Vacant Posts Research Articles

Health workforce needs in Malawi: analysis of the Thanzi La Onse integrated epidemiological model of care

BackgroundTo make the best use of health resources, it is crucial to understand the healthcare needs of a population—including how needs will evolve and respond to changing epidemiological context and patient behaviour—and how this compares to the capabilities to deliver healthcare with the existing workforce. Existing approaches to planning either rely on using observed healthcare demand from a fixed historical period or using models to estimate healthcare needs within a narrow domain (e.g., a specific disease area or health programme). A new data-grounded modelling method is proposed by which healthcare needs and the capabilities of the healthcare workforce can be compared and analysed under a range of scenarios: in particular, when there is much greater propensity for healthcare seeking.MethodsA model representation of the healthcare workforce, one that formalises how the time of the different cadres is drawn into the provision of units of healthcare, was integrated with an individual-based epidemiological model—the Thanzi La Onse model—that represents mechanistically the development of disease and ill-health and patients’ healthcare seeking behaviour. The model was applied in Malawi using routinely available data and the estimates of the volume of health service delivered were tested against officially recorded data. Model estimates of the “time needed” and “time available” for each cadre were compared under different assumptions for whether vacant (or established) posts are filled and healthcare seeking behaviour.ResultsThe model estimates of volume of each type of service delivered were in good agreement with the available data. The “time needed” for the healthcare workforce greatly exceeded the “time available” (overall by 1.82-fold), especially for pharmacists (6.37-fold) and clinicians (2.83-fold). This discrepancy would be largely mitigated if all vacant posts were filled, but the large discrepancy would remain for pharmacists (2.49-fold). However, if all of those becoming ill did seek care immediately, the “time needed” would increase dramatically and exceed “time supply” (2.11-fold for nurses and midwives, 5.60-fold for clinicians, 9.98-fold for pharmacists) even when there were no vacant positions.ConclusionsThe results suggest that services are being delivered in less time on average than they should be, or that healthcare workers are working more time than contracted, or a combination of the two. Moreover, the analysis shows that the healthcare system could become overwhelmed if patients were more likely to seek care. It is not yet known what the health consequences of such changes would be but this new model provides—for the first time—a means to examine such questions.

Current status of lung cancer care in Germany in the context of treatment centralization and lack of personnel

Lung cancer is the malignancy with the highest mortality rate worldwide. In January 2025, the German public healthcare system will introduce a new regulation according to which a centre can offer surgery for lung cancer only if it carries out a minimum number of lung resections. The purpose of this directive is to reduce the number of centres offering surgical treatment for primary lung cancer, thus centralising and improving lung cancer care. It is expected that the introduction of this regulation will lead to a significant shift in the staffing of thoracic units. The purpose of this survey was to examine the current occupational structures behind the units of thoracic surgery and respiratory medicine. We performed an online survey through the German Society for Thoracic Surgery and the Association of Respiratory Physicians. The responding centres were divided in two groups, centres that were certified by the German Cancer Society or the Society for Thoracic Surgery and centres which were not certified. The response rate was 29.3% (respiratory physicians) and 31.9% (thoracic surgeons); 67% of the participating colleagues answered that their unit was an independent department. The majority of the participants reported having to share the on-call duty of the trainees with other departments in order to be able to cover the required shifts. 35% of the respiratory physicians and 57% of the thoracic surgeons reported having vacant job posts in their units. The introduction of the minimum quantity regulation will have significant consequences for the treatment of lung cancer in Germany. The current staff shortage in healthcare will lead to both medical and nursing staff needing to be redistributed in order to meet the needs that will arise in 2025. Operating lists, theatre days, and operative equipment will need to be redistributed as well, not only within hospitals but probably on a nationwide level. A negative impact of the new regulation is to be expected on research and academic activities since most university hospitals are not expected to reach the minimum number of lung resections that is required in order keep performing lung cancer surgery.

Unforeseen Effects of the Post-Provisioning Model in Principal’s Administrative Roles in South African Public Schools

This study aims to investigate the effects of the Post-Provisioning Model in the management of public secondary schools in the King Cetsh wayo district of Kwa Zulu-Natal province in South Africa. Apart from previous studies on PPM, this investigation was conducted quantitatively to present numerical data. Since the study presented numerical data, this study was found grounded in the positivist paradigm. The literature findings reveal that school principals experience poor strategic management, lack of capacity-building workshops, poor filling of vacant posts; failure to manage educator job satisfaction, late admission of learners, and poor redeployment processes of educators. Empirical findings of this study also confirm such effects of PPM which threatens school management roles. The paper concludes by the submissions that there is a need to revise PPM implementation to address challenges and support the management roles of school principals. Moreover, there is a need to incapacitate school managers regarding the management of PPM for its effective implementation.

Dattopant Thengadi National Board for Workers Education and Development (DTNBWED): a need for re-organisation

Research methodology The students should go through the concepts of motivation, leadership, organisational communication, organisational culture, organisational conflict, power and politics and organisational change and development from their course on organisational behaviour. In Business Communication, the students could review effective communication skills, the process of communication and barriers to communication to prescribe suitable recommendations for the organisation. In Financial Accounting, the reader should revise the income statement and balance sheet. They can undertake financial analysis on the data presented in the case to analyse the performance of the organisation. The participants may be asked to identify future possible financial risks that may arise. Case overview/synopsis The Dattopant Thengadi National Board for Workers Education and Development (DTNBWED) was an autonomous body under the Ministry of Labour and Employment, Government of India. It had been responsible for creating a disciplined and skill-oriented workforce for the organised, unorganised and rural sectors in India. In the past, DTNBWED undertook training programmes to educate and improve the quality of life of workers. However, the objectives were far from being fulfilled because of challenges such as an acute shortage of education officers, a slow recruitment process, communication issues between the ministry and the DTNBWED and a large part of the budget being spent on salaries. The main challenges faced by DTNBWED were the implementation of the 7th Pay Commission and the higher contribution of the Government under a new pension scheme. The DTNBWED faced audit issues, including the absence of an inventory register, non-compliance with accounting rules and statutory norms and inadequate internal audit. The DTNBWED could not shift its headquarters from Nagpur to Delhi because of office politics and differences between the staff and the ministry. The organisation needed a complete reorganisation using principles of change management and agile management. It was recommended that departmental promotion committees review promotions immediately; recruitment of education officers should be done along with post-revival with the Ministry of Finance; rental of offices should be from Government departments only; and the administrative manual and recruitment rules should be revised. These measures would help to overcome the challenges faced by DTNBWED, such as low expenditure on training, poor communication between the ministry and headquarters, vacant top-level posts and low motivation levels among existing officers. Complexity academic level The case is appropriate for MBA students, executive MBAs, and those working in government organisations. Peer review The peer review history for this article is available at: https://publons.com/publon/10.1108/TCJ-04-2021-0056/

Maternal healthcare utilization in rural Bangladesh: A comparative analysis between high and low disaster-prone areas.

This study examined the disparity in antenatal care (ANC) visits and institutional delivery between high-disaster-prone (HDP) and low-disaster-prone (LDP) areas, defined based on multi-hazards, in Bangladesh and assessed the influencing factors using Andersen's behavioral model. In this study, cross-sectional data of 345 mothers, who had live birth the year preceding the survey, were used from the second-round multipurpose survey of a longitudinal research project conducted in May-June 2011. Hierarchical multinomial logistic and binary logistic models were respectively used to assess the determinants of ANC contacts and choice of childbirth place. We found very low utilization of 4+ ANC visits in both HDP (20%) and LDP (15%) areas. The difference is also not significant. The strong influencing factors of receiving 4+ ANC were mother's education, household size, income, and proximity to health facility. The level of institutional delivery was also low (21%), and no significant difference between HDP (15.2%) and LDP (25.7%) was found. However, in the case of institutional delivery, significant (p-value ≤ .01) difference was found in C-section between HDP (42%) and LDP (79%). A significant (p-value ≤ .05) difference was also found in the attendance of graduate doctors/gynecologists between HDP (58%) and LDP (88%). Mothers of HDP areas were 52 percent less likely to choose institutional delivery compared to those of LDP areas. Moreover, there was 30 percent less likelihood of choosing institutional delivery with an increase in distance to the nearest health facility. Specific demand-side (e.g., awareness raising, expanding maternal voucher scheme, covering more mothers under maternal allowance, and facilitating more income-generating activities especially off-farm ones) and supply-side interventions (e.g., providing training to local traditional birth attendants, and deployment of boat-based medical teams in coastal and char areas) need to be undertaken to increase institutional delivery, especially in HDP areas. However, the ultimate solution depends on adopting long-term measures to prepare facilities ready by filling the vacant posts and reducing absenteeism. Public-private partnerships modality can also be introduced especially in the HDP areas. Policy attention is needed to introduce such interventions.

Constraints Experienced by Extension Professionals in using Technology Dissemination System of State Department of Agriculture in Andhra Pradesh

Extension Professionals were the grass root level workers who worked directly with the farmers implementing the development activities. Competency and satisfaction of extension Professionals on their job makes all the difference in smooth functioning of the development initiatives. However, there are constraints experienced by extension professionals in using technology dissemination systems of State Department of Agriculture (SDA) which needs to be studied for effective implementation of the programmes and schemes of State Department of Agriculture. Hence, A survey was conducted among Andhra Pradesh extension professionals, with the sample size of 100 respondents who were actively involved in the fields of State Department of Agriculture through simple random sampling. The constraints were ranked based on the mean scores and also categorized the constraints based on their relative importance. Results showed that the major constraint faced by Andhra Pradesh extension professionals was technical and infrastructure problems associated with the SDA was the most important and first ranked constraint among fourteen constraints. Lack of training to employees on technology dissemination methods, accessibility to the ICT tools, uncontrollable changes in technology delivery methods, availability of required inputs to conduct demonstrations and lack of awareness on new approaches of technology dissemination were other most important constraints. In order to overcome these constraints so as to enhance the capability of extension professionals in utilizing technology dissemination systems of SDA, extension professionals expressed that, the vacant posts in the Department should be filled regularly to reduce the overburden on existing extension professionals as a most important suggestion with regular and relevant training programmes on latest technology dissemination methods for successful implementation of the extension delivery system.

Understanding the Grand Challenges of South African Police Women: Can Relevant Policy Measures Ease This Burden?

The population composition in South African total citizens displays that more than 50 percent are Females. In contrary, confusion arises when job opportunities and available vacant posts are not distributed equally with the Male. Thus, the objective of this study was to offer understandings of grand challenges of South African Police Women across South Africa, aided by this hanging question: Can relevant policy measures ease this burden? This qualitative study employed the Scoping Review research design. The non-probability: Purposive sampling was used. The collected data was restricted to 1990-2021. The inductive Textual Content Analysis (TCA) was applied for data analysis. Results indicate that there is an absence of effective policy and regulation that can boost the status of Females in the Police services or Law Enforcement Agencies (LEAs). This is selectively attributed to stereotypical outlook of Male population and resistance to contemporary changes. Moreover, the existence of numerous policies, including ‘laws, rules and regulations,’implementations seem distant,further fueled by limited inspections and audits, which continues to deprive Females fair competitiveness with Males across many aspects. It is recommended that implementations of available polices to address challenges faced by Females in different societal sectors should be made an urgent priority. Males should also subject Females to impartial, fair treatment and tolerance. The complexity of SAPS should not be gender-based.

A scoping review of strategies used to recruit and retain nurses in the health care workforce.

This article reports the results of a scoping review to identify initiatives for improving recruitment and retention of nurses in health care and ascertain their effectiveness. The global shortage of nurses has results in greater competition for vacant posts and an increased need to retain existing post holders. While there are a large number of publications discussing ways to improve recruitment and retention, the effectiveness of these needs to be established. Thirteen papers met the inclusion criteria. There was no literature identified focusing on recruitment and only one paper reported a formal evaluation of a retention initiative. Five themes summarized the initiatives for retaining nurses: leadership and support, ongoing professional development, recognition, work environment and flexible scheduling. While strategies have been proposed to retain nurses, there is a dearth of evidence supporting the effectiveness of these. Although there is a lack of evaluations of retention strategies, the review identified a number of initiatives that warrant consideration. With the launch of the National Health Service People Plan in England in 2021, which is recommending initiatives identified in this review without robust evidence, an integrated programme of research evaluating this is recommended.

A Systematic Approach for the Interview of the Application to Psychiatry Specialty Training: The “I AM” Approach

AimsJob interviews are the platform for employers to identify suitable candidates for vacant posts, i.e. those who are able to demonstrate a certain set of competencies specified in the job description. In the recent psychiatry specialty training (ST) application process, candidates are required to propose a management plan for two complex scenarios. This interview can be stressful given the high-stakes nature of the outcome, i.e. the successful enrolment into a training programme of a preferred deanery. Candidates who are unable to have an organised approach to problem-solving will likely have an unfavourable result. To overcome this difficulty, a simplified “I AM” approach is being proposed to assist applicants to organise their thoughts during their ST application interview.MethodsThe “I AM” approach stands for “Issues, Assessments, and Management”, which is adapted from the “Handbook of Psychiatry: Surviving Consultation Viva Examination of Malaysian Conjoint Board”. The “Issues” are the problems identified in a scenario, “Assessments” are the investigation required to get a clearer picture of the problems, and “Management” is the action plan to solve the problems. This approach was piloted with five applicants of ST in psychiatry prior to their interview practices.ResultsFor a complex clinical case scenario, the “I AM” approach can be put into the matrix of 3 × 3 tables together with a biopsychosocial model to ensure the issues in different domains are explored thoroughly. Further sub-classification into necessary subheadings, including ideas, concerns, and expectations from different parties, can be included in the assessment matrix. Lastly, a management plan using a multidisciplinary team and collaborative decision-making model with the patient and family can be proposed. For a complex managerial scenario, the seven pillars of the National Health Service's clinical governance model involving different stakeholders can be incorporated into the “I AM” approach to explore problem-solving strategies from different angles. Positive reactions had been received from all five trainees (Kirkpatrick's Evaluation Model Level One).ConclusionThe “I AM” approach can be flexibly applied in different problem-solving scenarios and it works well with other models. The approach may be limited by inadequate information and a failure to prioritise. Further systematic evaluation of the effectiveness and generalisability of the “I AM” approach to other disciplines is required.

Is the Grass Greener on the Other Side? A Qualitative Comparison Study of Psychiatry Trainee Views in England Compared to New Zealand

AimsThe Royal College of Psychiatrists census (2019) highlighted that 10% of all consultant psychiatrist roles remain unfilled. This pattern is replicated elsewhere in the UK with 7.8% in Northern Ireland, 9.6% in Scotland and 12.7% in Wales. This increase in consultant vacant posts is indicative of the recruitment challenges to psychiatry. On the other hand, the 2017 New Zealand Medical Workforce survey report showed recruitment to psychiatry was up by 8.2% in 2018 compared to 2017. I conducted a qualitative comparison study to look at psychiatry trainee views regarding their training in a UK and New Zealand deanery at similar stages of their psychiatric training.MethodsQuestionnaires were distributed to current psychiatry trainees in the Capital and Coast District Health Board (CCDHB) based in Wellington, New Zealand and Birmingham and Solihull Mental Health Foundation Trust (BSMHFT), UK who were between years 1–3 of their psychiatry training. Qualitative information was collated from the questionnaires regarding various aspects of their training. Areas of focus were; pros and cons of psychiatry training, suggestions for improvements, supervision, access to annual leave and study leave, teaching, encouragement to attend courses and involvement in research.ResultsOf the 33 current trainees working in CCDHB, 48% were immigrants from the UK, previously having worked in the NHS.17% of BSMHFT trainees felt valued in their organisation, compared to 64% in New Zealand.27% in New Zealand considered switching to another training programme, whereas none considered switching in the UK. Burn out was quoted as a problem in both New Zealand and the UK. 100% were able to take annual leave with ease in New Zealand, compared to 0% in BSMHFT.ConclusionThis small study gives a closer insight into the views of trainees in New Zealand, a place often thought as being more attractive for doctors to work in. What this study shows is 2 key factors; there are shocking differences in the quality of trainee experiences between New Zealand and the UK, however New Zealand is not free from issues around trainee retention, although the study does show overall trainee satisfaction being greater in New Zealand. Feeling valued, supported and leading a life with better work-life balance appear to be key driving factors for UK graduates leaving the UK and there is more that could be done to make trainees in the UK feel more valued and prevent burn out.

State Human Rights Commissions as Enforcement System in India: A Critical Appraisal

The deprivation and denial of the life and liberty of humans are very common in spite of the enforcement system of human rights, subject to exceptions. The State Human Rights Commissions (SHRCs) are for the better protection of human rights but the term ‘may’ have been used by the competent central legislature of India which has the connotation that to constitute the SHRC is at the discretion of the State governments but discretion cannot be arbitrary and against the Indian Constitution. Some state governments of India still did not constitute the SHRC so far now in these circumstances how the better protection of human rights shall be possible? In the States where SHRCs has been constituted but due to the shortage of staff members or manpower to perform the functions as conferred on the SHRCs, now how the human rights shall be protected of people? In addition to the aforesaid, large pendency of cases also is existent. Whether the Legal Legislative Mandate of the Parliament by way of the Protection of Human Rights Act 1993 (TPHRA) with the intention and objectives of this statue is being complied with or not by the state governments? Keeping in the special views as aforesaid, this research has been conducted which covers the existing State Human Rights Commissions (S.H.R.C.s), functions, power, procedure, the compositions, vacant posts, pendency, disposals, recommendations, registered cases on Suo-motu about the complaints in the furtherance of rule of law and in the adherence of Rule of Law in a democratic society.

Adopting workload-based staffing norms at public sector health facilities in Bangladesh: evidence from two districts

BackgroundBangladesh’s Health system is characterized by severe shortage and unequitable distribution of the formally trained health workforce. In this context, government of Bangladesh uses fixed staffing norms for its health facilities. These norms do not always reflect the actual requirement in reality. This study was conducted in public sector health facilities in two selected districts to assess the existing staffing norms with the purpose of adopting better norms and a more efficient utilization of the existing workforce.MethodsTo carry out this assessment, WHO’s Workload Indicators of Staffing Need (WISN) method was applied. Selection of the two districts out of 64 and a total of 24 health facilities were made in consultation with the formally established steering committee of the Ministry of Health. Health facilities, which were performing well in serving the patients during 2016–2017, were selected. This assessment examined staffing requirement of 20 staff categories.ResultsBased on the computer-generated WISN results, most of the staff categories were found to have a workload pressure of Very High (seven out of 20 staff categories), followed by Extremely High (five staff categories). Two staff categories had high, three had moderately high, two normal, and one low workload. Nurses were found to be predominantly occupied with support activities (50–60% of working time), instead of actual nursing care. Regarding vacancy, if all the vacant posts were filled, understandably, the workload would reduce, but not yet sufficient to meet the existing staff requirements such as consultants, general physicians and nurses at the district and sub-district/upazila-based hospitals.ConclusionThe existing staffing norms fall short of the WISN staffing requirement. The results provide evidence to prompt a revisit of the staffing policies and adopt workload-based norms. This can be supplemented by reviewing the scope of practice of the staff categories in their respective health facilities. In the short term, government might consider redistributing existing workforce as per workload. In the long term, revision of staffing norms is needed to provide quality health services for all.

Closing human resources gap in health: Moving beyond production to proactive recruitments.

Human Resources for Health (HRH) plays an integral role in healthcare service delivery. Gap in HRH has been a major concern with our healthcare ecosystem for a long time. It is vital to have adequately staffed public healthcare facilities, which are freely accessible to the population. To understand the reasons, we looked at the production, availability, and vacancies of HRH existing in public sector as well as measures taken for closing HRH gap during the period 2014-2015 to 2019-2020 and best practices adopted by the some of the State/UTs. We relied on official websites and official reports/statistics. While teaching capacity has increased significantly in recent past, and there are sufficient numbers of registered HRH, it has not translated into the recruitment of HRH in public facilities. Measures like campus placement, assured career progression, efficient and transparent recruitment process, modern and responsive HR management system, financial and non-financial incentives and notification of the vacant posts can play a vital role in filling the existing gaps. Some of the states have taken proactive measures for filling the vacancies, which can be replicated. The vacancies need to be filled in a mission mode. States also need to sanction required posts as per the norms. The ratio between different categories of healhtcare staff should be taken into consideration while sanctioning posts for these cadres. Availability of HRH in public sector as per norms would contribute toward achieving Sustainable Development Goal-3, reducing out of pocket expenditure and bring enormous socioeconomic gains.

PROFESSIONAL CERTIFICATION OF SCIENTIFIC AND PEDAGOGICAL ACTIVITY AS A TOOL FOR IMPROVING THE EFFICIENCY OF PUBLIC ADMINISTRATION OF HIGHER EDUCATION QUALITY

Assurance of higher education quality is constantly maintaining within the framework of professional and scientific attention of public administration subjects and scientists. The issue of staff provision of educational activities as well as management of staff risks in this field is becoming a significant obstacle for improving the quality of higher education in Ukraine. Individual professional certification of scientific and pedagogical activity can be considered as one of the mechanisms of personnel risk management. The institutionalization of the tools of professional certification of scientific and pedagogical activity, as well as its results, will contribute, on the one hand, the regulation of the content and practice of implementation of educational programs, and on the other - improvement of the procedures of the competition for the replacement of vacant posts of scientific and pedagogical workers. Using the instruments of certification, the state will have an opportunity to form a trajectory of the labour potential development both directly to scientific and pedagogical workers, and to the Institution of Higher Education and higher education system as a whole. Implementing norms of professional activity, obligatory presence of which is expected by the procedures of certification, will allow the subjects of formation of state policy in the sphere of higher education to promptly adjust the direction of professional development of science and pedagogic workers. Using by the state of tools of professional certification of science and pedagogic activity and its results in the final case will positively impact both, the effectiveness of public administration in the sphere of assurance of higher education quality in Ukraine and the quality of functioning of higher education system in general.

Experiences of Nurse Managers during the COVID-19 Outbreak in a Selected District Hospital in Limpopo Province, South Africa.

The South African health care system was hard hit by the second wave of Coronavirus disease (COVID-19), which affected nurse managers as healthcare facilities became overwhelmed due to an increased workload emanating from the overflow of admissions. Therefore, this study sought to explore and describe the nurse managers’ experiences during COVID-19 in order to identify gaps and lessons learnt. A descriptive phenomenological research approach was used to explore the experiences of ten nurse managers who were purposively selected from different units of a selected district hospital. Data was collected through telephonic unstructured individual interviews and analysed using Colaizzi’s seven steps method. The study revealed that nurse managers experienced human resource related challenges during COVID-19, worsened by the fact that vacant posts were frozen. It also emerged that there was a shortage of material resources that affected patient care. Nurse managers also indicated that COVID-19 brought a lot of administrative duties plus an additional duty of patient care. Also, nurse managers who had previously contracted COVID-19 experienced stigma and discrimination. The government needs to address resource related challenges in rural public hospitals and provide continuous support to nurse managers, particularly during a pandemic like COVID-19.

Access courses and their contribution to the widening participation agenda in the UK

Reasons for mental health nursing shortages in the UK are many and complex. The COVID-19 pandemic has highlighted the need to fill vacant posts, while at the same time negatively impacting on the UK's international recruitment strategy. Whereas international recruitment is essential to reduce workforce shortages, it offers only a short-term solution and potentially leaves lower-income countries with increased nursing shortages themselves. This article considers that a long-term domestic approach to recruitment is needed to reduce future workforce deficits. It is argued that benefits of access courses are increased if delivered by the university directly, as a familiarity with systems, the campus and supportive networks are promoted, and the potential for targeted support is increased. Further research is needed to establish the benefits, but access courses delivered this way may provide a more sustainable solution to nursing workforce shortages in the UK and beyond.

Predictors of ophthalmology career success (POCS) study

ObjectiveOphthalmology is the busiest outpatient specialty with demand predicted to rise over 40% in the next 20 years. A significant increase in the number of trainee ophthalmologists is required to...

Career Strategies of Russian Diplomats in the Second Half of the Eighteenth Century (the Cases of I.M. Simolin and P.A. Levashev)

The article examines the careers of the famous eighteenth-century Russian diplomats Ivan Matveevich Simolin and Pavel Artemyevich Levashev, whose paths repeatedly crossed – in Copenhagen, Vienna, and Regensburg, creating tension between them. Analysing the correspondence of diplomats preserved in the Archives of the Foreign Policy of the Russian Empire and the Russian State Archive of Ancient Documents, the author concludes that they acted in the same way to get a promotion: they constantly reminded of themselves to the superiors in the College of Foreign Affairs A.P. Bestuzhev-Ryumin, M.I. Vorontsov, N.I. Panin, and A.M. Golitsyn, devoting their literary works to them, helping purchase pieces of art or luxury goods, and keeping a keen eye on their real and potential rivals. Their lack of moderation in the implementation of such a strategy, blatant attempts to show off or to compromise colleagues were discouraged by the leadership of the Russian foreign office. There were also objective factors that hindered the career advancement of the two diplomats, which they were not always ready to take into account: the lack of vacant posts, the successful activities of their rivals, as well as conflicts with foreign courts, that, under certain circumstances, did not allow Russian monarchs to make necessary replacements for reasons of state prestige. The cases of I.M. Simolin and P.A. Levashev show how the principle of personal service, fixed by Peter I in the Table of Ranks of 1722, worked in the Collegium of Foreign Affairs and how it regulated its personnel policy.

Construction of the Ishikawa diagram for the incorporation into employment of graduates of the Ministry of emergency situations of Russia

The paper presents the results of the author’s study of the problem of employment of universities graduates of the Ministry of Emergency Situations (EMERCOM) of Russia for vacant posts in the EMERCOM of Russia. The purpose of the study is to develop a draft “road map” aimed at solving the management problem of insufficient active participation of EMERCOM universities in the employment of graduates for civil service in the EMERCOM of Russia. The authors have used the following methods: traditional document analysis, expert sociological survey in the form of a questionnaire; method of studying statistical data; method for constructing the Kaworu Ishikawa chart. As a result of processing statistical data and experts’ answers, the paper presents the author’s view of the draft “road map” the implementation of which will solve the problem of effective employment of graduates of EMERCOM universities. The paper presents for the first time the results of the causal relationship between the need for employment of graduates of EMERCOM universities and the low percentage of this employment presented in the form of the Ishikawa chart.

The training of school-doctors in France: ways of improvement, lessons to share

Abstract In France protection & prevention of students' health in schools is taken care of by school-doctors, in partnership. They follow a specific training for a year before becoming civil servants in the Ministry of Education. Around 1000 school-doctors are currently in post; 20-30 new school-doctors are trained each year. The training alternates academic sessions & supervised medical work in schools, under the responsibility of experienced mentors. Since 15 years, this training has been revised to improve its relevance in a Public health perspective, mainly by adding a strong health promotion component. The current organisation aims at (1) individualising the training, capitalising on the knowledge & competencies of trainees, leading to an individual scheme defined with the national coordinators (a school-doctor and a pedagogical engineer) between 8 & 16 weeks of academic sessions given at the French school of Public health; (2) articulating academic contents with pragmatic & professional skills; (3) integrating pedagogical innovations to maximise the development of the 10 competencies identified as core to school-doctors; (4) giving school-doctors a broad Public health perspective, with research and health promotion expertise, while fostering their specific and particular medical practice in the global context of schools. Each year improvements are implemented to answer the feed-back from trainees and professionals involved in the training. A closer articulation between local heads of school-doctors and the national level of their training has been fostered to improve coherence between academic & technical content while meeting ministerial requirements. The overall involvement & satisfaction of trainees are monitored. There is still space to improve the training of qualified school-doctors to promote the health of school-students in a Public heath perspective, in a time in France where health inequalities need to be better addressed and where the medical demography is critical. Key messages In a time of lack of medical doctors, school-doctors are important public-health actors for children and adolescent, with a very crucial position at the articulation of the health and school systems. The training of school-doctors must meet the challenge to accommodate pedagogical requirements & changes in their practice due to vacant posts while fulfilling ministerial expectations.