Managed migration : the Caribbean approach to addressing nursing services capacity

OBJECTIVE: To (1) provide a contextual analysis of the Caribbean region with respect to forces shaping the current and emerging nursing workforce picture in the region; (2) discuss country-specific case(s) within the Caribbean; and (3) describe the Managed Migration Program as a potential framework for addressing regional and global nurse migration issues. PRINCIPAL FINDINGS: The Caribbean is in the midst of a crisis of shortages of nurses with an average vacancy rate of 42 percent. Low pay, poor career prospects, and lack of education opportunities are among the reasons nurses resign. Many of these nurses look outside the region for job opportunities in the United Kingdom, Canada, the United States, and other countries. Compounding the situation is the lack of resources to train nurses to fill the vacancies. The Managed Migration Program of the Caribbean is a multilateral, cross-sector, multi-interventional, long-term strategy for developing and maintaining an adequate supply of nurses for the region. CONCLUSIONS: The Managed Migration Program of the Caribbean has made progress in establishing regional support for addressing the nursing shortage crisis and developing a number of interesting initiatives such as training for export and temporary migration. Recommendations to move the Managed Migration Program of the Caribbean forward focus on advocacy, integration of the program into regional policy decisions, and integration of the program with regional health programming

Developing a Nursing Database System in Kenya

Objective: To describe the development, initial findings, and implications of a national nursing workforce database system in Kenya. Principal Findings: Creating a national electronic nursing workforce database provides more reliable information on nurse demographics, migration patterns, and workforce capacity. Data analyses are most useful for human resources for health (HRH) planning when workforce capacity data can be linked to worksite staffing requirements. As a result of establishing this database, the Kenya Ministry of Health has improved capability to assess its nursing workforce and document important workforce trends, such as out-migration. Current data identify the United States as the leading recipient country of Kenyan nurses. The overwhelming majority of Kenyan nurses who elect to out-migrate are among Kenya’s most qualified. Conclusions: The Kenya nursing database is a first step toward facilitating evidencebased decisionmaking inHRH. This database is unique to developing countries in sub- Saharan Africa. Establishing an electronic workforce database requires long-term investment and sustained support by national and global stakeholders

Single-Cell Analysis of Crohn's Disease Lesions Identifies a Pathogenic Cellular Module Associated with Resistance to Anti-TNF Therapy

Clinical benefits of cytokine blockade in ileal Crohn's disease (iCD) are limited to a subset of patients. Here, we applied single-cell technologies to iCD lesions to address whether cellular heterogeneity contributes to treatment resistance. We found that a subset of patients expressed a unique cellular module in inflamed tissues that consisted of IgG plasma cells, inflammatory mononuclear phagocytes, activated T cells, and stromal cells, which we named the GIMATS module. Analysis of ligand-receptor interaction pairs identified a distinct network connectivity that likely drives the GIMATS module. Strikingly, the GIMATS module was also present in a subset of patients in four independent iCD cohorts (n = 441), and its presence at diagnosis correlated with failure to achieve durable corticosteroid-free remission upon anti-TNF therapy. These results emphasize the limitations of current diagnostic assays and the potential for single-cell mapping tools to identify novel biomarkers of treatment response and tailored therapeutic opportunities

Avtomatika i telemechanika

(Abridged) The Maunakea Spectroscopic Explorer (MSE) is an end-to-end science platform for the design, execution and scientific exploitation of spectroscopic surveys. It will unveil the composition and dynamics of the faint Universe and impact nearly every field of astrophysics across all spatial scales, from individual stars to the largest scale structures in the Universe. Major pillars in the science program for MSE include (i) the ultimate Gaia follow-up facility for understanding the chemistry and dynamics of the distant Milky Way, including the outer disk and faint stellar halo at high spectral resolution (ii) galaxy formation and evolution at cosmic noon, via the type of revolutionary surveys that have occurred in the nearby Universe, but now conducted at the peak of the star formation history of the Universe (iii) derivation of the mass of the neutrino and insights into inflationary physics through a cosmological redshift survey that probes a large volume of the Universe with a high galaxy density. MSE is positioned to become a critical hub in the emerging international network of front-line astronomical facilities, with scientific capabilities that naturally complement and extend the scientific power of Gaia, the Large Synoptic Survey Telescope, the Square Kilometer Array, Euclid, WFIRST, the 30m telescopes and many more