Indicators Associated With Job Morale Among Physicians and Dentists in Low-Income and Middle-Income Countries: A Systematic Review and Meta-analysis.

Importance: Improving health care in low- and middle-income countries (LMICs) requires a workforce with positive job morale. However, the level of job morale in this population remains unclear. Objective: To analyze studies measuring the job morale of physicians and dentists working in LMICs, using levels of job burnout, job satisfaction, and job motivation as indicators of job morale. Data Sources: A comprehensive search of Scopus, PubMed, PsycINFO, EMBASE, Web of Science, and the Cochrane Library, from database inception to October 30, 2018, and gray literature was performed. Study Selection: Studies were eligible if at least 50% of the sample were qualified physicians and/or dentists working in public health care settings in LMICs. Three indicators of job morale in this population were used: job burnout, job satisfaction, and job motivation. Of 12 324 records reviewed, 79 studies were included in the systematic review and 59 were eligible for the meta-analysis. Data Extraction And Synthesis: Data were extracted independently by several investigators in accordance with the Meta-analyses of Observational Studies in Epidemiology (MOOSE) reporting guidelines. Random-effects meta-analyses, planned subgroup analyses, and metaregression were performed. The Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies was used to assess bias. Main Outcomes and Measures: Levels of job burnout, job satisfaction, and job motivation as indicators of job morale. Results: Overall, 12 324 records were identified. Of them, 80 records, representing 79 studies and involving 45 714 participants across 37 LMICs, met the inclusion criteria for the review; however, only 3 were from low-income countries. In 21 studies with 9092 participants working mainly in middle-income countries, 32% (95% CI, 27%-38%; I2 = 95.32%; P < .001) reported job burnout, and in 20 studies with 14 113 participants, 60% (95% CI, 53%-67%; I2 = 98.21%; P < .001) were satisfied with their job overall. Sufficient data were not available for a meta-analysis of job motivation. Conclusions and Relevance: The findings suggest that, among physicians and dentists working mainly in middle-income countries, more than half reported having positive job morale. Positive job morale among physicians and dentists may help with recruitment and retention and thus support programs for improving health care in LMICs

Self-Presentation Strategies and Tactics in TED-Talks

The article tackles the notions of self-presentation strategy and self-presentation tactics as well as offers a detailed account of selfpresentation strategies and tactics employed by TED-Talk speakers. The author provides her own classification of tactics used to implement selfpresentation strategy in the setting where English-language presenters deliver their speeches before the audience, pointing at the most frequent linguistic means associated with these tactics.В статье представлены результаты исследования речевых стратегий и тактик самопрезентации, используемых участниками конференций в формате TED (TED-Talks). В работе описаны и разграничены понятия «стратегия самопрезентации» и «тактика самопрезентации», приведена классификация тактик, используемых для реализации данной стратегии в ситуации непосредственного выступления англоязычных говорящих перед аудиторией конференции, а также отмечены частотные языковые средства их реализации

ОСОБЕННОСТИ ТЕЧЕНИЯ РЕФРАКТЕРНЫХ ФОРМ АНЕМИИ У ДЕТЕЙ С ХРОНИЧЕСКИМ ГЕПАТИТОМ В

Examination of 125 children with chronic hepatitis В and concomitant anemia has determined the frequency of refractory forms of anemia (52,5%). The disease progressed more severely on the background of anemia, which was indicated by the prevalence of CHВ forms with severe activity (71,4%). The pathognomonic symptoms of anemic processes were revealed. Two pathogenetic variants of the anemia genesis in children with CHВ are being considered: the first is defined by veritable iron deficiency with ferrokinetic markers of iron-deficiency anemia; the second — by relocationable iron deficit that is typical for hemosiderosis and refractoriness development.Обследование 125 детей, больных хроническим гепатитом В (ХГВ) с сопутствующей анемией, позволило установить частоту рефрактерных ее форм (52,5%). На фоне рефрактерной анемии заболевание протекало тяжелее, о чем свидетельствовало превалирование выраженных форм ХГВ (71,4%). Выявлены патогномичные для анемического процесса клинические симптомы. В генезе развития анемии при ХГВ у детей рассматриваются два патогенетических варианта течения: первый характеризуется истинным дефицитом железа со спектром феррокинетических маркеров, свойственных железодефицитной анемии; второй — перераспределительным дефицитом железа, характерным для гемосидерического состояния и развития рефрактерности

Lateral scattering potential of the PTCDA/Ag(111) interface state

A modified scheme of scanning tunneling spectroscopy (STS) data analysis has been used to reconstruct the band structure of a strongly dispersive two-dimensional unoccupied electronic state located at the commensurate interface between a monolayer of PTCDA and Ag(111) surface up to the fourth band in the reduced Brillouin zone of the molecular monolayer. The two-dimensional scattering potential, evaluated with the help of the measured band structure data, is highly corrugated. This shows that the accepted picture, describing the interface state of PTCDA/Ag(111) as an upshifted Shockley state of Ag(111), is incomplete. Our findings indicate that the hybridization of unoccupied molecular orbitals of PTCDA on one of the two sublattices with the metals states of Ag(111) substantially influences the interface state properties

Coverage-dependent anisotropy of the NTCDA/Ag(111) interface state dispersion

We employ density functional theory (DFT) to analyze the dispersion of the electronic state that exists at the commensurate interface between a monolayer of 1,4,5,8-naphthalene-tetracarboxylic acid dianhydride (NTCDA) and the Ag(111) surface. First, we present and verify a hydrogen-termination approach which allows a meaningful DFT description of the interface state with relatively thin silver slabs. Complemented with a projection technique which maps the interface electronic structure onto the original Ag(111) Shockley state, the DFT calculations enable us to analyze the evolution of the dispersion of the NTCDA/Ag(111) interface state when changing of the molecular coverage. Our calculations yield a difference between the interface state energy and the Shockley state energy that scales linearly with coverage. Furthermore, they predict a pronounced anisotropy of the dispersion of the interface state at long wavelengths which also depends linearly on the molecular coverage. The dispersion anisotropy is fully confirmed by our Fourier transform (FT) scanning tunneling spectroscopy (STS) experiments performed on a relaxed phase NTCDA/Ag(111) monolayer. Using feature detection STS (FD-STS), we moreover measure a band gap in the interface state band structure at the Brillouin zone boundary which indicates Bragg scattering of the interface state electrons in the periodic potential of the molecular layer. We thus observe an influence of the molecular layer on the interface state both at long (DFT, STS) and short wavelengths (STS)

CLINICAL FEATURES OF REFRACTORY FORMS OF ANEMIA IN CHILDREN WITH CHRONIC HEPATITIS В

Examination of 125 children with chronic hepatitis В and concomitant anemia has determined the frequency of refractory forms of anemia (52,5%). The disease progressed more severely on the background of anemia, which was indicated by the prevalence of CHВ forms with severe activity (71,4%). The pathognomonic symptoms of anemic processes were revealed. Two pathogenetic variants of the anemia genesis in children with CHВ are being considered: the first is defined by veritable iron deficiency with ferrokinetic markers of iron-deficiency anemia; the second — by relocationable iron deficit that is typical for hemosiderosis and refractoriness development

ОСОБЕННОСТИ ТЕЧЕНИЯ РЕФРАКТЕРНЫХ ФОРМ АНЕМИИ У ДЕТЕЙ С ХРОНИЧЕСКИМ ГЕПАТИТОМ В

Examination of 125 children with chronic hepatitis В and concomitant anemia has determined the frequency of refractory forms of anemia (52,5%). The disease progressed more severely on the background of anemia, which was indicated by the prevalence of CHВ forms with severe activity (71,4%). The pathognomonic symptoms of anemic processes were revealed. Two pathogenetic variants of the anemia genesis in children with CHВ are being considered: the first is defined by veritable iron deficiency with ferrokinetic markers of iron-deficiency anemia; the second — by relocationable iron deficit that is typical for hemosiderosis and refractoriness development.Обследование 125 детей, больных хроническим гепатитом В (ХГВ) с сопутствующей анемией, позволило установить частоту рефрактерных ее форм (52,5%). На фоне рефрактерной анемии заболевание протекало тяжелее, о чем свидетельствовало превалирование выраженных форм ХГВ (71,4%). Выявлены патогномичные для анемического процесса клинические симптомы. В генезе развития анемии при ХГВ у детей рассматриваются два патогенетических варианта течения: первый характеризуется истинным дефицитом железа со спектром феррокинетических маркеров, свойственных железодефицитной анемии; второй — перераспределительным дефицитом железа, характерным для гемосидерического состояния и развития рефрактерности.</p