A Delphi consensus to identify the key screening tests/questions for a digital neurological examination for epidemiological research.

BACKGROUND: Most neurological diseases have no curative treatment; therefore, focusing on prevention is key. Continuous research to uncover the protective and risk factors associated with different neurological diseases is crucial to successfully inform prevention strategies. eHealth has been showing promising advantages in healthcare and public health and may therefore be relevant to facilitate epidemiological studies. OBJECTIVE: In this study, we performed a Delphi consensus exercise to identify the key screening tests to inform the development of a digital neurological examination tool for epidemiological research. METHODS: Twelve panellists (six experts in neurological examination, five experts in data collection-two were also experts in the neurological examination, and three experts in participant experience) of different nationalities joined the Delphi exercise. Experts in the neurological examination provided a selection of items that allow ruling out neurological impairment and can be performed by trained health workers. The items were then rated by them and other experts in terms of their feasibility and acceptability. RESULTS: Ten tests and seven anamnestic questions were included in the final set of screening items for the digital neurological examination. Three tests and five anamnestic questions were excluded from the final selection due to their low ratings on feasibility. CONCLUSION: This work identifies the key feasible and acceptable screening tests and anamnestic questions to build an electronic tool for performing the neurological examination, in the absence of a neurologist.

Trends and Patterns of Global Refugee Migration.

This paper studies long-term trends and patterns in global refugee migration. We explore the intensity, spread, and distance of refugee migration at a global, regional, and country level between 1951 and 2018. The analysis did not detect a long-term increase in the global intensity of refugee migration. Primarily depending on levels of conflict, refugee numbers have fluctuated at levels of between 0.1 and 0.3 percent of the world population. Apparent increases in numbers of the globally displaced are driven by the inclusion of populations and countries that were previously excluded from the data. While refugee populations continue to be concentrated in countries with low-to-medium income levels, the analysis reveals several geographic shifts in refugee migration. Refugees tend to come from a shrinking number of origin countries and move to an increasing variety of destination countries. This trend seems to reflect a concentration of recurrent conflict cycles in a relatively small number of countries and a parallel increase in the number of safe destinations. Although the vast majority of refugees remain near to origin countries, the average distance between origin and destination countries has increased over time, presumably linked to the greater ease of travel and migration-facilitating networks.

A theory of migration: the aspirations-capabilities framework.

This paper elaborates an aspirations-capabilities framework to advance our understanding of human mobility as an intrinsic part of broader processes of social change. In order to achieve a more meaningful understanding of agency and structure in migration processes, this framework conceptualises migration as a function of aspirations and capabilities to migrate within given sets of perceived geographical opportunity structures. It distinguishes between the instrumental (means-to-an-end) and intrinsic (directly wellbeing-affecting) dimensions of human mobility. This yields a vision in which moving and staying are seen as complementary manifestations of migratory agency and in which human mobility is defined as people's capability to choose where to live, including the option to stay, rather than as the act of moving or migrating itself. Drawing on Berlin's concepts of positive and negative liberty (as manifestations of the widely varying structural conditions under which migration occurs) this paper conceptualises how macro-structural change shapes people's migratory aspirations and capabilities. The resulting framework helps to understand the complex and often counter-intuitive ways in which processes of social transformation and 'development' shape patterns of migration and enable us to integrate the analysis of almost all forms of migratory mobility within one meta-conceptual framework.

Return Migration as Failure or Success?: The Determinants of Return Migration Intentions Among Moroccan Migrants in Europe.

Different migration theories generate competing hypotheses with regard to determinants of return migration. While neoclassical migration theory associates migration to the failure to integrate at the destination, the new economics of labour migration sees return migration as the logical stage after migrants have earned sufficient assets and knowledge and to invest in their origin countries. The projected return is then likely to be postponed for sustained or indefinite periods if integration is unsuccessful. So, from an indication or result of integration failure return is rather seen as a measure of success. Drawing on recent survey data (N = 2,832), this article tests these hypotheses by examining the main determinants of return intention among Moroccan migrants across Europe. The results indicate that structural integration through labour market participation, education and the maintenance of economic and social ties with receiving countries do not significantly affect return intentions. At the same time, investments and social ties to Morocco are positively related, and socio-cultural integration in receiving countries is negatively related to return migration intentions. The mixed results corroborate the idea that there is no uniform process of (return) migration and that competing theories might therefore be partly complementary.

Conceptualizing and measuring migration policy change.

This paper outlines the methodology of DEMIG POLICY, a new database tracking around 6,000 migration policy changes in 45 countries between 1945 and 2014. The article conceptualizes the notion of migration policy change and presents the coding system used to operationalize policy content, changes in policy restrictiveness, as well as the magnitude of policy changes. The paper also discusses the potential of DEMIG POLICY to improve our understanding of the nature, evolution, and effectiveness of migration policies. Besides significantly extending the geographical and historical coverage of existing migration policy databases, DEMIG POLICY also tracks emigration policies in order to overcome the common 'receiving country bias' in migration research. By offering key insights into the main features of the largest migration policy database completed to date, this paper hopes to provide useful guidelines to improve future efforts to measure migration policies. Such improvement is crucial given the heated debates on migration policy effectiveness on one hand and the still limited empirical evidence on this issue on the other.

Intra-household conflicts in migration decisionmaking: return and pendulum migration in Morocco.

By analyzing the migration behavior and transnational residential strategies of first-generation, aging migrants from a particular Moroccan sending region, this study contributes to a conceptual critique of migration theories that identify the household as the most relevant decisionmaking unit. It highlights the role of intra-household power inequalities and conflicts in migration decisionmaking as well as the effects of migration decisions for intra-household power relations. Many labor migrants who left Morocco to work in Europe in the 1960s and 1970s did not realize their wish to return but instead ended up reunifying their families at the destination. An increasing proportion adopts a pendulum migration strategy to reconcile their own wish to retain strong ties with Morocco with the reluctance of children and spouses to return. Migrants who unilaterally decided not to reunify their families usually return after their active working life. However, this unilateral decision also blocks legal entry into Europe for their children, which has generated considerable intergenerational tensions.

Migration and Development: A Theoretical Perspective.

The debate on migration and development has swung back and forth like a pendulum, from developmentalist optimism in the 1950s and 1960s, to neo-Marxist pessimism over the 1970s and 1980s, towards more optimistic views in the 1990s and 2000s. This paper argues how such discursive shifts in the migration and development debate should be primarily seen as part of more general paradigm shifts in social and development theory. However, the classical opposition between pessimistic and optimistic views is challenged by empirical evidence pointing to the heterogeneity of migration impacts. By integrating and amending insights from the new economics of labor migration, livelihood perspectives in development studies and transnational perspectives in migration studies - which share several though as yet unobserved conceptual parallels - this paper elaborates the contours of a conceptual framework that simultaneously integrates agency and structure perspectives and is therefore able to account for the heterogeneous nature of migration-development interactions. The resulting perspective reveals the naivety of recent views celebrating migration as self-help development "from below". These views are largely ideologically driven and shift the attention away from structural constraints and the vital role of states in shaping favorable conditions for positive development impacts of migration to occur.