societal characteristics demonstrated by aging Gen Xers and those in the Millennial generation blend seamlessly with the opportunities DMGPs offer their employees. Viewpoint 2 contends the traditional model of dental care delivery-allowing entrepreneurial practitioners to make decisions in an autonomous setting-is changing but not to the degree nor as rapidly as Viewpoint 1 professes. Millennials entering the dental profession, with characteristics universally attributed to their generation, see value in the independence and flexibility that a traditional practice allows. Although DMGPs provide dentists one option for practice, several alternative delivery models offer current dentists and future dental school graduates many of the advantages of DMGPs while allowing them to maintain the independence and freedom a traditional practice provides.

Is the dentist an entrepreneur? Yes and no.

Although dentists may have an entrepreneurial spirit, they are not true entrepreneurs. Simply by selecting dentistry as a profession, dentists have engaged in a business that has a high level of success and limited growth potential. By limited growth potential, I do not mean to imply that practices cannot be successful and create excellent lifestyles for dentists. As stated above, they will be limited in growth by the physical capacity of the dentist, the team and the facilities. There is a great deal of security in dental practice if basic management principles are followed and business systems are put in place. In my next column, I will continue to explore the similarities and differences between entrepreneurs and dentists, and how a dentist can take a practice through the multiple stages necessary to achieve the highest levels of dental practice success.

Will disruptive innovations cure health care?

It's no secret that health care delivery is convoluted, expensive, and often deeply dissatisfying to consumers. But what is less obvious is that a way out of this crisis exists. Simpler alternatives to expensive care are already here--everything from $5 eyeglasses that people can use to correct their own vision to angioplasty instead of open-heart surgery. Just as the PC replaced the mainframe and the telephone replaced the telegraph operator, disruptive innovations are changing the landscape of health care. Nurse practitioners, general practitioners, and even patients can do things in less-expensive, decentralized settings that could once be performed only by expensive specialists in centralized, inconvenient locations. But established institutions--teaching hospitals, medical schools, insurance companies, and managed care facilities--are fighting these innovations tooth and nail. Instead of embracing change, they're turning the thumbscrews on their old processes--laying off workers, delaying payments, merging, and adding layers of overhead workers. Not only is this at the root of consumer dissatisfaction with the present system, it sows the seeds of its own destruction. The history of disruptive innovations tells us that incumbent institutions will be replaced with ones whose business models are appropriate to the new technologies and markets. Instead of working to preserve the existing systems, regulators, physicians, and pharmaceutical companies need to ask how they can enable more disruptive innovations to emerge. If the natural process of disruption is allowed to proceed, the result will be higher quality, lower cost, more convenient health care for everyone.

Developing competency in research management, entrepreneurship, and technology transfer: a workshop course.

In July 1999, the National Institute of Dental and Craniofacial Research (NIDCR) convened a Blue Ribbon Panel that recommended management skills, entrepreneurship, and technology transfer should be included in dental education. The panel's recommendations were implemented in an NIDCR-funded pilot project, "Workshop Course to Promote and Develop Dental Products and Technologies." The workshop consisted of lectures presented by seven faculty members recruited from academia, government, and business, along with an analysis of a professor's invention and the barriers encountered in transforming the invention into a product. Evaluation consisted of a pre- and post-workshop survey. The workshop was presented to twenty-two participants on November 8 and 9, 2003 at the University of Connecticut School of Dental Medicine and, to refine the presentation further, will be tested at five additional dental schools (University of Pennsylvania, Harvard University, New York University, Nova Southeastern University, and University of Southern California). The results indicated that the workshop's courses would be helpful to the commercialization of inventions. In addition, dental students with experience in basic research expressed an interest in research of projects of use in dental practice. These findings suggest that pursuing research and an academic career might be more appealing if their research was product-oriented.

Starting a nursing consultation practice.

Because the clinical nurse specialist (CNS) role has been changed or eliminated in many hospital organizations, many CNSs in career transition are considering establishing collaborative or independent nursing consultation practices. Opportunities for consultants exist in diverse practice settings and specialties. Before starting a consultation practice, the CNS should carefully examine goals, identify resources, and begin contacting potential referral sources. He or she must also decide what form of business organization to establish and write a business plan to solidify ideas and prepare for the unexpected. Most CNS consultants rely on personal savings to cover initial business and personal expenses, and many continue working as a CNS until the consultation practice is established. Fees can be set based on community standards, what the market will bear, desired projected income, or a third-party payor's fee schedule. The consultation practice can be marketed by word of mouth, inexpensive advertising techniques such as distributing flyers and business cards, direct mall, and media advertising. In today's healthcare marketplace, opportunities abound for the CNS risk-taker interested in starting a nursing consultation practice.