scholarly journals Factors associated with the rural and remote practice of medical workforce in Maluku Islands of Indonesia: a cross-sectional study

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Farah Noya ◽  
Sandra Carr ◽  
Sandra Thompson ◽  
Rhonda Clifford ◽  
Denese Playford

Abstract Background Many factors contribute to engagement in rural and remote (RR) medical practice, but little is known about the factors associated with rural and remote medical practice in such remote locations as the Maluku Province of Indonesia. This study describes factors associated with actual RR practice, preferred RR practice, and intention to remain practice in Maluku Province. Methods An online survey of work-related experience and intentions for future rural work was administered to 410 doctors working in the Maluku province of Indonesia. Participant characteristics were described using descriptive statistics, associations between the independent variables with the location of the workforce, intention to remain practice in Maluku, preference for future RR practice in Maluku were analysed using Chi-square tests and logistic regression. Results A total of 324 responses (79% response rate) were recorded, comprising 70% females and 30% Pattimura University graduates of doctors employed in Maluku. Doctors working in RR areas were more likely to be a GP (OR 3.49, CI 1.03–11.8), have a monthly salary of more than IDR 6 million (OR 11.5, CI 4.24–31.1), and have no additional practice (OR 2.78, CI 1.34–5.78). Doctors intended to stay practice in Maluku were more likely to be born in Maluku (OR 7.77, CI 3.42–17.7) and have graduated from Pattimura University (OR 3.06, CI 1.09–8.54), and less likely to be a temporary employee (OR 0.24, CI 0.10–0.57). Doctors who prefer future RR practice in Maluku were more likely to experience rural living (OR 2.05 CI 1.05–3.99), have a positive indication of the impact of community exposure during medical schools on their current practice (OR 2.08, CI 1.06–4.09), currently practising in RR Maluku (OR 8.23, CI 3.27–20.8); and less likely to have bigger take-home pay (OR 0.30, CI 0.13–0.70). Conclusion This study indicates that special attention should be given to recruiting doctors with a rural background and ongoing support through attractive opportunities to build a sustainable RR workforce. Since a regional medical school helps supply doctors to the RR areas in its region, a sustained collaboration between medical schools and local government implementing relevant strategies are needed to widen participation and improve the recruitment and retention of RR doctors.

2022 ◽  
Vol 35 (13) ◽  
Author(s):  
Francisco Duarte ◽  
Nuno Rua ◽  
David Gomes ◽  
Vasco Ricoca Peixoto ◽  
Daniela Azevedo ◽  
...  

Introduction: Pre-exposure prophylaxis (PrEP) has gained relevance as a method of prevention for HIV in certain people and settings. Following the publication of the guideline on PrEP prescribing in Portugal, we aimed to assess the knowledge of Portuguese Medical Students about PrEP.Material and Methods: An online survey was sent to Medical students of Portuguese Medical Schools. We conducted a descriptive analysis of the results and an analytic cross-sectional study to identify factors associated with “knowing about PrEP”, “having had one class about PrEP” and “identifying eligible groups correctly”.Results: Of the 796 students that responded to the survey, 64.6% were aware of what PrEP is. Of these, 34.44% acquired this knowledge during their training. Out of the total amount of respondents, 4.77% could identify correctly and completely the eligible groups for PrEP. As the training years went by, the probability of being aware of PrEP, having had one class about PrEP, and identifying the eligible groups correctly, increased. Of the sixth-year students, 43.48% had had one class about PrEP and among the students that were aware of PrEP, 28% identified what the eligible groups were. After adjusting for the school year, we found differences between Medical Schools regarding the outcomes. The association between the different ways of learning about PrEP and the ability to correctly identify eligible groups for PrEP was not statistically significant.Conclusion: The differences between Medical Schools could be harmonized through changes in the medical curricula that would allow this topic to be addressed more often.


2021 ◽  
pp. 1-8
Author(s):  
Perla Werner ◽  
Sarang Kim

Background: Despite the increasing amount of research on dementia stigma, there is a dearth of cross-national studies conducted on this subject. This is surprising since the experience of stigma is closely associated to socio-cultural aspects. Objective: The present study intended to expand knowledge about the impact of culture on dementia stigma by comparing the level and correlates of stigmatic beliefs about dementia among the general public in Israel and Australia. Methods: A cross-sectional study using an online survey was conducted with two age-matched samples: 447 adults in Israel and 290 adults in Australia. Results: Overall, dementia stigma was moderate in both countries. However, the level of dementia stigma was significantly higher in Australia than in Israel. Lower levels of subjective knowledge and higher levels of ageism were associated with increased levels of stigmatic beliefs in both countries. Gender was a significant correlate of dementia stigma, with male participants reporting higher levels of public stigma than women, although this gender difference was mainly driven by the Australian sample. Conclusion: Our findings indicate that providing knowledge and decreasing ageist attitudes should be key considerations in dementia awareness and stigma reduction campaigns despite the cultural context. In addition, developing gender-specific messages should be considered as a way of improving the effects of such campaigns.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
David Hope ◽  
David Kluth ◽  
Matthew Homer ◽  
Avril Dewar ◽  
Richard Fuller ◽  
...  

Abstract Background Due to differing assessment systems across UK medical schools, making meaningful cross-school comparisons on undergraduate students’ performance in knowledge tests is difficult. Ahead of the introduction of a national licensing assessment in the UK, we evaluate schools’ performances on a shared pool of “common content” knowledge test items to compare candidates at different schools and evaluate whether they would pass under different standard setting regimes. Such information can then help develop a cross-school consensus on standard setting shared content. Methods We undertook a cross-sectional study in the academic sessions 2016-17 and 2017-18. Sixty “best of five” multiple choice ‘common content’ items were delivered each year, with five used in both years. In 2016-17 30 (of 31 eligible) medical schools undertook a mean of 52.6 items with 7,177 participants. In 2017-18 the same 30 medical schools undertook a mean of 52.8 items with 7,165 participants, creating a full sample of 14,342 medical students sitting common content prior to graduation. Using mean scores, we compared performance across items and carried out a “like-for-like” comparison of schools who used the same set of items then modelled the impact of different passing standards on these schools. Results Schools varied substantially on candidate total score. Schools differed in their performance with large (Cohen’s d around 1) effects. A passing standard that would see 5 % of candidates at high scoring schools fail left low-scoring schools with fail rates of up to 40 %, whereas a passing standard that would see 5 % of candidates at low scoring schools fail would see virtually no candidates from high scoring schools fail. Conclusions Candidates at different schools exhibited significant differences in scores in two separate sittings. Performance varied by enough that standards that produce realistic fail rates in one medical school may produce substantially different pass rates in other medical schools – despite identical content and the candidates being governed by the same regulator. Regardless of which hypothetical standards are “correct” as judged by experts, large institutional differences in pass rates must be explored and understood by medical educators before shared standards are applied. The study results can assist cross-school groups in developing a consensus on standard setting future licensing assessment.


Author(s):  
G. Sanjana ◽  
Vijaya Raghavan

Background: Loneliness can affect anyone at any point in their life. It can be detrimental to the wellbeing and quality of life of individuals and communities. In the ongoing COVID-19 pandemic, loneliness is considered as a public health crisis. Hence, the objectives of the study were to estimate the prevalence of loneliness and family related factors associated with loneliness among general population in south India. Materials and Methods: The study employed a crosssectional online survey design. The data was collected in the first phase of the lockdown in 2020 from adults in Southern India. Socio-demographic profile and family related variables were collected using a semistructured proforma. Loneliness was assessed by UCLA loneliness scale. Results: Of 573 total respondents to the survey, aged between 18-65 years, 43% were male and 57% were female. The overall prevalence of loneliness was 63% (358/573). No significant gender differences were observed in the prevalence of loneliness. Family discord was associated with higher rates of loneliness (p less than 0.01). Other factors associated were younger age and being single. Conclusion: Rates of loneliness during the COVID-19 lockdown were high in Southern India. Findings suggest that interventions should prioritize younger people. Increasing social support and improving interpersonal skills, which in turn would help reduce family discord and may reduce the impact of COVID-19 on loneliness.


10.2196/31664 ◽  
2022 ◽  
Vol 24 (1) ◽  
pp. e31664
Author(s):  
Jaegyeong Lee ◽  
Jung Min Lim

Background The prevalence and economic burden of dementia are increasing dramatically. Using information communication technology to improve cognitive functions is proven to be effective and holds the potential to serve as a new and efficient method for the prevention of dementia. Objective The aim of this study was to identify factors associated with the experience of mobile apps for cognitive training in middle-aged adults. We evaluated the relationships between the experience of cognitive training apps and structural variables using an extended health belief model. Methods An online survey was conducted on South Korean participants aged 40 to 64 years (N=320). General characteristics and dementia knowledge were measured along with the health belief model constructs. Statistical analysis and logistic regression analysis were performed. Results Higher dementia knowledge (odds ratio [OR] 1.164, P=.02), higher perceived benefit (OR 1.373, P<.001), female gender (OR 0.499, P=.04), and family history of dementia (OR 1.933, P=.04) were significantly associated with the experience of cognitive training apps for the prevention of dementia. Conclusions This study may serve as a theoretical basis for the development of intervention strategies to increase the use of cognitive training apps for the prevention of dementia.


2018 ◽  
Vol 72 (10) ◽  
pp. 880-887 ◽  
Author(s):  
Kate L Mandeville ◽  
Rose-Marie Satherley ◽  
Jennifer A Hall ◽  
Shailen Sutaria ◽  
Chris Willott ◽  
...  

BackgroundLittle is known about the political views of doctors in the UK despite doctors' importance in the functioning of the National Health Service (NHS).MethodsThis is a survey-based, cross-sectional study in which we asked questions about voting behaviour in 2015 and 2017 UK general elections and 2016 referendum on leaving the European Union (EU) (Brexit), and questions relating to recent health policies.Results1172 doctors (45.1% women) from 1295 responded to an online survey. 60.5% described their political views as ‘left-wing’ and 62.2% described themselves as ‘liberal’. 79.4% of respondents voted to remain in the EU in the 2016 referendum compared with 48.1% of voters as a whole (χ2=819.8, p<0.001). 98.6% of respondents agreed that EU nationals working in the NHS should be able to remain in the UK after Brexit. The median score for the impact of Brexit on the NHS on a scale of 0 (worst impact) to 10 (best impact) was 2 (IQR=1–4). Most respondents agreed with the introduction of minimum alcohol pricing in the UK (73.9%), charging patients who are not eligible for NHS treatment for non-urgent care (70.6%) and protecting a portion of national spending for the NHS (87.1%). 65.8% thought there was too much use of NHS-funded private sector provision in their medical practice. Specialty, income and grade were associated with divergent opinions.ConclusionsUK doctors are left-leaning and liberal in general, which is reflected in their opinions on topical health policy issues. Doctors in the UK voted differently from the general electorate in recent polls.


2020 ◽  
Vol 3 (02) ◽  
pp. 61-67
Author(s):  
G. Sanjana ◽  
Vijaya Raghavan

Background: Loneliness can affect anyone at any point in their life. It can be detrimental to the wellbeing and quality of life of individuals and communities. In the ongoing COVID-19 pandemic, loneliness is considered as a public health crisis. Hence, the objectives of the study were to estimate the prevalence of loneliness and family related factors associated with loneliness among general population in south India. Materials and Methods: The study employed a crosssectional online survey design. The data was collected in the first phase of the lockdown in 2020 from adults in Southern India. Socio-demographic profile and family related variables were collected using a semistructured proforma. Loneliness was assessed by UCLA loneliness scale. Results: Of 573 total respondents to the survey, aged between 18-65 years, 43% were male and 57% were female. The overall prevalence of loneliness was 63% (358/573). No significant gender differences were observed in the prevalence of loneliness. Family discord was associated with higher rates of loneliness (p less than 0.01). Other factors associated were younger age and being single. Conclusion: Rates of loneliness during the COVID-19 lockdown were high in Southern India. Findings suggest that interventions should prioritize younger people. Increasing social support and improving interpersonal skills, which in turn would help reduce family discord and may reduce the impact of COVID-19 on loneliness.


2021 ◽  
Author(s):  
Widya Lestari ◽  
Nur Hazirah Yazid ◽  
Zawin Najah Azhar ◽  
Azlini Ismail ◽  
Cortino Sukotjo

Abstract Background The coronavirus disease 2019 (COVID-19) caused by a novel coronavirus (SARS-CoV-2) has spread across the world at unprecedented speed and gained worldwide attention. The pandemic proved to hold an impact to humankind including dental students in all aspects of life. Dental students’ performances may indirectly be affected following the preventive measures in containing the disease. This study aims to evaluate the impact of COVID-19 pandemic on physical, mental, financial health and academic concern among dental students in Malaysia. Methods The current research implemented a cross sectional study among dental students in Malaysia. Assessment of the impact of COVID-19 on dental education was done by the distribution of a set of online survey consisting of 28 questions to dental students (n = 353) from public and private universities in Malaysia. The questionnaires include sociodemographic backgrounds and assessment on the 4 main domains. Results A total number of 353 respondents was recorded and 76.2% comprised of female. 59.7% were clinical students and 40.3% were preclinical students. 55.8% of the respondents attended hybrid mode of study. 78.0%, 76.5% and 91.8% students were concerned about their own emotional, physical health and the amount of clinical skill they acquire respectively. Year 3 students were found to be more concerned about their mental and financial health concern (p < 0.05). Conclusions COVID-19 pandemic had indeed significantly affected Malaysian dental students mainly due to fear of the quality of online learning and the amount of clinical skills acquired.


2021 ◽  
Author(s):  
David Hope ◽  
David Kluth ◽  
Matthew Homer ◽  
Avril Dewar ◽  
Richard Fuller ◽  
...  

Abstract Background Due to the diverse approaches to medical school assessment, making meaningful cross-school comparisons on knowledge is difficult. Ahead of the introduction of national licensing assessment in the UK, we evaluate schools on “common content” to compare candidates at different schools and evaluate whether they would pass under different standard setting regimes. Such information can then help develop a cross-school consensus on standard setting shared content. Methods We undertook a cross-sectional study in the academic sessions 2016-17 and 2017-18. Sixty “best of five” multiple choice items were delivered each year, with five used in both years. In 2016-17 30 (of 31 eligible) medical schools undertook a mean of 52.6 items with 7,177 participants. In 2017-18 the same 30 medical schools undertook a mean of 52.8 items with 7,165 participants for a full sample of 14,342 medical students sitting common content prior to graduation. Using mean scores, we compared performance across items and carried out a “like-for-like” comparison of schools who used the same set of items then modelled the impact of different passing standards on these schools. Results Schools varied substantially on candidate total score. Schools differed in their performance with large (Cohen’s d around 1) effects. A passing standard that would see 5% of candidates at high scoring schools fail left low-scoring schools with fail rates of up to 40%, whereas a passing standard that would see 5% of candidates at low scoring schools fail would see virtually no candidates from high scoring schools fail. Conclusions Candidates at different schools exhibited significant differences in scores in two separate sittings. Performance varied by enough that standard setting approaches that produce realistic fail rates in one medical school may produce substantially different pass rates in other medical schools – despite identical content and the candidates being governed by the same regulator. Regardless of which hypothetical standards are “correct” as judged by experts, large institutional gaps in pass rates must be explored and understood by medical educators before shared standards are applied. The study results can assist cross-school groups in developing a consensus on standard setting future licensing assessment.


2021 ◽  
Author(s):  
Desta Markos Minamo

Abstract Introduction Contrary to the recommendation, children under the age of 6 months be exclusively breastfed, many infants are also fed with other liquids such as water, non-milk liquids, and other milks before 6 months. Because of level of education and proportion of employed women in Ethiopia has been increasing gradually. Consequently the practice of exclusive breastfeeding became very lower. The main objective of this study was to assess the magnitude and factors associated with the practice of exclusive breastfeeding among employed and unemployed mothers in Ethiopia, using dataset from EDHS 2016. METHOD Data was extracted from Ethiopia Demographic and Health Survey (EDHS-2016). A total of 1089 mothers with infants aged 0 to 6 months in the data set were included in the analysis. Descriptive analysis, chi-square and binary logistic regression models were used. RESULT This study has demonstrated a 64.7%, 95%CI(58.9-70.5) and 75.4%, 95%CI(72.378.2) prevalence of EBF practices among employed and unemployed mothers respectively in the 24h preceding the survey. Other factors associated with EBF practice included being unemployed mother, larger to normal birth weight; infant aged 0-3 month old, infant being male, have radio in the house, infant being wanted, delivery by non CS mode and presence of ANC follow up during pregnancy were found to be significantly associated with exclusive breastfeeding practice. Conclusion the prevalence of exclusive breast feeding practice among employed mothers was significantly lower than that of unemployed mothers. Thus, Having in consideration the impact of appropriate infant and young children feeding practice on children’s nutritional status and mortality rate, policy makers still need to give more emphasis on promotion of exclusive breastfeeding through creating an enabling environment targeting the extension of postnatal maternity leave up to the first six month.


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