Community cohesion in Britain has been an issue of policy concern in recent years in which the role of migrants in the UK has been scrutinised in terms of their sense of belonging, integration and their economic and social contribution to society. However, much of the existing literature, in this area relates to the experiences of low/unskilled labour migrants. This thesis redresses this imbalance and examines the experiences of overseas-trained South Asian doctors. It provides unique insights into the debates about integration, cultural identity and community cohesion based on an empirical study of overseas-trained South Asian General Practitioners who are elite migrants. A mixed method approach was employed that included secondary data analysis of the GP Workforce Statistics and in-depth interviews with 27 overseas-trained South Asian doctors in three different geographical locales in England with varying ethnic populations. The quantitative analysis shows that a significant and increasing proportion of NHS doctors continue to be overseas-trained South Asian doctors. It also provides evidence of geographical clustering with South Asian doctors being over represented in deprived areas with high and low ethnic minority concentrations. The case studies and interviews with the GPs reveal a complex intertwining of macro-, micro- and meso- structures in the migratory process, related, in part, to the legacy of empire and also to the inner workings and opportunities provided by an organisation such as the NHS. In order to overcome blocked social mobility within the NHS hospital structure, entry into General Practice appears to be an entrepreneurial step for overseas-trained South Asian doctors, also facilitated by regional NHS institutional structures like Primary Care Trusts. Evidence shows that doctors have integrated their cultural/religious values creatively in their adaptation to Britain importing innovation into their everyday experiences. The findings show that there are parallels to be drawn with the experiences of low/unskilled South Asians, in particular, in the area of structural integration. However, there is variation as to how these elite professionals approach issues related to socio-cultural integration thus adding a new dimension to our existing understanding of community cohesion in the UK.

Magister Scientiae (Physiotherapy) - MSc(Physio) / Background: The role of the physiotherapist in the neonatal intensive care unit is unclear. How other neonatal healthcare professionals and physiotherapists themselves perceive their role in the management of neonates, their practice patterns and services, their role in the neonatal intensive care multidisciplinary team, their use of evidence-based practice and awareness of the profession in this setting has not been well explored. This information is lacking in the South African healthcare context as well. Therefore, the aim of the study was to explore and describe the perception of doctors, nurses and physiotherapists of the role of the physiotherapist in public and private sector neonatal intensive care units in South Africa. Methods: A qualitative exploratory research design was used. All medical practitioners (paediatricians and neonatologists), nurses and physiotherapists working in the neonatal intensive care units in two private sector and two public sector hospitals in the Cape Metropole region in the Western Cape South Africa who provided consent to participate were included. An inclusive (total population) sampling method was used where all healthcare professionals working in these units were invited to an individual face-to-face audiotaped interview using a semi-structured interview guide and conducted by the researcher at a time and place convenient to the participants following informed consent. Data was transcribed verbatim and analysed using both deductive and inductive thematic content analysis to develop codes, categories and themes. Trustworthiness was ensured by ensuring credibility, conformability, dependability and transferability of data. Ethics was obtained from the relevant Institutional Review Board. Results: Twenty-one healthcare professionals participated, including doctors (n=5), nurses (n=6) and physiotherapists (n=10). The mean age in years of the participants was 41+/–11 years with the physiotherapists having the lowest mean age. The participants had various years of general and neonatal intensive care experience and physiotherapists in specific only had basic undergraduate qualifications with minimal specialised training in neonatal intensive care. Five major themes emerged namely: i) the role of the physiotherapists in the management of the neonatal ICU patient, ii) practice patterns and services iii) teamwork iv) training and qualifications including evidence-based practice, v) awareness of and exposure to neonatal intensive care physiotherapy. Conclusion: Physiotherapists working in this neonatal intensive care setting need to promote their profession through education of other neonatal healthcare professionals in order to improve awareness, referral patterns and integration into the multidisciplinary team. Evidence-based practices and improving training and skills development in the area of neonatal physiotherapy can be further explored in this setting.

AIM This research attempts to understand the life of the medical professionals who play a pivotal role in the Swedish healthcare system. The main aim is to assess their burnout rates and workplace environment for understanding its direct or indirect effect on their performance and society. This research also includes suggestions and ideas for improvement and solutions to certain recurring problems that were highlighted by the professionals themselves during the research questionnaire. METHOD Questionnaire responses and the qualitative method of analysis are used for this study. Proper ethics for conducting a research questionnaire were followed. The demographic questionnaires took place with the help of google forms online, where doctors and medical professionals from different parts of Sweden who were willing to volunteer participated with full consent and were given the option to only answer questions that they were most comfortable with answering.RESULTSPromising results were established after the questionnaire, where the volunteering doctors were more than willing to express their working conditions, positive outcomes, and drawbacks. The final results can be divided into the following themes: work schedule, staff shortage, transport, session limitations, personal life, stress, self-accomplishment, job satisfaction, patient-care and areas of improvement. CONCLUSION This research’s findings show that there is a correlation between burnout rates and the performance of healthcare professionals, which in turn has a minor and indirect effect on society

The fact that many OECD countries are reliant on international medical graduates (IMGs) to serve their most vulnerable has become even more apparent in the wake of Covid-19. This dissertation examines the role that nation brands play on the international physician labor market and how visa regimes and migration industries shape IMG pathways to Sweden versus US; two widely different societies where around a third of all doctors are IMGs. The US and Sweden represent two different approaches to addressing the same problem — solving a shortfall of healthcare providers, especially in rural areas populated by ethnic minorities and low-income families. While many Swedish regions actively attempts to facilitate the incorporation of IMGs through an intra-European physician recruitment industry, the US seem to rely on the attraction of its political economy and has done little to modify the substantial financial and visa-related obstacles that IMGs face. As a high-skilled immigrant group, immigrant physicians occupy a complex position of advantage and disadvantage; they are privileged in comparison to low-income migrant workers and unauthorized immigrants, yet face more barriers in comparison to domestic physicians, and are often informally sorted into less prestigious positions. This study centers the two largest immigrant physician groups in each country: Indians in the US and Poles in Sweden. The experiences of these labor migrants are triangulated against a third IMG group that have undergone the asylum process in order to reach their host societies — Iraqis. / 2025-05-11T00:00:00Z

This study conducted a cross-sectional study amongst students at the University of Central Florida (UCF) that assessed degree of belief in Health at Every Size (HAES) and an accompanying Trust in Doctors to see if there was a significant relationship between the two variables. The HAES survey was constructed specifically for the use in this research and was constructed in a 0-10-point Likert scale in order to establish a gradient of belief in HAES. To identify degree of trust in doctors, a pre-established item-bank was drawn from and coupled with the piloted survey. The sample size included 400 UCF students which was gathered using digital surveys, which allowed for swift gathering of data. The data collected indicated a significant association between the varying levels of trust in doctors and the performance on the HAES spectrum. We found that while trust increased, scores on the HAES spectrum decreased. Thus, we were able to reject the null hypothesis and assume the relationship to be significant. Further testing heralded there to be no significant difference between STEM majors and non-STEM majors when assessing for both trust in doctors and belief in HAES. This study serves as groundwork for future assessment of belief in HAES as the movement evolves or devolves. Further, this survey fills a gap in the literature that assesses perception of HAES and trust in doctors as it pertains to young adults (18-24-years old).

This project provides the first comprehensive investigation into the experiences of people with dementia (PWD), their carers, and the staff who provide care in emergency departments (ED) in the UK. This is a mixed methods study which used a national survey (N=403) followed by ED observation (32 hours) and qualitative interviews with health professionals (N=29), in an iterative and sequential design to present a holistic evaluation of the current experiences of the key parties- patients, carers, and ED staff involved in receiving and providing care. The theoretical perspective of the Human Factors Approach to patient safety underpins this work. The project included people with dementia and carers as collaborators and co-designers in both the development of the research tools and in shaping the project outputs. This research explores the barriers and facilitators to safe and effective care, concluding that here are a number of barriers (poor integration of communication systems, inappropriate physical environments, misalignment of staff training and workplace staffing models), which may affect the healthcare team’s ability to provide effective dementia care. These systemic challenges both give rise to and exacerbate poor organisational and safety cultures. However, despite these challenges, there are examples of safe and effective care (positive deviants) where uncommonly good outcomes for this patient population are achieved. Examining these examples offers valuable insight into potential adaptions, which could be used to improve existing care.

Cette recherche vise à mettre en évidence les transformations des processus identitaires intervenant chez des médecins diplômés à l’étranger et exerçant en France et au Brésil. Nous avons appuyé notre travail sur une approche dynamique et adaptative de l’identité personnelle, en particulier à travers l’identité dialogique et l’identité narrative. De plus, dans la mesure où ce travail fait intervenir de manière importante le contexte professionnel, il nous semblait pertinent de faire intervenir aussi la question de l’identité professionnelle et de ses liens avec la reconnaissance. Enfin, l’interculturalité étant centrale dans cette problématique, nous avons choisi de l’aborder sous l’angle de l’identité interculturelle et de l’interculturation. L’objectif de cette recherche est de caractériser les processus identitaires présents chez médecins diplômés à l’étranger, confrontés à une situation de diversité culturelle dont la gestion a des rapports importants avec leurs processus identitaires personnels et professionnels. En particulier, nous cherchons à comprendre les processus psychiques permettant au sujet de donner sens à son expérience migratoire afin de se l’approprier et d’engager une transformation de son identité. Nous travaillerons également sur les obstacles rencontrés par les sujets et à établir la place de la reconnaissance au sein de ces différents processus. Enfin, l’analyse des données contribue à démontrer les processus d’influence mutuelle intervenant entre l’appartenance culturelle et le contexte d’activité professionnelle. Quatre méthodes de construction et d’analyse des données ont été combinées afin de répondre à ce questionnement. Dans un premier temps, nous avons réalisé un questionnaire visant à caractériser notre population et à recenser les facteurs déclencheurs d’une migration. Ensuite, nous avons conduit des entretiens de type biographique afin d’amener le sujet à « se raconter », à mettre en récit sa trajectoire personnelle, en rapport avec des aspects identitaires. Puis, en fin d’entretien, nous avons proposé aux sujets de visionner un ensemble d’extraits vidéo issus d’un documentaire et de deux reportages afin de les confronter à plusieurs points de vue et situations en vue de faire émerger une réflexion sur leur vécu. Enfin, nous avons effectué une analyse documentaire d’un ensemble d’articles de presse. 89 médecins ont répondu au questionnaire, 43 en France et 46 au Brésil. Huit récits de vie ont été menés en France avec des sujets âgés de 36 à 71 ans, trois femmes et cinq hommes parmi lesquels deux avaient obtenu leur diplôme dans un pays de l’UE et six hors de l’UE. Nous avons également analysé un corpus de 25 articles de presse et trois reportages télévisés. L’influence de la reconnaissance du diplôme sur la trajectoire et les processus identitaires de ces sujets ainsi que l’importance de la langue, du genre et du projet migratoire sur ces processus ont été clarifiés par l’analyse de l’ensemble des données. L’analyse des trajectoires personnelles, professionnelles et migratoires des sujets qui ont participé à cette recherche présente l’impact d’un ensemble de facteurs culturels, sociaux et institutionnels sur des événements biographiques — individuels. Ces deux dimensions — l’individuel et le culturel - se trouvent en constant dialogue et en constante co-évolution pour rendre chaque trajectoire unique et semblable, processus centrale à la formation de l’identité de chaque individu. / This research aims at investigating the changes that occur within the identity processes of physicians with a foreign diploma working in France and Brazil. Our work is based on a dynamic and adaptive approach of personal identity, specifically through the concept of dialogical self but also through the narrative identity approach. Since we also focus importantly on what happens in the professional environment, we also used theories related to professional identity and its relations with recognition. Finally, since the intercultural question is central in this research, we have chosen to include the intercultural identity theory and the concept of interculturation. This research aims at identifying and understanding the identity processes presented by medical doctors confronted to a changing cultural and professional context. We specifically intend to understand the psychological processes which allow the subject to give a meaning to his experience and make it his to start a transformation of his identity. We also focus on the obstacles the subject has to deal with, in particular regarding recognition. Finally, we intend to show the processes of mutual influence occurring between cultural belonging and professional context. We have crossed four methods to build and analyze our data. At first, we have used a questionnaire to characterized our population from a socio-demographic point of view and reunite all the factors which explain their migration. Then, we have conducted eight biographical interviews to encourage the subject to build a self-narrative. In the last phase of the interview, the have subjects have been shown four short videos from three documentaries to confront them to different points of view and situations and have them reflect on their own experience. We also included a documentary analysis using press articles regarding the Brazilian context. We obtained 89 answers to the questionnaire, 43 in France and 46 in Brazil. We conducted 8 narrative interviews, with physicians aged between 36 and 71, 3 women and 5 men, among which 2 had a European Union diploma and 6 had a diploma from outside the UE. Our analysis has shown that the validation of the diploma has a great impact on each individual’s recognition and identity related processes. This recognition aspects are also mediated by factors such as gender, language and cultural through dialogical relationships involving the subject.

During a long period of time, rental doctors have created a vast debate in Sweden. Currently, there is a shortage of doctors working in Sweden and to guarantee the lawful right to healthcare of high quality the counties must hire doctors through employment agencies. There are different opinions about rental doctors, some thinks the temporary employment results in a negative work environment and furthermore puts the patients at risk. Other people consider the Swedish healthcare to not function without rental doctors.  The purpose of this essay is to investigate rental doctors through a legal perspective and how temporary employment actually affects the patients’ security and the work environment in Sweden’s healthcare. Additionally, I want to examine options for counties to reduce the dependence of rental doctors and employment agencies. Through this essay I have foremost found a shortage of specialized doctors in Sweden, although there has been an incline of students in medicine. Counties in the northern parts of Sweden and sparsely populated areas have the vastest dependence of rental doctors, which results in future complications. Rental doctors are a necessity to guarantee a positive healthcare in counties that are having difficulties recruiting personal, but in long-term dependence of rental doctors complications appear. The long-termed temporary employment jeopardies the patient’s security and consistency of the treatment and affects the work environment in the healthcare. A majority of workers values social relations at work and a constant shortage of staff results in stress and illness. Therefore it is a necessity to reduce the dependency of rental doctors, although they are a necessity when no other caregiver is of disposal. When Sweden became a part of the European Union, the possibilities expanded for doctors to educate and work all around the union. All states in the union accepted the directive 2005/36/EG which means that all education for doctors to be equal and a simplification of the international labor market. In the beginning of the 21st century there was a growth in Swedish medical students that study and work abroad. There is also an incline of foreign doctors who decides to work in Sweden; furthermore it creates complications including longer introductions and language difficulties. However the inclines of foreign doctors are a useful alternative to reduce the dependence of rental doctors. / Hyrläkare, även kallat stafettläkare har länge skapat en hård debatt i Sverige. En läkarbrist råder i Sverige och för att garantera en god vård till befolkningen enligt HSL måste landstingen hyra in läkare genom bemanningsföretag. Det finns olika åsikter kring stafettläkare, vissa menar att inhyrningen orsakar en negativ arbetsmiljö som dessutom riskerar patientsäkerheten. Samtidigt som andra menar att den svenska vården inte skulle fungera utan stafettläkare. Mitt huvudsakliga syfte med denna uppsats är att belysa fenomenet stafettläkare ur ett rättsligt perspektiv och hur inhyrd personal påverkar patientsäkerheten samt arbetsmiljön i Sveriges hälso- och sjukvård. Uppsatsen ska även utreda tillgången på läkare, landstingens alternativ gällande bemanning och undersöka huruvida det är möjligt för landstingen att minska sitt beroende av stafettläkare. Genom denna uppsats har det framförallt visat sig en rådande brist på specialistläkare i Sverige, trots en ökning av studenter på läkarutbildningen. Beroendet av hyrpersonal är speciellt märkvärt i glesbygden och de norra delarna av Sverige.  Stafettläkare är en nödvändighet för att kunna garantera en god vård för befolkningen där det finns svårigheter att rekrytera läkare, men genom ett långvarigt behov uppstår det komplikationer. Stafettläkare riskerar att skada kontinuiteten i behandlingen samt patientsäkerheten. Ytterligare kan ett långvarigt användande av stafettläkare innebära negativa upplevelser av arbetsmiljön. Många arbetstagare värdesätter en social relation med sina arbetskamrater och ständig underbemanning skapar stress och ohälsa. Därför är det viktigt att finna alternativ för ett minskat behov av stafettläkare, trots att de är räddare i nöden när ingen annan vårdgivare finns.  När Sverige blev medlem i den Europeiska Unionen utvidgades möjligheterna markant för läkare att både utbildas och arbeta i unionens medlemsstater. Medlemstaterna harmoniserade direktivet 2005/36/EG som innebar att alla läkarutbildningar ska anses likvärdiga och underlätta läkares fria rörlighet inom unionen. I början av 2000-talet ökade antalet studenter som utbildar sig samt arbetar i ett annat land. Dessutom ökar antalet utländska läkare som kommer och arbetar i Sverige, vilket skapar ett tillskott av tillgången på läkare. Dock råder problematik gällande utländsk arbetskraft, det krävs en längre introduktion och komplikationer kring språkbarriärer. Trots detta är utländsk arbetskraft ett bra alternativ för att minska beroendet av stafettläkare.

In recent years medical societies have begun to recognize the effects and benefits of good communication between physician and patient. Like any other relationship, the exchange of information with fluent understanding creates a stronger bond of trust. Most applied research conducted in the area of physician-patient communication concentrates on physician behaviors which the patient views as problematic. This thesis focuses on patient assertiveness and its relationship to physician-patient satisfaction in the consultation process. Specifically, the study focuses on the relationship between patient assertiveness and physician-patient satisfaction. For the study the researcher developed a patient questionnaire and pre- and post-physician questionnaires to assess patient assertiveness. This factor relates to outcomes of satisfaction from the physician-patient consultation. Twenty doctors and two hundred patients participated in the study. The implications of these finding should provide insight into the patient-physician consultation process.

Thesis titled Commercial communications in czech pharmaceutical industry is about how to use marketing communication tools (advertising, public relations, sales promotion, personal selling, etc.) in the pharmaceutical industry. A specific feature of pharmaceutical marketing is separate communication to public (patients) and to professionals (doctors) which requires using different communication messages and also different channels to each target group. Pharmaceutical marketing is regulated by advertising law, by the Council for Radio and TV Broadcasting and by the provisions of the State Institute for Drug Control which control the ways how two target groups are addressed. Possible marketing tools are described from both theoretical (legal) and also practical (marketing communication of specific pharmaceutical company) terms.