ObjectiveTo assess medical and nursing students’ intentions to migrate abroad or practice in rural areas.MethodsWe surveyed 3199 first- and final-year medical and nursing students at 16 premier government institutions in Bangladesh, Ethiopia, India, Kenya, Malawi, Nepal, the United Republic of Tanzania and Zambia. The survey contained questions to identify factors that could predict students’ intentions to migrate. Primary outcomes were the likelihoods of migrating to work abroad or working in rural areas in the country of training within five years post-training. We assessed predictors of migration intentions using multivariable proportional odds models.FindingsAmong respondents, 28% (870/3156) expected to migrate abroad, while only 18% (575/3158) anticipated a rural career. More nursing than medical students desired professions abroad (odds ratio, OR: 1.76; 95% confidence interval, CI: 1.25–2.48). Career desires before matriculation correlated with current intentions for international (OR: 4.49; 95% CI: 3.21–6.29) and rural (OR: 4.84; 95% CI: 3.52–6.66) careers. Time spent in rural areas before matriculation predicted the preference for a rural career (20 versus 0 years: OR: 1.53, 95% CI: 1.19–1.98) and against work abroad (20 versus 0 years: OR: 0.69, 95% CI: 0.50–0.96).ConclusionA significant proportion of students surveyed still intend to work abroad or in cities after training. These intentions could be identified even before matriculation. Admissions standards that account for years spent in rural areas could promote greater graduate retention in the country of training and in rural areas.
In this urban community-based population, we observed that hypertension has significant effect on the residual LTR of stroke among both men and women of middle age, specifically for ischemic stroke.
ObjectivesFear of cancer recurrence (FCR) has not been widely explored in survivors of childhood cancer. Yet, childhood survivors are at risk of experiencing late effects and may be especially vulnerable. The aims of the current study were to conduct a retrospective chart review to determine the prevalence and persistence of FCR among survivors of childhood cancer and to examine factors that may be related to FCR.MethodsSurvivors of childhood cancer (n = 228, mean attained age = 14.5 years [range = 4.7‐21 years]; mean diagnosis age = 4.4 years [range = 0‐16.5 years]; mean time off treatment = 8.7 years [range = 2.8‐19.3 years]) seen in a Long‐Term Survivor Clinic (LTSC) completed questionnaires at each clinic visit detailing their current health. FCR was measured with a single item. Data from questionnaires from 2011 to 2018 were analyzed retrospectively. Descriptive statistics and a random effects model were used to address study aims.ResultsFCR was reported in 43% (n = 98) of survivors at least once across all clinic visits. Among survivors reporting FCR at least once, 66% were diagnosed with cancer under the age of 5, and 64% were 13 years or older at their most recent follow‐up. Twenty‐one percent of survivors (n = 48/224) reported FCR during at least 50% of their visits. Survivors with a higher number of depressive symptoms were more likely to report FCR (OR = 1.66, P = .03).ConclusionsFCR is prevalent among survivors of childhood cancer and is related to other health concerns. Research is needed to understand who is at risk and how to.
Findings of this study provide an example of how a social networking platform can enable patients and their families to share information and to encourage peer-based support for managing dialysis-related experiences.
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