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The pharmacy support workforce (PSW) is the mid-level cadre of the global pharmacy profession, referring to pharmacy technicians, assistants and other cadres that assist in the delivery of pharmaceutical services in a variety of practice contexts. The PSW undertake technical tasks delegated under the supervision of a pharmacist or performed collaboratively. The PSW are not intended to replace pharmacists, but rather work side-by-side with the pharmacist to achieve a shared goal. However, extensive variation in the PSW exists globally, ranging from an educated, regulated, and highly effective workforce in some countries to unrecognized or non-existent in others. Vast differences in education requirements, specific roles, regulatory oversight, and need for pharmacist supervision, inhibit the development and advancement of a global PSW. As clinical care providers, pharmacists worldwide need for a competent support workforce. Without the confidence to delegate technical responsibilities to a well-trained and capable PSW, pharmacists will be unable to fully deliver advanced clinical roles. A clear vision for the role of the PSW in the expanding scope of pharmacy practice is needed. One organization working to unite global efforts in this area is the International Pharmaceutical Federation (FIP). The FIP Workforce Development Hub Pharmacy Technicians & Support Workforce Strategic Platform was established to address the pharmacy workforce shortage in low and middle-income countries. Further developments were made in 2019, with the creation of a representative global PSW advisory panel, to provide guidance towards the development of the global PSW. Provision of frameworks and strategic input to support quality in education, development of legislative frameworks, guidelines for registration and licensure, and advice on appropriate role advancement are critical to move the PSW forward. In order to produce substantial advancement of roles and recognition of the PSW and advancement of pharmacists as patient care providers, global collaborative work is needed.

Background: Internationally, there is a growing body of literature regarding nurse leadership in health research, including the importance of programs to strengthen nurses in academic leadership roles. Nurse leaders provide a valuable contribution to global health research, influencing policy, clinical practice, and decision-making processes. Nurse leadership is important in rural and remote communities who generally experience poorer health outcomes and barriers to accessing services. Aim: To examine the contribution of nurse leaders to rural and remote health research by reviewing peer-reviewed publication outputs from the Rural Health Multidisciplinary Training (RHMT) program implemented in Australia. Methods: A scoping review framework using non-systematic searching was used. Peer-reviewed publication outputs from the RHMT program database published between 2016 and 2020 were reviewed. Findings were synthesised within the research parameters of the RHMT program. Findings: The RHMT program database contained 1222 unique citations. On title and abstract screening, 796 citations were excluded. Of the 426 citations reviewed for full text, 89 studies were included. Most studies examined the RHMT research parameters of rural health issues (n = 24) and rural training strategies (n = 22), followed by rural health workforce development (n = 21), Aboriginal and Torres Strait Islander health and wellbeing (n = 13), and innovative models of care (n = 9). Research was largely descriptive, with few studies examining issues specific to the nursing profession (n = 21). Discussion: Nurse leaders supported by the RHMT program in Australia provide valuable contributions to rural and remote health research which is not limited to the nursing profession. A paucity of nurse-led innovative models of care were identified. Although included studies were research outputs under the RHMT program, findings are of value to informing future directions of nursing research addressing rural and remote health. Conclusion: Findings provide an overview of the valuable contribution of nurse leaders to rural and remote health research by capturing the interdisciplinary and transdisciplinary nature of nursing research leadership. Refereed/Peer-reviewed

Background Conducting a systematic country-level workforce needs-assessment is a way to develop coherent strategic and justifiable workforce planning. Objective(s) This article describes a country-level needs-assessment process using a systematic approach (via the FIP Development Goals (FIP DGs) workforce element) as an analytical framework. The needs-assessment aimed to prioritise gaps toward transforming the pharmacy workforce as a prelude to practice and pharmaceutical services reform in Indonesia. Methods The needs assessment consisted of three stages: needs identification, needs analysis, and needs prioritisation. The needs (workforce development gaps) were defined as the discrepancies between the perceived workforce challenges and the existing national workforce development projects. Interviews or group discussions were conducted to gather the workforce challenges of individual pharmacists. A structured workshop was conducted to identify workforce challenges and existing organisations' projects, with main stakeholders contributing to pharmacists' development in Indonesia. Perceived challenges findings and identified national workforce projects were mapped to the FIP DGs workforce element. The needs prioritisation was conducted by comparing the proportional mapping to the FIP DGs workforce element. Results There were forty-three individual pharmacists and 7 principal stakeholder categories that provided information related to perceived workforce challenges; thirty national projects were identified from stakeholders. While this study identified perceived challenges with workforce “competency development” and “pharmacy workforce intelligence,” there were no active ongoing national projects mapped to those goals. The framework mapping analysis showed there are workforce development gaps centred on “competency development” initiatives, “advanced and specialist development” initiatives, and strategic pharmacy workforce intelligence data gathering. Additionally, there were policy gaps with initiatives for strengthening “working with others” and a lack of clarity on infrastructure for early-career training strategies and workforce impact. Conclusions This study prioritises the gaps in developing pharmacists in Indonesia. This process could be used in conducting needs assessment of pharmacy workforce development in other Low and Middle-Income Countries (LMICs).

Cell and gene therapy is a promising and disruptive new field of medicine for diseases lacking effective treatments. Collaboration among stakeholders has become critically important as investigators, health care providers, manufacturers, couriers, data registries, regulators and payers all become more invested in the success of this field. Many organizations have collaborated with each other to increase clarity, advocate for improvements and share lessons learned. These efforts appear to be making an impact, although the potential for duplicative efforts could slow progress. The second Regenerative Medicine InterCHANGE, hosted by the Foundation for the Accreditation of Cellular Therapy, took place at the Phacilitate Leaders World/World Stem Cell Summit conference in Miami, Florida, on January 24, 2020. Participants from several organizations outlined needs to advance cell and gene therapies. Efforts to address these include standardization, workforce development and advocacy. This article summarizes the major challenges and opportunities discussed during the InterCHANGE.

Introduction The Research and Clinical Trials Therapeutic Radiographers network is a College of Radiographers Specialist Interest Group. It was established to develop and facilitate a support network for therapeutic radiographers working in roles which involve the delivery of radiotherapy clinical trials. Its establishment highlighted the challenges faced by therapeutic radiographers employed in these roles. Consequently, the authors sought to formally capture the working landscape of this subsection of the radiographic workforce, aiming to ascertain any potential barriers to professional development and the increase of clinical trials activity by 15% mandated by NHS England. Methods A Qualtrics survey was designed, pilot tested and distributed to the sixty-two radiotherapy departments across England and the devolved nations. Departments were questioned on the size, structure and the scope of practice of their radiotherapy research and clinical trials team members. Findings Thirty-nine complete responses were received, providing a response rate of 62%, with each region of the UK represented in the survey. The findings demonstrated issues related to the number of posts affecting capacity, contract status jeopardising the security and effectiveness of their role and the activities specific to research and clinical trials being ‘bolted on’ to existing roles. Although advanced practice was being undertaken by around a third of this workforce the findings established several barriers including individual/teams' capacity and a perceived lack of support for therapeutic radiographers to progress in clinical trials roles. Conclusion The findings illustrate several important implications which if not addressed may not only hinder UK radiotherapy departments to achieve the national increase of 15% of clinical trial activity over the next three years but also restrict the growth in size and scope of professional practice of the workforce. Implications for practice The research and clinical trials workforce need to adopt a collaborative approach to profile raising and establish a standardised professional scope of practice to support growth and recognition of their role.

Summary Solutions to many of the world's problems depend upon materials research and development. However, advanced materials can take decades to discover and decades more to fully deploy. Humans and robots have begun to partner to advance science and technology orders of magnitude faster than humans do today through the development and exploitation of closed-loop, autonomous experimentation systems. This review discusses the specific challenges and opportunities related to materials discovery and development that will emerge from this new paradigm. Our perspective incorporates input from stakeholders in academia, industry, government laboratories, and funding agencies. We outline the current status, barriers, and needed investments, culminating with a vision for the path forward. We intend the article to spark interest in this emerging research area and to motivate potential practitioners by illustrating early successes. We also aspire to encourage a creative reimagining of the next generation of materials science infrastructure. To this end, we frame future investments in materials science and technology, hardware and software infrastructure, artificial intelligence and autonomy methods, and critical workforce development for autonomous research.

Objective Academic General Pediatrics (AGP) is a pediatric subspecialty with substantial faculty contributions in clinical care, research, education, and advocacy. However, AGP fellowship recruitment challenges exist. We aimed to describe AGP hiring practices from 2014 to 2019 and the role of fellowship training in hiring decisions. Methods We conducted a cross-sectional survey study of AGP Division Directors (DDs) and Fellowship Program Directors (PDs) from US-based academic institutions. Survey questions were developed iteratively and pilot-tested for content validity. Participants were identified from the Association of American Medical Colleges' directory of pediatric departments, Academic Pediatric Association's AGP Accreditation Committee's list of fellowship programs, and institutional websites. Descriptive analysis was used for close ended survey questions. Narrative responses were reviewed for trends. Results Forty-nine DDs (57%) and 22 PDs (73%) responded. All DDs reported at least one available faculty position and 73% reported filling a position with protected time. PDs reported 89 graduating fellows, 88% of whom secured an academic position with protected time. Seventy-percent of DDs and 100% of PDs reported that AGP fellows could secure an academic position with protected time, while only 22% and 1%, respectively, reported a graduating pediatric resident could secure a similar position. DDs indicated AGP fellowship trained candidates are preferable for enhancing research and education programs. Conclusion AGP remains an active subspecialty and the majority of graduating fellows secured faculty positions with protected time. Further studies are needed to understand ways to improve visibility of AGP fellowships.

Nurse residency programs (NRPs) are a critical workforce development tool to enhance professional nursing’s capacity to provide safe, efficient, and sustainable patient care. However, many nurse leaders continue to face the challenge of how to communicate the value of NRPs to the C-suite. A model for how to build a strong business case is discussed. In addition, recommendations on how to communicate its value are provided.

Adolescence is a critical period for physical and psychological development; therefore, health interventions at this phase may be especially beneficial. In this study, we aim to describe the distribution of the adolescent health care system in China and to compare the perceived barriers of running an adolescent clinic (AC) proposed by hospitals with corresponding government entities.A nationwide online survey was launched by the National Health Commission of China in December 2015, among 116 Maternal and Children's Healthcare (MCH) hospitals located across 24 randomized selected provinces. The online survey included management questionnaires filled out by health administrators from local health commissions and service questionnaires filled out by adolescent care providers from MCH hospitals.Among the surveyed provinces, only 7% have special funding for adolescent health care, 13% have a supporting policy, 8% have guidelines/service standards, and 16% provide adolescent health care based in MCH hospitals. Among the 116 MCH hospitals investigated, 31 (27%) had a functioning AC and 15 (13%) used to have an AC. Compared with the MCH hospitals that never have an AC, those that previously had an AC were more likely to perceive demand as a barrier (odds ratio = 8.02; p value.05) but less likely to perceive guidelines/service standards as a problem (odds ratio = .09; p value.01). The perceptions of health administrators and adolescent health care providers differed markedly on demand and profits: both were ranked highly by supply side (health providers) but ranked low by the health administrators.This national survey, for the first time, presents a whole picture of adolescent health care in MCH hospital settings in China. Among the surveyed MCH hospitals, major areas of discordance between administrators and health care providers were barriers in demand and profits, which health administrators tend to overlook. A number of strategic priorities are proposed to best guide the development of the adolescent health care system in China, including improved linkage between health and education and community systems, comprehensive approaches move beyond sexual and reproductive education, as well as the workforce development and capacity-building.

Objective Healthcare hackathons are fast-paced, mentored events that bring together individuals with diverse skillsets to identify clinical needs and propose solutions. Traditionally geared toward device development and workflow optimization, platforms that address women and minorities in surgery are rare. We aimed to expand the traditional healthcare hackathon model to include a novel workforce development (WD) track to address concerns faced by surgeons and trainees. Design The WD track was created as part of the first surgical hackathon at our academic institution. In a single-day event, participants identified concerns (pain points) of diversity and sustainability in surgery, formed interdisciplinary teams, and pitched solutions. Pain points, project themes, and postevent survey results were analyzed and compared between WD and other tracks. Setting Participants were surveyed at Yale School of Medicine, an academic medical tertiary center, in September 2018. Participants Thirty-one total participants. Twenty-five (80.6%) responded to the survey. Results Of 57 problem pitches, 23 (40.4%) were related to WD. Issues highlighted 5 themes: training and career exploration, leadership and communication of skills, mental health and burnout prevention, surgeon discrimination and harassment, and work-life balance. Participants formed 6 groups, with 1 focused on WD. There was no difference between participants in the WD track and non-WD track counterparts with regard to excitement for continuing their project beyond the hackathon (4.00, standard deviation [SD] 0.89, vs. 3.63, SD 1.12, p = 0.43), and in their perception of the mentorship they received (4.00, SD 1.00, vs. 4.11, SD 0.78, p = 0.84). The project presented within the WD track, on culturally sensitive scrub wear, was 1 of 3 prize-winners. Conclusions The first WD track at a healthcare hackathon identified 5 themes of unmet workforce needs. The pilot demonstrated that WD tracks can be implemented in hackathons with similar results to traditional tracks and create innovative and sustainable solutions to surgical workforce concerns.

The aim of this study was to examine the prevalence and importance of management skills in the pharmacy profession and pharmacists’ ability to respond to current and future challenges in healthcare provision. As service professionals, pharmacists are engaged based on their expertise and skills, and are noted for their contribution to the knowledge-based economy and control over the application of their knowledge (Abbott, 1991). The same premise would apply to other professionals e.g. healthcare (nurses, doctors and psychologists); legal (lawyers, solicitors and barristers); consultancy; accountancy; banking and architecture (von Nordenflycht, 2010). An exploratory analysis of UK and Spanish pharmacists’ roles and their adoption of management skills was thus undertaken. Both healthcare systems are very similar and likewise the clinical training and role of pharmacists, professional standards and regulations are similar but there are subtle differences. Data were collected using semi-structured online surveys; two thirds of the data were collected from a UK audience and the final third from Spanish pharmacists. The data collection was planned and iterative in the first two stages (stage one influencing stage two) (UK) and the final stage (Spain) offered an opportunistic comparator study. The results demonstrated that there was overwhelming support for management skills to be part of undergraduate studies. The outputs of this study identify the most important management skills pharmacists need to perform effectively. Consideration was also given to the impact of inability to perform in their role, and hence the possibility of occupational derailment (leaving their role or being demoted). These findings offer important learning to support workforce development in all professional services.

The United States healthcare system faces immense challenges related to cost, quality, and access. As the pharmacy profession addresses these challenges by shifting toward a practice model centered around direct patient care clinical services, a competent and capable technician workforce is needed to support the roles of pharmacists. Until recently, little focus has been paid to pharmacy technicians or their role as they relate to practice model change. With ongoing pharmacist practice transformation, an approach that ensures uniform technician education, training, registration, and certification is vital to support a practice model designed to transform medication management across the continuum of care. The purpose of this commentary is three-fold: to review the history of pharmacy technician training and practice, discuss current and future technician practice models, and examine workforce development implications.

Comorbidity with behavioral health conditions is highly prevalent among those experiencing serious medical illnesses and is associated with poor outcomes. Siloed provision of behavioral and physical healthcare has contributed to a workforce ill-equipped to address the often complex needs of these clinical populations. Trained specialist behavioral health providers are scarce and there are gaps in core behavioral health competencies among serious illness care providers. Core competency frameworks to close behavioral health training gaps in primary care exist, but these have not extended to some of the distinct skills and roles required in serious illness care settings. This paper seeks to address this issue by describing a common framework of training competencies across the full spectrum of clinical responsibility and behavioral health expertise for those working at the interface of behavioral health and serious illness care. The authors used a mixed-method approach to develop a model of behavioral health and serious illness care and to delineate seven core skill domains necessary for practitioners working at this interface. Existing opportunities for scaling-up the workforce as well as priority policy recommendation to address barriers to implementation are discussed.

Never has there been a more pressing time for the American Association for Geriatric Psychiatry (AAGP) to articulate a unified strategy to meet the challenges of our aging world. To this end, this report summarizes an AAGP leadership meeting that reviewed the results from a recent membership survey and launched a strategic planning process on behalf of AAGP members and stakeholders. This meeting was the first step in drafting a blueprint for the future that may serve as our guide in the context of finite resources to meet the infinitely complex and growing need for education, research, public advocacy, and clinical practice support. The following report serves to invite our valued colleagues to provide feedback and actively participate in defining our mission. Among the outcomes of the planning session, the following aspirations were identified by the participants 1) assert the AAGP as the "go to" organization for all things related to geriatric mental health, 2) prioritize activities that enhance the inclusivity/diversity of membership, and 3) collaborate across disciplines focused on geriatric mental health. From this initial framework, the group developed four general themes to guide AAGP's strategic future: 1) collaboration, 2) advocacy, 3) inclusivity, 4) high purpose. Inclusivity was further defined as encompassing growth, return on investment, and workforce development. Higher purpose was further defined as encompassing engagement, purpose, branding, communication, and expertise. The AAGP affirmed its commitment to serving the needs of its members and widening its scope of impact in view of staggering demands for better access to geriatric mental healthcare.

Background Public health and environmental challenges facing the world in the 21st century, including the ageing population, increasing urbanisation, rise of non-communicable diseases and climate instability, require an interdisciplinary response. A significant proportion of the population's time is spent indoors, be it at home, school, work or in leisure time; the work of an architect can cover all of these sectors, but their role in health and well-being remains an under explored area. Objective This article examines the architecture profession's potential to contribute to improved health and well-being of the population through healthier buildings and places. Methodology This short communication adopts a descriptive approach. First, it maps the remit, skills and influence of the architecture profession and applies this to a well-accepted public health model, the prevention pyramid. Second, it uses themes identified by the Royal Society for Public Health to discuss ways to improve engagement with the architecture profession as part of the wider public health workforce. Results This article finds that the remit, skills and potential influence of architects places them in a key position to improve the health and well-being of the population. Despite this, there has been relatively little engagement between public health and this profession. Much more attention to date has been on integrating the planning sector with public health. Conclusion Opportunities for improved engagement exist through partnership working, incorporating health into both undergraduate and postgraduate education and continuing professional development training, building the evidence base and developing architecture and health-related policy and legislation.

Informal or family caregivers are a substantial component of the U.S. health care system and are essential for addressing the needs of a growing number of U.S. citizens who are aging, managing chronic or disabling conditions, or facing life-limiting illness. The purpose of this study was to examine the representation of family caregiving in a set of foundational documents that shape nursing education, practice standard, and related policy. Electronic copies of these "canonical" documents were systematically mapped for the appearance of language, terms, and concepts related to family caregiving. Additionally, relevant passages of caregiving-related text were coded for content, phrasing, and meaning. Few meaningful references were found, exposing how the nursing profession may also be perpetuating the role of the family caregiver as unsupported and invisible. When present in the documents, family caregivers were generally situated as background or context for patient care, often as objects and less frequently as agents with influence. These findings are considered within the context of the emerging caregiving public health crisis and family caregiver health outcomes, family caregiver integration into the health care team, nursing education and practice standards, nursing leadership and workforce development, and nursing's policy advocacy role.

The Science Gateways Community Institute (SGCI), opened in August 2016, provides free resources, services, experts, and ideas for creating and sustaining science gateways. It offers five areas of services to the science gateway developer and user communities: the Incubator, Extended Developer Support, the Scientific Software Collaborative, Community Engagement and Exchange, and Workforce Development. While all these areas are available to US-based communities, the Incubator, the Scientific Software Collaborative and the Community Engagement and Exchange also serve international communities. We aim to reach out and support gateways on an international scale by forming and deepening collaborations with partner organizations and coalitions beneficial and/or related to the science gateways community. Research topics are independent of national borders and researchers spread worldwide can benefit from each other’s research results, software, data and from lessons learned — via online materials and publications or at international events. The gateway community has long benefited from this type of exchange. This paper will present related work describing the benefits of international collaborations generally, and specifically as they relate to science gateways. We go into detail regarding SGCI’s ongoing work on an international scale and its work planned in the near future.

The purpose of this paper is to investigate the determinants of customer satisfaction and quality results in the healthcare industry using the Baldrige data. We use publicly available data on quality assessment of healthcare organizations that applied for the Baldrige award to examine two research questions: 1) whether the Baldrige model is a reliable and valid model for assessment of quality practices in healthcare organizations, and 2) to determine the relationship between quality practices and their impact on quality results in the healthcare organizations. Using structural equation modeling, the findings suggest that the Baldrige model is a valid and reliable quality assessment model for healthcare organizations. Consistent with previous studies, the findings suggest that the main driver of the system is leadership, which has a significant effect on all quality practices in the healthcare industry. Controlling for the applicants’ year, the findings indicate that 1) Information analysis and knowledge management has a significant impact on Quality results, 2) Workforce development and human resource management has a significant impact on both Customer focus and satisfaction and Quality results, and 3) Strategic planning for quality has a significant impact on Customer focus and satisfaction. The study provides insights and suggestions for healthcare organizations on how to improve their quality systems using the Baldrige model.

Psychiatry of old age is a psychiatric subspecialty that has been developed in many countries since the 1950s as an attempt to improve the care of older adults with mental health disorders. Psychiatry of old age specialist training programs were subsequently established to develop a medical workforce that has the required competencies to work in this subspecialty. This article describes the psychiatry of old age specialist training programs in Australia, New Zealand, the United Kingdom, and Mexico. These training programs have varying durations, ranging from 1 to 3 years. Although it may not be a mandatory requirement to complete a psychiatry of old age clinical rotation, psychiatry of old age experience and competencies are expected during general psychiatry training. There is generally a lack of opportunity to learn about other clinical specialties relevant to older adults, such as geriatric medicine and neurology. Finally, much work is needed to better coordinate psychiatry of old age specialist training positions, workforce development, and service delivery to ensure there is a sufficient supply of psychiatry of old age specialists to meet the mental health needs of older adults in different countries in the coming years.

Shortly after the transition to the post-apartheid state, South Africa began a process of requiring mining companies to invest in community and workforce development in areas surrounding operations. This development shifted the concept of corporate social responsibility from mainly a discretionary activity to an issue of regulatory compliance. Drawing on field-based interviews and regulatory and company documents, this article analyzes the process of compliance with South Africa’s mining regulation and the stakeholders formally involved or marginalized in this process. Findings demonstrate the challenges that remain in ensuring that regulation leads to mining company activities that actually yield effective and impactful local social benefits. While regulation has increased entry points for government involvement and has increased corporate social spending, it has undermined the idea of corporate citizenship by focusing on mandatory compliance, while failing to put in place effective process transparency and monitoring mechanisms that would allow for local government and community participation and sanctioning. The lessons learned in the case of South Africa have implications as more African countries attempt to regulate the promotion of social benefits derived from mining.

Introduction Workforce development is one of the ten essential public health services. Recent studies have better characterized individual worker perceptions regarding workforce interests and needs, but gaps remain around workforce needs from program managers’ perspectives. This study characterized management perspectives regarding subordinate's abilities and training needs and perceived challenges to recruitment and retention. Methods In 2017, the Directors Assessment of Workforce Needs Survey was sent to 574 managers at state health agencies across the U.S. Respondents were invited based on the positions they held (i.e., to be included, respondents had to be employed as managers and oversee specific program areas). In 2018, descriptive statistics were calculated, including Fisher's exact for inferential comparisons and Tukey's test for multiple comparisons, as appropriate. Results Response rate was 49% after accounting for undeliverable e-mails; 226 respondents met the inclusion criteria. The largest perceived barriers to staff recruitment were wages or salaries (74%) and private sector competition (56%). Similarly, wages or salaries were identified as the main cause of turnover by 70% of respondents, followed by lack of opportunities for advancement (68%), and opportunities outside the agency (67%). Conclusions The Directors Assessment of Workforce Needs Survey fills important knowledge gaps and complements previously identified evidence to guide refinement of workforce development efforts. Although competition from the private sector remains challenging, these findings indicate that recruitment and retention must be top priorities in state health agencies nationwide. Prioritizing individual state health agency workforce gaps and committing to provide specific local-level interventions to those priorities is crucial for individual health agencies.

Background We developed the PCMedSafety conceptual framework to illustrate primary care medication safety transformation opportunities. PCMedSafety demonstrates the interrelationship between the practice-level primary care delivery system, medication workflow processes for common medication-related activities, and medication use and safety outcomes. This framework was used to conceptualize a workflow process mapping approach to characterize and evaluate the safety of medication-related activities performed in primary care practices. Objectives In this article, we conceptually describe how workflow process mapping of primary care medication-related activities can be used to: (1) understand and characterize common office-based primary care medication-related workflows, and (2) identify medication-related workflow process gaps and deviations and their impact on medication use and safety within office-based primary care. Methods Workflow process mapping of primary care medication-related activities consists of 9 major steps, including: (1) identification of a primary care practice, (2) establishment of a workflow mapping team, (3) selection of medication-related activities, (4) development of ideal-state workflow process map(s), (5) selection of data elements and development of data collection form(s), (6) development of a workflow observation schedule, (7) completion of direct workflow observations, (8) development of observed workflow process map(s), and (9) data analysis to identify medication safety workflow gaps and deviations. Conclusion The medication workflow process mapping approach illustrated in this article can be used by primary care executive leadership, clinician leaders, primary care providers, and clinical pharmacists to identify, resolve, and prevent medication safety concerns within a primary care practices. Workflow gaps and deviations identified through workflow process mapping can be used to inform practice-specific opportunities for: (1) team-based primary care redesign to integrate clinical pharmacists into the expanded primary care team; (2) workforce development, including staff/provider training and role delegation for common primary care medication-related activities; and (3) improvements in workflow efficiency and consistency to reduce preventable medication errors.

Despite global support for immunization as a core component of the human right to health and the maturity of immunization programs in low- and middle-income countries throughout the world, there is no comprehensive description of the standardized competencies needed for immunization programs at the national, multiple sub-national, and community levels. The lack of defined and standardized competencies means countries have few guidelines to help them address immunization workforce planning, program management, and performance monitoring. Potential consequences resulting from the lack of defined competencies include inadequate or inefficient distribution of resources to support the required functions and difficulties in adequately managing the health workforce. In 2015, an international multi-agency working group convened to define standardized competencies that national immunization programs could adapt for their own workforce planning needs. The working group used a stepwise approach to ensure that the competencies would align with immunization programs’ objectives. The first step defined the attributes of a successful immunization program. The group then defined the work functions needed to achieve those attributes. Based on the work functions, the working group defined specific competencies. This process resulted in three products: (1) Attributes of an immunization program described within eight technical domains at four levels within a health system: National, Provincial, District/Local, and Community; (2) 229 distinct functions within those eight domains at each of the four levels; and (3) 242 competencies, representing eight technical domains and two foundational domains (Management and Leadership and Vaccine Preventable Diseases and Program). Currently available as a working draft and being tested with immunization projects in several countries, the final document will be published by WHO as normative guidelines. Vertical immunization programs as well as integrated systems can customize the framework to suit their needs. Standardized competencies can support immunization program improvements and help strengthen effective health systems.

The next generation of manufacturing depends on innovation. While recent discourse focuses on the benefits of the digital revolution, there is also significant concern about the skills gap that it creates when compounded by an aging workforce. Technology implementation is intertwined with people and impacts the types of work people do and the skills necessary to be successful. Contrary to popular fears, the jobs challenge is not that automation will replace the labor force, but that if workforce develop programs do not rapidly evolve, automation might be necessary in order to fill the gaps left by the lack of qualified workers. By conducting an extended case study of three existing programs in Georgia, geared towards improving perceptions and increasing interest in manufacturing careers, as well as equipping students with 21st century and technical skills for manufacturing, our work highlights the need for strong partnerships between academia, industry, and government. Such partnerships are necessary to support the development of local workforce development programs through knowledge sharing, start up and scaling, and shared funding. These innovative programs provide ideas for how to sustain and scale these and similar initiatives to deliver the necessary workforce development for manufacturers to close the skills gap.

The economic development-environmental protection dichotomy is an out-dated construct. A 21st century approach to the world's water problems is progressively being developed by researchers and practitioners, who are combining traditional and ecosystem-based engineering systems to yield cost-effective solutions. Given the continuing and widespread loss of ecological services and functions, water security in a multi-generational, SDG context requires a meaningful, global commitment to redirect the current downward trajectory in both (i) the state of the world's ecosystems and the services they provide to society, and (ii) our collective level of stewardship of these important resources. Achieving sustainable water security will require overcoming strategic challenges related to protected areas, ecosystem-based solutions research, water observatories and expanded technical readiness. It also needs to address other limitations and demands related to water infrastructure, economies, human settlements and water quality, sanitation and health. Four globally significant actions can support the adoption of more efficient and sustainable water futures: green infrastructure watershed banks, an accelerated global research and solutions program, a new global water-ecosystem services observatory, and an improved technical capacity/workforce development initiative. Finally, the engagement of relevant stakeholders from academia, government, the private sector and civil society are needed to ensure that humankind will be able to meet its water security goals and commitments, including those expressed in the sustainable development agenda.

Health care team members are practicing under intense physical, emotional, relational, and social pressure during the Covid-19 pandemic. This pressure impacts their physical and mental well-being, and gives rise to questioning, positively and negatively, their "reason d'etre" and level of work engagement. In this unprecedented time, the practice world has been uprooted, creating serious implications for nurse leaders who work diligently to develop and sustain an engaged nursing workforce. Learning why nurses stay engaged despite adverse and difficult circumstances could generate new workforce development strategies. This article explains how linking passion to professional role clarity could deepen our understanding of nurse work engagement.

Summary Background The Global Fund to Fight AIDS, Tuberculosis and Malaria is a robust vertical global health programme. The extent to which vertical programmes financially support health security has not been investigated. We, therefore, endeavoured to quantify the extent to which the budgets of this vertical programme support health security. We believe this is a crucial area of work as the global community works to combine resources for COVID-19 response and future pandemic preparedness. Methods We examined budgets for work in Kenya, Uganda, Vietnam, Democratic Republic of the Congo, Guatemala, Guinea, India, Indonesia, Nigeria, and Sierra Leone from January, 2014 to December, 2020. These ten countries were selected because of the robustness of investments and the availability of data. Using the International Health Regulations Joint External Evaluation (JEE) tool as a framework, we mapped budget line items to health security capacities. Two researchers independently reviewed each budget and mapped items to the JEE. Budgets were then jointly reviewed until a consensus was reached regarding if an item supported health security directly, indirectly, or not at all. The budgets for the study countries were inputted into a single Microsoft Excel spreadsheet and line items that mapped to JEE indicators were scaled up to their respective JEE capacity. Descriptive analyses were then done to determine the total amount of money budgeted for activities that support health security, how much was budgeted for each JEE capacity, and how much of the support was direct or indirect. Findings The research team reviewed 37 budgets. Budgets totalled US$6 927 284 966, and $2 562 063 054 (37·0%) of this mapped to JEE capacities. $1 330 942 712 (19·2%) mapped directly to JEE capacities and $1 231 120 342 (17·8%) mapped indirectly to JEE capacities. Laboratory systems, antimicrobial resistance, and the deployment of medical countermeasures and personnel received the most overall budgetary support; laboratory systems, antimicrobial resistance, and workforce development received the greatest amount of direct budgetary support. Interpretation Over one-third of the Global Fund's work also supports health security and the organisation has budgeted more than $2 500 000 000 for activities that support health security in ten countries since 2014. Although these funds were not budgeted specifically for health security purposes, recognising how vertical programmes can synergistically support other global health efforts has important implications for policy related to health systems strengthening. Funding Resolve to Save Lives: An Initiative of Vital Strategies.

Lower income households, significantly less likely to have a computer or internet at home, were disproportionately impacted by the historic job losses in the Spring of 2020. In response, a Seattle-based workforce development nonprofit in partnership with the City of Seattle launched a program called Digital Bridge. The program distributed 197 refurbished computers and 174 internet hotspots and gave participants access to the Northstar Digital Literacy Assessment, online curriculum, and a technical support phone line. To understand Digital Bridge recipient needs, program impacts, and experiences of case managers implementing the program, we conducted a mixed methods study using a survey, Northstar Digital Literacy assessments, audio diaries, interviews, and a focus group. We found that most Digital Bridge participants needed individualized training and structured support to complete online training and look for employment. Case managers became participants’ default help desk without sufficient training and time allocated to properly support their clients. Participants did not use the technical support line but relied on family, friends, and their case manager when they needed assistance. Participants also wanted more structured support such as one-on-one walk throughs of their new devices and formal digital literacy training. After the initial pandemic shutdowns, more temporary federal funding has been allocated to support digital inclusion efforts. This study found that simply distributing technology will not get someone meaningfully connected; recipients want and need assistance from programs and people that they know and trust. Organizations implementing these programs need additional funding to support the time intensive personnel costs; funding cannot be limited to distributing the technology. Additionally, programs addressing digital inequalities need to work with broader social and economic assistance programs for their participants to access living wage careers.

In addressing local challenges, such as budget deficits, aging infrastructure, workforce development, opioid addiction, homelessness, and disaster preparedness

The coronavirus crisis has led to the unemployment of millions of workers and exposed a labor market that is full of poor-quality jobs. Policymakers intuitively resort to upgrading worker skills as a workforce response to the pandemic; however, the problem isn’t with retraining. The nation’s workforce development system is in shambles. It lacks appropriate accountability mechanisms to ensure workers are matched to decent work and instead steers training for any in-demand job including those that offer low pay and poor working conditions. Enabling the changes needed requires a new legal regime that establishes a right to training for a quality job.

Background: The Global Fund to Fight AIDS, Tuberculosis and Malaria is a robust vertical global health program. Other work has discussed potential synergies between various global health initiatives, but the extent to which investments from vertical programs support health security has not been investigated. We, therefore, endeavored to quantify the extent to which the budgets of this vertical program support health security. Methods: We examined budgets from the Global Fund for work in 10 countries from 2014–2020. Using the International Health Regulations Joint External Evaluation (JEE) Tool as a framework, we mapped budget items to health security capacities. We blinded researchers who independently reviewed each budget and mapped items to the JEE. We then unblinded the researchers and reviewed the budgets again until a consensus was reached regarding if an item supported health security directly, indirectly, or not at all. Findings: The budgets totaled USD 6,927,284,966, and USD 2,562,063,054 (37·0%) of this mapped to JEE capacities. USD 1,330,942,712 (19·2%) mapped directly to JEE capacities and USD 1,231,120,342 (17·8%) mapped indirectly. Laboratory systems, antimicrobial resistance, and the deployment of medical countermeasures and personnel received the greatest amount of overall budgetary support, while laboratory systems, antimicrobial resistance, and workforce development received the greatest amount of direct budgetary support. Interpretation: Over one-third of the Global Fund’s work supports health security and the Global Fund has budgeted more than USD 2,500,000,000 for activities that support health security in these 10 countries since 2014. Funding Statement: This work was funded by Resolve to Save Lives: An Initiative of Vital Strategies. Declaration of Interests: The authors have no competing interests to declare. Ethics Approval Statement: Not required.

Background The US is in the midst of one of the largest public health crises in recent history with over 63,000 drug poisoning deaths in 2016 and a projected annual economic cost of over $420 billion. With the rise of deaths and economic burden related to substance use, it is paramount that systemic barriers within the treatment industry be identified and resolved. Methods Data were collected from US substance use treatment professionals (N = 182) in the fall of 2016. Thematic analysis with axial coding was used on anonymized responses to an online open-ended survey. Additional ad hoc testing for variance (education, generation, regional location, and employment) was completed using Monte Carlo chi-square analyses. Results 7 major themes emerged: 1) additional training, education, and use of evidence-based practices, 2) expansion of treatment services, 3) increased resources, 4) stigma reduction, 5) increased collaboration and leadership, 6) reductions in regulations, requirements, and incentives, and 7) expansion of recovery support services. Participant response yielded a significant relationship between employment type (p = 0.002) and regional location (p = 0.046). Conclusions Systemic barriers in the treatment field are prevalent from the perspective of professionals engaged in the field. While previously identified barriers are still present, newly reported barriers include: 1) lack of treatment services (e.g., capacity), 2) lack of technological resources (e.g., technological support tools), 3) lack of recovery support services (e.g., recovery housing), 4) lack of collaboration and leadership (e.g., communication and partnership), and 5) increasing unethical practices in the field (e.g., incentive-based patient brokering).

Background In preparation for future needs of the health workforce there has been an increase of student enrolments into health-related courses resulting in competing demands for quality professional experience placements. Consequently, additional student and preceptor support is necessary to ensure positive learning outcomes for students placed in rural areas. Aim To evaluate a whole of community facilitator model of support for nursing students and their preceptors in rural practice settings. Methods An evaluation approach included a needs analysis; literature review and online surveys from preceptors, facilitators and nursing students. Findings The results of the needs analysis and surveys identified how the whole of community facilitator model contributed to supporting preceptors to build placement capability and promote workforce development. The results revealed benefits to students and preceptors. Emerging themes from responses centred on the interrelationship between the learning, teaching and healthcare environments. Conclusion Preceptors recognised the value of the whole of community facilitator model through their contribution of clinical and educational information, resources, modelling professional development, and provision of support. It was acknowledged multiple placement opportunities within a single community, enriched student experiences. With refinement, this model has potential to contribute to workforce development in other rural placement environments. To review the effectiveness of the model of facilitation, this paper focuses on the perspective of preceptors.

Lean Production (LP) is one of the most common initiatives in Operations Management that firms adopt to boost their competitiveness. The purpose of this paper is to examine the extant research on the relationship between LP and business performance (BP). The study analyses the data from 30 articles published from 2000 to 2016 that meet two targeted criteria, that they have: (i) empirically analysed the relationship between LP, or any measure of LP, and at least one measure of BP, and (ii) reported the effect size of the relationship between LP and BP measured with Pearson's correlation coefficients or related methods. Distinctions are made between two different performance outcomes (financial and market) and six LP practices. Using the Hunter and Schmidt (2004) meta-analysis based correlations approach, the obtained results show that a positive and moderate relationship exists between aggregate level LP and aggregate level business performance (r ´ = 0.31). There is also a positive relationship with market performance, but not with financial performance. Only three individual practices are statistically related to business performance (Process Control and Improvement, Workforce Development, and Customer Focus). The country's level of economic development is also found to act as a moderating variable in several of the studied relationships and to have a greater effect in Emerging Economies than in Advanced Economies.

Introduction Project Extension for Community Healthcare Outcomes (ECHO™) is a hub-and-spoke knowledge-sharing network, led by expert teams who use multipoint videoconferencing to conduct virtual clinics with community providers in order to improve the quality of care. For this project, members of the Addiction Technology Transfer Center network applied this model in order to enhance workforce capacity to deliver clinical supervision for the treatment of substance use disorders. Methods Clinical supervisors ( n =66) employed in substance use disorder treatment programs were recruited to participate in this pilot study. The virtual ECHO clinic consisted of 12 total sessions, each lasting 1 hour and comprising a 15-minute mini-lecture on a clinical supervision topic and a 45-minute case presentation and review. All data were collected and analyzed between September 2016 and June 2017. Results Forty-eight staff attended at least one ECHO session (mean=6.38) and results are presented for 20 staff who completed the follow-up survey. Participants were highly satisfied with the overall intervention, organization of the clinic and the facilitation of Hub experts, relevance of the technical assistance to their work, and with the impact of the intervention on their effectiveness as a supervisor. Results also indicate that there were significant self-reported improvements in clinical supervision self-efficacy following participation in the ECHO clinic. Conclusions Results from this pilot study suggest that ECHO virtual clinics are feasible to implement for the purpose of workforce development, are well liked by participants, and can enhance clinical supervision self-efficacy among participants. Further research should explore the impact of self-efficacy on the effective implementation of clinical supervision practices. Supplement information This article is part of a supplement entitled The Behavioral Health Workforce: Planning, Practice, and Preparation, which is sponsored by the Substance Abuse and Mental Health Services Administration and the Health Resources and Services Administration of the U.S. Department of Health and Human Services.

Purpose This study describes factors associated with epidemiologists from state health departments (HDs) who served as preceptors. Methods We used the 2014 Public Health Workforce Interests and Needs Survey, a national survey of state health agency workers, and selected those who identify their role in the organization as an epidemiologist and a state HD employee for analysis. Variables related to recruitment and retention were studied, and predictor variables were assessed. We applied statistical analysis of complex sampling design based on weights generated by the distribution of the epidemiologists. Logistic regression was used to determine factors that are significant predictors of preceptorship. Results Significant factors of increased preceptorship included being black (adjusted odds ratios [AOR] = 3.98, 95% confidence interval [CI], 2.01–7.88), being a team leader (AOR = 2.09, 95% CI, 1.07–4.05), a supervisor (AOR = 2.75, 95% CI, 1.25–6.08), or a manager (AOR = 2.70, 95% CI, 1.15–6.34), and collaborating with academia (AOR = 3.11, 95% CI, 1.82–5.34). Conclusions State HDs and academic institutions should collaborate to offer applied epidemiology practicum opportunities to (1) increase job satisfaction among applied epidemiologists and (2) prepare the incoming workforce to work in applied epidemiology.

Introduction Research and lessons from community implementation have informed evidence-based practices that can improve the effectiveness of health initiatives. Administrative evidence-based practices (A-EBPs) facilitate the role of public health departments in implementing the most effective programs and policies. The purpose of this study is to describe A-EBPs in relation to characteristics of chronic disease practitioners in state health departments. Methods Randomly selected chronic disease practitioners who worked in state health departments were invited to complete an online survey in 2016. The survey included questions on five domains of A-EBPs: workforce development, leadership, culture and climate, relationships and partners, and financial practices. State-level variables that could potentially affect the use of A-EBPs were collected and used in a regression model. Results Analysis was conducted in 2016 on data from 571 respondents. Mean percentages of those who strongly agreed/agreed were lowest for financial practices (41.49%) and leadership (42.33%) with higher means for culture and climate (54.52%) and relationships and partners (58.71%). State poverty level was the only significant predictor of A-EBP scores after adjusting for other covariates in a regression model. Conclusions These results show several areas of high agreement with A-EBP within the domains measured as well as opportunities for improvement. Highlighting the importance of A-EBPs to public health leadership level may enhance practice. There is also need for developing plans for an aging workforce and cultivating partnerships with health care and other sectors. Findings can be used to target training for enhancement of A-EBPs within state health departments.

Repeated inquiries into residential care for children and young people in out-of-home care have documented persistent service inadequacies. Calls for reforming residential care into therapeutic care have received growing attention in recent years. However, limited research exists to inform how therapeutic care can be optimally implemented in residential care settings. This research draws on the first-hand experience of residential care practitioners to examine the barriers they experienced when implementing therapeutic care. Twenty-six practitioners across five different service strata (senior managers, therapeutic specialists, caseworkers, team leaders and direct care workers) from three Australian residential care organizations participated in semi-structured interviews. Framework analysis of the interview data indicated, whilst there was a strong consensus that therapeutic residential care should be underpinned by trauma-informed knowledge, its implementation was constrained by six barriers: (1) inconsistent understandings of how therapeutic care should be operationalized; (2) crisis-driven referrals and assessments; (3) problematic placement configuration and client mix; (4) inadequate workforce development; (5) the emotional cost of care; and (6) atrophied clinical support. These barriers call into question the extent to which therapeutic residential care is implemented as intended. Findings indicate that, to actualize the full potential of therapeutic residential care, substantial work is needed to provide a more translatable practice framework, strengthen referral and assessment processes, revitalize the workforce and elevate implementation efforts to a systemic level, bringing closer alignment between different service systems to jointly avert re-traumatization and enhance consistency in service delivery.

Ecologized learning situated in diverse in-school, out-of-school, and after-school contexts poses daunting challenges to measuring, communicating, managing, and improving outcomes. Formal and informal educators, policymakers, funders, and other key stakeholders engaged in cross-sector collaborations defined five pillars of STEM learning ecosystem success: partnerships, measures, administrative systems, teaching and learning practices, and workforce development connections. Variation in the ecosystem success construct was mapped, existing items from an earlier ecosystem assessment were revised, four parallel survey forms with common items were devised, and an online administration system was created in early 2020. Data from over 400 stakeholders in dozens of ecosystems were fit to a probabilistic model of measurement capable of supporting metrological quality assurance standards.

Objective: CREST began in 2005 as a partnership between the ASRM, the National Institute for Child Health and Human Development, and the Duke University Clinical Research Training Program to train REI subspecialists in the conduct of clinical research. The program evolved to include urologists and other Ob-Gyn subspecialists seeking to develop their clinical research skills. Program support transitioned to an R25 grant after intramural NICHD support was terminated. CREST has trained over 100 Scholars to date. Evaluation of its first 6 years in 2012 indicated a desire for more mentoring and career advancement opportunities for Scholars. The current project sought to evaluate the recent experience of CREST Scholars to assess programmatic progress and further opportunities for improvement. Materials and Methods: Invitations to 41 Scholars from the 2013-2019 cohorts were sent by an independent evaluation entity. Scholars were invited to complete an on-line survey as well as participate in interviews. Survey questions asked about satisfaction with program components and the extent to which Scholars felt supported throughout the program. Scholar interviews centered on their experiences engaging with the program, perceptions of how CREST may have affected their careers, and the extent to which CREST contributed to Scholars’ ability to conduct ongoing research. Results: 22/41 invited Scholars completed the online survey (54%). 18/22 Scholars found the clinical research online training to be an ‘overwhelmingly positive’ experience, enabling them to acquire new and practical knowledge and skills to further their own research and/or better critique others;research. 12/22 Scholars felt very supported by program faculty and positive about mentorship throughout the program. Collaborativeness and response time of mentors were specifically cited. 6 Scholars felt specifically that CREST had motivated them to take a more research-oriented focus in their careers. A majority of Scholars interviewed believed that CREST participation helped them acquire a new leadership position or promotion. Specific barriers to research career development cited included inadequate protected time, COVID-19, and being in a subspecialty that did not quite ‘fit’ within the purview of CREST. The single biggest benefit of the program among Scholars interviewed were the networking and mentorship aspects. The proportion of Scholars who reported feeling 'very satisfied' or 'satisfied' with the program components were: 90% for the formal educational training program, 90% for the supporting faculty, 80% for the biostatistical support provided by CREST, and 68% for the manuscript publication process. Conclusions: The CREST Program continues to evolve as a premiere educational opportunity for physicians who practice reproductive medicine. CREST appears to influence physician scientists towards pursuing more research. Ongoing support through networking and career development are desired attributes of the program that can be further expanded. Impact Statement: The CREST Program has positive impact on careers beyond publications.

Background Structured workplace training supports pharmacists in achieving individual career goals as well as health services to meet workforce development goals. Hospital pharmacy residency programs offer structured training pathways for early career pharmacists. A residency program was introduced in Australia, modelled on formal programs already established in other countries. Objective This qualitative study explored key stakeholders' expectations and early experiences with the implementation of a pharmacy residency program using an analytical framework derived from implementation science. Methods Three focus groups and seven semi-structured interviews were conducted over a 24-months period with pharmacy managers, senior pharmacists and resident and non-resident pharmacists from different Australian State and hospital settings. They were audio recorded and transcribed verbatim. Transcripts were analysed via thematic analysis using Diffusion of Innovation Theory as a categorising framework. Results Thirty stakeholders participated in focus groups and interviews. Three of the five main factors that influenced the adoption of an innovation according to Diffusion of Innovation Theory were identified as prominent, two as weaker themes. The relative or perceived advantage of adopting or participating in a residency program was identified as a major theme. Pharmacy managers and resident pharmacists regarded individual and workforce advancement as creating a potential advantage for them. The complexity of the program's implementation, with concerns about its resourcing requirements and sustainability, influenced uptake. The compatibility of the program with already existing training pathways was explored, with the residency sharing similar objectives with current pharmacy education and workforce development goals. Observability and trialability played lesser roles in facilitating program uptake. Conclusion The implementation and diffusion of the pharmacy residency program can be interpreted by referring to key principles of Diffusion of Innovation Theory. Findings from this study and consideration of theory can inform the diffusion and ongoing maintenance of pharmacy workplace training and education programs.

Most studies that have examined the employment prospects of system-involved youth have done so from the perspective of the child welfare system or the juvenile justice system to determine employment-related outcomes. In the current study, by contrast, the focus is on the workforce development system and the extent to which these systems address the needs of youth in child welfare or juvenile justice. The key research question for the study is: How do State and Local Workforce Development Boards (WDBs) address the needs of system-involved youth? Data were collected via open-ended qualitative interviews with key workforce personnel in 10 states. The data identify mechanisms by which WDBs addressed these specific populations of youth as well as strengths and gaps in these efforts. We offer suggestions for further efforts to meet the employment and training needs of these highly vulnerable populations.

This study explored the changing views of key stakeholders (peer support workers, their co-workers, and service users) about peer support services in a non-Western community, using a longitudinal qualitative approach. Five trainee peer support workers (PSWs), 15 service users, and 14 co-workers were interviewed over a 12-month period, under the auspices of the Peer Support Workers Project (also known as the Mindset project) in Hong Kong. A total of 77 interviews were transcribed and thematic analyses were conducted across the participant groups at three different time points (training, work placements, and employment). During the initial implementation of the services, uncertainty about the role of the PSWs were reported. However, trusting and beneficial relationships with service users were gradually built, showing growing resilience and confidence over time. The participants realized that PSWs' experiences of mental illnesses were a unique asset that could help service users to alleviate their own somatic symptoms and improve their connections with others. Our findings highlight that the perceptions of peer support services changed from confusion to viewing PSWs as an asset, to an awareness of the importance of family support, and to the belief that implementing such a program will benefit both service users and PSWs.

Human capital theory identifies investments in health and health care policy as critical components to building human capital, however, there has been little research critically examining how health insurance policy factors into broader workforce development initiatives in the farm sector. In the U.S., the Patient Protection and Affordable Care Act (ACA), signed into law in 2010, represents the first major attempt to restructure the U.S. health insurance system, yet there has been little research examining how the ACA will affect the farm sector. This article seeks to broaden approaches to agriculturally based economic development by qualitatively and quantitatively: 1) establishing health insurance as an issue directly tied to human capital in the food and agriculture sector; 2) benchmarking farmer health insurance knowledge, the link between health insurance and farm finances, individual and employer attitudes towards the ACA, and health insurance decision-making shortly after the implementation of the ACA, and; 3) contributing research findings that inform national and state efforts to develop human capital in the food and agriculture sector. Farmers in this national sample tended to be well-insured, largely due to off-farm employment. However, a meaningful numbers of farmers reported being uninsured or underinsured and explained how their own personal health is linked to the health of the farm operation. Farmer attitudes towards the ACA and anticipated impacts varied across gender, race and ethnicity; age groups; farm scale; farmers who employ non-family members and state policy environments. Overall attitudes towards the ACA are largely mixed and differences are shades of grey rather than outright extremes. Young and beginning farmers tended to have the most positive attitudes towards the ACA and were most vocal in connecting health insurance to the viability, growth and development of their farm.

Demands for greater accountability and transparency in health care are increasing the visibility of professional case managers, including to fulfill the crucial care coordination role. While the competency of professional case managers can be assured through board certification, there is a growing need for preparation of case managers as they transition into the practice. This concern is also highlighted by recent research in the case management field, in which 89% of respondents said they use on-the-job training as their primary method to learn case management. Given the interdisciplinary nature of case management, there is a greater need to address how health and human services professionals are prepared for the advanced practice of case management. With few formal education programs in case management, greater dialogue and cooperation among interprofessional educators and case management leaders are needed to ensure a robust case management workforce development pipeline is established, with more professionals from multiple disciplines entering at earlier stages in their careers.

The world is experiencing significant, largely economic and sociotechnical, induced change. These induced changes are meaningful with a function of people taking collective actions around common beliefs. These changes are more than jargon, cliche, and hyperbole, and they are effecting major transformations. These transformations will impact on how human resources are developed, and we need to be able to forecast its effects. In order to produce such forecasts, Human Resource Development needs to become more predictive - to develop the ability to understand how human capital systems and organizations will behave in future. As part of a multi-phase, mixed methods study design based on systems and complexity theories to identify skill needs for the emerging agrifood nanotechnology sector, a strategic flexibility analysis (SFA) was conducted. Strategic Flexibility Framework (SFF) is a scenario analysis tool and its use in this study is based on the idea that Business Leaders, Managers, Educators and Human Resource Development professionals require flexibility to adjust decisions within given constraints. This paper describes the use of strategic flexibility analysis and the qualitative systems approaches as tools for systems research and it implications for human resources development and management.

We investigate with German data how the use of temporary agency work has helped establishments to manage the economic and financial crisis in 2008/09. We examine the (regular) workforce development, use of short-time work, and business performance of establishments that made differential use of temporary agency work prior to the crisis. Overall, our results suggest that establishments with a greater use of temporary agency work coped better with the sharp decline in demand and made less frequent use of government-sponsored short-time work schemes.

Accompanying the increasing advances and interest in Additive Manufacturing (AM) technologies is an increasing demand for an industrial workforce that is knowledgeable about the technologies and how to apply them to solve real-world problems. As a step towards addressing this knowledge gap, a workshop was held at the National Science Foundation (NSF) to discuss the educational needs to prepare industry for AM and its use in different fields. The workshop participants – 66 representatives from academia, industry, and government – identified several key educational themes: (1) AM processes and process/material relationships, (2) engineering fundamentals with an emphasis on materials science and manufacturing, (3) professional skills for problem solving and critical thinking, (4) design practices and tools that leverage the design freedom enabled by AM, and (5) cross-functional teaming and ideation techniques to nurture creativity. This paper summarizes the industry speakers and presentations from the workshop, along with several new educational partnerships identified by small working groups. Based on the presentations and partnerships, the following recommendations are offered to advance the AM workforce. First, ensure that all AM curricula provide students with an understanding of (i) AM and traditional manufacturing processes to enable them to effectively select the appropriate process for product realization; (ii) the relationships between AM processes and material properties; and (iii) “Design for AM”, including computational tools for AM design as well as frameworks for process selection, costing, and solution generation that take advantage of AM capabilities. Second, establish a national network for AM education that, by leveraging existing “distributed” educational models and NSF’s Advanced Technology Education (ATE) Programs, provides open source resources as well as packaged activities, courses, and curricula for all educational levels (K-Gray). Third, support K-12 educational programs in STEAM (STEM plus the arts) and across all formal and informal learning environments in order to learn the unique capabilities of AM while engaging students in hands-on, tactile, and visual learning activities to prepare them for jobs in industry while learning how to think differently when designing for AM. Fourth, provide support for collaborative and community-oriented maker spaces that promote awareness of AM among the public and provide AM training programs for incumbent workers in industry and students seeking alternative pathways to gain AM knowledge and experience. Recommendations for scaling and coordination across local, regional, and national levels are also discussed to create synergies among the proposed activities and existing efforts.

The NICU experience impacts all family dynamics not just during the intensive care unit stay but in the months and years afterwards. For each family, the first experiences with their baby, whether in the home or the intensive care unit, can set the trajectory for the long-term parent–child relationship and the parent's perspective of their parent roles. These difficult experiences have the potential to be addressed through infant and early childhood mental health (I/ECMH) methods. In this article we review the need for a wide range of social and emotional supports that present in intensive care and continue as families and infants transition to home and community. The potential for addressing these ongoing issues by a variety of providers within many different settings using Infant and Early Childhood Mental Health (I/ECMH) approaches is discussed and examples of successful programs are provided. Finally, we make recommendations for infusing I/ECMH across programs that serve intensive care unit graduates and their families, from the hospital to the home, with primary care providers and other community support programs.