scholarly journals Factors influencing subspecialty choice among medical students: a systematic review and meta-analysis

BMJ Open ◽  
2019 ◽  
Vol 9 (3) ◽  
pp. e022097 ◽  
Author(s):  
Yahan Yang ◽  
Jiawei Li ◽  
Xiaohang Wu ◽  
Jinghui Wang ◽  
Wangting Li ◽  
...  
Keyword(s):  
Systematic Review ◽  
Developing Countries ◽  
Medical Students ◽  
Influencing Factors ◽  
Meta Analysis ◽  
Developed Countries ◽  
Specialty Choice ◽  
Factors Influencing ◽  
Study Heterogeneity ◽  
Academic Interests

ObjectiveTo characterise the contributing factors that affect medical students’ subspecialty choice and to estimate the extent of influence of individual factors on the students’ decision-making process.DesignSystematic review and meta-analysis.MethodsA systematic search of the Cochrane Library, ERIC, Web of Science, CNKI and PubMed databases was conducted for studies published between January 1977 and June 2018. Information concerning study characteristics, influential factors and the extent of their influence (EOI) was extracted independently by two trained investigators. EOI is the percentage level that describes how much each of the factors influenced students’ choice of subspecialty. The recruited medical students include students in medical school, internship, residency training and fellowship, who are about to or have just made a specialty choice. The estimates were pooled using a random-effects meta-analysis model due to the between-study heterogeneity.ResultsData were extracted from 75 studies (882 209 individuals). Overall, the factors influencing medical students’ choice of subspecialty training mainly included academic interests (75.29%), competencies (55.15%), controllable lifestyles or flexible work schedules (53.00%), patient service orientation (50.04%), medical teachers or mentors (46.93%), career opportunities (44.00%), workload or working hours (37.99%), income (34.70%), length of training (32.30%), prestige (31.17%), advice from others (28.24%) and student debt (15.33%), with significant between-study heterogeneity (p<0.0001). Subgroup analyses revealed that the EOI of academic interests was higher in developed countries than that in developing countries (79.66% [95% CI 70.73% to 86.39%] vs 60.41% [95% CI 43.44% to 75.19%]; Q=3.51, p=0.02). The EOI value of prestige was lower in developed countries than that in developing countries (23.96% [95% CI 19.20% to 29.47%] vs 47.65% [95% CI 34.41% to 61.24%]; Q=4.71, p=0.01).ConclusionsThis systematic review and meta-analysis provided a quantitative evaluation of the top 12 influencing factors associated with medical students’ choice of subspecialty. Our findings provide the basis for the development of specific, effective strategies to optimise the distribution of physicians among different departments by modifying these influencing factors.

scholarly journals Factors Influencing Recanalization After Mechanical Thrombectomy With First-Pass Effect for Acute Ischemic Stroke: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 12 ◽  
Author(s):  
Xuesong Bai ◽  
Xiao Zhang ◽  
Jie Wang ◽  
Yinhang Zhang ◽  
Adam A. Dmytriw ◽  
...  
Keyword(s):  
Systematic Review ◽  
Ischemic Stroke ◽  
General Anesthesia ◽  
Acute Ischemic Stroke ◽  
Influencing Factors ◽  
Mechanical Thrombectomy ◽  
Meta Analysis ◽  
Female Gender ◽  
Factors Influencing ◽  
First Pass

Background: First-pass effect (FPE) is increasingly recognized as a predictor of good outcome in large vessel occlusion (LVO). This systematic review and meta-analysis aimed to elucidate the factors influencing recanalization after mechanical thrombectomy (MT) with FPE in treating acute ischemic stroke (AIS).Methods: Main databases were searched for relevant randomized controlled trials (RCTs) and observational studies reporting influencing factors of MT with FPE in AIS. Recanalization was assessed by the modified thrombolysis in cerebral ischemia (mTICI) score. Both successful (mTICI 2b-3) and complete recanalization (mTICI 2c-3) were observed. Risk of bias was assessed through different scales according to study design. The I2 statistic was used to evaluate the heterogeneity, while subgroup analysis, meta-regression, and sensitivity analysis were performed to investigate the source of heterogeneity. Visual measurement of funnel plots was used to evaluate publication bias.Results: A total of 17 studies and 6,186 patients were included. Among them, 2,068 patients achieved recanalization with FPE. The results of meta-analyses showed that age [mean deviation (MD):1.21,95% confidence interval (CI): 0.26–2.16; p = 0.012], female gender [odds ratio (OR):1.12,95% CI: 1.00–1.26; p = 0.046], diabetes mellitus (DM) (OR:1.17,95% CI: 1.01–1.35; p = 0.032), occlusion of internal carotid artery (ICA) (OR:0.71,95% CI: 0.52–0.97; p = 0.033), occlusion of M2 segment of middle cerebral artery (OR:1.36,95% CI: 1.05–1.77; p = 0.019), duration of intervention (MD: −27.85, 95% CI: −42.11–13.58; p &lt; 0.001), time of onset to recanalization (MD: −34.63, 95% CI: −58.45–10.81; p = 0.004), general anesthesia (OR: 0.63,95% CI: 0.52–0.77; p &lt; 0.001), and use of balloon guide catheter (BGC) (OR:1.60,95% CI: 1.17–2.18; p = 0.003) were significantly associated with successful recanalization with FPE. At the same time, age, female gender, duration of intervention, general anesthesia, use of BGC, and occlusion of ICA were associated with complete reperfusion with FPE, but M2 occlusion and DM were not.Conclusion: Age, gender, occlusion site, anesthesia type, and use of BGC were influencing factors for both successful and complete recanalization after first-pass thrombectomy. Further studies with more comprehensive observations indexes are need in the future.

scholarly journals Mycoplasma genitalium incidence, persistence, concordance between partners and progression: systematic review and meta-analysis

2019 ◽  
Vol 95 (5) ◽  
pp. 328-335 ◽  
Author(s):  
Manuel Cina ◽  
Lukas Baumann ◽  
Dianne Egli-Gany ◽  
Florian S Halbeisen ◽  
Hammad Ali ◽  
...  
Keyword(s):  
Systematic Review ◽  
Antimicrobial Resistance ◽  
Meta Analysis ◽  
Age Distribution ◽  
Mycoplasma Genitalium ◽  
Developed Countries ◽  
Sexual Partners ◽  
Risk Of Bias ◽  
Infection Status ◽  
Sexually Transmitted

BackgroundMycoplasma genitalium is increasingly seen as an emerging sexually transmitted pathogen, and has been likened to Chlamydia trachomatis, but its natural history is poorly understood. The objectives of this systematic review were to determine M. genitalium incidence, persistence, concordance between sexual partners and the risk of pelvic inflammatory disease (PID).MethodsWe searched Medline, EMBASE, LILACS, IndMed and African Index Medicus from 1 January 1981 until 17 March 2018. Two independent researchers screened studies for inclusion and extracted data. We examined results in forest plots, assessed heterogeneity and conducted meta-analysis where appropriate. Risk of bias was assessed for all studies.ResultsWe screened 4634 records and included 18 studies; six (4201 women) reported on incidence, five (636 women) on persistence, 10 (1346 women and men) on concordance and three (5139 women) on PID. Incidence in women in two very highly developed countries was 1.07 per 100 person-years (95% CI 0.61 to 1.53, I2 0%). Median persistence of M. genitalium was estimated from one to three months in four studies but 15 months in one study. In 10 studies measuring M. genitalium infection status in couples, 39%–50% of male or female sexual partners of infected participants also had M. genitalium detected. In prospective studies, PID incidence was higher in women with M. genitalium than those without (risk ratio 1.73, 95% CI 0.92 to 3.28, I2 0%, two studies).DiscussionIncidence of M. genitalium in very highly developed countries is similar to that for C. trachomatis, but concordance might be lower. Taken together with other evidence about age distribution and antimicrobial resistance in the two infections, M. genitalium is not the new chlamydia. Synthesised data about prevalence, incidence and persistence of M. genitalium infection are inconsistent. These findings can be used for mathematical modelling to investigate the dynamics of M. genitalium.Registration numbersCRD42015020420, CRD42015020405

Impact of economic and financial crimes on economic growth in emerging and developing countries

2019 ◽  
Vol 26 (3) ◽  
pp. 910-920 ◽  
Author(s):  
Sani Abubakar Saddiq ◽  
Abu Sufian Abu Bakar
Keyword(s):  
Systematic Review ◽  
Developing Countries ◽  
Negative Impact ◽  
Meta Analysis ◽  
Eligibility Criteria ◽  
Content Type ◽  
Research Reporting ◽  
Financial Crimes ◽  
Emerging And Developing Countries ◽  
The Impact

Purpose The purpose of the study is to investigate the impact of economic and financial crimes on the economies of emerging and developing countries. Design/methodology/approach Preferred Reporting Items for Systematic review and Meta-Analysis (PRISMA) guidelines and meta-analysis of economics research reporting guidelines were used to conduct a quantitative synthesis of empirical evidence on the impact of economic and financial crimes in developing and emerging countries. Findings A total of 103 studies were searched, out of which 6 met the selection/eligibility criteria of this systematic review. The six selected studies indicated that economic and financial crimes have a negative impact in emerging and developing countries. Originality/value To the best knowledge of the authors, no published systematic review of the impact of economic and financial crimes in developing countries has been conducted to date.

scholarly journals Prevalence of depression and depressive symptoms among outpatients: a systematic review and meta-analysis

BMJ Open ◽  
2017 ◽  
Vol 7 (8) ◽  
pp. e017173 ◽  
Author(s):  
Jinghui Wang ◽  
Xiaohang Wu ◽  
Weiyi Lai ◽  
Erping Long ◽  
Xiayin Zhang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Depressive Symptoms ◽  
Meta Analysis ◽  
Significant Proportion ◽  
Depression Scale ◽  
Developed Countries ◽  
Self Report ◽  
Cochrane Library ◽  
Significant Heterogeneity ◽  
Prevalence Of Depression

ObjectivesDepression and depressive symptoms are common mental disorders that have a considerable effect on patients’ health-related quality of life and satisfaction with medical care, but the prevalence of these conditions varies substantially between published studies. The aim of this study is to conduct a systematic review and meta-analysis to provide a precise estimate of the prevalence of depression or depressive symptoms among outpatients in different clinical specialties.DesignSystematic review and meta-analysis.Data sources and eligibility criteriaThe PubMed and PsycINFO, EMBASE and Cochrane Library databases were searched to identify observational studies that contained information on the prevalence of depression and depressive symptoms in outpatients. All studies included were published before January 2016. Data characteristics were extracted independently by two investigators. The point prevalence of depression or depressive symptoms was measured using validated self-report questionnaires or structured interviews. Assessments were pooled using a random-effects model. Differences in study-level characteristics were estimated by meta-regression analysis. Heterogeneity was assessed using standard χ2tests and the I2statistic. The study protocol has been registered with PROSPERO under number CRD42017054738.ResultsEighty-three cross-sectional studies involving 41 344 individuals were included in this study. The overall pooled prevalence of depression or depressive symptoms was 27.0% (10 943/41 344 individuals; 95% CI 24.0% to 29.0%), with significant heterogeneity between studies (p<0.0001, τ2=0.3742, I2=96.7%). Notably, a significantly higher prevalence of depression and depressive symptoms was observed in outpatients than in the healthy controls (OR 3.16, 95% CI 2.66 to 3.76, I2=72.0%, χ2=25.33). The highest depression/depressive symptom prevalence estimates occurred in studies of outpatients from otolaryngology clinics (53.0%), followed by dermatology clinics (39.0%) and neurology clinics (35.0%). Subgroup analyses showed that the prevalence of depression and depressive symptoms in different specialties varied from 17.0% to 53.0%. The prevalence of depression and depressive symptoms was higher among outpatients in developing countries than in outpatients from developed countries. Moreover, the prevalence of depression and depressive symptoms in outpatients slightly decreased from 1996 to 2010. Regarding screening instruments, the Beck Depression Inventory led to a higher estimate of the prevalence of depression and depressive symptoms (1316/4702, 36.0%, 95% CI 29.0% to 44.0%, I2=94.8%) than the Hospital Anxiety and Depression Scale (1003/2025, 22.0%, 95% CI 12.0% to 35.0%, I2=96.6%).ConclusionOur study provides evidence that a significant proportion of outpatients experience depression or depressive symptoms, highlighting the importance of developing effective management strategies for the early identification and treatment of these conditions among outpatients in clinical practice. The substantial heterogeneity between studies was not fully explained by the variables examined.

Factors Influencing Performance of ITES Firms in India

2012 ◽  
Vol 25 (4) ◽  
pp. 46-64 ◽  
Author(s):  
Soni Agrawal ◽  
Kishor Goswami ◽  
Bani Chatterjee
Keyword(s):  
Information Technology ◽  
Developing Countries ◽  
Service Provider ◽  
Business Processes ◽  
Developed Countries ◽  
Offshore Outsourcing ◽  
Competitive Advantages ◽  
Improve Quality ◽  
Factors Influencing

Firms from developed countries are increasingly offshore outsourcing services to developing countries to have cost as well competitive advantages. Although this is a growing practice, there has been limited empirical attention in understanding the outsourcing phenomenon, particularly from the perspective of service provider firms that execute important business processes for their overseas clients. Despite growing trends to outsource, only a few service provider firms report success. This puts the service provider firms under increasing pressure to add value and improve quality of relationship. They have to depend not only on tangible factors but some intangible factors also play an important role in their performance. In this paper, the authors try to find out factors that influence performance of service provider firms. Multiple regressions using four indicators of firm performance are carried out to see the influence of certain factors on information technology enabled service (ITES) firms’ performance.

scholarly journals Factors influencing medical students’ choice of specialization: A gender based systematic review

2020 ◽  
Vol 28 ◽  
pp. 100589
Author(s):  
Mathieu Levaillant ◽  
Lucie Levaillant ◽  
Nicolas Lerolle ◽  
Benoît Vallet ◽  
Jean-François Hamel-Broza
Keyword(s):  
Systematic Review ◽  
Medical Students ◽  
Factors Influencing ◽  
Gender Based
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