Zambian public sector nurses' incentives and motivation in the context of migration : how to retain Zambian nurses?

In Africa, attrition of health workers has reached critical rates in recent years and many countries have implemented incentive programmes without an empirical basis to guide their choice of intervention. This research uses a thorough understanding of nurses' perspectives to examine the complex factors and mechanisms that influence them to leave public hospitals. A case study approach was employed. Data were collected using mainly qualitative methods: in-depth semi-structured interviews. Quantitative data such as verifications from the professional body were also collected. Contextual factors (e.g. Structural Adjustment Program (SAP), Public Service Reform Programme (PSRP), health reform) and the increasing HIV/AIDS epidemic significantly influenced nurses' migration decisions. This was reflected in the concentration of breadwinners or widows in the failed migrants' group - those who had attempted, but failed, to migrate mainly due to high costs. Declining levels of funding for tertiary-level hospitals have broad implications for the motivation and turnover of their nurses as a result of fewer professional development opportunities, lower allowances, fewer staff and reduced access to essential equipment/drugs. The importance of a lifelong wage structure is stressed, especially the important role of training, a living wage and an adequate pension. While younger nurses tend to give higher value to training opportunities, senior nurses with family responsibilities need more financial support. While most nurses interviewed consider it important to meet a minimum standard of living, they are also guided strongly by their professional conscience. The quantitative data in this study suggest that restrictive immigration policies were effective in decreasing migration numbers. However, the primary focus of any retention strategy should be on retaining a motivated workforce through improved work and policy environments rather than restricting their migration. Specific areas are identified where the Government might intervene to provide effective incentive programmes for Zambian nurses

Injectable and Spatially Patterned Microporous Annealed Particle (MAP) Hydrogels for Tissue Repair Applications.

Spatially patterned hydrogels are becoming increasingly popular in the field of regenerative medicine and tissue repair because of their ability to guide cell infiltration and migration. However, postfabrication technologies are usually required to spatially pattern a hydrogel, making these hydrogels difficult to translate into the clinic. Here, an injectable spatially patterned hydrogel is reported using hyaluronic acid (HA)-based particle hydrogels. These particle hydrogels are sequentially loaded into a syringe to form a pattern and, once injected, they maintain the pattern. The applicability of this hydrogel in a wound healing skin model, a subcutaneous implant model, as well as a stroke brain model is examined and distinct patterning in all models tested is shown. This injectable and spatially patterned hydrogel can be used to create physical or biochemical gradients. Further, this design can better match the scaffold properties within the physical location of the tissue (e.g., wound border vs wound center). This allows for better design features within the material that promote repair and regeneration

Mechanisms of left-right asymmetric signal generation around the node

info:eu-repo/semantics/publishedVersio

International flow of Zambian nurses

This commentary paper highlights changing patterns of outward migration of Zambian nurses. The aim is to discuss these pattern changes in the light of policy developments in Zambia and in receiving countries

Self-regulated left-right asymmetric expression of Pitx2c in the developing mouse limb

AbstractThe transcription factor Pitx2c is expressed in primordial visceral organs in a left-right (L-R) asymmetric manner and executes situs-specific morphogenesis. Here we show that Pitx2c is also L-R asymmetrically expressed in the developing mouse limb. Human PITX2c exhibits the same transcriptional activity in the mouse limb. The asymmetric expression of Pitx2c in the limb also exhibits dorsal-ventral and anterior-posterior polarities, being confined to the posterior-dorsal region of the left limb. Left-sided Pitx2c expression in the limb is regulated by Nodal signaling through a Nodal-responsive enhancer. Pitx2c is expressed in lateral plate mesoderm (LPM)–derived cells in the left limb that contribute to various limb connective tissues. The number of Pitx2c+ cells in the left limb was found to be negatively regulated by Pitx2c itself. Although obvious defects were not apparent in the limb of mice lacking asymmetric Pitx2c expression, Pitx2c may regulate functional L-R asymmetry of the limb

p21 produces a bioactive secretome that places stressed cells under immunosurveillance

Immune cells identify and destroy damaged cells to prevent them from causing cancer or other pathologies by mechanisms that remain poorly understood. Here, we report that the cell-cycle inhibitor p21 places cells under immunosurveillance to establish a biological timer mechanism that controls cell fate. p21 activates retinoblastoma protein (Rb)-dependent transcription at select gene promoters to generate a complex bioactive secretome, termed p21-activated secretory phenotype (PASP). The PASP includes the chemokine CXCL14, which promptly attracts macrophages. These macrophages disengage if cells normalize p21 within 4 days, but if p21 induction persists, they polarize toward an M1 phenotype and lymphocytes mount a cytotoxic T cell response to eliminate target cells, including preneoplastic cells. Thus, p21 concurrently induces proliferative arrest and immunosurveillance of cells under duress

Transfer learning in a biomaterial fibrosis model identifies in vivo senescence heterogeneity and contributions to vascularization and matrix production across species and diverse pathologies

Cellular senescence is a state of permanent growth arrest that plays an important role in wound healing, tissue fibrosis, and tumor suppression. Despite senescent cells’ (SnCs) pathological role and therapeutic interest, their phenotype in vivo remains poorly defined. Here, we developed an in vivo–derived senescence signature (SenSig) using a foreign body response–driven fibrosis model in a p16-CreERT2;Ai14 reporter mouse. We identified pericytes and “cartilage-like” fibroblasts as senescent and defined cell type–specific senescence-associated secretory phenotypes (SASPs). Transfer learning and senescence scoring identified these two SnC populations along with endothelial and epithelial SnCs in new and publicly available murine and human data single-cell RNA sequencing (scRNAseq) datasets from diverse pathologies. Signaling analysis uncovered crosstalk between SnCs and myeloid cells via an IL34–CSF1R–TGFβR signaling axis, contributing to tissue balance of vascularization and matrix production. Overall, our study provides a senescence signature and a computational approach that may be broadly applied to identify SnC transcriptional profiles and SASP factors in wound healing, aging, and other pathologies.</p