Indian nurses in Italy: a qualitative study of their professional and social integration

AIMS AND OBJECTIVES: To investigate the lived subjective experiences of immigrant Indian nurses in Italy and specifically their professional and social integration. BACKGROUND: To study the worldwide, nursing flux is a health priority in the globalised world. The growth in migration trends among nurses, not only from Philippines or India, has proliferated in recent years. The research on nurses' mobility for Southern European countries is underexplored, and in Italy, the out-migration flows of Indian nurses were never analysed. DESIGN: Qualitative methodological approach. METHODS: Semi-structured interviews (n = 20) were completed with Indian clinical nurses working in Italy for more than one year mainly in private organisations. A purposive sampling technique was used for recruitment. The data were then content-analysed using an inductive method. RESULTS: The findings were categorised into four themes: (1) aspects of professional integration and working experience, (2) intra- and interprofessional relationships and perceptions of the IPASVI Regulatory Nursing Board, (3) initial nursing education and continuous professional development and (4) perceptions of social integration. CONCLUSION: The results show that for Indian nurses in Italy emigration is important to gain opportunities to expand economic and social privileges as well as escape from historical assumptions of stigma associated with nursing work, especially for women. However, these conclusions have to be seen in wider socio-cultural complexities that are at the basis of transnational fluxes (Prescott & Nichter ). RELEVANCE TO CLINICAL PRACTICE: The research offers an insight into the complicated reasons for Indian nurses out-migration to Italy. Without comprehending the interwoven textures of the political and social relations that are continually constructed and re-constructed among different nations, it is difficult to understand nurses out-migration and consequently have a better and safer collaborative teamwork in the host countries

Impaired transmission in the corticospinal tract and gait disability in spinal cord injured persons

Rehabilitation following spinal cord injury is likely to depend on recovery of corticospinal systems. Here we investigate whether transmission in the corticospinal tract may explain foot drop (inability to dorsiflex ankle) in persons with spinal cord lesion. The study was performed in 24 persons with incomplete spinal cord lesion (C1 to L1) and 15 healthy controls. Coherence in the 10- to 20-Hz frequency band between paired tibialis anterior muscle (TA) electromyographic recordings obtained in the swing phase of walking, which was taken as a measure of motor unit synchronization. It was significantly correlated with the degree of foot drop, as measured by toe elevation and ankle angle excursion in the first part of swing. Transcranial magnetic stimulation was used to elicit motor-evoked potentials (MEPs) in the TA. The amplitude of the MEPs at rest and their latency during contraction were correlated to the degree of foot drop. Spinal cord injured participants who exhibited a large foot drop had little or no MEP at rest in the TA muscle and had little or no coherence in the same muscle during walking. Gait speed was correlated to foot drop, and was the lowest in participants with no MEP at rest. The data confirm that transmission in the corticospinal tract is of importance for lifting the foot during the swing phase of human gait

On the acyclic disconnection and the girth

The acyclic disconnection, (omega) over right arrow (D), of a digraph D is the maximum number of connected components of the underlying graph of D - A(D*), where D* is an acyclic subdigraph of D. We prove that (omega) over right arrow (D) >= g - 1 for every strongly connected digraph with girth g >= 4, and we show that (omega) over right arrow (D) = g - 1 if and only if D congruent to C-g for g >= 5. We also characterize the digraphs that satisfy (omega) over right arrow (D) = g - 1, for g = 4 in certain classes of digraphs. Finally, we define a family of bipartite tournaments based on projective planes and we prove that their acyclic disconnection is equal to 3. Then, these bipartite tournaments are counterexamples of the conjecture (omega) over right arrow (T) = 3 if and only if T congruent to (C) over right arrow (4) posed for bipartite tournaments by Figueroa et al. (2012). (C) 2015 Elsevier B.V. All rights reserved.Peer ReviewedPostprint (author's final draft

Using Auxiliary Data to Guide the Recruitment of Sites for Randomized Controlled Trials

Sampling methods such as Stratified Random Sampling can be used to select representative samples of schools for randomized controlled trials of educational interventions. However, these methods may still yield external validity bias when participation by schools is voluntary and participation decisions are associated with unobserved variables. This paper offers a new sampling method called Stratified Random Sampling with Quotas. Under this method, quotas are set to avoid including too many schools of a particular type, as defined by auxiliary variables that are unobserved in the sampling frame, but whose population distribution can be estimated from external data. Our simulations find that when the auxiliary variables affect whether or not a school participates in the study, quotas set based on those variables reduce external validity bias. These results suggest that when auxiliary data are available on strong impact moderators for the target population, these data can be used to address non-ignorable self-selection by schools into randomized controlled trials

Dimension and codimension of simple games

This paper studies the complexity of computing a representation of a simple game as the intersection (union) of weighted majority games, as well as, the dimension or the codimension. We also present some examples with linear dimension and exponential codimension with respect to the number of players.Comment: 5 page

Reducing regional health inequality: a subnational distributional cost-effectiveness analysis of community-based treatment of childhood pneumonia in Ethiopia

Background Increasing the coverage of community-based treatment of childhood pneumonia (CCM) is part of the strategy to improve child survival, increase life-expectancy at birth and promote equity in Ethiopia. However, full coverage of CCM has not been reached in any regions of the country. There are no sub-national cost-effectiveness analyses available to inform decision makers on the most equitable scale up strategy. Objectives Our first objective is to estimate the sub-national cost-effectiveness and the interindividual inequality impacts of scaling up CCM coverages to 90% in each region. Our second objective is to explore the costs, health effects, and geographical inequality impacts associated with three scale-up scenarios promoting different policy-aims: maximizing health, reducing geographical inequalities, and achieving 90% universal coverage. Methods We used Markov modelling to estimate the sub-national cost-effectiveness of CCM in each region. All data were collected through literature review and adjusted to the region-specific proportions of the rural population. Health effects were modeled as life years gained and under-five deaths averted. Interindividual and geographical inequality impacts were measured by the GINI index applied to health. In scenario analysis we explored three different scale-up strategies: 1) maximizing health by prioritizing the regions where the intervention was the most cost-effective, 2) reducing geographical inequalities by prioritizing the regions with high baseline under-five mortality rate (U5MR), and 3) universal upscaling to 90% coverage in all the regions. Results The regional incremental-cost effectiveness ratio (ICER) of scaling up the intervention coverage varied from 26 USD per life year gained in Addis to 199 USD per life year gained in the Southern Nations, Nationalities, and Peoples’ region. Universal upscaling of CCM in all regions would cost about 1.3 billion USD and prevent about 90,000 under-five deaths. This is less than 15,000 USD per life saved and translates to an increase in life expectancy at birth of 1.6 years across Ethiopia. In scenario analysis, we found that prioritizing regions with high U5MR is effective in reducing geographical inequalities, although at the cost of fewer lives saved as compared to the health maximizing strategy. Conclusions Our model results illustrate a trade-off between maximizing health and reducing health inequalities, two common policy-aims in low-income settings.publishedVersio

The Complexity of Testing Properties of Simple Games

Simple games cover voting systems in which a single alternative, such as a bill or an amendment, is pitted against the status quo. A simple game or a yes-no voting system is a set of rules that specifies exactly which collections of ``yea'' votes yield passage of the issue at hand. A collection of ``yea'' voters forms a winning coalition. We are interested on performing a complexity analysis of problems on such games depending on the game representation. We consider four natural explicit representations, winning, loosing, minimal winning, and maximal loosing. We first analyze the computational complexity of obtaining a particular representation of a simple game from a different one. We show that some cases this transformation can be done in polynomial time while the others require exponential time. The second question is classifying the complexity for testing whether a game is simple or weighted. We show that for the four types of representation both problem can be solved in polynomial time. Finally, we provide results on the complexity of testing whether a simple game or a weighted game is of a special type. In this way, we analyze strongness, properness, decisiveness and homogeneity, which are desirable properties to be fulfilled for a simple game.Comment: 18 pages, LaTex fil