ABSTRACT
The COVID-19 pandemic has resulted in border closures in many countries and a sharp reduction in overall international mobility. However, this disruption of legal pathways to migration has raised concerns that potential migrants may turn to irregular migration routes as a substitute. We examine how the pandemic has changed intentions to migrate from The Gambia, the country with the highest pre-pandemic per-capita irregular migration rates in Africa. We use a large-scale survey conducted in 2019 and 2020 to ask about changes in intentions to migrate to Europe and to neighbouring Senegal. We find that youth say that the pandemic has reduced the intention to migrate to both destinations, with approximately one-third of young males expressing less intention to migrate. The largest reductions in migration intentions are for individuals who were unsure of their intent pre-pandemic and for poorer individuals who are no longer able to afford the costs of migrating at a time when these costs have increased and their remittance income has fallen. Nevertheless, despite these decreases in intentions, the overall desire to migrate the backway to Europe remains high, highlighting the need for legal migration pathways to support migrants and divert them from the risks of backway migration.
ABSTRACT
Introduction: One team, multiple sites is a principle supporting our Academic Health Sciences Centre (AHSC) partnership vision for academic and clinical excellence. COVID-19 has highlighted the need for co-ordinated crossorganisational working within ICU. There is currently no nationally agreed competency framework for ICU Physiotherapists. Having a streamlined set of competencies across the AHSC would be beneficial for safety, quality of care, training efficiency, workforce development, workforce mobility and further embed collaborative cross-site relationships. Objective: To develop streamlined competencies for ICU Physiotherapists working within an AHSC. Methods: Physiotherapy ICU leads from each site in the AHSC were identified via stakeholder mapping. This work stream was facilitated by a dedicated project lead, using a Plan-Do-Study-Act (PDSA) cycle. Organisational and national competencies1-3 relevant to ICU Physiotherapists were collated. Benchmarking and mapping were completed to identify commonalities and deficits. Initial meetings were conducted weekly via virtual forums to ensure benchmarking and mapping procedures were validated by all members. Two face-to-face meetings were employed to discuss the ideal competency set based on expert clinical opinion alongside the results from benchmarking and mapping. A whiteboard collaboration platform provided by Miro4 enabled all members to contribute whilst negotiations were facilitated by the project lead. Consensus on decisions pertaining to the streamlined document required all members to be in agreement. The method for achieving this centred on open discussion and regular communication. Results: The work stream utilised eighteen organisational competency documents and three national documents.1-3 The final competency set was formulated using common themes which allowed for incorporation of specific competencies from each site. Agreement on each theme and specific competencies were easily reached due to the extent of commonality between existing organisational documents. Rather than using bands to denote progression through competencies the work stream agreed on use of the terms Foundation, Specialist, Advanced and Expert, aligning the document with the Intensive Care Society AHP professional development framework.1 These levels are loosely aligned to the expectations for staff in bands 5-8, though allows staff to develop skills through the levels with no ceiling effect based on paygrade. The group comprehensively devised the foundation level set of competencies and approved a sign-off procedure using elements from organisational documents, including self-reported confidence measures and senior supervised assessment of competence. Conclusion: Using quality improvement methodology, the work stream was able to rapidly produce a comprehensive streamlined competency set for foundation level Physiotherapists in ICU across the AHSC. Next steps include gaining workforce feedback as part of a further PDSA cycle to refine the document prior to implementation. Continued collaboration by the work-stream will enable additional competency levels to be built from the foundation set. Education and training aligned to the document is essential for its success. Development of this will extend and reinforce the cross-organisational working and collaboration which is now embedded within the teams. The methodology to date demonstrates a proof of concept which can be utilised with other AHP groups in ICU, other settings or wider regional areas.
ABSTRACT
The COVID-19 pandemic has closed schools around the world, forcing school systems and students to quickly attempt remote learning. A rapid response phone survey of over 1,500 high school students aged 14 to 18 in Ecuador was conducted to learn how students spend their time during the period of quarantine, examine their access to remote learning, and measure their mental health status. The data show that 59 percent of students have both an internet connection at home and a computer or tablet, 74 percent are engaging in some online or telelearning, and 86 percent have done some schoolwork on the last weekday. Detailed time-use data show most students have established similar daily routines around education, although gender and wealth differences emerge in time spent working and on household tasks. Closure of schools and social isolation are the two main problems students say they face, and while the majority are mostly happy, 16 percent have mental health scores that indicate depression.