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Aim: This study explores the relationship between cultural intelligence and attitudes towards the intention to migrate among nursing and midwifery students., Methods: Using a correlational design, data were collected from 804 students through the Student Descriptive Form, The Attitude Scale for Brain Drain in Nursing Students and the Cultural Intelligence Scale. The analysis was conducted using IBM SPSS Statistics and AMOS, employing structural equation modelling and analysis of variance., Results: The majority of participants were female (84.8%) and Turkish citizens (89.1%). The findings showed that both cultural intelligence levels and attitudes towards brain drain were above average. A positive correlation was identified between cultural intelligence and attitudes towards the intention to migrate., Conclusion: Enhancing cultural intelligence through intercultural education, overseas experiences and multilingual proficiency is essential. The study underscores the critical need for policy reforms aimed at improving working conditions in low-income countries and addressing the challenges posed by the intention to migrate., Implications for the Profession And/or Patient Care: Incorporating cultural intelligence training into nursing and midwifery curricula is essential for preparing students to work in multicultural healthcare settings. Educational reforms are needed to equip future healthcare professionals with the skills required for diverse patient care. Additionally, policy interventions aimed at improving working conditions and offering better incentives in low-income regions are critical to mitigating brain drain by addressing the root causes of migration among skilled healthcare workers., Impact: The study underscores the role of cultural intelligence in shaping the migration intentions of nursing and midwifery students. It highlights how higher levels of cultural intelligence correlate with more positive attitudes towards migration, suggesting that culturally adept healthcare professionals may be more inclined to seek international opportunities., Reporting Method: This study adhered to the STROBE guidelines for reporting observational studies., Patient or Public Contribution: No patient or public contribution., (© 2024 The Author(s). Journal of Advanced Nursing published by John Wiley & Sons Ltd.)

Background: The escalating global nursing shortage, fueled by the migration of healthcare professionals from resource-constrained nations to those with greater economic prosperity, presents a formidable challenge to healthcare systems worldwide. Nepal, grappling with a significant brain drain of its nursing workforce, serves as a poignant illustration of this phenomenon. The departure of skilled nurses not only jeopardizes the country's healthcare quality but also underscores the urgent need to address the underlying educational and systemic deficiencies contributing to this trend., Aim: The study aims to explore the early formation of migration intentions among undergraduate nursing students in Nepal and identify key factors influencing their decision to pursue opportunities abroad., Design: A descriptive qualitative research design., Settings: The study was conducted at two urban nursing colleges in Nepal., Participants: Seventeen nursing students in their final year of undergraduate studies., Methods: Data were collected via semi-structured interviews and analyzed using thematic analysis., Results: The thematic analysis unearthed four principal themes: (1) Aspirations Beyond Borders: Structural and Systemic Catalysts; (2) Navigating Personal Ambitions; (3) Socio-Political Currents Influencing Career Pathways; (4) Economic Incentives and Realities: Weighing the Prospects., Conclusion: The study's findings highlight the need for systemic changes to retain nursing professionals in Nepal. There is a significant gap between policy initiatives aimed at improving the status of nursing and the persistent challenges nursing students face. This gap fosters disillusionment and drives migration intentions. The research underscores the urgent need to address systemic deficiencies, empower nurses, and ensure equitable recognition. These actions are crucial to cultivating a sustainable nursing workforce dedicated to advancing health equity., Competing Interests: Conflict of interest The authors declare no conflict of interest., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: Brain drain is the migration of trained professionals and scientists from low and middle-income countries to live and work in better conditions in high-income countries. The brain drain and brain drain intentions of qualified nurses have become a global burning issue for healthcare sustainability in low and middle-income countries. In Türkiye, the idea of brain drain has increased among nurses and nursing students. Realizing the factors affecting brain drain intention and how to manage them are crucial for proper planning, health equity, and positive patient outcomes in health care., Objectives: To verify a hypothesized model examining the factors contributing to brain drain intentions among nursing students., Design: A cross-sectional study., Settings and Participants: Data were collected from 528 undergraduate nursing students from a health sciences faculty with an online questionnaire sent through a link between December 16, 2021, and February 28, 2022., Methods: A hypothesized model was tested using path analysis., Results: Income level (middle) and income level (low) were indirectly and inversely related to attitudes towards brain drain through the mediating role of satisfaction with life. Sense of belonging to the occupation significantly mediated the indirect effect of concern regarding working conditions (yes) on attitudes towards brain drain. The direct effect of satisfaction with life on attitudes towards brain drain was significant. Sense of belonging to the occupation was indirectly and positively related to attitudes towards brain drain through the mediating role of satisfaction with life. In contrast, the direct effect of the sense of belonging to the occupation on attitudes towards brain drain was not statistically significant., Conclusion: Faculties and governments should consider that brain drain intention is a good predictor of future brain drain. To reduce nursing students' brain drain intentions, policy-driven changes in nurses' working conditions and psychological support for satisfaction with life and a sense of belonging to the occupation in their own country are required., Competing Interests: Declaration of competing interest None., (Copyright © 2024. Published by Elsevier Ltd.)

Background: American pediatric anesthesiologists have a long history of international volunteerism. However, the US healthcare system also benefits from the contributions of a large number of physicians who come from other nations to work within its borders. Despite this fact, little is known about the contribution of international medical graduates (IMG) to the pediatric anesthesiology subspecialty., Aims: To characterize the contribution of IMG to the field of pediatric anesthesiology in the United States, and to elucidate the geographic and demographic distribution of their national origins so as to understand the movement of skilled personnel between countries., Methods: Online physician directories of American children's hospitals were searched, and anesthesiologists were recorded for their national origin of medical education. International graduates were reported as a percentage of the pediatric anesthesiology workforce. Those attending medical colleges catering to American students ("offshore" medical schools) were analyzed separately from other IMGs. The cohort of non-offshore IMGs were analyzed for national and continental origins, and by national level of economic development., Results: Of 1979 anesthesiologists analyzed, 397 attended medical school outside the United States, with 58 being from offshore schools. The remaining 338 represented 17.1% of the total pediatric anesthesiology workforce. They came from 58 countries on six continents. Of those, 65.1% attended medical school in low- and middle-income countries., Conclusions: International medical graduates, disproportionately from low- and middle-income countries, compose a large proportion of the US Pediatric Anesthesiology workforce. While these clinicians play a vital role in providing care for American children, the potential impacts of skilled physician loss on their nations of origin must also be considered., (© 2024 John Wiley & Sons Ltd.)

Background: Brain drain is an issue of concern in developing countries. Many factors are involved in this issue, and their identification can be a good guide for decision-makers at different management levels. Therefore, the present study was carried out to identify the factors affecting brain drain and solutions to reduce it in Iran's health system., Methods: The data for this qualitative study was collected in 2023 through 15 semi-structured interviews with Iranian health experts and emigrant elites. Interviews were collected both face-to-face and virtually (on Skype and Google Meet) and analyzed using the thematic content analysis method., Results: Data analysis of the factors affecting brain drain in Iran's health system yielded seven main categories and 45 subcategories. The main categories were "individual factors," "economic factors," "social and cultural factors," "organizational and administrative factors," "political factors," "attraction factors for destination countries," and "attraction factors of destination countries for elites." Also, the solutions were divided into four categories of "economic," "social," "organizational and scientific," and "political" factors and 19 subcategories., Conclusion: Due to the increase in brain drain in recent years, it is necessary to make a serious decision in dealing with this issue. Solutions such as creating stable economic conditions, creating an atmosphere of hope, increasing respect and dignity for elite students by politicians, using the elites in macro-decisions, and creating the job rank for honorary professors can lead to reducing brain drain and decreasing the costs of the health system., (© 2024 The Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.)

Background: The brain drain of Ghanaian radiographers is a growing concern for the Ghana Health Service and patient care in the country. Unfortunately, this is affecting the quality of radiology services in Ghana. This study investigated the determinants of radiographers' brain drain from Ghana and identified potential mitigating factors., Methods: A cross-sectional survey was conducted using a semi-structured questionnaire which was administered online to Ghanaian radiographers. The questionnaire gathered data on push and pull factors that influenced brain drain. Statistical analysis was performed using SPSS version 29., Results: A total of 128 radiographers participated in the study. The findings indicated that 92.2 % of Ghanaian radiographers expressed intentions to work abroad. The estimated means and standard deviations on a five-point Likert Scale demonstrated that poor salary (4.47 ± 0.1) and poor working conditions (4.17 ± 1.1) were the main push factors, while improved living conditions (4.62 ± 0.9) and better health infrastructure (4.55 ± 0.9) were the influential pull/attractive factors. Although there are variations in participants' demographics, comparative analyses of push and pull factors indicated that respondents did not significantly differ in their migration decisions intentions (p < 0.05). To mitigate brain drain, respondents emphasised the need for better salaries (97.7 %) and comprehensive health insurance for radiographers and their families (92.2 %) among other factors., Conclusion: This study highlights the multifaceted factors that drive Ghanaian radiographers abroad and their consequences on the healthcare system. A comprehensive strategy encompassing financial incentives, career development, improved working conditions, and personal satisfaction was identified as a mitigating approach to addressing these challenges. Implementation of these recommendations by policymakers is necessary to create an environment that retains and empowers radiographers and ultimately enhances patient care and healthcare advancement in Ghana., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors.)

Objective: The purpose of this study was to investigate the emigration intentions of South African senior chiropractic students upon graduation, emphasizing motivations and considerations guiding migration decisions., Methods: A cross-sectional, quantitative, and exploratory approach was employed, utilizing an anonymous and adapted online survey administered to chiropractic students at 2 South African institutions ( n = 177) between March 15 and May 19, 2021. Data were analyzed using frequencies, descriptions, and cross-tabulations to identify trends and interrelationships related to students' intentions to emigrate postqualification., Results: Findings indicate that 75.5% of South African chiropractic senior students intend to emigrate. Motivations for emigration include improved quality of life and seeking of opportunities. Economic instability in South Africa (SA) (82.7%) and concern for the National Health Insurance implementation (57.7%) serve as a significant push factor, whereas economic stability abroad (85.7%) emerged as a key pull factor. Preferred emigration destinations are primarily developed countries with established chiropractic communities., Conclusion: High emigration intentions among students were driven by diverse push factors in SA, including economic decline, socio-political climates, and safety concerns, contrasting with pull factors abroad, such as better opportunities, living conditions, and economic stability. Concerns regarding healthcare reforms, particularly the National Health Insurance, are also highlighted. Destinations in order of preference such as the United Kingdom, Canada, and Australia offer valuable insights for policy interventions. Understanding these dynamics is crucial for developing effective retention strategies and addressing socio-economic challenges., (© 2024 by National University of Health Sciences.)

Background: Peer mentorship can be a potential tool to reduce the disparities in health research capacity between high- and low- and middle-income countries. This case study describes the potential of peer mentorship to tackle two critical issues: bridging health research capacity of doctors from low- and middle-income countries (LMICs) and the transformation of human resource for health brain drain into "brain gain"., Case Presentation: In 2021, a virtual peer mentorship group was established by 16 alumni of the University of Benin College of Medical Sciences' 2008 graduating class, residing across three continents. This program aimed to facilitate research collaboration and skill development among colleagues with diverse research experience levels, fostering a supportive environment for career development in research. The group relied heavily on digital technology to carry out its activities due to the different geographical locations of the group members. Led by experienced peer leaders, the group fostered a collaborative learning environment where members leveraged each other's expertise. Within 18 months, we published two research papers in high-impact peer-reviewed global health journals, launched a mixed-methods research study, and conducted training sessions on research design and implementation. Findings from our work were presented at conferences and workshops. However, logistical hurdles, competing priorities, structural constraints, and uneven participation presented challenges., Conclusion: The peer mentorship collaboration has achieved some successes so far, and this model can be emulated by other cohorts of medical professionals across LMICs. Despite the group's success at a micro- or individual level, there remain significant structural barriers to research capacity building in LMICs that can only be addressed at the meso- and macro-levels by institutions and government, respectively. A systems-level approach is required to develop and support research capacity building and foster global research collaboration and effectively turn brain drain into brain gain., (© 2024. The Author(s).)

As an Argentine scientist, the defunding of CONICET and INTA feels like a blow to progress and our future. Despite free education, these cuts force talented researchers to seek opportunities abroad. Argentina's history of scientific achievement, from Nobel Prizes to COVID-19 vaccines, is at risk. Defunding science weakens our ability to solve problems and compete globally., Competing Interests: The author declares no conflict of interest.

Background  Pakistan has a significant proportion of medical graduates who intend to leave the country for better opportunities abroad, leading to a brain drain. However, the push and pull factors within neurosurgery remain unexplored, emphasizing the need for evaluation to enact policy changes. Materials and Methods  We conducted a nationwide survey across 22 College of Physicians and Surgeons of Pakistan accredited neurosurgery training centers in all provinces of Pakistan. SPSS version 26 and STATA 15 were used for data analysis. Results  We collected responses from 120 neurosurgery trainees across Pakistan. Trainees were categorized into two groups: those intending to leave (64%) and those intending to stay (36%) in Pakistan. A significant association was observed between the availability of fellowship training in the residents' hospital and the decision to leave or remain in Pakistan ( p  = 0.034). About 67.5% of our respondents did not have any publication, and among the intention to leave group, a greater percentage had academic involvement, when compared with the stay group. A significant association ( p  = 0.012) was also observed between the decision to leave or remain in Pakistan and the number of publications in nonindexed journals. Conclusion  There remains a need for improvement in the standard of training provided by neurosurgery programs across the country. Our study found that disparities in research and academic exposure, as well as the lack of fellowship opportunities, may serve as stimuli for residents to leave Pakistan., Competing Interests: Conflict of Interest None., (Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. ( https://creativecommons.org/licenses/by-nc-nd/4.0/ ).)

The purpose of this study is to explore the impact of GDP per capita income (GDPPCI), unemployment, higher education (HE), and economic growth (EG) on migration in Sri Lanka. Numerous global and local studies have explored the influence of macroeconomic and socioeconomic factors on migration. In the Sri Lankan context, fewer studies have probed the impact of GDPPCI, unemployment, HE, and EG on migration, particularly concerning brain drain and domestic labour market pressure. An applied research methodology was adopted, utilising annual data from 1986 to 2022. The statistical data were sourced from reports by the Sri Lanka Bureau of Foreign Employment (SLBFE), the Central Bank of Sri Lanka (CBSL), Labor Force Survey Data from the Department of Census and Statistics (LFSDCS), and University Grants Commissions (UGC). This study utilised the Vector Error Correlation model (VECM), Vector Auto-regression (VAR), and Granger Causality test through STATA. The empirical findings of the VAR model highlighted that GDPPCI and EG negatively impact migration, whereas unemployment and HE positively affect migration. The study's implications demonstrated that GDPPCI, unemployment, HE, and EG were the primary factors influencing the country's migration decisions. These findings will hopefully inform and guide the Sri Lankan government and policymakers for more effective decision-making., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Kaluarachchi, Jayathilaka. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Brain drain refers to the emigration of scientists and other educated professionals from a low- or middle-income country to a high-income country for work. In recent years, this trend has increased, particularly in the health care arena. Prior studies among nurses and nursing students indicate that migration mainly occurs from low- and lower middle-income countries to high-income countries. This study aimed to explore the attitudes of Turkish nurses, nurse academics, and nursing students toward brain drain and the factors associated with these attitudes., Methods: The study used a mixed-methods research design. The quantitative part of the study was conducted with 1,018 participants. The qualitative part was conducted with 26 participants from the larger sample who volunteered for focus group interviews. Data were collected from June through August 2022 using an online survey, the Attitude Scale for Brain Drain, and a semistructured interview guide., Results: Of all participants, 84.3% indicated that they wanted to work and live abroad. Nearly 95% stated that there was a risk of brain drain in the nursing profession, with economic factors given as the most significant reason. As age and years of professional experience increased, brain drain tendency decreased. Nurses and nursing students had higher brain drain tendencies than nurse academics. In focus group interviews, participants reported concern that the brain drain might lead to losses in the qualified nursing workforce and increase the workload for the remaining nurses in the migrant-sending country, while cultural adaptation issues can be difficult for nurses in the migrant-receiving country., Conclusions: Brain drain in the nursing profession continues to be a current, crucial problem. This study showed that among Turkish nurses, nursing students, and nurse academics, the desire to work abroad was quite high, and all three groups had high brain drain tendency scores. Brain drain has serious consequences for both migrant-receiving and migrant-sending countries. These findings can help inform the development of initiatives aimed at preventing or mitigating nursing brain drain., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Background: Nigeria's shortage of psychiatrists is exacerbated due to health worker migration., Aim: This study explores migration experiences and tendencies among early-career psychiatrists in Nigeria., Methods: We conducted a cross-sectional survey covering Nigeria's six geopolitical zones, using a 61-item online questionnaire assessing short-term mobility, long-term migration experiences and migration attitudes. Data was analysed using IBM SPSS version 29., Results: Of 228 early-career psychiatrists surveyed, 9.7% had short-term mobility and 8.0% had long-term migration experiences. However, 85.8% had 'ever' considered migration, 69.2% were planning to leave 'now', and 52.9% had taken 'practical migration steps'. Over half (52.7%) said they would be working abroad in 5 years, with 25.2% indicating they would migrate within a year. The top reasons to leave were financial and academic, while personal and cultural factors were the key reasons to stay. Income dissatisfaction (OR = 2.27, 95%, CI = 1.05-4.88) predicted planning to leave 'now', while being in a relationship (OR = 3.46, 95%CI = 1.06-11.30) predicted taking 'practical migration steps'. Attractive job features were good welfare (85.4%) and high salaries (80.3%). Improvements in finances (90.8%) and work conditions (86.8%) were requested., Conclusions: Systemic changes to address psychiatrists' migration from Nigeria are needed., Competing Interests: The authors declare none., (© The Author(s) 2024.)

India being the second largest nurse exporter to the Organisation for Economic Cooperation and Development (OECD) countries, currently faces a shortage of 2.4 million nurses. The problem of nurse shortage has been aggravated by the COVID pandemic. The young age at which the Indian nurses migrate, suggests that the decision to work overseas is made probably at the time of pursuing the studies or probably one pursues nursing because it opens the opportunity for working overseas. The objective of this study was to assess the intensions of nursing students to pursue overseas career on completion of their studies. The study used a cross-sectional survey design to collect data from 1408 nursing students from across four states of India namely, Karnataka, Kerala, Maharashtra and Rajasthan using a google survey form. The major finding of the study was that 54% of the respondents intended to migrate overseas. Better career advancement opportunities, better working conditions, higher pay, better lifestyle, were the reasons cited by those who had an intension to migrate. Establishing norms for nurse-patient ratios, and scope of work along with pay scales for nurses with various qualifications and experience could be the most strategic moves that the policy makers can consider to control brain drain in nursing and control nurse migration.

No abstract available.

Background: The geo-strategic position of Pakistan on the world map is incredibly important and idyllic as the country is considered the gateway to central Asia. Pakistan has faced political instability for the last three decades, causing a brain drain and adversely affecting socioeconomic growth. This study aims to investigate the impact of an unstable environment on the brain drain of highly skilled professionals, healthcare workers, researchers, and research productivity in Pakistan from January 2000 to December 2022., Material and Methods: The data were recorded from the World Bank, the Higher Education Commission (HEC) Pakistan, the Pakistan Medical and Dental Council (PMDC), the Bureau of Emigration and Overseas Employment (BEOS), Pakistan, Academic Ranking of World Universities (ARWU), and Web of Science Clarivate Analytics. Initially, 32 documents were selected in this study, and finally, eight fact sheets, official government websites, and international organizations were included., Results: The result revealed that due to political instability, in 2022 about 832,339 highly qualified and accomplished experts headed abroad, among them 17976 (2.15%) were highly qualified and 20865 (2.50%) were highly competent professionals. These include accountants 7197 (0.86%), engineers 6,093 (0.73%), agricultural experts 3,110 (0.37%), doctors 2,464 (0.29%), computer experts 2,147 (0.25%), nurses and paramedics 1768 (0.21%), technicians 23347 (2.80%), electricians 20322 (2.44%), and schools and university faculty 1004 (0.12%). Pakistan has a total of 380 Higher Education Commission-indexed academic journals, among them 11 (2.89%) academic journals were indexed in the Web of Science and 23 journals were placed in the Web of Science emerging indexing. Among these journals, only one journal surpassed the impact factor of more than 2.0. The quartile ranking of Pakistani journals is 01 journal in Q2; 02 in Q3; and the remaining 08 journals in Q4. From August 1947 to December 2022, Pakistan produced a total of 259249 research articles, and from January 2000 to December 2022, the number of articles published was 248457 (95.83%). Since the last 22 years, the trend of research publications was continuously increased; however, the rising trend decreased in 2022 with a declined rate of 1263 (3.42%)., Conclusion: The unstable sociopolitical environment in Pakistan caused a brain drain of highly qualified and skilled professionals and impaired the global standing of universities, academic journals, and research productivity in Pakistan. Pakistan must resolve the instability and establish sustainable policies to minimize the brain drain of highly qualified and skilled experts and convalesce their academic institutes and their research productivity for the development of the nation., Competing Interests: There are no conflicts of interest., (Copyright: © 2023 Saudi Journal of Anesthesia.)

This study aimed to determine the correlation between cultural competence, xenophobia, and attitudes to brain drain in nursing students. Individuals with high levels of intercultural competence have more successful social and emotional interactions with people from various cultural backgrounds. A cross-sectional and correlational design was used. This study was conducted on 473 nursing students from two different provinces neighboring the Syrian border between October 28th and December 28th, 2021. An information form and nurse cultural competence, xenophobia, and attitude scales for brain drain were used to collect data. A negative nonsignificant correlation between cultural competence and xenophobia and a positive nonsignificant correlation between cultural competence and attitude towards brain drain were found. The students had high levels of cultural competence and positive attitudes towards brain drain, and a moderate level of xenophobia. Socio-demographic characteristics affected cultural competence, xenophobia, and attitudes towards brain drain., Competing Interests: Declaration of competing interest There is no conflict of interest. No funding or grant was obtained for the study., (Copyright © 2023. Published by Elsevier Ltd.)

Background and Objective:  Physician brain drain is of mounting concern worldwide, especially in lower-middle-income countries like Pakistan, where the healthcare sector is overworked, and the exodus of talented health professionals further deteriorates the country's health statistics. Our study's objective was to investigate the career and migration intentions of medical undergraduates and graduates in Peshawar., Design, Settings, and Participants:  A cross-sectional self-structured questionnaire was distributed among 305 fourth- and final-year medical students and demonstrators at Khyber Medical College and graduates working as house officers, medical officers, and training medical officers at its conjugate hospital, Khyber Teaching Hospital, Peshawar. The questionnaire consisted of four sections designed to collect demographic details, determine participants' career and migration intentions, evaluate reasons for and against migration, and assess their reasons for establishing these intentions. The data were analyzed using IBM Corp. Released 2011. IBM SPSS Statistics for Windows, Version 20.0. Armonk, NY: IBM Corp., Results:  67.5% of our respondents intended to migrate abroad, most of whom were men. The UK emerged as the top destination for those wishing to relocate. The most common reasons participants wanted to migrate were better quality of training and research, followed by a gain in professional skills over others, and lastly, better remuneration abroad. Most of those who wished to stay back chose family ties, a desire to serve the nation, and fixing flaws in the country's healthcare system as the most influential factors behind their decision to stay back., Conclusion:  The threat of brain drain is far-reaching and profound, putting Pakistan's people's health at risk. Policymakers must act to address the country's healthcare workers' concerns., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Tariq et al.)

Background and Purpose: Brain drain, also known as "human capital flight," refers to the migration of employees such as nurses from developing countries to wealthier countries for better living conditions. There is a dearth of literature internationally about the determinants and factors influencing nurses' brain drain using a standardized instrument. This study aimed to assess the psychometric properties of the brain drain questionnaire (BDQ). Methods: This methodological study was conducted with 325 Egyptian nurses who were recruited to answer the BDQ. The psychometric properties were examined. Results: The final BDQ contained 59 items. The Cronbach's α, content validity index, and intraclass correlation coefficient were 0.979, 0.88, and 0.778, respectively. Confirmatory factor analysis and convergent validity also validated the BDQ. Conclusion: The BDQ has acceptable reliability and validity among nurses and the potential to be clinically useful. Future cross-validation research across sectors and nations is recommended to optimize its utility., (© 2023 Springer Publishing Company, LLC.)

With the increased rate of the Turkish medical brain drain (MDB) in recent years, there is a need for more comprehensive studies to elucidate its vague migratory factors. The aim of this paper is to try to narrow that gap by analyzing present impacts of the MDB in Turkey and to evaluate if these aspects were driven by professional ethical values, and if so, what ethical principles they were based on. In-depth interviews were conducted with 19 doctors from various backgrounds, followed by a thematic analysis. The MDB in Turkey demonstrated a multifactorial structure, with prominent push factors that are intertwined at macro-meso-micro levels. The effort to maintain the principles of beneficence, non-maleficence, and protecting professional autonomy were the most important in the context of professional ethics. Only deep-rooted regulations might ensure the prevention of the MDB in Turkey and the prospect of doctors returning in the future. Conclusively, the recent criticisms the MDB has been garnering may inspire improvements in deteriorating human and health rights in Turkey., (© 2023 The Authors. Developing World Bioethics published by John Wiley & Sons Ltd.)

The healthcare system in Nepal faces challenges despite the establishment of numerous medical colleges and an increasing number of doctors. The distribution of medical colleges is disproportionately concentrated in urban areas, leaving rural populations without quality health care. The mental well-being of physicians is a growing concern, with studies indicating high levels of burnout, stress, and depression among healthcare workers, worsened by the Coronavirus Disease 2019 (COVID-19) pandemic. Rising suicide rates among medical professionals highlight the severity of burnout and depression in the healthcare sector. Factors contributing to this crisis include inadequate recruitment in government hospitals, a shortage of healthcare professionals, and inefficiencies in resource distribution. Attacks on physicians have become alarmingly frequent, necessitating comprehensive studies to understand the challenges faced by different specialties and the impact of rural versus urban settings. To address these issues, prompt filling of vacant positions in government hospitals and prioritizing physicians' mental health is crucial. The government should offer competitive salaries, effective management, and supportive working environments to combat the brain drain. Initiatives inspiring professionals to stay in Nepal, along with maintaining the National Health Insurance Program and controlling healthcare privatization, are necessary. Resilience training, professional programs, and improved infrastructure in government medical colleges are vital. This crisis demands global attention and a national study to evaluate burnout, depression, and suicide among healthcare professionals. By addressing these challenges and supporting the well-being of healthcare workers, Nepal can work toward a sustainable healthcare system that provides quality care for all., (© The Author(s) 2023. Published by Oxford University Press on behalf of International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Smartphones have become an indispensable part of everyday life. Given the current debate about the use of smartphones in classrooms and schools, it seems appropriate to examine their effects on aspects of cognitive performance in more detail. Ward and colleagues not only demonstrated the negative effect of smartphones on cognitive performance but also showed that the mere presence of these devices can have this effect-this is known as the Brain Drain effect. In the present article, a meta-analytic approach was adopted in order to verify these findings. Here we show a significant overall negative effect of smartphone use and presence. In a database search we identified 22 studies with a total of 43 relevant effects that could be assigned to the categories "memory", "attention", and "general cognitive performance". A subgroup analysis suggests that not all cognitive domains are equally affected by the negative effect of smartphones. The heterogeneity of the effects reinforces this finding. The nationality of the test subjects or the origin of the studies was identified as a further key variable. Our findings also indicate that the distracting effect of smartphones varies on the area studies and further research is necessary. In view of the present research results, it seems important that people in general, and especially children and adolescents in schools and classrooms, learn how to deal with the distracting potential of smartphones.

This paper explores the emerging field of neuroscience in Africa, considering the unique genetic diversity, socio-cultural determinants, and health inequalities in the continent. It presents numerous brain research initiatives, such as ABDRN, AMARI, APCDR, and H3Africa, aimed at understanding genetic and environmental factors influencing brain disorders in Africa. Despite numerous challenges like the brain drain phenomenon, inadequate infrastructure, and scarce research expertise, significant progress has been achieved. The paper proposes solutions, including international collaboration, capacity-building efforts, and policies to promote neuroscience research, to enhance the understanding of brain function and address brain-related health issues within the African context., Competing Interests: The authors have no conflict of interest to report., (© 2023 – IOS Press. All rights reserved.)

Purpose: A recent estimate indicates that Nigeria has about 70 clinical oncologists (COs) providing care for 124,815 patients with cancer and its 213 million total population. This staggering deficit is likely to worsen as about 90% of Nigerian physicians are eager to leave the country for perceived greener pastures in the United States, the United Kingdom, Canada, etc. Previous studies have examined general physician migration abroad; however, the CO workforce in Nigeria has been barely considered in the workforce literature. This study examined the push and pull factors to stay or leave the CO workforce and Nigeria., Methods: Using a correlational design, 64 COs completed turnover intention (TI), workload, and satisfaction measures. Multiple linear regression was used for the data analysis., Results: The results show that CO workload (number of outpatients attended to; r = 0.30, P < .01) and satisfaction with the delivery of CO care ( r = 0.23, P < .05) were significantly related to TI. The number of outpatients seen was also positively linked to TI. Hence, the more outpatients a CO sees, the higher the intention to leave. The United States (31%), the United Kingdom (30%), and Canada (10%) were the top countries of destinations for Nigerian COs., Conclusion: Higher CO workload is a push factor propelling the intention to leave CO practice and relocate to other countries. Nigeria's new National Cancer Control Plan and the Federal Ministry of Health need to explore innovative approaches to attract and retain the CO workforce, which would lead to improvement in cancer survival and outcomes. Increasing the number of CO programs and positions available, improving work conditions, and introducing work benefits may mitigate the shrinking CO workforce in Nigeria.

Since the creation of Pakistan in August 1947, political instability has been a persistent issue in the country, causing a migration of highly qualified, skilled people, and healthcare professionals. From 1971 to 2022 the total number of highly qualified and skilled people including healthcare professionals who migrated from the country is 60,19,888. Among them, 251677 (4.18%), were highly qualified, 455097 (7.55%) were highly skilled, and 5313114 (88.27%) were skilled professionals. Moreover, 50110 (0.83%) were healthcare professionals including doctors 31418 (62.69%), nurses 12853 (25.64%), and pharmacists 5839 (11.65%). The unsustainable political environment, lack of advanced technology-based institutes, poor healthcare infrastructure, low job opportunities and salary benefits in Pakistan caused the brain drain of highly qualified people including healthcare professionals. It adversely affected the academic institutes, the healthcare system, socio-economic growth, research productivity, and the development of the nation. The government of Pakistan must establish sustainable policies to minimize the brain drain of highly qualified people, and healthcare professionals, and recuperate the prosperity of their academic institutes and healthcare system for better healthcare services, and the advancement and sustainable development of the nation., (Copyright: © Pakistan Journal of Medical Sciences.)

Background: The emigration of physicians from low- and middle-income countries (LMICs) to high-income countries (HICs), colloquially referred to as the "brain drain", has been a topic of discussion in global health spheres for years. With the call to decolonize global health in mind, and considering that West Africa, as a region, is a main source of physicians emigrating to HICs, this rapid review aims to synthesize the reasons for, and implications of, the brain drain, as well as recommendations to mitigate physician emigration from West African countries to HICs., Methods: A literature search was conducted on PubMed, EMBASE and The Cochrane Library. Main inclusion criteria were the inclusion of West African trained physicians' perspectives, the reasons and implications of physician emigration, and recommendations for management. Data on the study design, reasons for the brain drain, implications of brain drain, and proposed solutions to manage physician emigration were extracted using a structured template. The Hawker Tool was used as a risk of bias assessment tool to evaluate the included articles., Results: A total of 17 articles were included in the final review. Reasons for physician emigration include poor working conditions and remuneration, limited career opportunities, low standards of living, and sociopolitical unrest. Implications of physician emigration include exacerbation of low physician to population ratios, and weakened healthcare systems. Recommendations include development of international policies that limit HICs' recruitment from LMICs, avenues for HICs to compensate LMICs, collaborations investing in mutual medical education, and incorporation of virtual or short-term consultation services for physicians working in HICs to provide care for patients in LMICs., Conclusions: The medical brain drain is a global health equity issue requiring the collaboration of LMICs and HICs in implementing possible solutions. Future studies should examine policies and innovative methods to involve both HICs and LMICs to manage the brain drain., (© 2023. The Author(s).)

Aim: The study aimed to determine the emigration intentions of specialist nurses (SNs) and ascertain the influencing factors, implications and mitigating factors in Ghana., Design: A cross-sectional study., Methods: The sample was composed of 225 participants conveniently selected from a tertiary facility in Ghana. A turnover intention scale and the researchers' developed questionnaire were used to collect the data between June 1 and September 30, 2021. Data were analysed through descriptive statistics and linear regression., Results: The composite mean score for specialist nurses' intention to migrate was high (mean = 3.43); and the push factors accounted for the intentions explaining 48.6% of the variation (R 2  = 0.486, F (5, 219)  = 38.46, p < 0.001). The associated challenges of specialist nurses' emigration are increased cost of training new specialist nurses, poor quality of specialist nursing care, burnout syndrome among staff and poor patient health outcomes., (© 2023 The Authors. Nursing Open published by John Wiley & Sons Ltd.)

Background and Objective: The term "brain drain" refers to the exodus of educated or professional individuals to another nation, industry, or field, typically in search of a higher salary or living standard. Our objective was to look into the reasons why medical students leave after graduation, how it affects Pakistan's socio-medical situation, and what may be done to address it., Methods: After receiving approval from the ethical committee, a cross-sectional survey was carried out among 420 undergraduate medical students of both genders at two different medical colleges in Pakistan for the current academic year 2021-2022. The core data was gathered via an organized questionnaire. The non-probability sampling method was employed to collect the sample. The data were analyzed with SPSS software., Result: Out of 420 medical students of both genders, 140 (33.3%) plan to leave Pakistan after graduation, while 280 (66.66%) want to pursue a career in Pakistan. Additionally, when asked about the amenities offered to Pakistani doctors throughout their training, the vast majority of medical students expressed satisfaction with living in Pakistan. However, among medical students who prefer to immigrate, the United States was at the top of their list. Although there are numerous reasons that affect doctors' immigration choices, the majority of students think that poor pay and long working hours are the main ones that lead to poor patient management and inadequate training. This may be prevented by improving the pay and service structure., Conclusion: According to this survey, one in three medical students aspires to move overseas after graduation owing to a lack of resources and ineffective management, which has been adversely affecting Pakistan's socio-medical situation. As a result, it is important for Pakistan's health officials to launch campaigns to address the issues faced by medical students and physicians in order to prevent brain drain., (Copyright: © Pakistan Journal of Medical Sciences.)

Introduction: Physician emigration (the brain drain ) and sociopolitical unrest significantly contribute to the instability of many low- and middle-income countries' healthcare systems. However, limited literature captures the locally driven and context specific suggestions to promote and sustain these health systems' resilience. Thus, the purpose of this study is to 1) understand the effects of physician emigration and sociopolitical unrest on Nigeria's healthcare system, and to 2) synthesize solutions suggested by Nigeria-trained physicians in the form of a resilience framework., Methods: An anonymous online survey was conducted among Nigeria-trained physicians. Respondents were recruited using convenience and snowball sampling methods via a WhatsApp group for Nigeria-trained doctors. Quantitative data were analyzed using Stata 17 and qualitative themes were coded by two independent researchers., Results: The final sample included 49 Nigeria-trained physicians-35 physicians practicing in Nigeria and 14 emigrated physicians. All of the physicians currently practicing in Nigeria have considered emigrating, with 79% of them having concrete plans to emigrate in the next five years. Among emigrated physicians, factors such as remuneration (92%) and socioeconomic state of the country (92%) contributed to their decision to emigrate. Suggestions to enhance health system resilience fell into six broad themes: 1) policy and politics, 2) funding and resources, 3) organization and structure, 4) training and education, 5) research and primary health, and 6) health for peace initiatives., Conclusions: The healthcare system is currently unstable and vulnerable due to physician emigration and sociopolitical unrest. To develop and implement solutions to mitigate these issues, capturing the locally trained physicians' perspectives are critical. While each country's healthcare system is unique, countries with similar strains can adapt this model for resilience building. Future studies should focus on adapting the model in different countries with policy-level action points., Competing Interests: The authors have no competing interests to declare., (Copyright: © 2023 The Author(s).)

The Russian invasion of Ukraine has caused large scale destruction, significant loss of life, and the displacement of millions of people. Besides those fleeing direct conflict in Ukraine, many individuals in Russia are also thought to have moved to third countries. In particular the exodus of skilled human capital, sometimes called brain drain, out of Russia may have a significant effect on the course of the war and the Russian economy in the long run. Yet quantifying brain drain, especially during crisis situations is generally difficult. This hinders our ability to understand its drivers and to anticipate its consequences. To address this gap, I draw on and extend a large scale dataset of the locations of highly active software developers collected in February 2021, one year before the invasion. Revisiting those developers that had been located in Russia in 2021, I confirm an ongoing exodus of developers from Russia in snapshots taken in June and November 2022. By November 11.1% of Russian developers list a new country, compared with 2.8% of developers from comparable countries in the region but not directly involved in the conflict. 13.2% of Russian developers have obscured their location (vs. 2.4% in the comparison set). Developers leaving Russia were significantly more active and central in the collaboration network than those who remain. This suggests that many of the most important developers have already left Russia. In some receiving countries the number of arrivals is significant: I estimate an increase in the number of local software developers of 42% in Armenia, 60% in Cyprus and 94% in Georgia., Supplementary Information: The online version contains supplementary material available at 10.1140/epjds/s13688-023-00389-3., Competing Interests: Competing interestsThe author declares no competing interests., (© The Author(s) 2023.)

Many parts of the world receive from abroad not only objects of technology, but also scientific discoveries, and organizing elements and practices as well. Since these entities materially comprehend a formidable part of their modes of existence, let us say that non-Western countries result from ontologies/epistemologies that in large part come from abroad. This manifested coloniality emerges in the feeling of contradiction between national realities and the ideological prestige of the Western imperial centers that serve as models to them. This configures a malaise that is deeply rooted in educated Brazilians. I discuss lines of flight from that malaise in an articulation that configures a philosophical and political novelty in Brazil. In examples concerning computing in Brazil, I juxtapose elements of STS, the metaphorical anthropophagic movement, and the European Enlightenment project, to enact a more symmetrical, dialogical, and inclusive world by constructing 'respectful enough' stories. In doing so, the anthropophagic movement, previously in practice restricted to the artistic realms, incorporates sciences and technologies. In each of these stories, the enlightened motto 'daring to know' is juxtaposed with the anthropophagic metaphorical motto 'eat the stranger' around modern Western scientific and technological issues in local situated ways.

Students' and graduates' mobility is an interesting topic of discussion especially for the Italian education system and universities. The main reasons for migration and for the so called brain drain, can be found in the socio-economic context and in the famous North-South divide. Measuring mobility and understanding its dynamic over time and space are not trivial tasks. Most of the studies in the related literature focus on the determinants of such phenomenon, in this paper, instead, combining tools coming from graph theory and Topological Data Analysis we propose a new measure for the attitude to mobility. Each mobility trajectory is represented by a graph and the importance of the features constituting the graph are evaluated over time using persistence diagrams. The attitude to mobility of the students is then ranked computing the distance between the individual persistence diagram and the theoretical persistence diagram of the stayer student. The new approach is used for evaluating the mobility of the students that in 2008 enrolled in an Italian university. The relation between attitude to mobility and the main socio-demographic variables is investigated., Competing Interests: Conflict of interestThe authors declare that they have no conflict of interest., (© The Author(s) 2022.)

Background: It is important to understand the perceptions of career plans and attitudes towards migration of nursing students so that it can be possible to review the education programs in this direction and plan an effective health workforce., Aim: To determine nursing students' career future perceptions and attitudes towards migration., Design: Descriptive and cross-sectional online survey., Methods: The study was completed with 3053 students from 52 universities located in seven different regions of Turkey who agreed to participate in the study. The data were collected using the "Student Information Form", "Attitude Scale for Brain Drain (ASBD)" and "Career Futures Inventory (CFI)" with an online questionnaire. Descriptive statistics, independent samples t-test, one-way analysis of variance and correlation were used to analyze the data., Results: Mean age of the students was 20.29 ± 2.28 and most were females. Students' mean total scores of ASBD, and CFI were 56.64 ± 12.22 and 91.32 ± 11.71 respectively. There was a statistically significant difference between the total mean scores of ASBD and the region of the university where the students studied, gender, being multilingual, desire to work abroad after graduation and experience of participating in student exchange programs and between the total mean scores of CFI and experience of participating in an exchange program. There was a positive and statistically significant relationship between ASBD and CFI total mean scores (p < 0.05)., Conclusion: Nursing students' attitudes towards migration and perceptions of career future were positive and there was a positive relationship between attitudes towards migration and perceptions of career future., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Worldwide doctors have been migrating from low- and middle-income countries to high-income countries for decades. This contributes to dearth of doctors, especially psychiatrists, in low- and middle-income countries - often referred to as 'brain drain'. Australia has a fair share of psychiatrists of Indian origin in its workforce. This article endeavours to re-formulate the migration phenomenon as 'brain exchange' through the experiential insight of the authors along with published literature and discusses the contribution of substantial number of psychiatrists of Indian origin to the Australian society. Furthermore, the article highlights the potential for the Royal Australian and New Zealand College of Psychiatrists to be a leader in this area by facilitating globally responsible practice by giving back to countries from which psychiatrists originate. The key observations and recommendations are transferrable to other similar countries and equally to other medical specialities.

Scientific diasporas from developing countries represent an opportunity to strengthen international collaborations. These collaborations build upon the desire of members of the diasporas to establish scientific, academic, technological, and cultural exchange networks with the communities in their country of origin. While Mexico has a significant number of scientists residing abroad, particularly in North America, and most of them are committed to aid in the country's development, institutional coordination has not harnessed its benefits. In this work, we present an analysis of initiatives carried out by Mexican scientists, members of the diaspora, studying or working in the United States of America and Canada. The study is based on a set of interviews with members of this diaspora. We asked scientists about the conditions that enabled or obstructed their initiatives back in Mexico, and we discussed the role of these factors for capacity building. We also provide general recommendations to enhance contributions to the advancement of science in the country., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Gómez-Flores, Morales-Salgado, Maza, Villarreal, Lara-Jacobo, Jiménez-Córdova, Jiménez-Alvarez and Hernández-Mondragón.)

Competing Interests: Conflict of interest still remains a serious challenge in Iran's health system. The following are considered as the underlying causes of conflict of interest in the healthcare system: the structure of the existing financial system fee for service, lack of transparency in the healthcare system, existence of the problem of having two simultaneous jobs dual practice in governmental and private sector, and lack of an integrated information system and electronic healthcare structure (21). Recently, the conflict of interest challenge has attracted the attention of public and media however there is no clear strategy to resolve the potential conflict of interest in the healthcare management structure.

The social and economic situation in Europe seems to play a role in the migratory flow of doctors and other health professionals within the continent. However, little is known about the particular reality of workforce migration in Spain. The objective of this study was to explore the factors that motivate migration among junior doctors training in psychiatry in Spain. A semistructured questionnaire of 61 items was circulated to psychiatric trainees in Spain to explore the extent and the factors that influence the decisions regarding workforce migration. A total of 95 psychiatric trainees participated in the survey. More than two-thirds (n = 71, 74.7%) had "ever" considered migrating to another country, and more than one-fourth (n = 21, 29.5%) had already taken "practical steps" to go abroad. The main reasons to consider leaving the country were financial (n = 82, 86%) and the opportunity to progress professionally (n = 82, 84%). However, nearly half of the trainees (n = 47, 49%) were satisfied with their current income. While the majority of the psychiatric trainees in this survey had considered migrating abroad, these potential future migrations could lead to a loss of human capital with an important sociosanitary impact.

Air pollution is a major problem that severely affects the health of inhabitants in developing countries' urban areas. To deal with the problem, they may consider migration to another place as an option, which can result in the loss of skillful and talented workforces. This situation is called the brain drain phenomenon. The current study employed the Bayesian mindsponge framework (BMF) on the responses of 475 urban inhabitants in Hanoi, Vietnam-one of the most polluted capital cities in the world-to examine the risk of losing talented workforces due to air pollution. Our results show that people with higher educational levels are more likely to have intentions to migrate both domestically and internationally due to air pollution. Regarding the domestic migration intention, younger people and males have a higher probability of migrating than their counterparts. Age and gender also moderate the association between educational level and international migration intention, but their reliability needs further justification. Based on these findings, we suggest that environmental stressors caused by air pollution can influence citizen displacement intention on a large scale through the personal psychological mechanism of cost-benefit judgment. Due to the risk of air pollution on human resources, building an eco-surplus culture is crucial for enhancing environmental and socio-economic resilience.

Countries increasingly compete to attract and retain human capital. However, empirical studies, particularly those of migrants moving back to developing countries, have been limited due to the lack of education-specific migration flow data. Drawing on census microdata from IPUMS, we derive flow data by level of education and age group to quantify the level of return migration and examine the educational and age profile of return migrants for a global sample of 60 countries representing 70% of the world population. We show that return migrants account for a significant share of in-migration flows, particularly in Africa and Latin America, and, in all countries but six, return migrants are more educated than the population in the migrants' country of birth. Our age decomposition reveals that young adults contribute the most to the positive educational selectivity of return migrants, particularly in Africa and Asia. While this paper does not quantify the net effect of return migration on education levels, it underlines the importance of the human capital contributions of young adult returnees., Supplementary Information: The online version contains supplementary material available at 10.1007/s11113-021-09655-6., (© The Author(s), under exclusive licence to Springer Nature B.V. 2021.)

Today, the question is often raised about the need to increase investment in human capital, the efficiency of its use, as well as attraction to the regions. Working on the accumulation of human capital, it is necessary to ensure that it does not "leak" from the country; especially for highly skilled workers. The article considers the features of modern migration statistics in Russia. Using the methodology developed by the author, the paper assesses the losses caused by emigration. According to the results of the study, it was found that emigration statistics do not correctly reflect real migration flows. The resulting estimates of the loss of human capital turned out to be quite significant. Taking into account the additional potential losses caused by a possible slowdown in the scientific and technological development of the country, it is necessary to pay close attention to the ongoing processes, the adjustment of economic development programs and migration policy., (© Pleiades Publishing, Ltd. 2022, ISSN 1075-7007, Studies on Russian Economic Development, 2022, Vol. 33, No. 4, pp. 432–439. © Pleiades Publishing, Ltd., 2022.Russian Text © The Author(s), 2022.)

In recent years, a proportion of older Germans has been sent to relatively high-end care homes within lower-income countries where the care tends to be cheaper and more extensive than that in German care homes. Destination countries are found predominantly within Eastern Europe (e.g. Poland, Hungary, Czech Republic), but to a lesser extent also within South-East Asia (e.g. Thailand). At the same time, these expatriations have caused much controversy, with some German commentators calling them 'inhumane' and 'shameful'. In this article, I argue that such criticisms are overdrawn. Although sending an older individual to a care home within a lower-income country can be morally impermissible, I find that there are at least three sets of conditions under which it is not., (© 2021 The Authors. Bioethics published by John Wiley & Sons Ltd.)