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Source
Pages 376-380 in N. Murphy and A. Parkinson, eds. Circumpolar Health 2012: Circumpolar Health Comes Full Circle. Proceedings of the 15th International Congress on Circumpolar Health, Fairbanks, Alaska, USA, August 5-10, 2012. International Journal of Circumpolar Health 2013;72 (Suppl 1):376-380
Publication Type
Article
Date
2013
  1 document  
Author
Sarah Shoffstall-Cone
Mary Williard
Author Affiliation
DENTEX, Alaska Native Tribal Health Consortium, USA. sshoffstallcone@anthc.org
Source
Pages 376-380 in N. Murphy and A. Parkinson, eds. Circumpolar Health 2012: Circumpolar Health Comes Full Circle. Proceedings of the 15th International Congress on Circumpolar Health, Fairbanks, Alaska, USA, August 5-10, 2012. International Journal of Circumpolar Health 2013;72 (Suppl 1):376-380
Date
2013
Language
English
Geographic Location
U.S.
Publication Type
Article
Digital File Format
Text - PDF
Physical Holding
University of Alaska Anchorage
Keywords
Alaska
Delivery of Health Care - manpower - organization & administration - standards
Health Services, Indigenous - manpower - organization & administration - standards
Humans
Indians, North American
Preventive Dentistry - organization & administration
Quality of Health Care
Abstract
In 1999, An Oral Health Survey of American Indian and Alaska Native (AI/AN) Dental Patients found that 79% of 2- to 5-year-olds had a history of tooth decay. The Alaska Native Tribal Health Consortium in collaboration with Alaska's Tribal Health Organizations (THO) developed a new and diverse dental workforce model to address AI/AN oral health disparities.
This paper describes the workforce model and some experience to date of the Dental Health Aide (DHA) Initiative that was introduced under the federally sanctioned Community Health Aide Program in Alaska. These new dental team members work with THO dentists and hygienists to provide education, prevention and basic restorative services in a culturally appropriate manner.
The DHA Initiative introduced 4 new dental provider types to Alaska: the Primary Dental Health Aide, the Expanded Function Dental Health Aide, the Dental Health Aide Hygienist and the Dental Health Aide Therapist. The scope of practice between the 4 different DHA providers varies vastly along with the required training and education requirements. DHAs are certified, not licensed, providers. Recertification occurs every 2 years and requires the completion of 24 hours of continuing education and continual competency evaluation.
Dental Health Aides provide evidence-based prevention programs and dental care that improve access to oral health care and help address well-documented oral health disparities.
Notes
Cites: J Am Dent Assoc. 2008 Nov;139(11):1530-5; discussion 1536-918978392
Cites: Int Dent J. 2008 Apr;58(2):61-7018478885
Cites: MMWR Morb Mortal Wkly Rep. 2011 Sep 23;60(37):1275-821937973
PubMed ID
23984306 View in PubMed
Documents
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Alberta launches physician assistant pilot project.

https://arctichealth.org/en/permalink/ahliterature107075
Source
CMAJ. 2013 Nov 5;185(16):E741
Publication Type
Article
Date
Nov-5-2013

Assessment of treatment provided by dental health aide therapists in Alaska: a pilot study.

https://arctichealth.org/en/permalink/ahliterature91409
Source
J Am Dent Assoc. 2008 Nov;139(11):1530-5; discussion 1536-9
Publication Type
Article
Date
Nov-2008
Author
Bolin Kenneth Anthony
Author Affiliation
Department of Public Health Sciences, Texas A&M University Health Science Center, Baylor College of Dentistry, Dallas, TX 75246, USA. kbolin@bcd.tamhsc.edu
Source
J Am Dent Assoc. 2008 Nov;139(11):1530-5; discussion 1536-9
Date
Nov-2008
Language
English
Publication Type
Article
Keywords
Age Distribution
Alaska
Community Health Aides - standards
Delivery of Health Care - manpower - standards
Dental Audit
Dental Auxiliaries - standards
Dental Care - manpower - standards
Dental Caries - prevention & control
Dentists - standards
Health Services Accessibility
Health Services, Indigenous - manpower
Humans
Outcome Assessment (Health Care)
Pilot Projects
Quality of Health Care
Abstract
BACKGROUND: Dental health aide therapists (DHATs) in Alaska are authorized under federal law to provide certain dental services, including irreversible dental procedures. The author conducted this pilot study to determine if treatments provided by DHATs differ significantly from those provided by dentists, to determine if DHATs in Alaska are delivering dental care within their scope of training in an acceptable manner and to assess the quality of care and incidence of reportable events during or after dental treatment. METHODS: The author audited the dental records of patients treated by dentists and DHATs who perform similar procedures for selected variables. He reviewed the records of 640 dental procedures performed in 406 patients in three health corporations. RESULTS: The author found no significant differences among the provider groups in the consistency of diagnosis and treatment or postoperative complications as a result of primary treatment. The patients treated by DHATs had a mean age 7.1 years younger than that of patients treated by dentists, and the presence or adequacy of radiographs was higher among patients treated by dentists than among those treated by DHATs, with the difference being concentrated in the zero- to 6-year age group. CONCLUSIONS: No significant evidence was found to indicate that irreversible dental treatment provided by DHATs differs from similar treatment provided by dentists. Further studies need to be conducted to determine possible long-term effects of irreversible procedures performed by nondentists. CLINICAL IMPLICATIONS: A need to improve oral health care for American Indian/Alaska Native populations has led to an approach for providing care to these groups in Alaska. The use of adequately trained DHATs as part of the dental team could be a viable long-term solution.
Notes
Comment In: J Am Dent Assoc. 2008 Dec;139(12):1585; discussion 158519047661
Comment In: J Am Dent Assoc. 2009 Jun;140(6):640, 642; author reply 642-319491156
PubMed ID
18978392 View in PubMed
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Barefoot or professional? Community health workers in the Third World: some important questions concerning their function, utilization, selection, training and evaluation.

https://arctichealth.org/en/permalink/ahliterature246110
Source
J Trop Med Hyg. 1980 Feb;83(1):3-10
Publication Type
Article
Date
Feb-1980

Delivery models of rural surgical services in British Columbia (1996-2005): are general practitioner-surgeons still part of the picture?

https://arctichealth.org/en/permalink/ahliterature155820
Source
Can J Surg. 2008 Jun;51(3):173-8
Publication Type
Article
Date
Jun-2008
Author
Nancy Humber
Temma Frecker
Author Affiliation
Department of Family Practice (Research Division), University of British Columbia, Vancouver, BC. Saffron2@telus.net
Source
Can J Surg. 2008 Jun;51(3):173-8
Date
Jun-2008
Language
English
Publication Type
Article
Keywords
Appendectomy - statistics & numerical data
British Columbia
Delivery of Health Care - manpower - organization & administration
Emergency Medical Services - statistics & numerical data
Family Practice - organization & administration
Foreign Medical Graduates
General Surgery - organization & administration
Humans
Maternal Health Services - statistics & numerical data
Outcome Assessment (Health Care)
Physician's Practice Patterns - statistics & numerical data
Physician's Role
Referral and Consultation - statistics & numerical data
Retrospective Studies
Rural Health Services - manpower - organization & administration
Surgical Procedures, Operative - statistics & numerical data
Abstract
To define the models of surgical service delivery in rural communities that rely solely on general practitioner (GP)-surgeons for emergency care, to examine how they have changed over the past decade and to identify some effects on communities that have lost their local surgical program.
We undertook a retrospective study using the Population Utilization Rates and Referrals For Easy Comparative Tables database (versions 6.0 and 9.0) and telephone interviews to hospitals that we identified. We included all hospitals in rural British Columbia with surgical programs that had no resident specialist surgeon and that relied on general practitioner-surgeons (GP-surgeons) for emergency surgical care. We examined surgical program characteristics, community size, distance from referral centre, role of itinerant surgery, where GPs were trained, their age and years of experience and referral rates for appendectomies and obstetrics.
Changes over the past decade include a decrease in the total number of GP-surgeons operating in these communities, more itinerant surgery and the loss of 3 of 12 programs. GP-surgeons are older, are usually foreign-trained and have more than 5 years of experience. Communities with no local program or that rely on solo practitioners refer more emergencies out of the community and do less maternity care than those with more than a single GP-surgeon.
GP-surgeons still play an integral role in the provision of emergency and elective surgical services in rural communities without the population base to sustain resident specialist surgeons. As GP-surgeons retire and surgical programs close, there is no accredited training program to replace them. More outcome comparisons between procedures performed by GP-surgeons and general surgeons are needed, as is the creation of a nationally accredited training program to replace these practitioners as they retire.
Notes
Cites: Can Med Assoc J. 1979 Apr 21;120(8):919436065
Cites: Am J Public Health. 1997 Jan;87(1):85-909065233
Cites: Can Fam Physician. 1998 Oct;44:2117-249805166
Cites: Can Fam Physician. 2005 Sep;51:1238-916926940
Cites: Can J Surg. 2008 Jun;51(3):179-8418682764
Cites: Am J Public Health. 1983 Apr;73(4):414-216829824
Cites: Can Med Assoc J. 1984 Mar 1;130(5):571-66697267
Cites: J Fam Pract. 1988 Oct;27(4):377-843171489
Cites: Am J Public Health. 1990 Jul;80(7):814-82356904
Cites: CMAJ. 1991 Jul 1;145(1):46-82049697
Cites: CMAJ. 1993 Nov 15;149(10):1541-58221438
Cites: CMAJ. 1995 Nov 15;153(10):1447-527585371
Cites: CMAJ. 1995 Nov 15;153(10):1453-47585372
Cites: Am J Public Health. 1996 Jul;86(7):1011-58669503
Cites: CMAJ. 1996 Aug 15;155(4):395-4018752064
Cites: Br J Gen Pract. 1997 Apr;47(417):205-109196961
PubMed ID
18682795 View in PubMed
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Evaluation of ethical reflections in community healthcare: a mixed-methods study.

https://arctichealth.org/en/permalink/ahliterature275850
Source
Nurs Ethics. 2015 Mar;22(2):194-204
Publication Type
Article
Date
Mar-2015
Author
Ulrika Söderhamn
Helga Tofte Kjøstvedt
Åshild Slettebø
Source
Nurs Ethics. 2015 Mar;22(2):194-204
Date
Mar-2015
Language
English
Publication Type
Article
Keywords
Adult
Community Health Services - ethics
Delivery of Health Care - manpower
Female
Focus Groups
Health Personnel - ethics
Humans
Male
Middle Aged
Moral Obligations
Norway
Nursing Care - ethics - methods
Professional Competence
Surveys and Questionnaires
Workplace - standards
Abstract
Ethical reflections over care practices are important. In order to be able to perform such reflections, healthcare professionals must learn to think critically about their care practice.
The aim of this study was to evaluate whether an introduction to and practice in ethical reflections in community healthcare have consequences for the healthcare personnel's practice.
A mixed-methods design was adopted with five focus group interviews and an electronic questionnaire based on results from the interviews.
A total of 29 community healthcare personnel with experience in ethical reflections participated in the interviews. The electronic questionnaire was sent via email to 2382 employees in community healthcare services in 13 municipalities in southern part of Norway.
The study was guided by the intentions of the Declaration of Helsinki and ethical standard principles and approved by the Norwegian Social Science Data Services.
An introduction to and practice in performing ethical reflections brought about an ethical awareness with understanding and respect for both colleagues and patients. The leader had a key role. Lack of time was a hindrance for ethical reflections. Three factors could predict meaningful ethical reflections: higher age of personnel, higher percentage of employment and longer experience with ethical reflections.
According to other studies, ethical reflections may enhance moral development of colleagues and their actions as advocates for the patients. A deepened ethical awareness, professional competency and sufficient time resources will guarantee proper caregiving.
A supportive environment that prioritizes participation in reflection meetings is decisive. To practice ethical reflections will provide better care for patients. A challenge for the community healthcare system is to offer adequate positions that provide the personnel an opportunity to be involved as caregivers and to participate in ethical reflections.
PubMed ID
24714049 View in PubMed
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Factors enabling advanced practice nursing role integration in Canada.

https://arctichealth.org/en/permalink/ahliterature135433
Source
Nurs Leadersh (Tor Ont). 2010 Dec;23 Spec No 2010:211-38
Publication Type
Article
Date
Dec-2010
Author
Alba DiCenso
Denise Bryant-Lukosius
Ruth Martin-Misener
Faith Donald
Julia Abelson
Ivy Bourgeault
Kelley Kilpatrick
Nancy Carter
Sharon Kaasalainen
Patricia Harbman
Author Affiliation
CHSRF/CIHR in Advanced Practice Nursing, Ontario Training Centre in Health Services & Policy Research, McMaster University, Hamilton, ON.
Source
Nurs Leadersh (Tor Ont). 2010 Dec;23 Spec No 2010:211-38
Date
Dec-2010
Language
English
Publication Type
Article
Keywords
Advanced Practice Nursing - manpower - organization & administration
Awareness
Canada
Curriculum
Decision Support Systems, Clinical
Delivery of Health Care - manpower - organization & administration
Education, Nursing, Continuing
Focus Groups
Great Britain
Health Care Surveys
Health Policy
Humans
Interprofessional Relations
Leadership
Nurse Clinicians - organization & administration - supply & distribution
Nurse Practitioners - organization & administration - supply & distribution
Personnel Turnover
Primary Health Care - organization & administration
United States
Abstract
Although advanced practice nurses (APNs) have existed in Canada for over 40 years and there is abundant evidence of their safety and effectiveness, their full integration into our healthcare system has not been fully realized. For this paper, we drew on pertinent sections of a scoping review of the Canadian literature from 1990 onward and interviews or focus groups with 81 key informants conducted for a decision support synthesis on advanced practice nursing to identify the factors that enable role development and implementation across the three types of APNs: clinical nurse specialists, primary healthcare nurse practitioners and acute care nurse practitioners. For development of advanced practice nursing roles, many of the enabling factors occur at the federal/provincial/territorial (F/P/T) level. They include utilization of a pan-Canadian approach, provision of high-quality education, and development of appropriate legislative and regulatory mechanisms. Systematic planning to guide role development is needed at both the F/P/T and organizational levels. For implementation of advanced practice nursing roles, some of the enabling factors require action at the F/P/T level. They include recruitment and retention, role funding, intra-professional relations between clinical nurse specialists and nurse practitioners, public awareness, national leadership support and role evaluation. Factors requiring action at the level of the organization include role clarity, healthcare setting support, implementation of all role components and continuing education. Finally, inter-professional relations require action at both the F/P/T and organizational levels. A multidisciplinary roundtable formulated policy and practice recommendations based on the synthesis findings, and these are summarized in this paper.
PubMed ID
21478695 View in PubMed
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Goin' to the country: challenges for women's health care in rural Canada.

https://arctichealth.org/en/permalink/ahliterature204635
Source
CMAJ. 1998 Aug 25;159(4):339-41
Publication Type
Article
Date
Aug-25-1998
Author
M T Johnston
Source
CMAJ. 1998 Aug 25;159(4):339-41
Date
Aug-25-1998
Language
English
Publication Type
Article
Keywords
Canada
Delivery of Health Care - manpower - standards
Family Practice - manpower - standards
Female
Humans
Male
Physician-Patient Relations
Physicians, Women
Rural Population
Socioeconomic Factors
Women's health
Women's Health Services - manpower - standards
Notes
Cites: Lancet. 1985 Aug 24;2(8452):429-322863454
Cites: Am J Obstet Gynecol. 1983 Jan 15;145(2):170-66849351
Cites: CMAJ. 1993 Apr 15;148(8):1281-48267698
Cites: Can Fam Physician. 1998 Jun;44:1208-10, 1219-229640507
Cites: Med J Aust. 1998 Apr 20;168(8):386-99594948
Cites: Med J Aust. 1997 Jan 6;166(1):7-89006604
Cites: Can Fam Physician. 1996 Jan;42:109-108924802
Cites: CMAJ. 1994 May 1;150(9):1466-78168012
Cites: Acad Med. 1995 Apr;70(4):305-127718063
Cites: Soc Sci Med. 1995 Sep;41(5):739-457502106
Cites: Aust N Z J Med. 1995 Oct;25(5):512-78588774
Cites: Can Fam Physician. 1996 Jun;42:1063-7, 1077-828704479
Cites: Can Fam Physician. 1993 Jul;39:1591-68348020
PubMed ID
9732712 View in PubMed
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Growing your own: community health workers and jobs to careers.

https://arctichealth.org/en/permalink/ahliterature133728
Source
J Ambul Care Manage. 2011 Jul-Sep;34(3):234-46
Publication Type
Article
Author
Brandy Farrar
Jennifer Craft Morgan
Emmeline Chuang
Thomas R Konrad
Author Affiliation
Institute on Aging, University of North Carolina at Chapel Hill, Chapel Hill, NC 27514, USA. bfarrar@schsr.unc.edu
Source
J Ambul Care Manage. 2011 Jul-Sep;34(3):234-46
Language
English
Publication Type
Article
Keywords
Alaska
Career Choice
Community Health Services - manpower - organization & administration
Community Health Workers - education - supply & distribution
Delivery of Health Care - manpower
Health Services Needs and Demand - statistics & numerical data
Humans
Massachusetts
New York
Program Development
Qualitative Research
Abstract
This article evaluates the implementation and impact of 5 workforce development programs aimed at achieving skills upgrades, educational advancement, and career development for community health workers (CHWs). Quantitative and qualitative case study data from the national evaluation of the Jobs to Careers: Transforming the Front Lines of Health Care initiative demonstrate that investing in CHWs can achieve measurable worker (eg, raises) and programmatic (eg, more skilled workers) outcomes. To achieve these outcomes, targeted changes were made to the structure, culture, and work processes of employing organizations. These findings have implications for other health care employers interested in developing their CHW workforce.
PubMed ID
21673522 View in PubMed
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The health system and international recruitment.

https://arctichealth.org/en/permalink/ahliterature143116
Source
Healthc Pap. 2010;10(2):28-34; discussion 51-5
Publication Type
Article
Date
2010
Author
Sandra Macdonald-Rencz
Janet Davies
Author Affiliation
Office of Nursing Policy, Strategic Policy Branch, Health Canada.
Source
Healthc Pap. 2010;10(2):28-34; discussion 51-5
Date
2010
Language
English
Publication Type
Article
Keywords
Acculturation
Canada
Delivery of Health Care - manpower
Foreign Professional Personnel - supply & distribution
Health Care Sector
Humans
Personnel Selection - methods
Population Dynamics
Abstract
Labour mobility is a characteristic of the first decade of the 21st century. Individuals, employers, regulators and governments are all involved. In Canada, these efforts are framed by the Pan-Canadian Framework for the Assessment and Recognition of Foreign Qualifications. The framework describes processes to support international labour mobility. It defines benchmarks and service standards related to the recruitment of internationally educated individuals. The framework acknowledges and addresses barriers faced by immigrants to Canada. International labour mobility is one of the strategies being used in the health sector to respond to demands for health services. Various programs and actions have been put in place in the health sector to facilitate international recruitment; these programs and actions are the focus of this paper.
Notes
Comment On: Healthc Pap. 2010;10(2):8-2020523135
PubMed ID
20523137 View in PubMed
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37 records – page 1 of 4.