scholarly journals Migration of Junior Doctors: The Case of Psychiatric Trainees in Portugal

2019 ◽  
Vol 33 (13) ◽  
Author(s):  
Mariana Pinto da Costa ◽  
Cátia Moreira ◽  
Luis F. S. Castro-de-Araujo ◽  
Fábio Monteiro Da Silva ◽  
Renato Antunes Dos Santos
Keyword(s):  
Working Conditions ◽  
Low Income ◽  
Prior Experience ◽  
Low Income Countries ◽  
Junior Doctors ◽  
Medical Migration ◽  
Push And Pull Factors ◽  
Push And Pull ◽  
The Impact ◽  
The Brain

Introduction: In the last few decades, the rates of international medical migration have continuously risen. In Psychiatry, there is great disparity in the workforce between high and low-income countries. Yet, little is known about the ‘push’ and ‘pull’ factors and the migratory intentions of trainees. This study aims to assess the factors impacting the decisions of psychiatric trainees in Portugal towards migration.Material and Methods: A questionnaire was developed in the Brain Drain study and was distributed to psychiatric trainees in Portugal.Results: The sample consists of 104 psychiatric trainees (60.6% female). Overall, 40.4% of the trainees had prior experience of living abroad and the majority (96.9%) felt that this experience influenced their attitude towards migration in a positive way. About 75% of trainees had ‘ever’ considered leaving the country, but the majority (70.0%) had not taken any ‘practical steps’ towards migration. The main reasons to stay in Portugal were personal, while the main reason to leave was financial. The majority of the trainees (55.7%) were dissatisfied or very dissatisfied with their income, working conditions and academic opportunities.Discussion: Working conditions, salaries and academic opportunities are the main triggers for the migration of psychiatric trainees from Portugal.Conclusion: These results may inform the decisions of stakeholders in the health and education sectors and point out the necessary investments required and the impact it may have on the workforce.

scholarly journals The Clean pilot study: evaluation of an environmental hygiene intervention bundle in three Tanzanian hospitals

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Giorgia Gon ◽  
Abdunoor M. Kabanywanyi ◽  
Petri Blinkhoff ◽  
Simon Cousens ◽  
Stephanie J. Dancer ◽  
...  
Keyword(s):  
Pilot Study ◽  
Study Design ◽  
Low Income ◽  
High Volume ◽  
Surface Cleaning ◽  
Low Income Countries ◽  
Training Period ◽  
Future Research ◽  
Environmental Hygiene ◽  
The Impact

Abstract Background Healthcare associated infections (HAI) are estimated to affect up to 15% of hospital inpatients in low-income countries (LICs). A critical but often neglected aspect of HAI prevention is basic environmental hygiene, particularly surface cleaning and linen management. TEACH CLEAN is an educational intervention aimed at improving environmental hygiene. We evaluated the effectiveness of this intervention in a pilot study in three high-volume maternity and newborn units in Dar es Salaam, Tanzania. Methods This study design prospectively evaluated the intervention as a whole, and offered a before-and-after comparison of the impact of the main training. We measured changes in microbiological cleanliness [Aerobic Colony Counts (ACC) and presence of Staphylococcus aureus] using dipslides, and physical cleaning action using gel dots. These were analysed with descriptive statistics and logistic regression models. We used qualitative (focus group discussions, in-depth interviews, and semi-structured observation) and quantitative (observation checklist) tools to measure why and how the intervention worked. We describe these findings across the themes of adaptation, fidelity, dose, reach and context. Results Microbiological cleanliness improved during the study period (ACC pre-training: 19%; post-training: 41%). The odds of cleanliness increased on average by 1.33 weekly during the pre-training period (CI = 1.11–1.60), and by 1.08 (CI = 1.03–1.13) during the post-training period. Cleaning action improved only in the pre-training period. Detection of S. aureus on hospital surfaces did not change substantially. The intervention was well received and considered feasible in this context. The major pitfalls in the implementation were the limited number of training sessions at the hospital level and the lack of supportive supervision. A systems barrier to implementation was lack of regular cleaning supplies. Conclusions The evaluation suggests that improvements in microbiological cleanliness are possible using this intervention and can be sustained. Improved microbiological cleanliness is a key step on the pathway to infection prevention in hospitals. Future research should assess whether this bundle is cost-effective in reducing bacterial and viral transmission and infection using a rigorous study design.

scholarly journals COVID-19 in children treated with immunosuppressive medication for kidney diseases

2020 ◽  
pp. archdischild-2020-320616
Author(s):  
Matko Marlais ◽  
Tanja Wlodkowski ◽  
Samhar Al-Akash ◽  
Petr Ananin ◽  
Varun Kumar Bandi ◽  
...  
Keyword(s):  
Kidney Disease ◽  
Immunosuppressive Therapy ◽  
Low Income ◽  
Kidney Diseases ◽  
Low Income Countries ◽  
Reference Network ◽  
Immunosuppressive Medication ◽  
Immunosuppressive Medications ◽  
Significant Difference ◽  
The Impact

BackgroundChildren are recognised as at lower risk of severe COVID-19 compared with adults, but the impact of immunosuppression is yet to be determined. This study aims to describe the clinical course of COVID-19 in children with kidney disease taking immunosuppressive medication and to assess disease severity.MethodsCross-sectional study hosted by the European Rare Kidney Disease Reference Network and supported by the European, Asian and International paediatric nephrology societies. Anonymised data were submitted online for any child (age <20 years) with COVID-19 taking immunosuppressive medication for a kidney condition. Study recruited for 16 weeks from 15 March 2020 to 05 July 2020. The primary outcome was severity of COVID-19.Results113 children were reported in this study from 30 different countries. Median age: 13 years (49% male). Main underlying reasons for immunosuppressive therapy: kidney transplant (47%), nephrotic syndrome (27%), systemic lupus erythematosus (10%). Immunosuppressive medications used include: glucocorticoids (76%), mycophenolate mofetil (MMF) (54%), tacrolimus/ciclosporine A (58%), rituximab/ofatumumab (11%). 78% required no respiratory support during COVID-19 illness, 5% required bi-level positive airway pressure or ventilation. Four children died; all deaths reported were from low-income countries with associated comorbidities. There was no significant difference in severity of COVID-19 based on gender, dialysis status, underlying kidney condition, and type or number of immunosuppressive medications.ConclusionsThis global study shows most children with a kidney disease taking immunosuppressive medication have mild disease with SARS-CoV-2 infection. We therefore suggest that children on immunosuppressive therapy should not be more strictly isolated than children who are not on immunosuppressive therapy.

Foreign capital inflows and economic growth: the experience of low-income countries in Sub Saharan Africa

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Atif Awad
Keyword(s):  
Low Income ◽  
Foreign Capital ◽  
Ordinary Least Squares ◽  
Capital Inflows ◽  
Sub Saharan Africa ◽  
Low Income Countries ◽  
Content Type ◽  
Long Run ◽  
Foreign Capital Inflows ◽  
The Impact

Purpose This paper aims to investigate the long-run impact of selected foreign capital inflows, including aid, remittances, foreign direct investment (FDI), trade and debt, on the economic growth of 21 low-income countries in the Sub Saharan Africa (SSA) region, during the period 1990–2018. Design/methodology/approach To obtain this objective and for robust analysis, a parametric approach, which was dynamic ordinary least squares, and a non-parametric technique, which was fully modified ordinary least squares, were used. Findings The results of both models confirmed that, in the long run, trade and aid affected the growth rate of the per capita income in these countries in a positive way. However, external debt seemed to have an adverse influence on such growth. Originality/value First, this is the initial study that has addressed this matter across a homogenous group of countries in the SSA region. Second, while most of the previous studies regarding capital inflows into the SSA region have focused on the impact of only one or two aspects of such foreign capital inflows on growth, the present study, instead, examined the impact of five types of foreign capital inflows (aid, remittances, FDI, trade and debt).

scholarly journals Poultry farmer response to disease outbreaks in smallholder farming systems

2020 ◽  
Author(s):  
Alexis Delabouglise ◽  
Nguyen Thi Le Thanh ◽  
Huynh Thi Ai Xuyen ◽  
Benjamin Nguyen-Van-Yen ◽  
Phung Ngoc Tuyet ◽  
...  
Keyword(s):  
Avian Influenza ◽  
Low Income ◽  
Low Income Countries ◽  
Farm Size ◽  
Small Scale ◽  
Flock Size ◽  
Smallholder Farming ◽  
Southern Vietnam ◽  
Poultry Farms ◽  
The Impact

AbstractAvian influenza outbreaks have been occurring on smallholder poultry farms in Asia for two decades. Farmer responses to these outbreaks can slow down or accelerate virus transmission. We used a longitudinal survey of 53 small-scale chicken farms in southern Vietnam to investigate the impact of outbreaks with disease-induced mortality on harvest rate, vaccination, and disinfection behaviors. We found that in small broiler flocks (≤16 birds/flock) the estimated probability of harvest was 56% higher when an outbreak occurred, and 214% higher if an outbreak with sudden deaths occurred in the same month. Vaccination and disinfection were strongly positively correlated with flock size and farm size, respectively. Small-scale farmers – the overwhelming majority of poultry producers in low-income countries – tend to rely on rapid sale of birds to mitigate losses from diseases. As depopulated birds are sent to markets or trading networks, this reactive behavior has the potential to enhance onward transmission.One sentence summaryA cohort study of fifty three small-scale poultry farms in southern Vietnam reveals that when outbreaks occur with symptoms similar to highly pathogenic avian influenza, farmers respond by sending their chickens to market early, potentially exacerbating the effects of the outbreak.

scholarly journals Challenges and Opportunities: Experiences of Mathematics Lecturers Engaged in Emergency Remote Teaching during the COVID-19 Pandemic

Mathematics ◽  
2021 ◽  
Vol 9 (18) ◽  
pp. 2303
Author(s):  
Eabhnat Ní Fhloinn ◽  
Olivia Fitzmaurice
Keyword(s):  
Working Conditions ◽  
Online Teaching ◽  
Online Survey ◽  
Prior Experience ◽  
Teaching Mathematics ◽  
Experience Teaching ◽  
Challenges And Opportunities ◽  
Teaching Of Mathematics ◽  
Nature Of Mathematics ◽  
The Impact

In this paper, we consider the experiences of mathematics lecturers in higher education and how they moved to emergency remote teaching during the initial university closures due to the COVID-19 pandemic. An online survey was conducted in May–June 2020 which received 257 replies from respondents based in 29 countries. We report on the particular challenges mathematics lecturers perceive there to be around teaching mathematics remotely, as well as any advantages or disadvantages of teaching mathematics online that they report. Over 90% of respondents had little or no prior experience teaching mathematics online, and, initially, 72% found it stressful and 88% thought it time-consuming. 88% felt there was a difference between teaching mathematics in this way compared with other disciplines. Four main types of challenges were associated with emergency remote teaching of mathematics: technical challenges; student challenges; teaching challenges; and the nature of mathematics. Respondents identified flexibility as the main advantage of online teaching, with lack of interaction featuring strongly as a disadvantage. We also consider respondents’ personal circumstances during this time, in terms of working conditions and caring responsibilities and conclude by summarizing the impact they perceive this experience may have upon their future teaching. Forty-six percent% of respondents self-identified as having caring responsibilities, and 61% felt the experience would affect their future teaching.

Comparative Analysis of Mobile Pain Management Applications in Developed versus Developing Countries (Preprint)

2021 ◽  
Author(s):  
Wilson Mupfururirwa ◽  
Victoria Nembaware ◽  
Jack Morrice ◽  
Khuthala Mnika ◽  
Gaston Kuzamunu Mazandu ◽  
...  
Keyword(s):  
Pain Management ◽  
Uniform Distribution ◽  
Mobile Health ◽  
Low Income ◽  
Cochrane Review ◽  
High Income ◽  
Low Income Countries ◽  
App Store ◽  
Significant Difference ◽  
The Impact

BACKGROUND The impact of mobile phones and their applications in healthcare (mobile health) is well established for a range of diseases and cross-cutting complications, such as pain. While numerous mobile health (mHealth) pain interventions have been established, an evaluation of their prevalence, adequacy and distribution remains limited. OBJECTIVE This study aims at reviewing and comparing current pain management mHealth tools in high- versus low-income countries. METHODS A literature and application (app) store search was conducted in May 2021 using combinations of the following keywords: “pain management”, “pain”, “mobile health”, “telemedicine”, and “app”. Literature searches were conducted in PubMed, Scopus, Cochrane Review Library, and Google scholar. App store searches were conducted in Google Play and Apple App Store. Data characteristics descriptive analysis was performed using R software to summarize different datasets and compute p-values (P) for testing the significance of different hypotheses with the significance level set to 0.05. RESULTS The search identified 40 publications (literature search) and 230 mHealth applications (app store search), revealing a non uniform distribution of search categories (χ2= 133.7, P < 0.004) with a ratio approximating 1:6 (OR = 5.730, 95%CI:3.745-8.909, P < 0.004). About 86.7% of these 270 applications (apps) are from high-income countries, showing a statistically significant non uniform distribution of country categories: high- and low-income (χ2= 145.2, P < 0.004) approximating the theoretical distribution of a 7:1 ratio (OR = 6.476, 95%CI:4.180-10.222, P < 0.004). Moreover, there is no significant difference in the proportion of search categories between country categories ( χ2= 0.113, P = 0.737) and the difference in pain app prevalence in high- versus low-income countries is not statistically significant. Finally, we have observed that pain-tracking apps are significantly more prevalent in developed countries in comparison to low-income countries. CONCLUSIONS As expected, pain management app prevalence is higher in high-income countries. However, more research is required to readily comprehend the effectiveness of these apps.

A Decade After the 2009 Global Recession: Macroeconomic Developments

2021 ◽  
pp. 2150011
Author(s):  
Wee Chian Koh ◽  
Shu Yu
Keyword(s):  
Low Income ◽  
Developing Economies ◽  
Emerging Market ◽  
Bank Lending ◽  
Low Income Countries ◽  
Short Term ◽  
Fiscal Stimulus ◽  
Cross Border ◽  
Global Recession ◽  
The Impact

Emerging market and developing economies (EMDEs) weathered the 2009 global recession relatively well. However, the impact of the global recession varied across economies. EMDEs with stronger pre-crisis fundamentals — such as large foreign exchange reserves, sound fiscal positions, and low inflation — suffered milder growth slowdowns, in part due to their greater capacity to engage in monetary and fiscal stimulus. Low-income countries were also resilient, as foreign aid and inflows of remittances remained relatively stable. In contrast, EMDEs that were heavily dependent on short-term capital flows — such as portfolio investment and cross-border bank lending — fared less well, especially those in Europe and Central Asia. A key lesson for EMDEs is the need to strengthen macroeconomic frameworks and create policy space to prepare for future global downturns.

Impact of Social Isolation on Physical Activity and Factors Associated With Sedentary Behavior in Older Adults During the COVID-19 Pandemic

2021 ◽  
pp. 1-5
Author(s):  
Giovana Z. Mazo ◽  
Felipe Fank ◽  
Pedro S. Franco ◽  
Bruna da Silva Vieira Capanema ◽  
Franciele da Silva Pereira
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Sedentary Behavior ◽  
Social Isolation ◽  
Low Income ◽  
Low Income Countries ◽  
Moderate Physical Activity ◽  
Cross Sectional ◽  
Factors Associated ◽  
The Impact

The objective was to analyze the impact of social isolation on moderate physical activity and factors associated with sedentary behavior of older adults during the COVID-19 pandemic. This was a cross-sectional study involving 111 older adults (aged 71.0 ± 6.87 years). The data were collected at two time points: in November 2019 and in June 2020. There was a decline in moderate physical activity when the minutes/week were compared before and during social isolation (p < .001). Sedentary behavior was associated with the condition of living alone. Older adults who lived alone were 3.29 times more likely to spend 4 hr or more in sedentary behavior than those who lived with a partner (95% confidence interval [1.01, 10.74]). Government agencies must establish PA-related health promotion strategies, especially in developing and low-income countries. Therefore, home exercises need to be encouraged to prevent the consequences of this pandemic period.

Bilateral Aid Allocation for International Development: Impact of the Financial Crisis

2018 ◽  
Vol 2018 (4) ◽  
pp. 100-121
Author(s):  
Elena Balter ◽  
Aleksandra Morozkina
Keyword(s):  
Financial Crisis ◽  
International Development ◽  
Low Income ◽  
Development Assistance ◽  
Development Aid ◽  
Low Income Countries ◽  
External Financing ◽  
Bilateral Aid ◽  
The Impact ◽  
Allocation Decisions

This article examines the impact of financial crisis of 2008-2009 on allocation of development aid. Using OECD data on Official Development Assistance (ODA) allocation for international development by key donor countries, authors test three hypotheses: first, general impact of crisis on ODA allocation; second, impact of crisis on three recipient income groups; third, impact of crisis on relative importance of analyzed factors for ODA allocation decisions. The results show that general impact of crisis on ODA volumes was negative, although donors preferred to increase aid to low-income countries. Impact of factors describing economic situation in donor countries (public debt level, government expenditures and donor growth) increased after crisis. Donor countries might make use of these results to increase efficiency of their development assistance strategies, whereas recipient countries may exploit these results in order to attract more external financing for development.

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