The Impact of Primary Care Clinic and Family Physician Continuity on Patient Health Outcomes: A Retrospective Analysis From Alberta, Canada.

PURPOSE: Continuity of care is broadly associated with better patient health outcomes. The relative contributions of continuity with an individual physician and with a practice, however, have not generally been distinguished. This retrospective observational study examined the impact of continuity of care for patients seen at their main clinic but by different family physicians. METHODS: We analyzed linked health administrative data from 2015-2018 from Alberta, Canada to explore the association of physician and clinic continuity with rates of emergency department (ED) visits and hospitalizations across varying levels of patient complexity. Physician continuity was calculated using the known provider of care index and clinic continuity with an analogous measure. We developed zero-inflated negative binomial models to assess the association of each with all-cause ED visits and hospitalizations. RESULTS: High physician continuity was associated with lower ED use across all levels of patient complexity and with fewer hospitalizations for highly complex patients. Broadly, no (0%) clinic continuity was associated with increased use and complete (100%) clinic continuity with decreased use, with the largest effect seen for the most complex patients. Levels of clinic continuity between 1% and 50% were generally associated with slightly higher use, and levels of 51% to 99% with slightly lower use. CONCLUSIONS: The best health care outcomes (measured by ED visits and hospitalizations) are associated with consistently seeing one's own primary family physician or seeing a clinic partner when that physician is unavailable. The effect of partial clinic continuity appears complex and requires additional research. These results provide some reassurance for part-time and shared practices, and guidance for primary care workforce policy makers.

Association between the Combination of Speed-Eating and Eating until Full and Overweight/Obesity in Part-Time High School Students.

INTRODUCTION: This cross-sectional study aimed to examine the association between overweight/obesity and the combined behavior of speed-eating and eating until full among part-time high school students. METHODS: In 2015, 2,507 male and female part-time high school students from Hyogo Prefecture, Japan, who completed a self-reported questionnaire on lifestyle, were included in the analysis. Overweight/obesity was defined as a body mass index of 25 kg/m2 or more. Responses regarding speed-eating and eating until full were obtained by self-reporting. Logistic regression analysis was used to estimate the odds ratio (OR) for overweight/obesity. RESULTS: Among the participants, 340 (13.6%) were overweight/obese and 468 (18.7%) reported both speed-eating and eating until full. Compared to neither speed-eating nor eating until full group, after adjustment for sex, age, work pattern, physical activity level, sleep duration, frequency of picky eating, frequency of snack intake, fast food intake frequency, frequency of adding salty condiments, frequency of eating less food to save money, and survey schools, the OR (95% CI) for overweight/obesity in speed-eating and not eating until full, eating until full and not speed-eating, and speed-eating and eating until full was 2.11 (1.38-3.22), 1.54 (1.12-2.10), and 2.94 (2.08-4.16), respectively. CONCLUSIONS: The combination of speed-eating and eating until full was associated with overweight/obesity among part-time high school students independent of other lifestyle factors.

Work hours, weekend working, nonstandard work schedules and sleep quantity and quality: findings from the UK household longitudinal study.

BACKGROUND: Atypical temporal work patterns such as working longer than the standard 35-40 h/ week, weekend working, and nonstandard work schedules (i.e. outside of the typical 9-5, including but not restricted to shiftwork) are increasingly prevalent in the UK. Aside from occupation-specific studies, little is known about the effects of these atypical temporal work patterns on sleep among workers in the UK, even though poor sleep has been linked to adverse health problems, lower workplace productivity, and economic costs. METHOD: We used regression models to investigate associations between three types of atypical temporal work patterns (long and short weekly work hours, weekend working, and nonstandard schedules) and sleep duration and disturbance using data from over 25,000 employed men and women from 2012-2014 and/or 2015-2017 in the UK Household Longitudinal Study, adjusting for potential confounders and psychosocial work factors. RESULTS: We found that relative to a standard 35-40 h/week, working 55 h/week or more was related to short sleep (less than 7 h/night) and sleep disturbance. Working most/all weekends compared to non-weekends was associated with short sleep, long sleep (more than 8 h/night), and sleep disturbance, as was working nonstandard schedules relative to standard schedules (fixed day-time schedules). Further analyses suggested some gender differences. CONCLUSIONS: These results should prompt employers and policymakers to recognise the need for rest and recovery, consider how the timing and scheduling of work might be improved to better support workers' health and productivity, and consider appropriate compensation for anyone required to work atypical temporal work patterns.

Differences in Role and Support Between Volunteer and Paid Community Health Workers in the State of Nebraska.

Despite the growing importance of community health workers (CHWs) in public health, it has been difficult to characterize the roles and scope of services for this workforce in part because of the variability in the employment status of CHWs, ranging from full-time, part-time, to volunteer. Based on analysis of survey data from a statewide assessment of the CHW workforce in Nebraska (n = 142) conducted between 2019 and 2020, the proportions of CHWs who worked full-time, part-time, or volunteer were respectively 64%, 12%, and 21%. Over three quarters (76.7%) of volunteer CHWs were primarily working with Hispanic communities, as compared to less than 30% among full-time and part-time CHWs. About 80% of volunteer CHWs received training before becoming a CHW, substantially higher than the corresponding proportions among full-time (46.2%) and part-time CHWs (52.9%). In terms of tasks performed, the proportion of volunteer CHWs who provided health screenings (70%) were much higher than full or part-time CHWs (41.8% and 11.8% respectively, p < 0.001); whereas the latter two groups were significantly more likely than volunteer CHWs to provide other tasks such as coordinating care, health coaching, social support, transportation, interpretation, data collection, advocacy, and cultural awareness. Volunteer CHWs may hold potential for serving non-Hispanic communities. Future development of the CHW workforce can benefit from understanding and leveraging the significant differences in roles and scope of services among CHWs with various employment statuses.

Current perceptions and working time models of female urologists in Germany: results of a large-scale survey.

PURPOSE: Female urologists are distinctly underrepresented in leading positions. The reasons behind this inequity remain unclear, with some suggesting factors such as family responsibilities, part-time work and insufficient mentorship. This study aimed to explore and characterize the working conditions of female urologists in Germany, with a focus on factors influencing the working time model. METHODS: A questionnaire was developed and distributed to 1343 female members of the German Society of Urology between February and March 2022. The survey consisted of 43 questions covering the categories demographics, occupation situation, satisfaction at work, family situation, career aspects and research activity. RESULTS: Of the 487 female German urologists who participated in the survey, 167 (34.3%) worked part-time. Doctors in training were significantly less likely to work part-time than colleagues who had completed their specialist training (p < 0.001). Only 10% of female doctors in training reported working part-time. Similarly, having children (p < 0.001) and engaging in scientific activities (p = 0.03) were independent factors influencing part-time work, with children increasing the likelihood of working part-time as expected, while scientifically active female urologists were more likely to work full-time. CONCLUSION: This study provides the largest survey on the situation of female urologists in German-speaking countries to date. Part-time work during specialist training is rare, while more than 50% of female urologists with children work part-time. With the projected decline in the number of practicing physicians and the increasing demand for medical attention, it is crucial to find ways to retain and support healthcare professionals, particularly female urologists.

Efficacy of part-time patching in preventing recurrence after bilateral lateral rectus recession in children with intermittent exotropia.

BACKGROUND: This study evaluate the efficacy of part-time patching in preventing recurrence after bilateral lateral rectus recession (BLR) in patients with intermittent exotropia (IXT). METHODS: A total of 190 children aged 3-13 years who experienced recurrence after BLR for IXT and received part-time patching were retrospectively reviewed. The patching was prescribed for 2 h per day for more than 6 months. Patients who had a recurrence of 18 PD or more underwent reoperation. Changes in exodeviation and reoperation ratio after part-time patching were analyzed. RESULTS: A total of 34 patients (17.9%) received reoperation after part-time patching, and the reoperation ratio after 2 years was 20.3% as per the Kaplan-Meier survival analysis. Patients with a recurrence of 7 to 10 PD showed a significantly better effect compared to those with a recurrence of more than 10 PD (p < 0.001), and the reoperation ratio was also lower in the survival analysis (p = 0.004). The factor associated with reoperation in patients with part-time patching was the duration between the operation and the initiation of part-time patching (hazard ratio [HR] = 1.006, p = 0.002). CONCLUSIONS: Part-time patching was effective in maintaining the efficacy of surgery and delaying the need of reoperation after BLR. This effect was better in patients with a recurrence of ≤ 10 PD.

Part-time work and sickness absence - an organization-level analysis.

BACKGROUND: Absenteeism is consistently higher in public than in private organizations, as is the use of part-time employment. The aim of this study is to identify whether there is a relationship between part-time work and sickness absence at the organizational level. METHODS: The data is a six-year panel for the full population of Norwegian municipalities (N = 422), linking objective register data on both part-time employment and sickness absence. Using OLS regression with fixed effects for municipality and time, we estimate the statistical effects of the municipalities' use of part-time work on sickness absence. RESULTS: The bivariate correlation between percentage position at the municipal level and percentage sickness absence is positive and significant (Pearson's r = .25, sig LE 0.01). When controlling for fixed effects for municipality and time, as well as municipality economy, municipality size, ratio of female employees in the municipality and characteristics of the general population, the multivariate regression coefficient is still positive but insignificant (coefficient = 1.56, robust standard error = 1.31). CONCLUSIONS: The main findings are that the organizations' use of part-time work is unrelated to sickness absence indicating that organizations with extensive use of part-time work do not experience higher levels of absenteeism than those having less extensive use of part-time employees.

The Influence of Part-Time Occlusion Therapy on Control of Intermittent Exotropia: A Meta-Analysis of Randomized Controlled Trials.

BACKGROUND: Intermittent exotropia is the most prevalent subtype of exotropia in children. Part-time occlusion (PTO) as an anti-suppression therapy was applied for nonsurgical management of intermittent exotropia. OBJECTIVE: The aim of the study was to compare the effectiveness of PTO therapy and observation in the treatment of intermittent exotropia. METHOD: An exhaustive search of the literature from PubMed, Embase, Web of Science, and Cochrane Library databases was carried out until July 2022. No language restrictions were applied. The literature was rigorously screened against eligibility criteria. Weighted mean differences and 95% confidence interval (CI) were calculated. RESULTS: A total of 4 articles with 617 participants were included in this meta-analysis. Our pooled results showed that PTO exhibited superior effects compared to observation, with greater decrease in exotropia control at distance and near (MD = -0.38, 95% CI: -0.57 to -0.20, p < 0.001; MD = -0.36, 95% CI: -0.54 to -0.18, p < 0.001); patients subjected to PTO therapy had greater decrease in distance deviations (MD = -1.95, 95% CI: -3.13 to -0.76, p = 0.001), and there was greater improvement in near stereoacuity among the PTO group in comparison with the observation group (p < 0.001). CONCLUSIONS: The present meta-analysis indicated that PTO therapy showed a better effect in improving control and near stereopsis and decreasing distance exodeviation angle of children with intermittent exotropia in comparison with observation.

A Cost-Benefit Analysis of School Nursing in One Large Urban School District.

This study is a cost-benefit analysis examining an urban district's partial school nurse coverage conversion to full-time coverage. Through a partnership with a health care system, the district received funding, resulting in the hiring of full-time nurses to cover all K-8 elementary schools. Researchers compared the cost of nursing services to the savings in teacher, secretary, principal, and parent productivity, reduced medical procedure costs, and grants nurses managed. The year before implementing additional nurses, the return on investment (ROI) to the community for nursing services was calculated to be $1.59 for every dollar invested in schools with full-time coverage and $1.29 for schools with partial coverage. After implementing full-time nurses in each school, there was an ROI of $1.50 during the 2015-2016 school year, $1.64 for 2016-2017, and $1.67 for 2017-2018. The analysis provides evidence that full-time coverage could result in a positive ROI for schools and the community.

Efficacy of vision therapy for unilateral refractive amblyopia in children aged 7-10 years.

BACKGROUND: There is a critical period for visual development, conventionally considered to be the first 6 years of life. Children aged 7 years and older are significantly less responsive to amblyopia treatment. This study investigated the efficacy of binocular vision therapy in amblyopic children aged 7-10 years. METHODS: This retrospective study enrolled 36 children with unilateral amblyopia who were divided into a case group (receiving vision therapy, optical correction, and part-time patching of the weaker eye) and a control group (receiving optical correction and part-time patching of the weaker eye). Visual acuity (VA) was measured at baseline, at the 3-month, 6-month, and 9-month visits, and 3 months after cessation of treatment. RESULTS: There were 19 subjects in the case group and 17 subjects in the control group. Mean VA in the case group improved from 0.39 ± 0.24 logMAR at baseline to 0.10 ± 0.23 logMAR at the endpoint of treatment (p < 0.001, paired t-test). Mean VA in the control group improved from 0.64 ± 0.30 logMAR at baseline to 0.52 ± 0.27 logMAR at the endpoint of treatment (p = 0.015, paired t-test). The improvement was significantly greater in the case group than in the control group (p = 0.006, two-samples independent t-test). All subjects underwent follow-up examinations within 6 to 12 months. There was no regression of VA in the case group 3 months after cessation of vision therapy. The patients in the case group who received visual therapy were with better VA improvement then patients with only optic correction and patching. CONCLUSIONS: Vision therapy combined with conventional treatment (optical correction and part-time patching) is more effective than conventional treatment alone in children aged 7-10 years with unilateral refractive amblyopia. The treatment results not only in greater vision gain, but also in shorter duration of treatment.

Comparison of alternate part-time patching and pencil push-up training for patients with intermittent exotropia.

BACKGROUND: To compare the effect of alternate part-time patching and pencil push-up training on control ability in patients with intermittent exotropia. METHODS: Patients (3-7 years old) with previously untreated intermittent exotropia were randomly assigned to receive alternate part-time patching, pencil push-up training, or observation. Control ability was assessed using the Office Control Score. Stereoacuity at 40 cm was evaluated with Titmus. Results were compared after a 12-week follow-up. RESULTS: Ninety-two patients (28 in patching, 30 in pencil push-ups, and 34 in observation group) completed 12-week follow-up assessments. Based on 6-point scale, the mean deviation control was significantly better in patching and pencil push-up group after 12 weeks at distance (P = 0.002 and 0.026, respectively). Furthermore, there were greater control changes in patching and pencil push-up groups in comparison with observation group from baseline to 12 weeks (P<0.001; P = 0.003, respectively). After 12 weeks of treatment, stereoacuity and stereoacuity changes were not significantly different between either the intervention group or control group (P = 0.140 and 0.393, respectively). CONCLUSIONS: Based on the common office control scale, alternate part-time patching and pencil push-up training were effective treatment strategies for intermittent exotropia.

Combining jobs and motherhood: is it worse when raising children alone?

BACKGROUND: Paid employment has been shown to benefit childless women's health, while employed mothers experience poorer health, and more pronounced fatigue. This study measures the association between job characteristics and the health and well-being of employed mothers and the differential susceptibility to job characteristics between coupled and single-parent mothers. METHODS: We used data from the 5th Portuguese National Health Survey from 1649 employed women (aged 25-54) living with a child under 16. We modelled depression (assessed by the Personal Health Questionnaire-8) and self-reported health as a function of job characteristics, adding interaction terms to compare coupled and single-parent mothers, using logistic regressions. RESULTS: Working part-time was associated with depression (odds ratio (OR) = 3.39, 95% confidence interval (CI) = 3.31-3.48) and less-than-good health (OR = 1.28, 95%CI = 1.26-1.31), compared to working full time. Compared to high-skill jobs, the likelihood for depression among low-skill occupations was lower among coupled mothers (OR = 0.25, 95%CI = 0.24-0.26), and higher among single-parent mothers (OR = 1.75, 95%CI = 1.54-1.99). Unstable jobs were associated with depression among coupled mothers. CONCLUSIONS: Part-time jobs are detrimental for mothers' mental health, but high-skilled jobs are protective for single-parent mothers. Part-time and unstable jobs are linked to poorer self-reported health among coupled mothers. Results question the gendered arrangements that may face employed coupled mothers.

Burnout and work-privacy conflict - are there differences between full-time and part-time physicians?

BACKGROUND: Changes in everyday work with regard to working time models have reached the medical profession. The number of physicians working part-time is steadily increasing. At the same time, however, the population's need for care is also rising. This can reinforce the impending shortage of doctors in the future. The aim was to investigate differences in work-privacy conflict and burnout among physicians working full-time or part-time. METHOD: The present study includes data from a baseline survey of the long-term study of physicians with different medical backgrounds. The analysis focused on a sub-sample of 598 physicians (not self-employed). The two main outcomes under investigation-burnout and work-privacy conflict-were measured using the Copenhagen Burnout Inventory adapted for health care professionals, as well as the associated subscale of the Copenhagen Psychosocial Questionnaire (COPSOQ). Data analyses included descriptive statistics followed by regression models. RESULTS: Descriptive analyses show, that 31.8% of physicians are working part-time, whereas 68.2% are working full-time. The part-time subsample is significantly older, and female physicians are more likely to work part-time. With regard to workload and work-privacy conflict, significant differences between part-time and full-time physicians were only observed in terms of work-privacy-conflict. However, regression analysis underline the importance of possible confounding variables (such as medical setting) within the relationship between job size and job-related well-being. DISCUSSION: Differences in working hour arrangements (full-time or part-time work) are only accompanied by less work-privacy conflict. No differences with regard to burnout (patient-related, work-related or personal) could be obtained. Rather, the data suggests that other job-related variables may play a role and should be further investigated.

From clinical expert nurse to part-time clinical nursing instructor: design and evaluation of a competency-based curriculum with structured mentoring: a mixed methods study.

BACKGROUND: Transition from a clinical expert nurse to a  part time clinical nursing instructor (PTCNI) poses several challenges. Designing a professional development curriculum to facilitate the transition from a clinical expert nurse to a  PTCNI is critical to effective education. A comprehensive competency-based curriculum was developed and implemented with structured mentoring to prepare clinical expert nurses as PTCNIs. METHODS: A mixed-methods study with a sequential-exploratory approach was conducted in Iran in 2019. In the qualitative phase, Saylor et al.'s (1981) seven-step model was used, consisting of (1) collecting evidence from a systematic review, (2) conducting interviews with learners, (3) setting goals and objectives, (4) design, (5) implementation, (6) evaluation, and (7) feedback. In the quantitative phase, curriculum domains were evaluated. Additionally, the effective professional communication skills module was implemented using a quasi-experimental study with a pre-test post-test single-group design for 5 PTCNIs in a pilot study. RESULTS: After integrating the findings of the literature review and field interviews in the analysis stage, a curriculum was developed with a total of 150 h, six modules, and 24 topics. Results of the pilot study showed a significant improvement in the confidence of PTCNIs as a result of the implementation of the effective communication skills module using the mentoring method (t = - 16.554, p = 0.0005). CONCLUSIONS: This competency-based curriculum was based on the evidence and needs of PTCNIs and provides a complete coverage of their clinical education competencies. It is suggested that managers of educational institutes that offer nursing programs use this curriculum to prepare them in continuing education programs. Further studies are needed to thoroughly evaluate the learning outcomes for students.

Work-related communication mediates the relationship between perceived diversity climate and psychological empowerment among part-time nurses: A cross-sectional study.

AIM: This study investigates which work-related communication mediates the relationship between diversity climate and psychological empowerment among part-time nurses. BACKGROUND: Part-time nurses' high psychological empowerment is desirable because it may lead to high quality nursing practice. METHODS: Anonymous self-report questionnaires or web-based surveys were used to measure diversity climate (Climate for Inclusion Scale), psychological empowerment (Japanese version of the Psychological Empowerment Scale) and work-related communication (scale developed in this study). The respondents were part-time nurses from departments with shift work in six Japanese hospitals having over 200 beds. The surveys were conducted from September to October 2020. Multiple regression analyses and a significance test of indirect effects were then conducted. RESULTS: Among the work-related communication components, 'expressing thoughts about their work' fully mediated the relationship between diversity climate and psychological empowerment. CONCLUSIONS: It is important for part-time nurses to be actively 'expressing thoughts about their work' to enhance their psychological empowerment. Positive diversity climate is also important because it allows part-time nurses to express their thoughts regarding work. IMPLICATIONS FOR NURSING MANAGEMENT: Managers can enhance part-time nurses' psychological empowerment by encouraging them to express their work-related opinions based on the diversity climate.

[ANALYSIS OF THE STAFFING OF MEDICAL ORGANIZATIONS SUBORDINATE TO THE DEPARTMENT OF HEALTH OF THE CITY OF MOSCOW IN 2021].

An analysis was made of the structure and number of medical workers (doctors and paramedical personnel) of the Moscow healthcare system for the period 2017-2021. The analysis showed that the number of medical full-time positions over the same period increased by 13.6%, and regular positions of nursing staff by 8.9%. The provision of the population (per 10 thousand population) with doctors increased by 13.0% from 35.6 in 2017 to 40.2 in 2021. The provision of the population with nurses decreased by 2.4% from 58.4 in 2017 to 57.0 in 2021. Among medical workers, the number of individual doctors, over the same period, increased by 15.5%, and the number of individuals of paramedical personnel decreased by 3.4%. The staffing of medical rates (by positions), in general, decreased by 2.4% from 82.5 in 2017 to 80.5 in 2021, and the rates of nursing staff decreased by 9.7% from 87.4% in 2017 to 79.0% in 2021. The part-time ratio was 1.1 for medical positions and for positions of paramedical personnel. Issues related to low staffing and the coefficient of part-time employment for individual medical positions and positions of paramedical personnel require further resolution.

The influence of alternate part-time patching on control of intermittent exotropia: a randomized clinical trial.

PURPOSE: To evaluate the effect of alternate part-time patching on deviation control in patients with intermittent exotropia in comparison to observation. METHODS: In a randomized clinical trial, untreated 3-8-year-old children with intermittent exotropia were randomly divided into patching group who treated with alternate part-time patching and observation group. Deviation control was assessed with 3-point and 6-point scales. Stereoacuity and suppression were evaluated with Titmus and Worth-4-dot tests respectively. All exams were repeated 3 and 6 months after beginning of treatment. RESULTS: Seventy-six patients (35 in patching and 41 in observation group) with a mean age of 4.99 ± 1.33 years completed the 6-month course of study. Based on 3-point scale, deviation control was significantly better in patching group after 3 and 6 months at near and after 3 months at far (p = 0.011, 0.011, and 0.03, respectively) but non-significant after 6 months at far (p = 0.16). According to 6-point scale, deviation control was also significantly better in patching group after 3 months (p = 0.03 at far, 0.003 at near) and 6 months (p = 0.03 at far, 0.003 at near). Three and 6 months stereoacuity was not significantly different between groups (p = 0.86 for both). However, there was greater stereoacuity changes among patching group in comparison with observation group from baseline to 3 and 6 months (p = 0.006 for both). CONCLUSION: Patching seems effective in improving deviation control of 3-8-year-old children with intermittent exotropia in comparison with observation based on two common office control scales. TRIAL REGISTRATION NUMBER AND DATE: NCT03700632 (10/9/2018).

Part-time work and other occupational risk factors for suicide among working women in the Swiss National Cohort.

OBJECTIVE: The aim of this study was to describe the factors associated with mortality by suicide among working women focusing on work-related factors. METHODS: The study population consisted in all Swiss residents recorded in the 1990 and/or the 2000 compulsory national censuses and were linked to emigration and mortality registers. We selected all women aged 18-65 and at work at the official census dates. Following work-related variables were available: socio-economic status, weekly hours of work, the sector of activity and the job title coded according to the International Standard Classification of Occupations (ISCO). The risk of suicide was modelled using negative binomial regression. RESULTS: The cohort comprised 1,771,940 women and 2526 deaths by suicide corresponding to 24.9 million person-years. The most significant non-occupational predictors of suicide were age, period, civil status, religion, nationality and geographical regions. Adjusted on these factors, part-time work was associated with increased suicide rates. According to job codes, health and social activities, in particular care-worker had the highest suicide risks. CONCLUSION: Suicide among working women depended on work-related factors even taking into account other socio-demographic factors.

[Employment of older people in the modern labor market.]

The article examines the employment of older people in the context of disrupted technological, medical and demographic changes. The relevance of the research topic is due to the demographic aging of the population, modern medical advances and changes in the nature of labor operations as a result of scientific and technological progress. In this article, the following competing hypotheses are tested: the productivity of older workers is below the level of profitability due to a steady decline in health, or vice versa, the value of older workers in the modern labor market is increasing due to the increasing role of experience, skills and qualifications. Additionally, the question of the impact of pension systems on the motivation of older people to continue working is analyzed. To test these hypotheses, based on OECD statistics, we analyzed the overall level of employment, labor force participation and unemployment, as well as temporary and underemployment for several age groups in the range of 15-65+ years. To assess the dynamics, the situation for 2000 and 2019 was analyzed. In general, the author concludes that the quantitative and qualitative parameters of employment of older people are inferior to the average working age, but over time, the use of the human capital of older people is growing. In the field of gerontology, it is recommended to pay increased attention to improving the health of the 65+ age cohort and changing labor legislation in order to stimulate the continuation of work.

Barriers to Post-CCST training in orthodontics: A survey of trainee perceptions.

INTRODUCTION: In order to be eligible for consultant appointments within the NHS, orthodontists can undertake higher specialty training after their Certificate of Completion of Specialist Training (CCST). These training posts are known as Post-CCST positions and orthodontists must be eligible for inclusion on the General Dental Council's (GDC) specialist list for orthodontics before applying. There has been a decline in the number of applicants and the number of filled Post-CCST positions in recent years, leading to concerns over a potential shortage of appropriately trained consultant orthodontists to provide a secondary care service in the near future. This survey was undertaken to identify barriers to applying for Post-CCST training and assess potential options for increasing trainee numbers. METHODS: An online survey was distributed, by email, to current orthodontic trainees and those that had recently completed training in the last six months via the British Orthodontic Society Training Grades Group. Reminder emails were sent at two and four weeks. A total of 201 trainees were invited to complete the survey. RESULTS: Eighty-nine trainees completed the survey (response rate of 44.3%). Regarding applying to Post-CCST training, 32.6% and 47.7% of respondents, respectively, either wanted to or were considering applying for Post-CCST training. The South East was the most preferred region for Post-CCST training (38.0%). Reasons for not wishing to complete Post-CCST training included salary (71.9%), lack of consultant posts in desired regions (64.1%) and inability/unwillingness to relocate (63.5%). Part-time training (91.0%) and a higher salary during training (86.0%) were most likely to incentivise application for Post-CCST training. CONCLUSION: Financial, family and geographical concerns appear to be the main reasons why trainees might not consider Post-CCST training. Part-time and run-through training options may encourage trainees to apply for Post-CCST training.