NewsMakers
WHO and partners call for urgent investment in nurses
To avert the global shortage, the report estimates that countries experiencing shortages need to increase the total number of nurse graduates by on average 8% per year, along with improved ability to be employed and retained in the health system.
The Covid-19 pandemic underscores the urgent need to strengthen the global health workforce.
According to a new report, The State of the World’s Nursing 2020, there are important gaps in the nursing workforce and priority areas for investment in nursing education, jobs, and leadership to strengthen nursing around the world and improve health for all. Nurses account for more than half of all the world’s health workers, providing vital services throughout the health system. Historically, as well as today, nurses are at the forefront of fighting epidemics and pandemics that threaten health across the globe. Around the world they are demonstrating their compassion, bravery and courage as they respond to the COVID-19 pandemic: never before has their value been more clearly demonstrated.
The report, by the World Health Organization (WHO) in partnership with the International Council of Nurses (ICN) and Nursing Now, reveals that today, there are just under 28 million nurses worldwide. Between 2013 and 2018, nursing numbers increased by 4.7 million. But this still leaves a global shortfall of 5.9 million – with the greatest gaps found in countries in Africa, South East Asia and the WHO Eastern Mediterranean region as well as some parts of Latin America.
Revealingly, more than 80 per cent of the world’s nurses work in countries that are home to half of the world’s population. And one in every eight nurses practices in a country other than the one where they were born or trained. Ageing also threatens the nursing workforce: one out of six of the world’s nurses are expected to retire in the next 10 years.
To avert the global shortage, the report estimates that countries experiencing shortages need to increase the total number of nurse graduates by on average 8% per year, along with improved ability to be employed and retained in the health system. This would cost roughly USD 10 per capita (population) per year.
“Politicians understand the cost of educating and maintaining a professional nursing workforce, but only now are many of them recognizing their true value,” said ICN President Annette Kennedy. “Every penny invested in nursing raises the wellbeing of people and families in tangible ways that are clear for everyone to see. This report highlights the nursing contribution and confirms that investment in the nursing profession is a benefit to society, not a cost. The world needs millions more nurses, and we are calling on governments to do the right thing, invest in this wonderful profession and watch their populations benefit from the amazing work that only nurses can do.”
About 90 per cent of all nurses are female, yet few nurses are found in senior health leadership positions– the bulk of those positions are held by men. But when countries enable nurses to take a leadership role, for example by having a government chief nursing officer (or equivalent), and nursing leadership programmes, conditions for nurses improve.
“This report places much-needed data and evidence behind calls to strengthen nursing leadership, advance nursing practice, and educate the nursing workforce for the future,” said Lord Nigel Crisp, Co-Chair of Nursing Now. “The policy options reflect actions we believe all countries can take over the next ten years to ensure there are enough nurses in all countries, and that nurses use of the full extent of their education, training, and professional scope to enhance primary health care delivery and respond to health emergencies such as COVID-19. This must start with broad and intersectoral dialogue which positions the nursing evidence in the context of a country’s health system, health workforce, and health priorities.”
To equip the world with the nursing workforce it needs, WHO and its partners recommend that all countries:
- increase funding to educate and employ more nurses;
- strengthen capacity to collect, analyze and act on data about the health workforce;
- monitor nurse mobility and migration and manage it responsibly and ethically;
- educate and train nurses in the scientific, technological and sociological skills they need to drive progress in primary health care;
- establish leadership positions including a government chief nurse and support leadership development among young nurses;
- ensure that nurses in primary health care teams work to their full potential, for example in preventing and managing noncommunicable diseases;
- improve working conditions including through safe staffing levels, fair salaries, and respecting rights to occupational health and safety;
- implement gender-sensitive nursing workforce policies;
- modernize professional nursing regulation by harmonizing education and practice standards and using systems that can recognize and process nurses’ credentials globally; and
- strengthen the role of nurses in care teams by bringing different sectors (health, education, immigration, finance and labour) together with nursing stakeholders for policy dialogue and workforce planning.
The report’s message is clear: governments need to invest in a massive acceleration of nursing education, creation of nursing jobs, and leadership. Without nurses, midwives, and other health workers, countries cannot win the battle against outbreaks, or achieve universal health coverage and the Sustainable Development Goals.
NewsMakers
Study finds low-dose eye drops successful in managing adult myopia for 24 hours
A single low-dose atropine eye drop can produce daylong effects in managing myopia, or nearsightedness.
Groundbreaking research from the University of Houston shows that a single low-dose atropine eye drop can produce daylong effects in managing myopia, or nearsightedness, which affects roughly one-third of U.S. adults.
Professor of Optometry Lisa Ostrin and postdoctoral researcher Barsha Lal are reporting that even one drop in the eye of low-dose atropine (0.01%–0.1%) produces clear changes in pupil size and focusing ability that persist for at least 24 hours. Importantly, they also found that the drop shows no short-term structural effects on the eye, with only temporary changes in blood flow inside the retina.
Ostrin’s latest research is published in the journal Eye and Vision. It adds to a growing body of vision research from David Berntsen, Golden-Golden Professor of Optometry at the University of Houston, who is co-leading a national $25 million NIH-funded clinical trial to delay the development of myopia in children by using the atropine drops.
Low concentration atropine is widely prescribed to slow myopia progression in children, yet its short-term retinal and choroidal effects remain incompletely understood. Ostrin’s new study evaluated short-term effects of a range of low atropine concentrations on the length of the eye, the blood vessels in the retina and the thickness of the retina and choroid, which sits just behind the retina. These are important measurements because longer eye length is associated with myopia and as it gets longer, the retina and choroid are stretched.
“These findings indicate that a single instillation of atropine does not alter axial length or retinal or choroidal thickness over 24 hours but may transiently affect superficial retinal perfusion in a time-dependent manner,” said Ostrin.
In the double-masked, randomized study, twenty healthy adults received a single instillation of either a placebo or atropine in the right eye during five separate sessions. Researchers then checked the eye structure, thickness, and length in the central retina both one-hour and 24-hours later.
“Characterizing these short-term effects is important for a better understanding of the physiological responses to atropine in clinical and research settings,” said Ostrin who previously published research results of a study investigating the short-term effects of a range of low-dose atropine concentrations on the pupils of young adults. In that study, she found similar results with a single drop of atropine inducing significant changes in the pupils.
Together, the studies indicate that atropine induces early functional and vascular effects in the eye, in the absence of structural change.
“By linking objective ocular responses with subjective visual experience, this work advances our understanding of how atropine works and supports more precise, evidence-based, and individualized approaches to myopia management,” said Ostrin.
NewsMakers
Study: Egg consumption is associated with a lower risk of Alzheimer’s Disease
Compared to never eating eggs, eating at least five eggs per week can decrease risk of Alzheimer’s.
Consumption of eggs is associated with a lower risk of being diagnosed with Alzheimer’s Disease for those 65 years and older, according to researchers at Loma Linda University Health
Eating one egg per day for at least five days a week reduces risk of Alzheimer’s by up to 27%, researchers found.
“Compared to never eating eggs, eating at least five eggs per week can decrease risk of Alzheimer’s,” said Joan Sabaté, MD, DrPH, a professor at Loma Linda University School of Public Health and the study’s principal investigator.
Even less frequent consumption of eggs significantly reduced the risk of Alzheimer’s. Researchers found that eating eggs 1 to 3 times per month had a 17% decrease in risk, while eating eggs 2 to 4 times per week had a 20% decrease in risk, Sabaté said.
The study, Egg intake and the incidence of Alzheimer’s disease in the Adventist Health Study-2 cohort linked with Medicare data, was published last week in the Journal of Nutrition.
Researchers said they embarked on the study because of a substantial knowledge gap in the relationship between modifiable dietary factors and risk of Alzheimer’s disease risk.
Eggs are known to be a source of key nutrients that support brain health. Sabaté said. Eggs provide choline, a precursor to acetylcholine and phosphatidylcholine, both of which are critical for memory and synaptic function, the study stated. Eggs also contain lutein and zeaxanthin—carotenoids that accumulate in brain tissue and are associated with improved cognitive performance and reduced oxidative stress. Eggs also contain key omega-3 fatty acids, and yolks are particularly rich in phospholipids, which constitute nearly 30% of total egg lipids and are essential for neurotransmitter receptor function.
Researchers said they studied the consumption of eggs in visible ways — such as eating eggs in various forms, like scrambled, fried, boiled, etc. — and hidden ways, such as eggs included in baked goods and packaged foods.
The cases of Alzheimer’s Disease in the Adventist Health Study 2 cohort were diagnosed by physicians, according to Medicare records, among the study population of 40,000 subjects. Eligibility was determined using the Medicare Master Beneficiary Summary Files. The average follow-up period was 15.3 years.
The team emphasized that moderate egg consumption should be part of a balanced diet.
“Research supports eggs as part of a healthy diet,” said Jisoo Oh, DrPH, MPH, an associate professor of epidemiology at Loma Linda University School of Public Health and the study’s lead author. “Seventh-day Adventists do eat a healthier diet than the general public, and we want people to focus on overall health along with this knowledge about the benefit of eggs.”
NewsMakers
Telling people they might lose motivates more than telling them they might win, research shows
How managers choose to frame problems directly influences employees’ motivation to speak up at work. For managers, this is an insightful approach for building more open and collaborative teams.
Athletes say they hate to lose more than they love to win. New research finds the same sentiment is shared in organizations.
A Virginia Tech researcher and his colleagues discovered that when managers frame work problems as a potential loss, employees are more likely to take action than when those problems are framed as potential gains. The research also revealed that when the potential loss impacts a larger group, employees are more likely to take action in the form of speaking up to a supervisor in hopes of finding a solution. The findings were recently published in the Journal of Applied Psychology.
For managers, this research suggests that framing work problems as potential losses can influence employees to speak up more.
“Employee voice occurs when suggestions are made to improve organizational functioning,” said Phil Thompson, associate professor in the Pamplin College of Business Department of Management. “From an organizational perspective, the positive outcomes of employee voice include improved performance, effectiveness, and workplace safety. From an employee level, speaking up is positively related to creativity, innovation, engagement, and ethical behavior.”
At its core, this research shows that how managers choose to frame problems directly influences employees’ motivation to speak up at work. For managers, this is an insightful approach for building more open and collaborative teams.
“When managers say, ‘If we don’t get this done, not only will you lose the $5,000 bonus, but everybody in this work group is going to lose a $5,000 bonus,’ it magnifies an employee’s motivation to act in a proactive way,” said Thompson. “This suggests that framing work problems as what will be collectively lost – compared to what can be individually lost – makes employees want to speak up more.”
Thompson was part of a research team led by Jeffery Thomas and Jonathan Booth from The London School of Economics and Mark Bolino from Oklahoma University. Together they analyzed responses from nearly 2,000 full-time employees, MBA students, and employee-supervisor pairs for their experience in situations where work problems were framed as either a gain or a loss. Across three different studies, framing something as a loss yielded employees to voice a work suggestion more.
For example, a manager dealing with a reputational crisis of their team, such as a product quality issue, can frame the problem in a way to spark helpful employee suggestions on how to resolve the issue. For example, instead of saying “if this product has great quality, our company will look really good” a manager saying “if this product is not up to quality standards, our reputation will be damaged” carries more weight for the team. When this reputational risk is shared by everyone, employees are more willing to step forward to help the problem.
In the first study, participants were asked to think about a problem at work that was significant for them. From there, they were randomly assigned to write about the potential losses or gains from that problem. They were also asked to indicate how likely they were to talk about these problems to their supervisor. Participants who reflected on their potential losses showed a 16 percent higher willingness to speak up compared to those who focused on the potential gains.
When it came to the MBA students, they read a fictional performance review scenario where a workplace problem was described. They then rated how willing they would be to speak up about that scenario if they were in the situation. One example suggested that the entire team might fall short of its goals if an issue was not addressed. This specific scenario yielded the most likelihood of speaking up 35 percent more than the scenario’s suggesting that only they would miss their goal, supporting the research’s findings that an employee is more likely to speak up when the loss impacts more people.
The third study looked at employee-supervisor pairings to understand how these relationships play out in the real world. Using pairings from across three industries, employees reported a workplace problem they encountered and their supervisor rated how often that employee spoke up on the job. While the first two studies involved hypothetical scenarios, this real-world evidence showed that employees were 8-10 times more likely to speak up when issues were framed as a potential collective loss compared with a potential collective gain.
“This research is really geared toward managers so they can facilitate and understand how and why their employees will speak up,” said Thompson. “You can talk about the issue, but it always ends in terms of how we frame things.”
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