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Background COVID-19 has reinforced the importance of having a sufficient, well-distributed and competent health workforce. In addition to improving health outcomes, increased investment in health has the potential to generate employment, increase labour productivity and foster economic growth. We estimate the required investment for increasing the production of the health workforce in India for achieving the UHC/SDGs. Methods We used data from National Health Workforce Account 2018, Periodic Labour Force Survey 2018–19, population projection of Census of India, and government documents and reports. We distinguish between total stock of health professionals and active health workforce. We estimated current shortages in the health workforce using WHO and ILO recommended health worker:population ratio thresholds and extrapolated the supply of health workforce till 2030, using a range of scenarios of production of doctors and nurses/midwives. Using unit costs of opening a new medical college/nursing institute, we estimated the required levels of investment to bridge the potential gap in the health workforce. Results To meet the threshold of 34.5 skilled health workers per 10 000 population, there will be a shortfall of 0.16 million doctors and 0.65 million nurses/midwives in the total stock and 0.57 million doctors and 1.98 million nurses/midwives in active health workforce by the year 2030. The shortages are higher when compared with a higher threshold of 44.5 health workers per 10 000 population. The estimated investment for the required increase in the production of health workforce ranges from INR 523 billion to 2 580 billion for doctors and INR 1 096 billion for nurses/midwives. Such investment during 2021–2025 has the potential of an additional employment generation within the health sector to the tune of 5.4 million and to contribute to national income to the extent of INR 3 429 billion annually. Conclusion India needs to significantly increase the production of doctors and nurses/midwives through investing in opening up new medical colleges. Nursing sector should be prioritized to encourage talents to join nursing profession and provide quality education. India needs to set up a benchmark for skill-mix ratio and provide attractive employment opportunities in the health sector to increase the demand and absorb the new graduates.

The Health Foundation's REAL Centre sets out its projections of future NHS workforce supply and demand in England, up to 2030/31.

COVID‐19 has reinforced the centrality of health workers at the core of a well performing and resilient health system. It has concomitantly exposed the risks of staffing and skills shortages and the importance of protecting the health workforce. The present commentary focuses on highlighting some of the lessons learnt, challenges and future needs of the health workforce in Europe in the context of COVID‐19. During the pandemic innovative and flexible approaches were implemented to meet increasing demand for health workers and new skills and responsibilities were adopted over a short period of time. We have seen the rapid adaptation and use of new technologies to deliver care. The pandemic has underlined the importance of valuing, protecting and caring for our health workforce and the need to invest appropriately and adequately in the health workforce to have sufficient, capable and well‐motivated health workers. Some of the main challenges that lie ahead of us include the imperative for better investment, to need to improve recruitment and retraining whilst better retaining health workers, a focus on domestic sustainability, redeploying and developing new skills and competences among health workers, enabling more effective multi‐professional collaboration and team work, improving the quality of education and training, increasing the public health focus and promoting ethical and sustainable international recruitment of health workers. The WHO European Region through its European Programme of Work 2020–2025 is fully committed to support countries in their efforts to continue to respond to COVID‐19 and whilst addressing upcoming health workforce challenges.

Optimizing the management of the health workforce is necessary for the progressive realization of universal health coverage. Here we discuss the six main action fields in health workforce management as identified by the Human Resources for Health Action Framework: leadership; finance; policy; education; partnership; and human resources management systems. We also identify and describe examples of effective practices in the development of the health workforce, highlighting the breadth of issues that policy-makers and planners should consider. Achieving success in these action fields is not possible by pursuing them in isolation. Rather, they are interlinked functions that depend on a strong capacity for effective stewardship of health workforce policy. This stewardship capacity can be best understood as a pyramid of tools and factors that encompass the individual, organizational, institutional and health system levels, with each level depending on capacity at the level below and enabling actions at the level above. We focus on action fields covered by the organizational or system-wide levels that relate to health workforce development. We consider that an analysis of the policy and governance environment and of mechanisms for health workforce policy development and implementation is required, and should guide the identification of the most relevant and appropriate levels and interventions to strengthen the capacity of health workforce stewardship and leadership. Although these action fields are relevant in all countries, there are no best practices that can simply be replicated across countries and each country must design its own responses to the challenges raised by these fields.Il est nécessaire d'optimiser la gestion du personnel de santé pour parvenir progressivement à la couverture sanitaire universelle. Dans cet article, nous nous intéressons aux six grands domaines d'action en matière de gestion du personnel de santé qui sont définis dans le Cadre d'action concernant les ressources humaines pour la santé: leadership; finances; politiques; éducation; partenariats; et systèmes de gestion des ressources humaines. Nous décrivons également des exemples de pratiques efficaces pour renforcer le personnel de santé, en mettant en avant l'étendue des questions que les responsables politiques et les planificateurs devraient prendre en compte. Il n'est pas possible de réussir dans ces domaines d'action en les abordant de manière séparée. Ce sont des fonctions étroitement liées qui dépendent d'une forte capacité à gérer efficacement les politiques relatives au personnel de santé. Cette capacité de gestion peut être mieux comprise sous la forme d'une pyramide d'outils et de facteurs englobant les niveaux des individus, des organisations, des institutions et des systèmes de santé, dans laquelle chaque niveau dépend de la capacité du niveau inférieur et permet d'agir au niveau supérieur. Nous nous intéressons ici aux domaines d'action qui correspondent aux niveaux des organisations ou des systèmes et qui concernent le renforcement du personnel de santé. Selon nous, il est indispensable d'analyser le cadre stratégique et les structures de gouvernance, ainsi que les mécanismes d'élaboration et de mise en œuvre des politiques relatives au personnel de santé. Cette analyse devrait permettre de déterminer les niveaux et les interventions les plus appropriés pour renforcer la capacité de gestion et de direction du personnel de santé. Bien que ces domaines d'action concernent tous les pays, aucune meilleure pratique ne peut être simplement reproduite dans tous les pays. Chaque pays doit trouver ses propres réponses aux questions soulevées par ces domaines.La optimización de la gestión de la fuerza laboral sanitaria es necesaria para la realización progresiva de la cobertura sanitaria universal. La optimización de la gestión de la fuerza laboral sanitaria es necesaria para la realización progresiva de la cobertura sanitaria universal. En este documento se examinan los seis campos de acción principales de la gestión de la fuerza laboral sanitaria identificados en el Marco de Acción de Recursos Humanos para la Salud: liderazgo, finanzas, políticas, educación, asociaciones y sistemas de gestión de los recursos humanos. También se identifican y describen ejemplos de prácticas efectivas en el desarrollo de la fuerza laboral sanitaria, destacando la amplitud de los temas que los responsables de formular políticas y los planificadores deben considerar. No es posible alcanzar el éxito en estos campos de acción si se persiguen de forma aislada. Más bien, se trata de funciones interrelacionadas que dependen de una fuerte capacidad de gestión eficaz de la política de la fuerza laboral sanitaria. Esta capacidad de gestión puede entenderse mejor como una pirámide de herramientas y factores que abarcan los niveles individual, organizativo, institucional y del sistema de salud, en la que cada nivel depende de la capacidad en el nivel inferior y de las medidas de habilitación en el nivel superior. Se hace énfasis en los campos de acción cubiertos por los niveles de la organización o de todo el sistema que se relacionan con el desarrollo de la fuerza laboral sanitaria. En este contexto, es necesario realizar un análisis del entorno normativo y de gobernanza y de los mecanismos para el desarrollo y la implementación de las políticas de la fuerza laboral sanitaria, y debe guiar la identificación de los niveles e intervenciones más pertinentes y apropiados para fortalecer la capacidad de gestión y liderazgo de la fuerza laboral sanitaria. Aunque estos campos de acción son relevantes en todos los países, no hay mejores prácticas que puedan ser simplemente replicadas a través de los países y cada país debe diseñar sus propias respuestas a los desafíos planteados por estos campos.يعد تحسين إدارة القوى العاملة في القطاع الصحي أمراً ضرورياً لتنفيذ التغطية الصحية الشاملة بشكل تدريجي. سوف نناقش هنا مجالات العمل الستة الرئيسية في إدارة القوى العاملة في القطاع الصحي وفقاً للتوضيح الوارد في "الموارد البشرية لإطار العمل الصحي": القيادة؛ والشؤون المالية؛ والسياسات؛ والتعليم؛ والشراكة؛ ونظم إدارة الموارد البشرية. كما نقوم كذلك بتوضيح ووصف أمثلة للممارسات الفعالة في تطوير القوى العاملة في القطاع الصحي، مع التركيز على مجموعة القضايا التي يجب أن يضعها واضعو ومخططو السياسات في الاعتبار. من غير الممكن تحقيق النجاح في مجالات العمل هذه من خلال السعي لتحقيقها بمعزل عن غيرها. بل هي وظائف مترابطة تعتمد على قدرة قوية على الإشراف الفعال لسياسة القوى العاملة في القطاع الصحي. يمكن الوصول لأفضل فهم لقدرة الإشراف تلك على أنها هرم من الأدوات والعوامل التي تشمل مستويات النظام الفردية والتنظيمية والمؤسسية والصحية، حيث يعتمد كل مستوى على قدرة المستوى أدناه، ويقوم بتمكين الإجراءات على المستوى أعلاه. نحن نركز على مجالات العمل التي تغطيها المستويات التنظيمية، أو على مستوى النظام، والتي تتعلق بتطوير القوى العاملة بالقطاع الصحي. نحن نعتبر أنه من المطلوب القيام بتحليل وتنفيذ السياسات وبيئة الحكم وآليات تطوير سياسة القوى العاملة بالقطاع الصحي، كما يجب أن نقوم بالتوجيه في تحديد المستويات الملائمة والأكثر صلة، والتدخلات المطلوبة لدعم الإشراف على القوى العاملة بالقطاع الصحي وقيادتها. على الرغم من أن مجالات العمل تلك مناسبة لكل البلدان، إلا أنه ليست هناك ممارسات مُثلى يمكن ببساطة تكرارها عبر البلدان، ويجب على كل بلد تصميم الاستجابات الخاصة بها للتحديات التي تطرحها هذه المجالات.优化卫生人力管理是逐步实现全民健康覆盖的必然要求。这里我们讨论的是《卫生人力资源行动框架》中确定的卫生人力资源管理的六大行动领域：领导力；财政；政策；教育；伙伴关系；和人力资源管理系统。我们还确立并描述了发展卫生人力中有效做法的例子，强调政策制定者和规划者应注重思考问题时的广度。在这些行动领域取得成功是不可能分开进行的。相反，环环相扣、相互关联才能发挥出它们的价值，而这取决于有效管理卫生人力政策的强大能力。这种管理能力的最佳理解是由工具和因素组成的金字塔，它包括个人、组织、机构和卫生系统，每一级都取决于下一级的能力，并扶持上一级的行动。我们重点关注与卫生人力资源发展相关的组织或系统等级所涵盖的行动领域。我们认为，需要对政策和治理环境以及制定和执行卫生人力政策的机制进行分析，并应指导确定最相关和最适当的等级和干预措施，以加强卫生人力管理的管理和领导能力。尽管这些行动领域在所有国家都具有相关性，但没有一个可以适用于各个国家的最佳做法，每个国家都必须设计自己的应对措施，克服来自这些领域的挑战。.Оптимизация управления кадровыми ресурсами в сфере здравоохранения необходима для последовательной реализации программы всеобщего охвата услугами здравоохранения. Авторы обсуждают шесть основных областей деятельности в сфере управления трудовыми ресурсами здравоохранения, которые определены в Рамочной программе действий в области кадровых ресурсов здравоохранения: лидерство, финансирование, политику, образование, партнерство и системы управления кадровыми ресурсами. Авторы также выявляют и описывают примеры эффективных методов по развитию кадровых ресурсов здравоохранения, подчеркивая широкий спектр вопросов, которые следует учитывать лицам, формирующим политику, и специалистам по планированию. Добиться успеха в данных областях деятельности невозможно, если работать над ними изолированно. Напротив, они являются взаимосвязанными функциями, которые зависят от того, существует ли значительный потенциал эффективного руководства политикой кадровых ресурсов здравоохранения. Такой руководящий потенциал легче всего представить как пирамиду инструментов и факторов, охватывающих индивидуальный, организационный, ведомственный уровни и уровень системы здравоохранения, причем каждый уровень зависит от потенциала нижестоящего уровня и стимулирующих мер на вышестоящем уровне. Авторы уделяют особое внимание областям деятельности на организационном и общесистемном уровнях, которые связаны с развитием кадровых ресурсов здравоохранения. Они считают, что необходим анализ политики и культуры управления, а также механизмов разработки и реализации политики в области кадровых ресурсов здравоохранения, который должен послужить основанием для определения наиболее актуальных и подходящих уровней и мероприятий для укрепления потенциала управления кадрами здравоохранения и их лидерства. Несмотря на то что данные области деятельности актуальны для всех стран, универсальных методов, которые можно применять в разных странах, не существует. Следовательно, каждая страна должна разработать свои собственные решения для проблем, возникающих в указанных областях.

BACKGROUND: COVID-19 has reinforced the importance of having sufficient, well-distributed and competent health workforce. In addition to improving health outcomes, increased investment has the potential to generate employment, increase labour productivity along with fostering economic growth. With COVID-19 highlighting the gaps in human resources for health in India, there is a need to better and empirically understand the level of required investment for increasing the production of health workforce in India for achieving the UHC/SDGs.METHODS: The study used data from a range of sources including National Health Workforce Account 2018, Periodic Labour Force Survey 2018-19, population projection of Census of India, and review of government documents and reports. The study estimated shortages in the health workforce and required investments to achieve recommended health worker: population ratio thresholds by the terminal year of the SDGs 2030.RESULTS: Our results suggest that to meet the threshold of 34.5 skilled health worker per 10,000 population, there will be a shortfall of 0.16 million doctors and 0.65 nurses/midwives in the total stock of human resources for health by the year 2030. The shortages at the same threshold will be much higher (0.57 million doctors and 1.98 million nurses/midwives) in active health workforce by 2030. The shortages are even higher when compared with a higher threshold of 44.5 health workers per 10,000 population. The estimated investment for the required increase in the production of health workforce ranges from INR 523 billion to 2,580 billion for doctors. For nurses/midwives, the required investment is INR 1,096 billion. Such investment during 2021-25 has the potential of an additional employment generation within the health sector to the tune of 5.4 million and contribute to national income to the extent of INR 3,429 billion annually.Conclusion: India needs to significantly increase the production of doctors and nurses(/midwives) through investing in opening up of new medical colleges. Nursing sector should be prioritized to encourage talents to join nursing profession and provide quality education. India needs to set-up a benchmark of skill-mix ratio and provide attractive employment opportunities in health sector to increase the demand and absorb the new supply of graduates.

Context: Most prior software visualisation (SV) research has focused primarily on making aspects of intangible software product artefacts more evident. While undoubtedly useful, this focus has meant that software process visualisation has received far less attention. Objective: This paper presents Conceptual Visualisation, a novel SV approach that builds on the well-known CodeCity metaphor by situating software code artefacts alongside their software development processes, in order to link and synchronise these typically separate components. Method: While the majority of prior SV research has focused on representing what is already available in the code (i.e., the implementation) or information derived from it (i.e., various metrics), the presented approach instead makes the design concepts and original developers' intentions -- both significant sources of information in terms of software development and maintenance -- readily and contextually available in a visualisation environment that tightly integrates the code artefacts with their original functional requirements and development activity. Results: Our approach has been implemented in a prototype tool called ScrumCity with the proof of concept being demonstrated using six real-world open source systems. A preliminary case study has further been carried out with real world data. Conclusion: Conceptual Visualisation, as implemented in ScrumCity, shows early promise in enabling developers and managers (and potentially other stakeholders) to traverse and explore multiple aspects of software product and process artefacts in a synchronised manner, achieving traceability between the two., Journal paper, 18 pages, 4 figures

Context: User involvement is generally considered to contributing to user satisfaction and project success and is central to Agile software development. In theory, the expectations about user involvement, such as the PO's, are quite demanding in this Agile way of working. But what are the expectations seen in practice, and are the expectations of user involvement aligned among the development team and users? Any misalignment could contribute to conflict and miscommunication among stakeholders that may result in ineffective user involvement. Objective: Our aim is to compare and contrast the expectations of two stakeholder groups (software development team, and software users) about user involvement in order to understand the expectations and assess their alignment. Method: We have conducted an exploratory case study of expectations about user involvement in an Agile software development. Qualitative data was collected through interviews to design a novel method for the assessing the alignment of expectations about user involvement by applying Repertory Grids (RG). Results: By aggregating the results from the interviews and RGs, varying degrees of expectation alignments were observed between the development team and user representatives. Conclusion: Alignment of expectations can be assessed in practice using the proposed RG instrument and can reveal misalignment between user roles and activities they participate in Agile software development projects. Although we used RG instrument retrospectively in this study, we posit that it could also be applied from the start of a project, or proactively as a diagnostic tool throughout a project to assess and ensure that expectations are aligned., Conference paper, 10 pages, 1 figure, 7 tables

Background Investment in human resources for health not only strengthens the health system, but also generates employment and contributes to economic growth. India can gain from enhanced investment in health workforce in multiple ways. This study in addition to presenting updated estimates on size and composition of health workforce, identifies areas of investment in health workforce in India. Methods We analyzed two sources of data: (i) National Health Workforce Account (NHWA) 2018 and (ii) Periodic Labour Force Survey 2017–2018 of the National Sample Survey Office (NSSO). Using the two sources, we collated comparable estimates of different categories of health workers in India, density of health workforce and skill-mix at the all India and state levels. Results The study estimated (from NHWA 2018) a total stock of 5.76 million health workers which included allopathic doctors (1.16 million), nurses/midwives (2.34 million), pharmacist (1.20 million), dentists (0.27 million), and traditional medical practitioner (AYUSH 0.79 million). However, the active health workforce size estimated (NSSO 2017–2018) is much lower (3.12 million) with allopathic doctors and nurses/midwives estimated as 0.80 million and 1.40 million, respectively. Stock density of doctor and nurses/midwives are 8.8 and 17.7, respectively, per 10,000 persons as per NHWA. However, active health workers’ density (estimated from NSSO) of doctor and nurses/midwives are estimated to be 6.1 and 10.6, respectively. The numbers further drop to 5.0 and 6.0, respectively, after accounting for the adequate qualifications. All these estimates are well below the WHO threshold of 44.5 doctor, nurses and midwives per 10,000 population. The results reflected highly skewed distribution of health workforce across states, rural–urban and public–private sectors. A substantial proportion of active health worker were found not adequately qualified on the one hand and on the other more than 20% of qualified health professionals are not active in labor markets. Conclusion India needs to invest in HRH for increasing the number of active health workers and also improve the skill-mix which requires investment in professional colleges and technical education. India also needs encouraging qualified health professionals to join the labor markets and additional trainings and skill building for already working but inadequately qualified health workers.

© 2020, Springer Nature Switzerland AG. [Context & Motivation] Agile Requirements Engineering (ARE) is a collaborative, team-based process based on frequent elicitation, elaboration, estimation and prioritization of the user requirements, typically represented as user stories. While it is claimed that this Agile approach and the associated RE activities are effective, there is sparse empirical evidence and limited theoretical foundation to explain this efficacy. [Question/problem] We aim to understand and explain aspects of the ARE process by focusing on a cognitive perspective. We appropriate ideas and techniques from Distributed Cognition (DC) theory to analyze the cognitive roles of people, artefacts and the physical work environment in a successful collaborative ARE activity, namely requirement prioritization. [Principal idea/results] This paper presents a field study of two early requirements related meetings in an Agile product development project. Observation data, field notes and transcripts were collected and qualitatively analyzed. We have used DiCoT, a framework for systematically applying DC as a methodological contribution, to analyze the ARE process and explain its efficacy from a cognitive perspective. The analysis identified three main areas of cognitive effort in the ARE process as well as the significant information flows and artefacts. Analysis of these have identified that the use of physical user story cards, specific facilitator skills, and development of shared understanding of the user stories, were all key to the effectiveness of the ARE activity observed. [Contribution] The deeper understanding of cognition involved in ARE provides an empirically evidenced explanation, based on DC theory, of why this way of collaboratively prioritizing requirements was effective. Our result provides a basis for designing other ARE activities.

The Australian Nursing and Midwifery Federation has published the Australian Journal of Advanced Nursing since 1983. In 2020, the World Health Organization-designated Year of the Nurse and Midwife, we are pleased to introduce the new-look journal along with new guidance for authors for preparing their publications for submission. The Australian Journal of Advanced Nursing will continue the journal’s previous character and aligns and advances the Australian Nursing and Midwifery Federation’s overall strategic objectives as Australia’s largest professional nursing and midwifery organisation. The Australian Nursing and Midwifery Federation’s diverse and dispersed membership works in many sectors including but not limited to public and private health, aged care, schools, tertiary education, research, the community, and disability care across a wide variety of metropolitan, regional, and remote locations. Accordingly, the Australian Journal of Advanced Nursing will seek to showcase and promote a wide variety of original research and scholarly work to inform and empower nurses, midwives, and other healthcare professionals to improve the health and wellbeing of all communities and be prepared for the future. We look forward to working with authors, readers, and our Editorial Board to enhance the reach, readership, and profile of the Australian Journal of Advanced Nursing. https://doi.org/10.37464/2020.371.1

Context: It is not uncommon for a new team member to join an existing Agile software development team, even after development has started. This new team member faces a number of challenges before they are integrated into the team and can contribute productively to team progress. Ideally, each newcomer should be supported in this transition through an effective team onboarding program, although prior evidence suggests that this is challenging for many organisations. Objective: We seek to understand how Agile teams address the challenge of team onboarding in order to inform future onboarding design. Method: We conducted an interview survey of eleven participants from eight organisations to investigate what onboarding activities are common across Agile software development teams. We also identify common goals of onboarding from a synthesis of literature. A repertory grid instrument is used to map the contributions of onboarding techniques to onboarding goals. Results: Our study reveals that a broad range of team onboarding techniques, both formal and informal, are used in practice. It also shows that particular techniques that have high contributions to a given goal or set of goals. Conclusions: In presenting a set of onboarding goals to consider and an evidence-based mechanism for selecting techniques to achieve the desired goals it is expected that this study will contribute to better-informed onboarding design and planning. An increase in practitioner awareness of the options for supporting new team members is also an expected outcome.

Mob Programming, or "mobbing", is a relatively new collaborative programming practice being experimented with in different organizational contexts. There are a number of claimed benefits to this way of working, but it is not clear if these are realized in practice and under what circumstances. This paper describes the experience of one team's experiences experimenting with Mob Programming over an 18-month period. The context is programming in a software product organization in the Financial Services sector. The paper details the benefits and challenges observed as well as lessons learned from these experiences. It also reports some early work on understanding others' experiences and perceptions of mobbing through a preliminary international survey of 82 practitioners of Mob Programming. The findings from the case and the survey generally align well, as well as suggesting several fruitful areas for further research into Mob Programming. Practitioners should find this useful to extract learnings to inform their own mobbing experiments and its potential impact on collaborative software development., 6 pages. Best Paper in Industry Collaboration Track at EASE'18

© 2019 The Author(s). Background: The recession of 2008 triggered large-scale emigration from Ireland. Australia emerged as a popular destination for Irish emigrants and for Irish-trained doctors. This paper illustrates the impact that such an external shock can have on the medical workforce and demonstrates how cross-national data sharing can assist the source country to better understand doctor emigration trends. Method: This study draws on Australian immigration, registration and census data to highlight doctor migration flows from Ireland to Australia, 2008-2018. Findings: General population migration from Ireland to Australia increased following the 2008 recession, peaked between 2011 and 2013 before returning to pre-2008 levels by 2014, in line with the general economic recovery in Ireland. Doctor emigration from Ireland to Australia did not follow the same pattern, but rather increased in 2008 and increased year on year since 2014. In 2018, 326 Irish doctors obtained working visas for Australia. That doctor migration is out of sync with general economic conditions in Ireland and with wider migration patterns indicates that it is influenced by factors other than evolving economic conditions in Ireland, perhaps factors relating to the health system. Discussion: Doctor emigration from Ireland to Australia has not decreased in line with improved economic conditions in Ireland, indicating that other factors are driving and sustaining doctor emigration. This paper considers some of these factors. Largescale doctor emigration has significant implications for the Irish health system; representing a brain drain of talent, generating a need for replacement migration and a high dependence on internationally trained doctors. This paper illustrates how source countries, such as Ireland, can use destination country data to inform an evidence-based policy response to doctor emigration.

DevOps is a set of principles and practices to improve collaboration between development and IT Operations. Against the backdrop of the growing adoption of DevOps in a variety of software development domains, this paper describes empirical research into factors influencing its implementation. It presents findings of an in-depth exploratory case study that explored DevOps implementation in a New Zealand product development organisation. The study involved interviewing six experienced software engineers who continuously monitored and reflected on the gradual implementation of DevOps principles and practices. For this case study the use of DevOps practices led to significant benefits, including increase in deployment frequency from about 30 releases a month to an average of 120 releases per month, as well as improved natural communication and collaboration between IT development and operations personnel. We found that the support of a number of technological enablers, such as implementing an automation pipeline and cross functional organisational structures, were critical to delivering the expected benefits of DevOps.

An amendment to this paper has been published and can be accessed via the original article.

Background Health workers are the cornerstone of primary health care (PHC) services, the delivery of an effective coronavirus disease 2019 (COVID-19) response and progress towards universal health coverage (UHC). In 2014, the World Health Organization (WHO) South-East Asia Region committed to the Decade for Health Workforce Strengthening 2015–2024, and UHC became a regional flagship with a focus on strengthening the health workforce. Since its inception, three rounds of monitoring with standardized indicators have been completed. Methods In 2019, data on human resources for health were collected through the National Health Workforce Accounts online platform by the country focal points; this was complemented by a regional online consultation in June 2020. A mid-term review report on the Decade for Health Workforce Strengthening was launched during the 73rd session of the Regional Committee in September 2020. Results The availability of doctors, nurses and midwives in the South-East Asia Region has increased by 21% since the decade began in 2014. Nine countries of the region are now above the 2006 WHO threshold of 22.8 doctors, nurses and midwives per 10 000 population, compared with only six countries in 2014. However, only two countries are above the 2016 revised WHO threshold of 44.5 doctors, nurses and midwives per 10 000 population, the density estimated to be needed to achieve the Sustainable Development Goals. Countries of the WHO South-East Asia Region have made progress to different extents during the past 5 years on strengthening governance of human resources for health, data, rural retention and health professional education. Discussion Addressing broader health workforce challenges and particularly PHC workforce challenges will require extra commitment and prioritization by governments for the second half of the decade. COVID-19 presents the necessity and an opportunity to increase long-term investment in the health workforce and in strengthening PHC in the South-East Asia Region.

© 2015 Elsevier Ltd. Aim: To discuss the perceptions about the International English Language Testing System (IELTS) and its impact on migration and practice of migrant health professionals in Australia. Methods: Thematic analysis of interviews with 14 health industry participants and 35 migrated health professionals in Australia. Results and discussion: Language testing is a barrier to health professional registration for migrant health workers in Australia. While two English language tests are recognised by the registration authorities in Australia, it is the International English Language Testing System that is most commonly used. This paper reports that study participants had underlying negative perceptions of the International English Language Testing System which they report, affect their move to Australia.These negative perceptions are caused by: frustration due to changes to processes for migration and registration; challenges regarding the structure of IELTS including timing of when test results expire, scoring requirements, cost, and suitability; and the resulting feelings of inadequacy caused by the test itself. Conclusion: This study has shown that some respondents have experienced difficulties in relation to the International English Language Testing System as part of their migration process. It was found that there is very little research into the effectiveness of the IELTS as it is currently administered for overseas health care professionals. Several recommendations are provided including areas for further research.

Nurse turnover is a critical issue facing workforce planners across the globe, particularly in light of protracted and continuing workforce shortages. An ageing population coupled with the rise in complex and chronic diseases, have contributed to increased demands placed on the health system and importantly, nurses who themselves are ageing. Costs associated with nurse turnover are attracting more attention; however, existing measurements of turnover show inconsistent findings, which can be attributed to differences in study design, metrics used to calculate turnover and variations in definitions for turnover. This paper will report the rates and costs of nurse turnover across three States in Australia.

© 2018 IEEE. In order to improve and increase their utility, software products must evolve continually and incrementally to meet the new requirements of current and future users. Online reviews from users of the software provide a rich and readily available resource for discovering candidate new features for future software releases. However, it is challenging to manually analyze a large volume of potentially unstructured and noisy data to extract useful information to support software release planning decisions. This paper investigates machine learning techniques to automatically identify text that represents users' ideas for new features from their online reviews. A binary classification approach to categorize extracted text as either a feature or non-feature was evaluated experimentally. Three machine learning algorithms were evaluated in the experiments: Naïve Bayes (with multinomial and Bernoulli variants), Support Vector Machines (with linear and multinomial variants) and Logistic Regression. Variations on the configurations of k-fold cross validation, the use of n-grams and review sentiment were also experimentally evaluated. Based on binary classification of over a thousand separate reviews of two products, Trello and Jira, linear Support Vector Machines with review sentiment as an input, using n-gram (1,4) together with k-fold 10 cross validation gave the best performance. The results have confirmed the feasibility and accuracy of semi-automated extraction of candidate requirements from a large volume of unstructured and noisy online user reviews. The next steps planned are to experiment with machine supported grouping, prioritizing and visualizing the extracted features to best support release planners' work, as well as extending the sources of candidate requirements.

In Israel, approximately one-third of the country's nurses work in community settings - primarily as salaried employees in Israel's four non-profit health plans. Many health system leaders believe that the roles of health plan nurses have changed significantly in recent years due to a mix of universal developments (such as population aging and academization of the profession) and Israel-specific changes (such as the introduction of extensive quality monitoring in primary care).The main objectives of the study were to identify recent changes in the roles of health plan nurses and their current areas of activity. It also explored the experience of front-line nurses with regard to autonomy, work satisfaction, and barriers to further role development.The study integrated interviews and surveys of nurses and other professionals conducted across 4 years. Data generated from earlier study components were used to guide questions and focus for later components. In 2013, in-depth interviews were held with 55 senior nursing and medical professionals supplemented by interviews in mid-2017 with the head nurses in the four health plans. In addition, a national survey was conducted in 2014-5 among a representative sample of 1019 community nurses who work for the health plans and who are engaged in direct patient care. Six hundred ninety-two nurses responded to the survey, yielding a response rate of 69%. The survey sample consisted of an equal number of nurses from each health plan, and the observations were weighted accordingly.Senior professionals identified general themes associated with a shift in nursing roles, including a transition from reactive to initiated work, increased specialization, and a shifting of tasks from hospitals to community settings. They identified the current main areas of activity in the health plans as being: routine care, chronic care, health promotion, quality monitoring and improvement, specialized care (such as wound care), and home care. In the survey of front-line nurses, 38% of the nurses identified "caring for chronically ill patients" as their main area of activity aside from routine care; 30% did so regarding "health promotion", and 26% did so regarding "a specific area of specialization" e.g., diabetes, wound care or women's health). In response to a separate question, 77% reported "great" or "very great" involvement in quality measurement programs. Four out of five front-line nurses were satisfied with their work to a great or very great extent, and approximately three out of four of them (73%) felt that they had autonomy at work to a great or very great extent. About half of the nurses take into account, to a great or very great extent, the financial concerns of the health plans that employ them. A large majority of the nurses (85%) indicated that the nature of their work had changed substantially in recent years, with an increase in autonomy noted as one of the key changes. Perceived barriers to further role development include attitudes on the part of some physicians and nurses, an insufficient number of dedicated nursing positions, and insufficiently attractive wage levels.The findings, gathered over 4 years, indicate alignment between universal and Israel-specific trends in health care and the evolving roles of nurses in Israel's health plans. The findings provide support for ongoing efforts in the health plans to give nurses more authority and responsibility in the management of chronically ill patients, a more central role in health promotion efforts, more advanced training - both inter-professional and nurse-specific, and more opportunity to focus on the roles and tasks that require nursing professionals.

Background Mounting evidence suggests that holding multiple concurrent jobs in public and private (dual practice) is common among health workers in low- as well as high-income countries. Nurses are world’s largest health professional workforce and a critical resource for achieving Universal Health Coverage. Nonetheless, little is known about nurses’ engagement with dual practice. Methods We conducted a scoping review of the literature on nurses’ dual practice with the objective of generating hypotheses on its nature and consequences, and define a research agenda on the phenomenon. The Arksey and O’Malley’s methodological steps were followed to develop the research questions, identify relevant studies, include/exclude studies, extract the data, and report the findings. PRISMA guidelines were additionally used to conduct the review and report on results. Results Of the initial 194 records identified, a total of 35 met the inclusion criteria for nurses’ dual practice; the vast majority (65%) were peer-reviewed publications, followed by nursing magazine publications (19%), reports, and doctoral dissertations. Twenty publications focused on high-income countries, 16 on low- or middle-income ones, and two had a multi country perspective. Although holding multiple jobs not always amounted to dual practice, several ways were found for public-sector nurses to engage concomitantly in public and private employments, in regulated as well as in informal, casual fashions. Some of these forms were reported as particularly prevalent, from over 50% in Australia, Canada, and the UK, to 28% in South Africa. The opportunity to increase a meagre salary, but also a dissatisfaction with the main job and the flexibility offered by multiple job-holding arrangements, were among the reported reasons for engaging in these practices. Discussion and conclusions Limited and mostly circumstantial evidence exists on nurses’ dual practice, with the few existing studies suggesting that the phenomenon is likely to be very common and carry implications for health systems and nurses’ welfare worldwide. We offer an agenda for future research to consolidate the existing evidence and to further explore nurses’ motivation; without a better understanding of nurse dual practice, this will continue to be a largely ‘hidden’ element in nursing workforce policy and practice, with an unclear impact on the delivery of care. Electronic supplementary material The online version of this article (10.1186/s12960-018-0276-x) contains supplementary material, which is available to authorized users.

In 2010, all member states of the World Health Assembly, including the United States, adopted the World Health Organization (WHO) Global Code of Practice on the International Recruitment of Health Personnel (the WHO Code). 1 The development and unanimous adoption of the Code by all WHO affiliate countries marked a watershed in policy focus on the issue of health worker migration.

Aim Examine metrics and policies regarding nurse workforce across four countries. Background International comparisons inform health policy makers. Methods Data from the OECD were used to compare expenditure, workforce and health in: Australia, Portugal, the United Kingdom (UK) and the United States (US). Workforce policy context was explored. Results Public spending varied from less than 50% of gross domestic product in the US to over 80% in the UK. Australia had the highest life expectancy. Portugal has fewer nurses and more physicians. The Australian national health workforce planning agency has increased the scope for co-ordinated policy intervention. Portugal risks losing nurses through migration. In the UK, the economic crisis resulted in frozen pay, reduced employment, and reduced student nurses. In the US, there has been limited scope to develop a significant national nursing workforce policy approach, with a continuation of State based regulation adding to the complexity of the policy landscape. The US is the most developed in the use of nurses in advanced practice roles. Ageing of the workforce is likely to drive projected shortages in all countries. Limitations There are differences as well as variation in the overall impact of the global financial crisis in these countries. Conclusion Future supply of nurses in all four countries is vulnerable. Implications for nursing and health policy Work force planning is absent or restricted in three of the countries. Scope for improved productivity through use of advanced nurse roles exists in all countries.

Headlines about the soaring number of vacancies in the NHS in England have prompted warnings that the service is facing desperate problems of understaffing. According to NHS Digital, the number of full-time-equivalent posts available rose from 26,424 in March 2016 to 30,613 in March 2017 - the highest number on record.

Every nurse who leaves an organisation incurs big costs. Research shows the financial impact of nurse turnover on an employer is equivalent to at least several months' salary per nurse. Lost productivity, and the time and cost of finding replacement nurses, are major concerns for most NHS trusts. At a time of nursing shortages, these problems are exacerbated.

Buried in the recent avalanche of negative news about nursing shortages and Brexit is a glimmer of hope - perhaps. The NHS Confederation has floated the idea of setting up a £10 billion NHS homes fund to enable the health service to provide staff housing.

As a relatively expensive staffing solution, agency nursing is often in the spotlight in the cost-conscious NHS.

For years this country has been sleepwalking towards a major nursing shortage that is self-inflicted. The Brexit vote was a wake-up call, but it has merely quickened the pace towards a staffing crisis that was already coming.

The impact of Brexit on the NHS and on nursing remains a 'known unknown'. We all agree it will have an impact, but we cannot agree yet what that impact will be. The 28 April report on Brexit by the Commons health committee does a good job of sorting out the facts from the speculation. The committee points to two other 'known unknowns' that complicate an assessment of UK nursing numbers after the referendum vote to leave the European Union (EU) last June.

Differences between the employment situation of NHS nurses working in Scotland and England are becoming ever more pronounced. This was reinforced recently in the report from the NHS Pay Review Body (RB) on staff pay in Scotland.