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COVID: Short on ICU nurses, Germany looks abroad – DW (English)

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Amid a nursing staff shortage, German hospitals have had to take matters into their own hands. When the coronavirus pandemic hit, a new arrival from Mexico proved very valuable at Berlin’s well-known Charite Hospital.

The story of German Health Minister Jens Spahn and Judith Heepe, the nursing director at Berlin’s Charite Hospital,  is a little like the tale of the hare and the hedgehog. Heepe, like the wily hedgehog, is somehow always faster.

In September 2019, Spahn was in Mexico signing a contract to speed up the process for Mexican nursing staff to receive work permits in Germany. Heepe had already been there. A month before that, Spahn had sent his state secretary to the Philippines on a recruitment mission. Heepe had been there, too. 

In the Brothers Grimm fairy tale, the hare thinks to itself: That’s not possible. Judith Heepe sees the funny side as she recounts her imaginary competition with Spahn. In the race to recruit nursing staff from overseas, you must be highly creative. And sometimes take matters into your own hands. 

‘The international nursing staff have brought warmth and openness,’ says Judith Heepe

For more than five years, Heepe has led the nursing division at Charite, Berlin’s oldest hospital and Germany’s most famous. She is responsible for 4,600 staff members, and during the second wave of the pandemic they’ve been working under pressure every day, especially the intensive care nurses in the COVID-19 ward. 

Struggle to recruit nurses in Germany

If the pandemic had broken out four years ago, Charite would probably have had to admit defeat. “At that time we were lacking 400 nurses. Every year we have plugged this gap by 100 workers and expanded our training capacities at the same time,” says Heepe.

That’s why she has not only flown to Mexico and the Philippines, but has also been to Albania and made approaches in South America. Soon, Charite also wants to bring Brazilian nurses to Germany. “The market in Germany has totally run dry,” she says. According to the German Interdisciplinary Association for Intensive and Emergency Medicine (DIVI), the country lacks about 3,500 to 4,000 skilled workers in intensive care.

Politicians are constantly asking Heepe how the situation has come to this. “I can only tell them: this situation is our own fault. In recent years there have simply not been enough people trained and qualified. We now have what was a totally avoidable gap in the next four or five years,” she says. It’s an emergency that could cost Germany dearly in the next few weeks, with intensive care stations overcrowded due to the pandemic. “It also means that we must pay people better,” Heepe says. 

Struggles with officials and bureaucracy

Heepe is someone who gets things done. Her motto: Don’t take no for an answer.

“At some point, I was more familiar with the State Office for Health and Social Affairs than I ever wanted to be,” she says with a laugh. She was always having to discuss the office’s requirements for foreign nurses to supply original documents. Her relationship with the Berlin health authorities has a history: It happened almost three years ago, half a world away in Mexico. And Heepe can still recall every detail. 

“I was in a video conference with 15 Mexicans who were in complete despair because their recruitment company had gone bust,” she remembers. “And then I told them: ‘Who cares? We can do it! We’ll bring you here!'”

For Heepe, that marked the start of a nerve-wracking side job. She took on everything that the agencies would normally sort out, from visas and flights to dealing with officials, bank accounts and health insurance to organizing language courses. And sometimes, when the whole project looked at risk due to German bureaucracy, she took unconventional measures.

Herbert Perez in the ICU office area

‘I tell my German colleagues: ‘You have everything here. You don’t need to emigrate,” says Mexican nurse Herbert Perez

A suitcase full of documents

In April 2018, Herbert Perez boarded a plane from Mexico City to Berlin with a suitcase and a backpack. Charite had paid for the flight. In the backpack were two pairs of trousers, three T-shirts and two shirts. In the suitcase: all the original paper documents for the 15 Mexican nurses who wanted to work in Germany. The young Indigenous nurse from the southern state of Oaxaca with the German first name became the vanguard; he had everything in his luggage that officials in Berlin were demanding.

“The scales at the airport showed exactly 22.5 kilograms,” Perez remembers. “At the very last second people were still coming to the airport to drop off documents.” The nurse can laugh now when he thinks back to his first trip to Germany, but at the time he was a nervous wreck.

“What would have happened if I had forgotten something amidst all the hustle and bustle, or if documents were lost in transit or if the airlines made a mistake and the suitcase went missing?” All these thoughts were running through his head. But everything worked out. Today, following a six-month program to certify his credentials, Perez is a valued colleague. He works on the coronavirus intensive care ward and helps day in, day out to bring Germany through the crisis.

Dramatic situations in intensive care wards

“The current situation is extremely critical, there are only a few intensive care beds,” Perez says. “At the moment we are reaching the limits of our capacities.” He has himself already tested his limits — like many nurses he contracted the coronavirus and was bedridden with fever for a week. 

Perez wanted to be a nurse since he was a small child. He is the kind of person who needs to be told when to slow down. Even today, he’s surprised whenever his colleagues tell him he needs to relax, that he is entitled to a vacation or days off. “I didn’t know such things from Mexico, there you have fewer rights as a worker.”

Heepe is organizing everything so that Perez’s partner, a preschool teacher, can soon join him in Berlin and start work in Charite’s kindergarten. 

An international success story, then, with only winners? Not quite. There is growing criticism that Germany is snapping up well-trained personnel from developing nations when they are also urgently needed in their own countries. A recent report in the German newspaper Frankfurter Rundschau spoke of “nursing imperialism.”

‘Germany needs to solve its nursing problem itself’

The German Interdisciplinary Association for Intensive and Emergency Medicine (DIVI) is familiar with these accusations. The experts agree: Germany’s nursing shortage is a problem of the country’s own making and in an emergency like the current coronavirus pandemic, other countries should not be further weakened.

“Bringing in qualified staff from abroad always sounds like the big answer to the problem. But the more you investigate it, the less of an answer it seems,” says Michael Isfort, deputy board chairman of the German Institute of Applied Nursing Research. The proportion of foreign nursing staff in the hospital sector is currently about 1%. “That is extremely small.”

Nurses like Herbert Perez go mainly to large cities like Berlin; according to Isfort 90 to 95% of the international staff are working in the big urban centers. “We’ve still not yet succeeded in getting care workers from abroad into rural areas,” he says.

According to experts, it’s clear that recruiting staff from abroad won’t be the long-term solution to Germany’s nursing emergency. 

This article was translated from German.

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What’s the greatest holiday gift: lips, hair, skin? Give the gift of great skin this holiday season

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Give the gift of great skin this holiday season

Skinstitut Holiday Gift Kits take the stress out of gifting

Toronto, October 31, 2024 – Beauty gifts are at the top of holiday wish lists this year, and Laser Clinics Canada, a leader in advanced beauty treatments and skincare, is taking the pressure out of seasonal shopping. Today, Laser Clincs Canada announces the arrival of its 2024 Holiday Gift Kits, courtesy of Skinstitut, the exclusive skincare line of Laser Clinics Group.

In time for the busy shopping season, the limited-edition Holiday Gifts Kits are available in Laser Clinics locations in the GTA and Ottawa. Clinics are conveniently located in popular shopping centers, including Hillcrest Mall, Square One, CF Sherway Gardens, Scarborough Town Centre, Rideau Centre, Union Station and CF Markville. These limited-edition Kits are available on a first come, first served basis.

“These kits combine our best-selling products, bundled to address the most relevant skin concerns we’re seeing among our clients,” says Christina Ho, Senior Brand & LAM Manager at Laser Clinics Canada. “With several price points available, the kits offer excellent value and suit a variety of gift-giving needs, from those new to cosmeceuticals to those looking to level up their skincare routine. What’s more, these kits are priced with a savings of up to 33 per cent so gift givers can save during the holiday season.

There are two kits to select from, each designed to address key skin concerns and each with a unique theme — Brightening Basics and Hydration Heroes.

Brightening Basics is a mix of everyday essentials for glowing skin for all skin types. The bundle comes in a sleek pink, reusable case and includes three full-sized products: 200ml gentle cleanser, 50ml Moisture Defence (normal skin) and 30ml1% Hyaluronic Complex Serum. The Brightening Basics kit is available at $129, a saving of 33 per cent.

Hydration Heroes is a mix of hydration essentials and active heroes that cater to a wide variety of clients. A perfect stocking stuffer, this bundle includes four deluxe products: Moisture 15 15 ml Defence for normal skin, 10 ml 1% Hyaluronic Complex Serum, 10 ml Retinol Serum and 50 ml Expert Squalane Cleansing Oil. The kit retails at $59.

In addition to the 2024 Holiday Gifts Kits, gift givers can easily add a Laser Clinic Canada gift card to the mix. Offering flexibility, recipients can choose from a wide range of treatments offered by Laser Clinics Canada, or they can expand their collection of exclusive Skinstitut products.

 

Brightening Basics 2024 Holiday Gift Kit by Skinstitut, available exclusively at Laser Clincs Canada clinics and online at skinstitut.ca.

Hydration Heroes 2024 Holiday Gift Kit by Skinstitut – available exclusively at Laser Clincs Canada clinics and online at skinstitut.ca.

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Here is how to prepare your online accounts for when you die

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LONDON (AP) — Most people have accumulated a pile of data — selfies, emails, videos and more — on their social media and digital accounts over their lifetimes. What happens to it when we die?

It’s wise to draft a will spelling out who inherits your physical assets after you’re gone, but don’t forget to take care of your digital estate too. Friends and family might treasure files and posts you’ve left behind, but they could get lost in digital purgatory after you pass away unless you take some simple steps.

Here’s how you can prepare your digital life for your survivors:

Apple

The iPhone maker lets you nominate a “ legacy contact ” who can access your Apple account’s data after you die. The company says it’s a secure way to give trusted people access to photos, files and messages. To set it up you’ll need an Apple device with a fairly recent operating system — iPhones and iPads need iOS or iPadOS 15.2 and MacBooks needs macOS Monterey 12.1.

For iPhones, go to settings, tap Sign-in & Security and then Legacy Contact. You can name one or more people, and they don’t need an Apple ID or device.

You’ll have to share an access key with your contact. It can be a digital version sent electronically, or you can print a copy or save it as a screenshot or PDF.

Take note that there are some types of files you won’t be able to pass on — including digital rights-protected music, movies and passwords stored in Apple’s password manager. Legacy contacts can only access a deceased user’s account for three years before Apple deletes the account.

Google

Google takes a different approach with its Inactive Account Manager, which allows you to share your data with someone if it notices that you’ve stopped using your account.

When setting it up, you need to decide how long Google should wait — from three to 18 months — before considering your account inactive. Once that time is up, Google can notify up to 10 people.

You can write a message informing them you’ve stopped using the account, and, optionally, include a link to download your data. You can choose what types of data they can access — including emails, photos, calendar entries and YouTube videos.

There’s also an option to automatically delete your account after three months of inactivity, so your contacts will have to download any data before that deadline.

Facebook and Instagram

Some social media platforms can preserve accounts for people who have died so that friends and family can honor their memories.

When users of Facebook or Instagram die, parent company Meta says it can memorialize the account if it gets a “valid request” from a friend or family member. Requests can be submitted through an online form.

The social media company strongly recommends Facebook users add a legacy contact to look after their memorial accounts. Legacy contacts can do things like respond to new friend requests and update pinned posts, but they can’t read private messages or remove or alter previous posts. You can only choose one person, who also has to have a Facebook account.

You can also ask Facebook or Instagram to delete a deceased user’s account if you’re a close family member or an executor. You’ll need to send in documents like a death certificate.

TikTok

The video-sharing platform says that if a user has died, people can submit a request to memorialize the account through the settings menu. Go to the Report a Problem section, then Account and profile, then Manage account, where you can report a deceased user.

Once an account has been memorialized, it will be labeled “Remembering.” No one will be able to log into the account, which prevents anyone from editing the profile or using the account to post new content or send messages.

X

It’s not possible to nominate a legacy contact on Elon Musk’s social media site. But family members or an authorized person can submit a request to deactivate a deceased user’s account.

Passwords

Besides the major online services, you’ll probably have dozens if not hundreds of other digital accounts that your survivors might need to access. You could just write all your login credentials down in a notebook and put it somewhere safe. But making a physical copy presents its own vulnerabilities. What if you lose track of it? What if someone finds it?

Instead, consider a password manager that has an emergency access feature. Password managers are digital vaults that you can use to store all your credentials. Some, like Keeper,Bitwarden and NordPass, allow users to nominate one or more trusted contacts who can access their keys in case of an emergency such as a death.

But there are a few catches: Those contacts also need to use the same password manager and you might have to pay for the service.

___

Is there a tech challenge you need help figuring out? Write to us at onetechtip@ap.org with your questions.

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Pediatric group says doctors should regularly screen kids for reading difficulties

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The Canadian Paediatric Society says doctors should regularly screen children for reading difficulties and dyslexia, calling low literacy a “serious public health concern” that can increase the risk of other problems including anxiety, low self-esteem and behavioural issues, with lifelong consequences.

New guidance issued Wednesday says family doctors, nurses, pediatricians and other medical professionals who care for school-aged kids are in a unique position to help struggling readers access educational and specialty supports, noting that identifying problems early couldhelp kids sooner — when it’s more effective — as well as reveal other possible learning or developmental issues.

The 10 recommendations include regular screening for kids aged four to seven, especially if they belong to groups at higher risk of low literacy, including newcomers to Canada, racialized Canadians and Indigenous Peoples. The society says this can be done in a two-to-three-minute office-based assessment.

Other tips encourage doctors to look for conditions often seen among poor readers such as attention-deficit hyperactivity disorder; to advocate for early literacy training for pediatric and family medicine residents; to liaise with schools on behalf of families seeking help; and to push provincial and territorial education ministries to integrate evidence-based phonics instruction into curriculums, starting in kindergarten.

Dr. Scott McLeod, one of the authors and chair of the society’s mental health and developmental disabilities committee, said a key goal is to catch kids who may be falling through the cracks and to better connect families to resources, including quicker targeted help from schools.

“Collaboration in this area is so key because we need to move away from the silos of: everything educational must exist within the educational portfolio,” McLeod said in an interview from Calgary, where he is a developmental pediatrician at Alberta Children’s Hospital.

“Reading, yes, it’s education, but it’s also health because we know that literacy impacts health. So I think that a statement like this opens the window to say: Yes, parents can come to their health-care provider to get advice, get recommendations, hopefully start a collaboration with school teachers.”

McLeod noted that pediatricians already look for signs of low literacy in young children by way of a commonly used tool known as the Rourke Baby Record, which offers a checklist of key topics, such as nutrition and developmental benchmarks, to cover in a well-child appointment.

But he said questions about reading could be “a standing item” in checkups and he hoped the society’s statement to medical professionals who care for children “enhances their confidence in being a strong advocate for the child” while spurring partnerships with others involved in a child’s life such as teachers and psychologists.

The guidance said pediatricians also play a key role in detecting and monitoring conditions that often coexist with difficulty reading such as attention-deficit hyperactivity disorder, but McLeod noted that getting such specific diagnoses typically involves a referral to a specialist, during which time a child continues to struggle.

He also acknowledged that some schools can be slow to act without a specific diagnosis from a specialist, and even then a child may end up on a wait list for school interventions.

“Evidence-based reading instruction shouldn’t have to wait for some of that access to specialized assessments to occur,” he said.

“My hope is that (by) having an existing statement or document written by the Canadian Paediatric Society … we’re able to skip a few steps or have some of the early interventions present,” he said.

McLeod added that obtaining specific assessments from medical specialists is “definitely beneficial and advantageous” to know where a child is at, “but having that sort of clear, thorough assessment shouldn’t be a barrier to intervention starting.”

McLeod said the society was partly spurred to act by 2022’s “Right to Read Inquiry Report” from the Ontario Human Rights Commission, which made 157 recommendations to address inequities related to reading instruction in that province.

He called the new guidelines “a big reminder” to pediatric providers, family doctors, school teachers and psychologists of the importance of literacy.

“Early identification of reading difficulty can truly change the trajectory of a child’s life.”

This report by The Canadian Press was first published Oct. 23, 2024.

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