Examining Inequality in the Public Health Workforce Distribution in the Centers for Disease Control and Prevention(CDCs) System in China, 2008–2017

Objective Allocation of human resources to address inequalities in the public health system has increasingly attracted societal and political attention.Using the Centers for Disease Control and Prevention(CDCs)system of China as an example,we evaluated inequality in the public health workforce distribution across different regions in China between 2008 and 2017,with the aim of providing information for policymakers to support resource allocation and address growing health inequities.Methods We used three standard public health workforce inequality indices-Gini coefficient,Theil L,and Theil T-and spatial autocorrelation analysis to explore spatial clusters of the workforce in different provinces,visualized with geographical tools.Results The aggregate workforce-to-population ratio decreased from 1.47 to 1.42 per 10,000 population from 2008 to 2017,and was consistently lower than the National Health Commission’s(NHC)recommended critical shortage threshold of 1.75.The workforce distribution inequality indices varied by regional socioeconomic and health system development.Geographic clustering of CDCs workforce distribution was evident,with H–H and L–L clusters in western China and the Guangdong-Fujian region,respectively.Conclusions Our study addressed key issues for government and policymakers in allocation of public health human resources.There is an urgent need for careful identification of analytic questions that will help carry out public health functions in the new era,alongside policy implications for an equitable distribution of the public health workforce focusing on the western region and low–low cluster areas.

Equity Study in Health Workforce on Tuberculosis Control in China: a Nationwide Evaluation

We aimed to describe the distribution of tuberculosis （TB） health workers in China and provide evidences of potential inequity for policy development. We used Lorenz curves and Gini index to characterize the distribution of TB health workers by population size, geographical area and number of annual registered TB cases. An additional stratified analysis was done by three economic regions. The Gini index were 0.33 for population size, 0.62 for geographical area and 0.30 for number of registered tuberculosis cases that indicated an acceptable average, significant inequity and a relative average distribution nationwide respectively.

Design of Software for Maintenance Workforce Scheduling (A Case Study of Afam Power Station, Nigeria)

This paper is concerned with the optimization of the workforce scheduling for solving maintenance problems. To achieve this aim an optimsation software for (5, 7) problem was developed. The programme was written in Quick Basic. The software was designed to produce a seven day schedule for organization operating a seven day week. Hence organization operating a five day schedule wishing to change to a seven day schedule we find this software very useful. The Quick-Basic computer programme was based on Alfares [1, 2] algorithm for solving (5,7) schedule problem. Data collected from Afam power station, Nigeria was used as input data. The test result shows the software is capable of determining workforce size and assigning workers to day-off pattern. The seven-day schedule produced savings of 11% maintenance labour cost when compared with the 5-day schedule currently being practiced by the Power station [3].

Working Longer and Happier:Inclusive Design for the Ageing Workforce

This paper estimates the population to be influenced by China's policy of postponed retirement age and provides design strategies and suggestions in the workplace for the ageing workforce from the perspective of inclusive design.First,the literature review about western design principles and practices for the ageing workforce is conducted.It is estimated that China would face approximately 100 million elderly workers in the near future with diverse physical conditions and demands.However,the design research and practices dedicated to ageing workforce in the workplace are comparatively weak in China.Inclusive design,one of the design approaches mainly focusing on ageing problems in developed countries,as well as its theory and methodology,could act as a good reference for Chinese policymakers and designers.Then based on the concept of inclusive design,a human-centered design model is established and design suggestions from four aspects are presented.Finally,two cases are further discussed to illustrate the idea of inclusive design.

Hypothesizing “Reward” Gene Polymorphisms May Predict High Rates of Injury and Addiction in the Workforce: A Nutrient and Electrotherapeutic Based Solution

We hypothesize that individuals with genetic predisposition to Substance Use Disorder (SUD) may have greater likelihood of experiencing work related accidents. We further hypothesize that high risk populations will carry single or multiple polymorphisms associated with brain reward circuitry and/or brain reward cascade, including: Dopaminergic (i.e. DRD2 receptor genes);Serotonergic (i.e. 5-HTT2 receptor genes);Endorphinergic (i.e. pre-enkephalin genes);Gabergic (i.e. GABAA receptor genes);Neurotransmitter Metabolizing genes (i.e. MAO and COMT genes) among others (GARSRXTM). Analgesic addiction as well as “pseudoaddiction” must be treated to improve pain control and its management. We propose that non-pharmacological alternatives to pain relief, in high risk, addiction-prone individuals, are Electrotherapeutic Device(s) and Programs. We further propose patented KB220Z, a nutraceutical designed to release dopamine at the nucleus accumbens, will reduce craving behavior, in genetically programmed individuals. By utilizing both alternatives in DNA analyzed injured workers, a reduction in analgesic addiction (genuine or pseudo) leads to improved health and quicker return to work. We also hypothesize that this novel approach will impact costs related to injuries in the workforce. Effective management of chronic pain, especially in high addiction-prone workforce populations, is possible in spite of being particularly elusive. A series of factors encumber pain assessment and management, including analgesia addiction, pharmacogenomic response to pain medications, and genetically inherited factors involving gene polymorphisms. Additional research is required to test these stipulated hypotheses related to genetic proneness to addiction, but also proneness to accidents in the workplace and reduction of craving behavior. Our hypothesis that genotyping coupled with both KB220ZTM and the pharmaceutical-free Electrotherapy, will reduce iatrogenic induced analgesia addiction. This approach will achieve attainable effective pain management and quicker return to work. We propose outcomes such as the Reward Deficiency System SolutionTM may become an adjunct in the war against iatrogenic pain medication addiction.

Generational Gap： Intrinsic （Non-monetary） Versus Extrinsic （Monetary） Rewards in the Workforce

Traditionally, organizations assume that compensation/pay and monetary benefits are what all employees need to work harder, be productive, or remain with the company. According to Abraham Maslow, within every person is a hierarchy of five needs： physiological needs, safety needs, social needs, esteem needs, and self-actualization needs Organizations must be able to identify what employees desire to secure optimum performance and to meet the needs of both employees and employers. This research focuses on the generational gap and the significance of intrinsic and extrinsic rewards in the workforce. The purpose and objective of this research are to test the significance of monetary versus non-monetary rewards among the different generations in the organization. A self-designed questionnaire distributed to a multi-generational group of employees of selected organizations was used to collect the analyzed data. Sixty-five （65%） responses were obtained. Secondary data were used to elucidate the needs in this area of study. Because the workforce is predicted to become more diverse in terms of age, organizations will be unlikely to implement one set of rewards for the multiple generations. This is due to the differing expectations and requirements among the generations. However, the results indicate no significant difference in monetary versus non-monetary rewards among the different generations in the workforce.

Adaptive Classification Methods for Predicting Transitions in the Nursing Workforce

Earlier analyses of transitions from licensed practical nurse (LPN) to registered nurse (RN) in the North Carolina (NC) nursing workforce in terms of 11 categorical predictors were limited by not considering parsimonious classifications based on these predictors and by substantial amounts of missing data. To address these issues, we formulated adaptive classification methods. Secondary analyses of data collected by the NC State Board of Nursing were also conducted to demonstrate adaptive classification methods by modeling the occurrence of LPN-to-RN transitions in the NC nursing workforce from 2001-2013. These methods combine levels (values) for one or more categorical predictors into parsimonious classifications. Missing values for a predictor are treated as one level for that predictor so that the complete data can be used in the analyses;the missing level is imputed by combining it with other levels of a predictor. An adaptive nested classification generated the best model for predicting an LPN-to-RN transition based on three predictors in order of importance: year of first LPN licensure, work setting at transition, and age at first LPN licensure. These results demonstrate that adaptive classification can identify effective and parsimonious classifications for predicting dichotomous outcomes such as the occurrence of an LPN-to-RN transition.

Evaluation of the Impact of Tinnitus on Health-Related Quality of Life amid Sawmill Workforces

Background: Tinnitus is the phantom aural perception of sound lacking an exterior stimulus, a sub-type of auditory hallucination and it is a common sensation among noise-exposed employees. It is a symptom, not an illness. Tinnitus can be extremely perplexing for its subjects and it may perhaps dis-turb their health-related quality of life (HR-QoL) if exposed to extreme noises in many ways. Objective: This study is intended to discover the effects and pattern of tinnitus on health-related quality of life (HR-QoL) amid noise-exposed saw mill workforces. Method: This study was a prospective and public-centered cross-sectional study, including 510 sawmill personnel. 510 directorial staff was used as the control. Health-related quality of life (HR-QoL) of all subjects was assessed with the WHO Quality of Life brief questionnaire. Self-reported tinnitus morbidity was assessed by means of the Tinnitus Handicap Inventory. A correlation was established amid health-related quality of life scores and tinnitus severity scores. Result: There were 510 sawmill employees enlisted into the study, out of which 490 were men and 20 were women with control of the same age and sex. The mean age was 36.85 ± 7.68 years for the sawmill workers and 35.75 ± 8.65 years for the control group (t = 1.02, P = 0.275). The mean tinnitus score for the sawmill workers was 20.80 ± 2.56. Out of the 510 sawmill workers, 52 (10.2%) had tinnitus and one of the controls had tinnitus. The mean health-related quality of life scores were 62.20 ± 8.62 and 72.56 ± 5.98 for the sawmill workers and control group respectively. There was a substantial and remarkable difference between the health-related quality of life of the sawmill workers and the control group (P Conclusion: The prevalence of tinnitus from this study was found to be 10.20% and an upsurge in tinnitus rigorousness was seen to be related with a substantial drop in physical, psychological and social domains of the health related quality of life. We highly endorse hearing conservation programmes and use of personal protective equipments for sawmills workers which will aid to decrease the effects of exposure to loud noise. Those sawmill labors already having tinnitus must attempt to go for treatment.

The Education ＆ Training and the Utilization of Multi-cultural Workforce

The international movement of workers and the inflow/outflow of immigrants are increasing, the term immigrant communities which country in the world is more familiar. Also, the country that accumulated a history of immigration over decades have been promoted while continuously changing the integration policies for immigrants. The immigration into home country such as the married immigrant women, etc. is constantly increasing in South Korea that had a homogeneous culture. While, it is continued to the overseas movement of young people looking for opportunities in foreign rather than domestic. In South Korea, the multi-cultural families are increasing together with the immigration of foreign workers, the marriage immigrants, etc. in accordance with the globalization of capital and labor, and the multi-cultural society is being formed in accordance with the influx of alien culture and various religious. In this paper, it explored the trends and the future outlook for the multi-cultural workforce in these dimensions. Also, in a multi-cultural society, it suggested the implications and the future assignments for the new changes in the education ＆ training and the employment in order to improve the quality of life and to use as the production entities of multi-cultural workforce.

Maintenance Capacity Planning: Determination of Maintenance Workforce

Determining the size of maintenance workforce is an essential element of maintenance planning. It is important for performing maintenance programs perfectly. However, it is a complex and challenging problem since it involves the consideration of several important factors. The mathematical model developed in this paper aims at finding out the optimal size of the maintenance workforce taking into account all of the important factors that affect this size. It is based on determining the needed number of workers with different skill levels and from different sources to meet maintenance workload of different grades that is to be performed in a specified planning horizon with minimum cost acquired.

Impact of Workforce and Schedule Constraints on New Nuclear Construction

Due to recent legislative incentives and a general change in the public eye towards environmental and energy issues, a renewed interest in building nuclear power plants has taken place in the U.S. The Nuclear Regulatory Commission has also recently given approvals to build four nuclear reactors in two southeast states, which further indicates the resurging interest in nuclear power in the U.S. Such approvals, however, do not specifically address the impact on having a constrained labor force when manufacturing and constructing multiple reactors. Key findings include the comparison of a constrained and unconstrained workforce on construction and manufacturing completion times, the identification of peak labor requirements based on different construction schedules, and the development of training estimates to ensure the workforce and industry are prepared for the new jobs being created. Results suggest that a shorter planned construction timeline is effective when the workforce is moderately constrained to unconstrained. However, with a severely-constrained starting workforce, a longer construction timeline is preferred. For multiple reactor plans, spreading out the construction start dates outperforms all other construction start date schedules. In particular, heavily compressed start dates could effectively kill a resurgent nuclear industry, especially if workforce expansion is not pursued simultaneously.

A trajectory data warehouse solution for workforce management decision-making

In modern workforce management,the demand for new ways to maximize worker satisfaction,productivity,and security levels is endless.Workforce movement data such as those source data from an access control system can support this ongoing process with subsequent analysis.In this study,a solution to attaining this goal is proposed,based on the design and implementation of a data mart as part of a dimensional trajectory data warehouse(TDW)that acts as a repository for the management of movement data.A novel methodological approach is proposed for modeling multiple spatial and temporal dimensions in a logical model.The case study presented in this paper for modeling and analyzing workforce movement data is to support human resource management decision-making and the following discussion provides a representative example of the contribution of a TDW in the process of information management and decision support systems.The entire process of exporting,cleaning,consolidating,and transforming data is implemented to achieve an appropriate format for final import.Structured query language(SQL)queries demonstrate the convenience of dimensional design for data analysis,and valuable information can be extracted from the movements of employees on company premises to manage the workforce efficiently and effectively.Visual analytics through data visualization support the analysis and facilitate decisionmaking and business intelligence.

Impact of federalization for health financing and workforce in Nepal

The adoption of its 2015 constitution has converted Nepal to a federal government while simultaneously resulted in significant reforms of the health system in Nepal in terms of both structure and commitment.In this commentary,we review evidence ranging from health financing to health workforce development to show that the impact of federalization on Nepal’s health system and its efforts to achieve equitable and affordable universal health care have been mixed.On the one hand,careful efforts of the federal government to support subnational governments during the transition appears to have avoided serious disruption,subnational governments have successfully taken on the financial burden of the health system,and increase subnational control has allowed more flexible adaptation to changing needs than might have otherwise been possible.On the other hand,financing resource and ability disparities across subnational governments contributes to significant disparities in workforce development,and subnational authorities appear to have underestimated significant health issues(e.g.NCDs)in their budgets.We then provide three recommendations to improve the success of the Nepalese system:(1)to assess whether the services covered by health financing and insurance schemes like the National Health Insurance Program adequately address the needs of the rising burden of NCDs in Nepal,(2)to set clear minimum requirements on key metrics for subnational health systems,and(3)to extend grant programs to address resource disparities.

Deployment of workforce in global health:what should be the priorities for China?

Background:China has increasingly emerged as an important player in global health.However,compared to developed countries,China still lacks a sufficient health workforce for global health engagement with the necessary competencies required.The world has recognized that to solve global health issues,the role of China needs to be strengthened.The priorities for the deployment of the Chinese workforce in global health remain unclear.This study aims to identify the priorities of the deployment of Chinese global health workforce by exploring the core competencies for Chinese global health workforce,factors influencing the deployment and the approach of deployment.Methods:Quantitative descriptive statistical analysis was applied to analyze the quantitative data.A total of 148 key respondents from 10 provinces in China conducting global health projects over the last 3 years were selected as the study subjects.A structured questionnaire was developed to collect the data on four aspects,including general information,core competencies,factors influencing deployment,and mode of deployment.The questionnaire was distributed to the respondents through an online survey.All original data were exported to Microsoft Excel 2010 to calculate the frequencies and percentages of each option.A descriptive analysis was carried out of the priorities of deployment of the Chinese global health workforce.Results:More than half of the respondents(51.4%,76/148)regarded“communication”as the most important competency of the Chinese global health workforce,while a large proportion of participants from Chinese embassies(50.0%,6/12)and international organizations(75.0%,12/16)believed that“professional skills”were paramount.In addition,58.1%(86/148)of the participants agreed that incentive factors(salary,professional position,etc.)were the main factors that influenced deployment,whereas 75%(12/16)of participants from international organizations emphasized“security”as the most important determinant.In addition,60.8%(90/148)of the participants thought that the deployment of staff should be based on the needs of the global health project implementation.Conclusions:This study highlights the deployment priorities of the Chinese global health workforce,including strengthening communication and professional skills,focusing on personal security and incentives,and catering to the project implementation.This study also highlights the importance of Chinese agencies in developing global health mindsets through global health practices and proactive integration within the global community.

Applying the workload indicators of staffing needs method in determining frontline health workforce staffing for primary level facilities in Rivers state Nigeria

Background:Nigeria faces health workforce challenges and poor population health indices resulting from disparities in health worker densities by geographical locations and levels of health care delivery.Nigeria is constantly reforming its health system with the primary aim of having the right number of health workers in the right place at the right time to meet the population’s health needs.The majority of primary health facilities in the country are staffed using perceived needs.The Workload Indicators of Staffing Need(WISN)tool developed by the World Health Organization is used to determine staffing requirements for facilities.Methods:The WISN tool was used in assessing the staffing requirements for nurses/midwives and community health practitioners in 26 primary health facilities in Port Harcourt City Local Government Area(PHALGA)and Obio Akpor Local Government Area(OBALGA).Documents were reviewed to obtain information on working conditions and staffing,and interviews conducted with key informants in 12 randomly selected facilities.We supported an expert working group that comprised of nurses/midwives and community health practitioners to identify workload components and activity standards and validate both.We also retrieved workload data from January 1-December 31,2015 from the national district health information system.Results:Findings showed varying degrees of shortages and inequitable distribution of health workers.Health facilities in PHALGA had a WISN ratio of 0.63 and a shortage of 31 nurses/midwives.There was also a shortage of 12 community health practitioners with a WISN ratio of 0.85.OBALGA had a shortage of 50 nurses/midwives and 24 community health practitioners;and WISN ratios of 0.60 and 0.79 for nurses/midwives and community health practitioners respectively.Conclusion:Our findings provide evidence for policies that will help Nigeria improve the population’s access to quality health services and reduce inequities in distribution of the health workforce.Evidence-based health workforce planning and redistribution using WISN should be institutionalized.Review of scopes of practice of health workforce should be conducted periodically to ensure that the scope of practice matches the training received by the specific cadres and those skills are used to deliver quality services.

Comparing outcomes from the two most recognized acupuncturist workforce surveys

OBJECTIVE： To determine the informational consistency produced by the two most recent independent surveys and draw a conclusion whether the data would be sufficient for the National Center for Health Workforce Analysis and Bureau of Labor and Statistics consideration. METHODS： This paper compares workforce outcomes collected by the two most prominent acupuncture entities that have produced the most useful acupuncturist workforce data （California Acupuncture Board 2015 Occupational Analysis and the National Certification Commission of Acupuncture and Oriental Medicine^2013 Job Analysis） at national and state levels. RESULTS： Findings based upon the most compatible survey questions showed the following： more than 70% of acupuncturists work fewer than 40 hours weekly; approximately 76% work in solo practice or in shared space with other acupuncturists; more than 70% of the national sample have been in practice 15 years or less; and median income is between $40 000 and $50 000. A preponderance of acupuncturists is less than 50 years of age, and fewer than 15% of all respondents have been in practice more than 20 years. CONCLUSION： Basic workforce information is a necessary precursor for conducting workforce projections. It is useful to track the expansion or contraction of any given profession. Tracking influences subsequent planning for the profession based upon reliable and valid information about its growth. The ability of the profession to collect its own workforce data is paramount to workforce projection models. Any future survey should be a shared project that follows guidelines supported by the National Center for Health Workforce Analysis.

Global neurosurgical workforce density-you cannot improve what you do not measure

Five million neurosurgical cases go untreated each year.This is in part due to the lack of neurosurgical care providers.The World Federation of Neurosurgical Societies has spearheaded efforts to monitor the number of neurosurgical providers around the globe since 2016.In this perspective,we discuss why,when,and how the neurosurgical workforce should be measured.

The role of intermediaries in US workforce and education innovation

Intermediaries are specialised organisations that perform bridging and integrative functions to achieve improved results of social policies.Intermediaries have been most effective in the United States(US)when aligned with education and workforce system improvements and redesign,not as parallel and separate efforts.Intermediaries operate in many US social policy domains,including workforce and education,where they contribute to overcoming fragmented institutions and solving mismatch problems that interfere with hiring,career pathways and educational achievements.Intermediary solutions are especially important for creating better outcomes for low-income students and workers and improving overall racial and ethnic equity.Five mismatches especially prevalent in the US labour market require intermediary solutions:organising business to improve human resources,creating improved pathways from school to work,integrating and focussing multiple education investments,linking workforce and economic development,and improving access and use of data for design,performance management and advocacy.This paper discusses these mismatches and related intermediary solutions in more depth,offers examples of specific intermediaries in action and identifies intermediary challenges and opportunities faced by intermediaries to function better.The paper also points out that,more broadly,intermediaries are only a part of the solution to labour market and education inequalities and that broader changes in the political economy and policies are required to effect wage growth and labour market participation.

Inequality and workforce development in the post-COVID-19 environment:The case of Maine

The article analyses the interaction between the COVID-19 pandemic and social inequality in the United States,taking the state of Maine as a case study.The pandemic has revealed the effects of high economic inequality on public health in the United States,where in comparison to most developed capitalist democracies,the health care system is expensive,inefficient,and highly skewed in quality and accessibility.Likewise,for industries that were already losing jobs,the pandemic has accelerated a painful transition and intensified the harsh social and economic consequences of high and rising inequality,especially for low-wage workers.The case of Maine underscores the point that policies aimed at reducing the disparities in the distribution of income,health care,education,and opportunity will reduce inequality,protect public health,and stimulate economic growth.

Workforce Watches Labor Law

The upcoming law on labor dispute mediation and arbitration could lead to better protection of worker's interests