BackgroundMigration of healthcare workers is receiving increased attention worldwide. In Europe, the creation of a border-free labor market and its expansion with the EU enlargements of 2004, 2007, and 2013 endowed health professionals with the right to provide services and to relocate to another EU Member State. For the Romanian doctors, the EU-wide recognition of the medical degree obtained in Romania has created new opportunities, while inadequate working conditions and relatively low salaries pushed many of them to search for employment abroad. As there is considerable uncertainty about the magnitude of the Romanian physicians’ exodus, we performed a survey to assess the emigration intention of future Romanian doctors.MethodsThe study was conducted over three consecutive years: 2013, 2014, and 2015 at the University of Medicine and Pharmacy “Iuliu Hatieganu” Cluj-Napoca, Romania. The self-administrated questionnaire included 19 questions regarding students’ emigration intentions.ResultsAll the 957 license-degree students participated in the study. In this study, 84.7% of subjects planned on seeking employment abroad after graduation. A large number of the students who have participated in the study have already started preparing for emigration, 21.7% of those who wished to migrate had already performed at least one Erasmus mobility in their country of choice, 44.5% have been enrolled in a language course, and 42.7% have searched for jobs on the Internet.ConclusionsThe majority of Romanian medical students considering migration see it as a serious alternative to the continuation of their professional training started in Romania. The findings of this study are upsetting and can impact both policy crafting and future research. Structural reforms in the healthcare provisions are needed in order to facilitate the retention of medical personnel. Romanian policy makers need to devise a comprehensive national health workforce plan to deal with physician migration.Electronic supplementary materialThe online version of this article (doi:10.1186/s12960-017-0181-8) contains supplementary material, which is available to authorized users.

Background: Wide geographical variations in depression and anxiety rates related to the ethical climate have been reported during the COVID-19 pandemic in intensive care units (ICUs). The objective was to investigate whether moral distress is associated and has predictive values for depression, anxiety, and intention to resign. Methods: 79 consenting ICU nurses completed MMD-HP and PHQ-4 scales in this cross-sectional study between October 2020–February 2021, after ethical approval. The association between MMD-HP and PHQ-4, and the predictive value of MMD-HP for anxiety, depression, and an intention to leave were analyzed (linear regression and receiver operating characteristics curve analysis). Results: From MMD-HP items, system related factors had highest scores (Kruskal–Wallis test, p < 0.0001). MMD-HP and PHQ-4 were weakly correlated (r = 0.41 [0.21–0.58]). MMD-HP and its system-related factors discriminate between nurses with and without depression or anxiety, while system-related factors differentiate those intending to resign (p < 0.05). The MMD-HP score had 50 [37.54–62.46] sensitivity with 80.95 [60–92.33] specificity to predict the intention to leave, and 76.12 [64.67–84.73] sensitivity with 58.33 [31.95–80.67] specificity to detect anxiety or depression symptoms. Conclusions: During the COVID-19 pandemic, system-associated factors seem to be the most important root factors inducing moral distress. Moral distress is associated with negative psychological outcomes.

Alcohol consumption is a major public health problem facing universities. The objectives of the present study were to investigate alcohol consumption and the behaviors associated with it among Romanian university medical students, with particular reference to sex differences, behavioral consequences, and lifestyle patterns. We performed a cross-sectional study on 722 medical students (60.4% females; 39.6% males); the participants filled out a validated questionnaire containing the following items co-occurring with alcohol consumption: smoking, illicit drug use, energy drink consumption, and other behavioral drinking consequences. Physical activity was estimated using the IPAQ questionnaire. We statistically analyzed the interrelation between alcohol consumption and target factors. The present study showed a high percentage of at-risk drinkers among male (15.0%) and female medical students (14.9%) in the studied group. Male students reported higher illicit drug use and physical activity than female students, but the at-risk female drinkers’ group consumed more drugs than the low-risk female drinkers. Both male and female drinkers engaged in other risky behaviors correlated with drinking (e.g., smoking, low academic performance, and driving a car after drinking). Public health policies, strategies, and interventions should be initiated to reduce alcohol consumption and associated behaviors in medical students.

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This narrative review presents the findings from intervention studies on the effects of sleep deprivation on eating habits, metabolic rate, and the hormones regulating metabolism, and discusses their relevance to weight loss efforts. Disturbed sleeping patterns lead to increased energy intake, partly from excessive snacking, mainly on foods high in fat and carbohydrates. The studies focused mainly on the effects of sleep duration, but also of sleep quality, on dietary intake during weight loss trials, and on weight loss maintenance. It is important to explore sleep routines that could enhance the efforts of obese and overweight people to lose weight, maintain their weight loss, and improve their overall health.