Use of locums in the Regular GP Scheme 2016-22. / Vikarlegebruk i fastlegeordningen 2016­22.

Background: Under the Regular GP Scheme, locum GPs must be used when GPs are absent or when a patient list has no GP. We have studied the prevalence and development of locum contracts registered in the Regular GP Scheme in the period from 1 January 2016 to 31 December 2022. Material and methods: In this descriptive registry study, we categorised 21 418 locum contracts from the period 1 January 2016 to 31 December 2022 according to municipality and duration. We divided the municipalities into groups according to Statistics Norway's six centrality classes. Classes 1‒2 are central; 3‒4 are less central; and 5‒6 are the least central municipalities. The analysis is based on frequency tables, contingency tables and rates. Results: In the period studied, the number of registered locum contracts increased in Norway from 916 to 5003 (446 %). The increase was largest in centrality group 5‒6. The average duration of the locum positions was 195 days in centrality groups 1‒2 (95 % confidence interval (CI) 190‒200), 130 days in centrality groups 3‒4 (95 % CI 127‒134) and 67 days in centrality groups 5‒6 (95 % CI 64‒69). Centrality groups 5‒6 had twice as many locum contracts for full-time positions compared to centrality groups 1‒2, where part-time positions were more common. Locum contracts per list without a GP increased nationally from 0.5 to 4.7 in the study period. Interpretation: The GP Registry provides increasingly useful, nationwide information on the use of locum GPs. Use of locums in the Regular GP Scheme has increased significantly since 2016, and this may represent a challenge to equal access to health services. Future research should examine the causes and consequences of increased use of locum GPs.

Social capital, government guidance and contract choice in agricultural land transfer.

This study explores the impact of farm households' social capital characteristics and local government policies on the selection of farmland transfer contracts in China's rural industrial revitalization context. Utilizing field research data from 1,979 households in ethnic areas of Hunan Province, this paper constructs an econometric model to assess how farm households' social capital and local governments' involvement in rural industrial revitalization influence farmland transfer contract selections. The findings indicate that, lacking government program support, farmers' social capital significantly affects contract type and duration, but not the rent. Specifically, farmers possessing extensive social capital prefer verbal and short-term contracts (coefficients of 0.525 and 0.643, significant at the 5% level), whereas their influence on rent (coefficient of 2.418, significant at the 5% level) manifests under government program support. These results challenge the conventional theory of farmland transfer contracts and offer substantial empirical support for the development of local government policies in rural industrial revitalization, underlining the critical role of government guidance and social capital in enhancing farmland transfer.

Regulating seafarers' welfare: an examination of the protection of Filipino seafarers' well-being through a legal analysis of the POEA-Standard Employment Contract.

BACKGROUND: The Philippines is the global maritime industry's single biggest source of seafarers. This article examines how the Philippines protects the welfare of its seafarers working on board ocean-going vessels. MATERIALS AND METHODS: We employed a multi-method approach to better understand the POEA-SEC as a regulatory instrument. First, we analysed Philippine legislation and regulations that are shaping the employment, welfare, and working conditions of Filipino seafarers. Second, we examined the Philippine Overseas Employment Administration Standard Employment Contract (POEA-SEC) which requires that minimum standards of employment for seafarers are met. We use legal analysis to examine three specific provisions that pertain to their well-being: duration of employment, monetary considerations, and working conditions in terms of hours of work and rest periods. Third, we analysed interview and focus group data on the experiences of Filipino seafarers on board ships in respect of the POEA-SEC's efficacy in protecting their well-being. RESULTS: Analysis of the policy environment for Filipino seafarers shows how the interests of powerful actors have taken precedence over those of Filipino seafarers. Seafarers' experiences suggest that they cannot be reached by the contract, whether symbolic or otherwise. The contract fails to address seafarer issues, such as security of tenure, excessive working hours resulting in fatigue, stress and anxiety. CONCLUSIONS: The POEA-SEC falls short as a legal document to address occupational, health and safety issues, which contribute to the detriment of seafarers' health and well-being. This indicates that the Philippine government cannot fully protect its seafarers.

A primer on brand-name prescription drug contracting.

Prescription drug contracting in the United States has evolved over decades from discounts provided to members of early health maintenance organization plans to rebate contracts to more complex value-based purchasing arrangements. This primer describes the history of contracting between pharmaceutical manufacturers and managed care pharmacy organizations and details the various contracting methods used today.

Contract development and manufacturing organization selection: critical considerations that can make or break your cell and gene therapy development.

BACKGROUND AIMS: With the increase in cell and gene therapy (CGT) clinical trials in recent years has come a subsequent increase in the number of contract development and manufacturing organizations (CDMOs). Successful transition from development and early-phase clinical trials to commercialization of a CGT product often depends on selecting the best-suited CDMO. However, many CGT companies are small biotech companies that lack expertise in the field or do not have experience selecting and transferring a process to a CDMO. METHODS: Given the interest in this topic, a roundtable with CGT developers and CDMO members at the 2023 annual meeting of the International Society of Cell and Gene Therapy Paris discussed these critical aspects of product development, including technical expertise, risk sharing and timing of partnerships. RESULTS AND CONCLUSIONS: Here, we'll analyze the considerations discussed by the panel and elaborate on other factors crucial for CGT development.

It's not just about the money: recruitment and retention of clinical staff in general dental practice - part 1: dentists.

Increasing difficulties in recruitment and retention of dentists and dental care professionals in general dental practice in the UK is affecting delivery of NHS dental services. Reports of dissatisfaction among the general dental practice workforce indicate there is a significant risk to the future dental workforce supply which will affect access to dental care and worsen oral health inequalities. Understanding the factors related to job satisfaction and dissatisfaction of dental professionals would be useful in managing recruitment and retention issues and ensure a dental workforce exists which is able to meet the needs of the population. The aim of this literature review was to identify factors which contribute to job satisfaction and dissatisfaction of clinical staff in general dental practice. Database searching was conducted systematically through PubMed/Medline, Scopus, Ovid, and the National Grey Literature Collection. Part 1 of this two-part series discusses the factors relating to dentists. Twenty-two relevant articles were identified, which were qualitatively analysed using Herzberg's motivation-hygiene theory as an analysis tool. Target-driven and restrictive contractual arrangements are a major factor contributing to dissatisfaction of dentists, as well as time pressures, poor quality equipment, and unfair remuneration. Dental contract reform should aim to minimise factors contributing to dissatisfaction and increase factors which increase satisfaction, if sufficient numbers of dentists are to be persuaded to continue to provide state-funded dentistry.

Surrogacy as fertility treatment in Denmark.

Gestational surrogacy, in which an infertile couple contracts with a woman to carry a foetus that the intended parents will raise, increases worldwide, and offers a route to parenthood for individuals and couples who otherwise have limited options. However, the situation in Denmark at present is that surrogacy with the help of healthcare professionals is illegal, and international adoption is no longer available. This review gives an overview of the legal situation of surrogacy in Denmark, the impact of the legislation, and medical issues to be aware of as healthcare professionals in the future.

What do consumers understand about predispute arbitration agreements? an empirical investigation.

The results of a survey of 1,071 adults in the United States reveal that most consumers do not pay attention to, let alone understand, arbitration clauses in their everyday lives. The vast majority of survey respondents (over 97%) report having opened an account with a company that requires disputes to be submitted to binding arbitration (e.g., Netflix, Hulu, Cash App, a phone or cable company), yet most are unaware that they have, in fact, agreed to mandatory arbitration (also known as "forced arbitration"). Indeed, over 99% of respondents who think they have never entered into an arbitration agreement likely have done so. Over 92% of respondents report that they have never based a decision to use a product or service on whether the terms and conditions contain an arbitration agreement. When prompted, they largely endorse the following reasons: they were unaware of the arbitration clause, they did not read the terms and conditions, and they thought they had no choice but to agree to mandatory arbitration. Moreover, many respondents presume that if a dispute arises, they will still be able to access the public courts, notwithstanding that they agreed to the terms and conditions. Consumers are largely unaware of opportunities to opt out of mandatory arbitration. They generally do not pay attention to or retain information about the steps required to opt out successfully (e.g., contacting the company within a specified time period). Generally, consumers are unaware that companies like Cash App and Venmo (mobile payment systems utilized by nearly 60% of respondents) allow customers to opt out of mandatory arbitration if they act within a limited time period. Among the minority of respondents (21%) who stated that they had been given an opportunity to opt out, vanishingly few could name any of the steps required to opt out successfully. When presented with a run-of-the-mill contract, of the type consumers routinely encounter, most respondents did not take notice of the arbitration clause. Less than 5% of respondents could recall that the contract they were shown had said anything at all about arbitration. Furthermore, most consumers misperceive the consequences of signing a predispute arbitration agreement. Most mistakenly believe that, after agreeing to terms and conditions mandating binding arbitration, they can still choose to settle their dispute in court, have a jury decide their case, join a class action, and appeal a decision made based on a legal error. For instance, less than 5% of respondents correctly reported that they could neither appeal an erroneous decision to another arbitrator (or set of arbitrators) nor start all over again in court. Less than 1% of respondents correctly understood the full significance of the arbitration agreement, as indicated by their responses to questions about whether they retained the rights to sue, have a jury decide their case, access the public courts, and appeal a decision based on a legal error. In summary, consumers are generally unaware of arbitration clauses, and they tend to hold mistaken beliefs about how arbitration agreements affect consumers' procedural rights.