Tendencies towards emigration and their association with introversion and ethnocentrism among final-year medical students from Osijek, Croatia: a cross-sectional study.

BACKGROUND: The migration of healthcare workers is attracting growing attention worldwide. Attitudes towards emigration develop over the years, and it is possible that, in addition to social factors, they are influenced by the characteristics of a person's personality and the sense of belonging to the social environment. This study aimed to determine the tendencies of final-year medical students' from Osijek, Croatia, towards emigration after graduation and after specialization, as well as their specialty preferences and to investigate whether introversion and ethnocentrism have an impact on attitudes toward leaving the country in search of employment elsewhere. METHODS: A cross-sectional study was conducted among final-year (6th year) medical students from Osijek, Croatia, in two consecutive academic years - 2014/2015 and 2015/2016. Students completed a questionnaire about sociodemographic characteristics, academic and scientific performance, preferences about their future medical career, the medical specialty of choice, emigration tendencies after graduation and specialization, ethnocentrism and introversion. RESULTS: There were 124 students who participated in the study (response rate: 96%). A quarter of participants agreed that they are likely or very likely to emigrate after graduation (25.0%) or after specialization (23.39%). Variables associated with the intention to emigrate were specialty preferences (students that prefer endocrinology and psychiatry had the highest emigration tendencies), academic year in which the participants were included (students included in 2014/2015 were more prone to emigrate after specialization, p = 0.060), prior involvement in scientific projects (students with experience in scientific projects expressed higher tendencies to emigrate after graduation, p = 0.023), and ethnocentrism (higher ethnocentrism was associated with a lower tendency towards emigration after specialization, Spearman's rho = -0.191). CONCLUSION: Our finding that a quarter of final-year medical students from the Faculty of Medicine Osijek were considering emigrating from Croatia in search of employment elsewhere after graduation or specialization is not as high as in previous Croatian studies or studies conducted in other European countries. Even though these data may be encouraging, considering the lack of physicians in Croatia, interventions are needed to prevent permanent emigration to protect the future functioning of the Croatian health system. Furthermore, our study did not find significant associations between levels of introversion and ethnocentrism and tendency to emigrate from Croatia. It seems that the phenomenon covering the emigration of students is more complex and influenced by many other factors which were not included in our study.

Sexual function in hemodialysis and post-renal transplant women in a relationship: a cross-sectional study.

PURPOSE: Difficulties in sexual functioning are very frequent in patients with chronic kidney disease (CKD). Sexual dysfunction (SD) can significantly diminish the quality of life (QOL) of affected individuals. The aim of this study was to determine the prevalence of SD in female patients undergoing chronic hemodialysis (CHD) and after renal transplantation (RTx) and to compare these groups with each other and with healthy control. METHODS: The survey was conducted among 123 female participants in a relationship, 28 of them undergoing CHD, 39 after RTx, and 56 healthy women without CKD. For the assessment of the sexual function and comorbidities, the Female Sexual Function Index (FSFI) questionnaire and Ifudu Comorbidity Index were used, respectively. RESULTS: Median age of all female participants was 60 (50-68). The median age of female CHD patients was 66 (61.3-72.8), RTx patients 56 (48-61), and the control group 59.5 (47.5-67.75). Among all participants, CHD female patients had the lowest scores in all sexual functioning domains. Compared to their age-adjusted control group, CHD patients had lower scores in desire, orgasm, and FSFI full score, whereas RTx patients had lower total FSFI scores and scores in all domains except for desire compared to their controls. Women with lower education, in marriage, and with more comorbidities had lower scores in sexual function domains. CONCLUSION: Our study shows that SD in female patients undergoing CHD treatment or those after RTx is substantially higher than that in healthy women. We suggest that female patient treated for CKD should have proper care regarding their sexual health, and differences in demographic and medical factors should be taken into consideration during the treatment management.