Determinants and mitigating factors of the brain drain among Egyptian nurses: a mixed-methods study.

BACKGROUND: A brain drain is a migration of employees in their quest for an improved level of living conditions, better earnings, access to advanced technology and secure political conditions in diverse places worldwide. The brain drain of nurses is an ongoing phenomenon that impacts the quality and quantity of the nursing workforce and affects the quality of care. The nurses' brain drain is commonly known as a result of the interplay of many factors. So, identification of these factors and how to manage them is a timely topic in nursing research. AIMS: This study aims to investigate determinants of the nurses' brain drain and mitigating factors from nurses' perspectives in Egypt. METHODS: Mixed-methods research was conducted using a concurrent triangulation design. A sample of 325 nurses who were working at an Egyptian university hospital answered a brain drain questionnaire while the qualitative investigation was guided by a semi-structured interview with a purposive sample of 35 nurses to elicit exploratory perspectives on factors causing brain drain and mitigation strategies. Results were analysed using inferential statistics and thematic data analysis. RESULTS: Both push and pull factors can predict about 99.6% and 97.5% of the nurses' brain drain, respectively. Seven themes were derived from the qualitative content analysis, and six themes were categorised under 'push-pull' factors. In addition, the 'mitigating factors theme' was identified with five sub-factors as possible solutions. Economic and work environment reasons were reported as the most influential for nurses' brain drain. CONCLUSIONS: Policymakers could use the identified factors from quantitative and qualitative data for creating a system that would improve nurses' conditions and policies, and prevent nurses' migration. Nursing leaders have a significant role with non-remuneration strategies in retaining nurses through creating an empowering work environment. In addition, shared governance, a strong nursing syndicate role and professorial marketing would be essential mitigating factors for the nurses' brain drain.

Immune tolerance elicited via unique ocular and oral routes.

Immune tolerance can be induced by numerous methods. This review article aims to draw lines of similarity and contrast between two unique models of immune tolerance, namely Anterior Chamber Associated Immune Deviation (ACAID) and Nickel-induced oral tolerance. ACAID is an immune tolerance model that leads to the generation of CD4(+) T regulatory cells and CD8(+) T regulatory cells in the periphery after the injection of an antigen into the anterior chamber of the eye. Nickel-induced oral tolerance is another immune tolerance model that is induced by the contact allergen Nickel and leads to the generation of Nickel-specific CD4(+) CD25(+) T regulatory cells after oral exposure. The goal of comparing different models of immune tolerance is to identify which mechanisms are universal and which mechanisms are model-specific. The knowledge of such mechanisms would allow scientists and clinicians to better intervene in different immune deregulation scenarios.

Synthesis of novel 2-[2-(substituted amino)phenethyl]-1 H-benzimidazoles; 3,4-dihydro and 1,2,3,4,-tetrahydropyrimido[1,6-a]-benzimidazoles as potential antiulcer agents.

In an effort to establish new antiulcer agents a series of 2-(2-substituted amino)-1 H-benzimidazoles 8, 9, 14; 1,3-disubstituted-3,4-dihydropyrimido[1,6-a]benzimidazoles 4, 7, 11, 12; 3-substituted-3,4-dihydropyrimido[1,6-a]benzimidazol-1 (2H)-thiones (or (2H)-ones) 10, 17 and 3-substituted-1,2,3,4-tetrahydropyrimido[1,6-a]benzimidazoles 15 were synthesized. Representative members were selected to evaluate their gastric antisecretory activity using an in vivo pylorus ligated rat method. Omeprazole was used as reference. The results indicated that the test compounds exhibit gastric antisecretory activity. The percent inhibition+/-SEM at the indicated dose level was demonstrated as omeprazole (59%+/-0.16 at 3 mg/kg) > 15a (53%+/-1.39 at 3 mg/kg) > 7a (51%+/-1.04 at 1 mg/kg) > 10a (50%+/-1.36 at 3 mg/kg).