Fixed laws, fluid lives: the citizenship status of post-retirement migrants in the European Union

This paper presents key findings of a recently completed socio-legal study of international retirement migration in the European Union (EU).1 It highlights the diverse nature of retirement migration and the differential citizenship status that is formally granted to various groups of retired migrants. ‘Citizenship of the European Union’ (Articles 17–22 of the Treaty establishing the European Community) bestows important social and political rights on nationals of EU Member States (‘Community nationals ’). These rights are not, however, universal or based on nationality as such. In practice, the residency and social rights that a mobile EU national can claim in another Member State depend on the type of social contribution they have made and their personal relationships. Contributions through paid employment and/or membership of the family of a mobile EU worker gives rise to maximum social benefit. Whilst the European Union citizenship provisions extend residency rights to all EU nationals (irrespective of work status), those whose mobility is not connected to employment derive significantly inferior social entitlements when resident in a host Member State. Put simply, the rights of people (and members of their family) who move following retirement in their home country differ substantially from those who retire following a period of working in another Member State (and achieve the status of ‘community migrant worker’ prior to retirement). This formal ‘ discrimination ’ is further compounded by the diversity of the social welfare systems of the member states that results in distinct social, economic and spatial inequalities across the EU. To that extent, the ‘choice’ of retirement location significantly impacts on citizenship status. However, retired migrants are not merely passive spectators of formal rights and policies. Many show considerable skill in actively managing their rights (at both national and EU levels) and other resources to optimise personal benefit. This ability to maximise wellbeing is unevenly distributed

‘The matrix of all problems’: Stephen King’s marriage of fundamentalism and the monstrous-feminine as social critique

The place of women in society has long been decried by their place in religion – at least according to horror novelist Stephen King. Indeed, the release of first novel Carrie (1974) was the beginnings of an avid interest in both religion and gender stereotyping, the latter of which the author has been accused of utilising for horrific effect. Yet, this unison of themes is more complex than this. Certainly, these thematic concerns become the means with which King interrogates religious extremism and the conditions which cultivate such devotion; the novel succeeded in exposing the cataclysmic aftermath of a childhood so governed and restricted by militant Puritanism as to metamorphose Carrie White from a wholesome, all-American teen into an ardent evangelist responsible for a town massacre and the murder of her mother. However, utilisation of the fundamentalist agenda within this novel and later releases becomes the means with which King critiques both the archaic notions of the sin of femininity upheld within Christianity, and crucially, how and why such conceptions still pervade modern-day culture. In particular, King turns ‘his women’ monstrous because of their adherence to roles placed upon them by the conservative – even oppressive – conception of gender found within fundamentalist discourse; monstrous when they succeed in following such ideals – and monstrous when they do not – King also suggests that the origins and perpetuation of the image of the monstrous-feminine are far more sewn into the fabric of US society than its citizens would care to admit. This study will thus focus upon the methods of control found within fundamentalist ideology and how they presume to demarcate boundaries which dictate appropriate behaviour for women. Analyses of the monstrous-feminine within later novels will also demonstrate King’s motivation for marrying religion and the woman-as-horror scenario, and will be highlighted as not simply a mechanism within King’s oft-used toolbox of terror, but as the mechanism with which he turns the spotlight on both fundamentalism - and an avidly patriarchal society still struggling to maintain a hold over women

The social security rights of older international migrants in the European Union

Europe is now home to a significant and diverse population of older international migrants. Social and demographic changes have forced the issue of social security in old age onto the European social policy agenda in the last decade. In spite of an increased interest in the financial well-being of older people, many retired international migrants who are legally resident in the European Union face structured disadvantages. Four linked factors are of particular importance in shaping the pension rights and levels of financial provision available to individual older migrants: migration history, socio-legal status, past relationship to the paid labour market, and location within a particular EU Member State. Building on a typology of older migrants, the paper outlines the ways in which policy at both the European Union and Member State levels serves to diminish rather than enhance the social security rights of certain older international migrants

A questionnaire study of the negative outcomes for UK health professional volunteers in low and middle income countries

© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. INTRODUCTION: Past research has reported considerable benefits of international health professional volunteering for British healthcare professionals; however, there are also some negative outcomes reported. Negative outcomes reportedly happen on a personal, professional and organisational level. However, there is little evidence of the frequency they might occur. METHODS: We aimed to understand what the negative outcomes of health professional volunteering in low-income and middle-income countries were, and how frequently they occurred, in an opportunistic sample of UK health professionals. We used a questionnaire developed using potential negative outcomes reported in the peer-reviewed papers. We conducted secondary analysis on cross-sectional questionnaire data from 222 healthcare professionals. RESULTS: This research provides an indication of the frequency that negative outcomes might occur. Post hoc analyses revealed that some outcomes were experienced by the majority of health professional volunteers, for example, lack of formal recognition (131/169, 78%) and financial cost (92/169, 68%). While others happened less, for example, a reliance on agency or locum work (12/169, 7%) and loss of pension (31/169, 18%). CONCLUSION: The outcomes reported in this research quantify some of the concerns that have been raised in previous literature. Negative outcomes might be associated with certain features of volunteering and further research is needed to prospectively compare different features. Organisers of volunteering opportunities should be aware of the potential negative outcomes and engage with the research into negative outcomes to generate and apply findings about minimising potential negative outcomes, carefully balancing these against the needs of the host country

Anti-microbial resistance in global perspective

This open access book provides an accessible introduction to the mechanics of international development and global health text for policy-makers and students across a wide range of disciplines. Antimicrobial resistance is a major threat to the well-being of patients and health systems the world over. In fragile health systems so challenged, on a day-today basis, by the overwhelming burden of both infectious and non-communicable disease, it is easy to overlook the impacts of AMR. The Maternal Sepsis Intervention, focusing on a primary cause of maternal death in Uganda, demonstrates the systemic nature of AMR and the gains that can be made through improved Infection Prevention Control and direct engagement of laboratory testing in antibiotic prescribing

Enhancing skills to promote the utilization of medical laboratory equipment in low resource settings

Objective This study was to demonstrate the efficacy of an intervention model involving on-going skills enhancement of users, Biomedical Engineers and Technicians (BMETs) in enhancing the utilization of medical laboratory equipment in low resource settings. Methods In an action research study, the condition of 202 pieces of medical equipment in seven regional blood banks in the Uganda Blood Transfusion Service (UBTS) were studied prospectively from January 2018 to December 2018. Of these, 160 pieces were included in the intervention group where users and BMETs were mentored and trained in the use and preventive maintenance for all equipment types. A second group of 42 pieces of medical equipment which were not involved in the intervention program, were assessed for comparison. Twenty-one participants were interviewed to obtain detailed information about their experiences and the impact of the training interventions. Results The percentage of equipment in good working condition and in use in the intervention group improved from 60% to 74%, while the improvement recorded in the second group was slower (48% to 55%) over the one-year period. Equipment in the intervention group were three times more likely to be in good working condition and in use at the end of the study period with an odds ratio of 3.2 (95% CI: 1.49 to 6.83) and P value < 0.001. Conclusion The model applied by Knowledge for Change (K4C) that involves co-learning and mentorship of users and BMETs was successful and should be implemented in other health facilities in Low- and Middle-Income Countries

An Integrative Review of Literature Regarding Health Concerns of Rural Dwelling Adolescents

Those living in rural areas face particular risks to health and well-being as they are more likely to be poor, have no health insurance, and have less access to health care. Many obstacles exist in achieving optimal rural health outcomes. Many of the health related issues experienced by adolescents are preventable and are often related to risky behavior such as substance use and abuse, smoking, and unprotected sex. The purpose of this review is to define the current primary health concerns of rural dwelling adolescents worldwide. Based on current research, the primary health related problems of rural adolescents were identified as risky sexual behaviors, mental health issues, violence and bullying, substance and alcohol use, and overweight and obesity. These problems are exacerbated by diminished access to care, peer influences, and parental influences. This integrative review also illustrates many dimensions of health disparities exist in rural areas. When addressing diversity in care models, it is important to consider the rural setting as well as race or ethnicity, sex, and socioeconomic status in designing curriculum and interventions. Globally, evidence based findings are needed to inform curriculum and respond to the health needs of rural adolescents. Programs and rural initiatives for adolescents can decrease the prevalence of established health problems and lower health care expenditures across life spans

Dual career couples in academia, international mobility and dual career services in Europe

The number of dual career couples in academia is growing due to the increasing proportion of women with a doctoral degree and the greater propensity of women to choose another academic as their partner. At the same time, international mobility is required for career advancement in academia creating challenges for dual career couples where both partners pursue careers. This paper has two objectives: a) to raise the increasingly important issue of dual career couples in academia and the gendered effect that the pressure for mobility has on career advancement and work-life interference, and b) to present examples of recently established dual career services of higher education institutions in Germany, Denmark and Switzerland, responding to the needs of the growing population of dual career couples. Due to long established practices of dual career services in the US, the European examples will be compared with US practices. This paper raises the significance of considering dual career couples in institutional policies that aim for an internationally excellent and diversified academic workforce. It will appraise dual career services according to whether they reinforce or address gender inequalities and provide recommendations to HEIs interested in developing services and programmes for dual career couples

The study of HIV and antenatal care integration in pregnancy in Kenya: design, methods, and baseline results of a cluster-randomized controlled trial

Background: Despite strong evidence for the effectiveness of anti-retroviral therapy for improving the health of women living with HIV and for the prevention of mother-to-child transmission (PMTCT), HIV persists as a major maternal and child health problem in sub-Saharan Africa. In most settings antenatal care (ANC) services and HIV treatment services are offered in separate clinics. Integrating these services may result in better uptake of services, reduction of the time to treatment initiation, better adherence, and reduction of stigma. Methodology/Principal Findings: A prospective cluster randomized controlled trial design was used to evaluate the effects of integrating HIV treatment into ANC clinics at government health facilities in rural Kenya. Twelve facilities were randomized to provide either fully integrated services (ANC, PMTCT, and HIV treatment services all delivered in the ANC clinic) or non-integrated services (ANC clinics provided ANC and basic PMTCT services and referred clients to a separate HIV clinic for HIV treatment). During June 2009– March 2011, 1,172 HIV-positive pregnant women were enrolled in the study. The main study outcomes are rates of maternal enrollment in HIV care and treatment, infant HIV testing uptake, and HIVfree infant survival. Baseline results revealed that the intervention and control cohorts were similar with respect to sociodemographics, male partner HIV testing, sero-discordance of the couple, obstetric history, baseline CD4 count, and WHO Stage. Challenges faced while conducting this trial at low-resource rural health facilities included frequent staff turnover, stock-outs of essential supplies, transportation challenges, and changes in national guidelines. Conclusions/Significance: This is the first randomized trial of ANC and HIV service integration to be conducted in rural Africa. It is expected that the study will provide critical evidence regarding the implementation and effectiveness of this service delivery strategy, with important implications for programs striving to eliminate vertical transmission of HIV and improve maternal health

Echoes of time. The mobility of Brazilian researchers and students in Portugal

A investigação que apresentamos, de caráter exploratório, recaiu sobre histórias biográficas de brasileiros que escolhem Portugal para prosseguir formação e ou investigação. Procura-se encontrar na sua experiência elos de ligação explicativos sobre as motivações e os processos que os trazem para Portugal, assim como as expetativas e os projetos que comportam para os seus futuros e que incluem, ou não, este país. Temos em conta, especialmente, a forma como essa narrativa transporta sentidos identitários decorrentes das formas de relacionamento intercultural e político entre Portugal e Brasil e formas de cooperação implícitas, assim como mapas representacionais acerca dos lugares de eleição para desenvolvimento de carreiras científicas e académicas. A nossa pesquisa incide sobre as informações recolhidas através de um inquérito por questionário e entrevistas realizadas junto de estudantes e bolseiros brasileiros em Portugal.We present an exploratory study that investigated biographical stories of Brazilians who choose to continue their education or develop research in Portugal. We sought to find in their experiences explanatory links connecting the motivations and processes that bring them to Portugal, as well as the expectations and projects that they hold for the future, which may include, or not, this country. We take into account, particularly, the way this narrative carries senses of identity arising from the forms of intercultural and political relationship between Portugal and Brazil, as well as implicit forms of cooperation and representations about the places chosen for the development of scientific and academic careers. Our research draws on information collected through a survey based on questionnaires and interviews with Brazilian students and scholarship holders in Portugal.(undefined