Globally, the health workforce has long suffered from labour shortages. This has been exacerbated by the workload increase caused by the COVID-19 pandemic. Major collapses in healthcare systems ...across the world during the peak of the pandemic led to calls for strategies to alleviate the increasing job attrition problem within the healthcare sector. This turnover may worsen given the overwhelming pressures experienced by the health workforce during the pandemic, and proactive measures should be taken to retain healthcare workers. This review aims to examine the factors affecting turnover intention among healthcare workers during the COVID-19 pandemic. A mixed studies systematic review was conducted. The PubMed, Embase, Scopus, CINAHL, Web of Science and PsycINFO databases were searched from January 2020 to March 2022. The Joanna Briggs Institute's Critical Appraisal Tools and the Mixed Methods Appraisal Tool version 2018 were applied by two independent researchers to critically appraise the methodological quality. Findings were synthesised using a convergent integrated approach and categorised thematically. Forty-three studies, including 39 quantitative, two qualitative and two mixed methods studies were included in this review. Eighteen were conducted in the Middle East, ten in the Americas, nine in the Asia-Pacific region and six in Europe. Nurses (n = 35) were included in the majority of the studies, while physicians (n = 13), allied health workers (n = 11) and healthcare administrative or management staff (n = 7) were included in a smaller proportion. Five themes emerged from the data synthesis: (1) fear of COVID-19 exposure, (2) psychological responses to stress, (3) socio-demographic characteristics, (4) adverse working conditions, and (5) organisational support. A wide range of factors influence healthcare workers' turnover intention in times of pandemic. Future research should be more focused on specific factors, such as working conditions or burnout, and specific vulnerable groups, including migrant healthcare workers and healthcare profession minorities, to aid policymakers in adopting strategies to support and incentivise them to retain them in their healthcare jobs.
Online learning in nursing education has been demonstrated to exert positive effects on knowledge, skills, learning attitudes, and confidence in performance. However, a noteworthy caveat has been ...that such benefits could vary depending on the content of pedagogical materials.
To examine the impact of online-tutorials in place of face-to-face tutorials on knowledge level and understand the perspectives of learners who experience online-tutorials.
This study adopted a mixed method experiential design in which the perspectives of learners who experience online-tutorials are embedded within the trial. Two cohort of nursing students enrolled for the module on Psychology for Nurses were recruited to evaluate the impact of online-tutorials compared to face-to-face tutorials in terms of knowledge level. Apart from the dissimilar mode of delivery, both cohorts experienced the same teaching structure, content, and assessments. Examination results from these two cohorts were compared upon completion of the course. For the online group, additional one-to-one interviews were conducted to further understand the impacts exerted by online learning on the level of knowledge among them.
There was a significant difference between the knowledge level of the two cohorts. Responses elicited during the interviews revealed five themes: lack of motivation; limited teamwork; missed learning opportunities; decreased interactions; and differences between online and face-to-face learning.
Conclusion: Online-tutorials may be a feasible pedagogical approach but the motivation to learn, teamwork and quality of discussion may be compromised due to the lack of socialization and interactions between students and tutors.
•Socializing remains an important element in the learning process.•Teaching methods and lessons need to be re-design to enhance meaningful collaboration between students.•Group dynamics and students’ comfort level in technology-based communication should be considered when planning online lesson.
Given nurses' increasing international mobility, Asian internationally educated nurses (IENs) represent a critical human resource highly sought after within the global healthcare workforce. Developed ...countries have grown excessively reliant on them, leading to heightened competition among these countries. Hence, this review aims to uncover factors underlying the retention of Asian IENs in host countries to facilitate the development of more effective staff retention strategies.
A mixed-methods systematic review was conducted using the Joanna Briggs Institute methodology for mixed-method systematic review. A search was undertaken across the following electronic databases for studies published in English during 2013-2022: CINAHL, Embase, PubMed, Scopus, Web of Science and PsycINFO. Two of the researchers critically appraised included articles independently using the Joanna Briggs Critical Appraisal Tools and Mixed Methods Appraisal Tool (version 2018). A data-based convergent integrated approach was adopted for data synthesis.
Of the 27 included articles (19 qualitative and eight quantitative), five each were conducted in Asia (Japan, Taiwan, Singapore and Malaysia), Australia and Europe (Italy, Norway and the United Kingdom); four each in the United States and the Middle East (Saudi Arabia and Kuwait); two in Canada; and one each in New Zealand and South Africa. Five themes emerged from the data synthesis: (1) desire for better career prospects, (2) occupational downward mobility, (3) inequality in career advancement, (4) acculturation and (5) support system.
This systematic review investigated the factors influencing AMN retention and identified several promising retention strategies: granting them permanent residency, ensuring transparency in credentialing assessment, providing equal opportunities for career advancement, instituting induction programmes for newly employed Asian IENs, enabling families to be with them and building workplace social support. Retention strategies that embrace the Asian IENs' perspectives and experiences are envisioned to ensure a sustainable nursing workforce.
SARS-CoV-2 continues to evolve, with many variants evading clinically authorized antibodies. To isolate monoclonal antibodies (mAbs) with broadly neutralizing capacities against the virus, we ...screened serum samples from convalescing COVID-19 patients. We isolated two mAbs, 12-16 and 12-19, which neutralized all SARS-CoV-2 variants tested, including the XBB subvariants, and prevented infection in hamsters challenged with Omicron BA.1 intranasally. Structurally, both antibodies targeted a conserved quaternary epitope located at the interface between the N-terminal domain and subdomain 1, uncovering a site of vulnerability on SARS-CoV-2 spike. These antibodies prevented viral receptor engagement by locking the receptor-binding domain (RBD) of spike in the down conformation, revealing a mechanism of virus neutralization for non-RBD antibodies. Deep mutational scanning showed that SARS-CoV-2 could mutate to escape 12-19, but such mutations are rarely found in circulating viruses. Antibodies 12-16 and 12-19 hold promise as prophylactic agents for immunocompromised persons who do not respond robustly to COVID-19 vaccines.
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•Isolated bnAbs 12-16 and 12-19 from a SARS-CoV-2 recovered/vaccinated individual•These mAbs target a conserved quaternary epitope at the interface between NTD-SD1•The mAbs neutralize all current SARS-CoV-2 VOCs by locking RBD in down conformation•12-19 escape mutations are rarely found in circulating SARS-CoV-2 viruses
Current variants of SARS-CoV-2 can evade clinically authorized antibodies. Liu et al. demonstrate that two monoclonal antibodies isolated from convalescing COVID-19 patients neutralize all current SARS-CoV-2 variants of concern via interaction with a mechanism that locks the RBD in the down conformation. Mutations in the epitope targeted by these mAbs are rarely found in circulating SARS-CoV-2 viruses, suggesting clinical applicability.
The devastation caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has made clear the importance of pandemic preparedness. To address future zoonotic outbreaks due to related ...viruses in the sarbecovirus subgenus, we identified a human monoclonal antibody, 10-40, that neutralized or bound all sarbecoviruses tested in vitro and protected against SARS-CoV-2 and SARS-CoV in vivo. Comparative studies with other receptor-binding domain (RBD)-directed antibodies showed 10-40 to have the greatest breadth against sarbecoviruses, suggesting that 10-40 is a promising agent for pandemic preparedness. Moreover, structural analyses on 10-40 and similar antibodies not only defined an epitope cluster in the inner face of the RBD that is well conserved among sarbecoviruses but also uncovered a distinct antibody class with a common CDRH3 motif. Our analyses also suggested that elicitation of this class of antibodies may not be overly difficult, an observation that bodes well for the development of a pan-sarbecovirus vaccine.
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