The Need for Public Policy Initiatives to Retain Medical Doctors in Ethiopia

Ethiopia suffers from a medical shortage or brain drainthat has severely affected its already fragile health care system. The country has a very low physician-to-population ratio,whilemany in the medical community continue to leave in great numbers. Aphenomenological approach was used in this study to explore the lived experiences of medical doctors who have left Ethiopia, with contemporary migration theory serving as the conceptual framework. The central research question focused onwhy Ethiopian medical doctors leave their country and what can be done to retain them. Participants were 10 medical doctors of Ethiopian origin who live and practice medicine in the Washington, DC metropolitan area. Participantswere purposively selected, and in-depth interviews and a focus group discussion were used to collect data from them. The study followed Moustakas\u27 recommendations for phenomenological analysis, which representeda modification of the Stevick-Colaizzi-Keen method. The themes that emerged during data analysis have economic, political, professional, and personal dimensions. The findings includelow pay, lack of professional development, poor working conditions, the threat of political persecution, fear of contracting HIV, and inability to participate in health care decision-making. Recommendations accordingly include offering pay raises and fringe benefits, creating opportunities for professional development, improving working conditions, and limiting political interference in the health care system. Implications for positive social change include the fact that stemming the outflow of medical doctors could help save the lives of thousands of Ethiopians threatenedby preventable and curable diseases

ICAR: endoscopic skull‐base surgery

n/

Do Economists Reach a Conclusion On Rail Transit?

In the United States, the public debate over urban rail projects is complicated by the lack of agreement on goals. Supporters offer a wide variety of justifications to build and expand rail transit. If one focuses on the judgments of economists, the list of justifications shrinks considerably, but we are still left with a bundle of goals. Compared to other justifications, economists appear to be somewhat optimistic about rail transit’s impact on local economic development, but less optimistic about rail’s ability to achieve environmental improvement and serve the transit-dependent poor. Economists seem quite pessimistic about rail’s ability to achieve key transportation goals like reducing congestion. Economists often attribute rail’s political success to rent-seeking and romantic political factors. Of those economists who offer a big-picture view, there appears to be wide, though not unanimous, agreement that rail’s costs exceed its benefits. And it seems that almost all economists who write about rail agree that various demographic features, such as suburbanization, the declining influence of central business districts, and increasing wealth will make it increasingly difficult to design successful rail systems.rail transit,transportation,economists

Do Economists Reach a Conclusion on Taxi Deregulation?

Taxicabs are an important part of the urban transportation system, and in most communities are heavily regulated. In the past 25 years many cities have deregulated taxi markets. A substantial literature has emerged examining the merits of deregulation. Here we provide a tour of the main points of contention in the scholarly research on the desirability of taxi deregulation. We find that most economic studies of taxi deregulation find it to be on net beneficial. We mined the literature for economists’ judgments on taxi deregulation. The support for taxi deregulation is preponderant, but not overwhelmingly so. We suggest that the literature favorable to deregulation is richer and broader than the unfavorable literature, which disproportionately is model-building. There is wide consensus that taxi deregulation has been less impressive than advocates had hoped. A very important matter of interpretation is whether the disappointment was due to the over-estimation of what deregulation could deliver, or to deregulation not having been thoroughgoing. Another interpretative issue is whether restrictions on service originating at airports ought to be deemed intervention or contract within the nexus of property relations. Finally, there are also unresolved questions about whether the effects of deregulation have been fully accounted for.Taxi markets,transportation,regulation,deregulation,liberalization,economists

Evolution of Sinonasal Symptoms Following Endoscopic Anterior Skull Base Surgery

To assess the severity and evolution of sinonasal symptoms in patients following endoscopic anterior skull base surgery to define the typical postoperative course. Design: Cross sectional study. Participants include 69 patients who underwent endoscopic skull base surgery by a dual surgeon team (otolaryngologist and neurosurgeon) from January 2008 to August 2009. Main outcome measures: Sinonasal Outcomes Test (SNOT)-20 survey scores at preoperative and at three postoperative time points. An ordinal logistic regression model was used to analyze the data, summarizing the relationship between the outcome (SNOT score) and the predictor (time point) using an odds ratio. Scores for the symptoms of need to blow nose, sneezing, runny nose, postnasal discharge, thick nasal discharge, ear fullness, and facial pain showed significant worsening at the early postoperative time point. These symptoms showed significant improvement over time; however, scores for post nasal discharge remained high at the late time period compared with baseline. All patients will experience considerable sinonasal symptoms following transnasal endoscopic skull base surgery. Postnasal discharge and thick nasal discharge improve significantly over time. Symptoms approach baseline by 6 to 9 months following surgery