Influence of social media and the digital environment on international migration of health workforce from low- and middle-income countries post COVID-19 pandemic: a scoping review protocol.
Migration of the health workforce from low- and middle-income countries (LMCIs) is increasingly becoming a phenomenon of interest within migration governance systems. The COVID-19 pandemic aggravated health workforce shortages that have created job opportunities in high-income countries such as the USA, UK, Canada and Germany among others. Conditions of service in LMCIs are unattractive, leading to the search for better opportunities. The digital environment is becoming one of the facilitators of migration intentions due to the activities of recruitment agencies and the search for job opportunities on the World Wide Web. The digital environment creates opportunities for migration but also poses a security threat, economic loss and a brain drain to departure countries. However, there is a paucity of evidence on how the proliferation of advertisements on health workforce recruitment within social media, unsolicited emails and activities of recruitment agencies in the digital environment influence the migration of the health workforce and the implications of migration governance.
This scoping review protocol describes a comprehensive systematic extraction and examination of existing literature to map key concepts and identify previous literature, noting the gaps in how social media and the digital environment are influencing the migration of the health workforce. We lean on Arksey and O'Malley's scoping framework in developing this protocol. This involves the following: identifying research questions, searching for the literature, selecting articles or studies, charting the data and organising and reporting the outcome of the review. The review question is informed by the population, concept and context framework, which details the population as the health workforce (doctors, nurses, midwives and pharmacists), the key concepts as migration, social media and digital environment, and the context as LMICs. The search strategy was developed with the assistance of an experienced librarian who will work with the team to conduct a Peer Review of Electronic Search Strategies to evaluate titles, abstracts and full-text articles for inclusion from databases such as Scopus, PubMed, MEDLINE and Google Scholar. Additionally, we will search grey literature sources including online news media, social media platforms (Facebook, Instagram and Twitter), web pages of WHO, UN and migration-related agencies, and interfaces like EBSCO host. Two members of the team will screen titles and abstracts, and all team members will screen full text for data extraction. Data from grey sources will be converted to transcripts, coded and grouped into themes and subthemes consistent with thematic analysis strategies. All authors will be involved in the synthesis of the data. We intend to follow Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines in reporting the outcome of peer-review sources.
This is a scoping review protocol that addresses a subject of interest that poses no risk to individuals or groups. All the information will be retrieved from open sources only. The protocol was registered with the Open Science Framework registry (osf.oi/zan3q) to serve as an audit trail. Reports from the review will be published in peer-reviewed journals and presented at conferences.
Dzansi G
，Abdul-Mumim A
，Menkah W
，Ametefe V
，Xatse E
，Azanku BA
... -
《BMJ Open》
Ethics of Procuring and Using Organs or Tissue from Infants and Newborns for Transplantation, Research, or Commercial Purposes: Protocol for a Bioethics Scoping Review.
Since the inception of transplantation, it has been crucial to ensure that organ or tissue donations are made with valid informed consent to avoid concerns about coercion or exploitation. This issue is particularly challenging when it comes to infants and younger children, insofar as they are unable to provide consent. Despite their vulnerability, infants' organs and tissues are considered valuable for biomedical purposes due to their size and unique properties. This raises questions about the conditions under which it is permissible to remove and use these body parts for transplantation, research, or commercial purposes. The aim of this protocol is to establish a foundation for a scoping review that will identify, clarify, and categorise the main ethical arguments regarding the permissibility of removing and using organs or tissues from infants. The scoping review will follow the methodology outlined by the Joanna Briggs Institute (JBI), consisting of five stages: (1) identifying the research question, (2) developing the search strategy, (3) setting inclusion criteria, (4) extracting data, and (5) presenting and analysing the results. We will include both published and unpublished materials that explicitly discuss the ethical arguments related to the procurement and use of infant organs or tissues in the biomedical context. The search will cover various databases, including the National Library of Medicine, Web of Science, EBSCO, and others, as well as grey literature sources. Two raters will independently assess the eligibility of articles, and data from eligible studies will be extracted using a standardised form. The extracted data will then be analysed descriptively through qualitative content analysis.
There has been debate about how to respect the rights and interests of organ and tissue donors since the beginning of transplantation practice, given the moral risks involved in procuring parts of their bodies and using them for transplantation or research. A major concern has been to ensure that, at a minimum, donation of organs or other bodily tissues for transplantation or research is done under conditions of valid informed consent, so as to avoid coercion or exploitation among other moral harms. In the case of infants and younger children, however, this concern poses special difficulties insofar as infants and younger children are deemed incapable of providing valid consent. Due to their diminutive size and other distinctive properties, infants' organs and tissues are seen as valuable for biomedical purposes. Yet, the heightened vulnerability of infants raises questions about when and whether it is ever permissible to remove these body parts or use them in research or for other purposes. The aim of this protocol is to form the basis of a systematic scoping review to identify, clarify, and systematise the main ethical arguments for and against the permissibility of removing and using infant or newborn (hereafter, "infant") organs or tissues in the biomedical context (i.e. for transplantation, research, or commercial purposes).
Our scoping review will broadly follow the well-established methodology outlined by the Joanna Briggs Institute ( Peters et al., 2020). We will follow a five-stage review process: (1) identification of the research question, (2) development of the search strategy, (3) inclusion criteria, (4) data extraction, and (5) presentation and analysis of the results. Published and unpublished bibliographic material (including reports, dissertations, book chapters, etc.) will be considered based on the following inclusion criteria: the presence of explicit (bio)ethical arguments or reasons (concept) for or against the procurement and use of organs or tissues from infants, defined as a child from birth until 1 year old (population), in the biomedical domain, including transplantation, research, and commercial development (context). We will search for relevant studies in the National Library of Medicine (including PubMed and MEDLINE), Virtual Health Library, Web of Science, Google Scholar, EBSCO, Google Scholar, PhilPapers, The Bioethics Literature Database (BELIT), EthxWeb as well as grey literature sources (e.g., Google, BASE, OpenGrey, and WorldCat) and the reference lists of key studies to identify studies suitable for inclusion. A three-stage search strategy will be used to determine the eligibility of articles, as recommended by the JBI methodological guidelines. We will exclude sources if (a) the full text is not accessible, (b) the main text is in a language other than English, or (c) the focus is exclusively on scientific, legal, or religious/theological arguments. All articles will be independently assessed for eligibility between two raters (MB & XL); data from eligible articles will be extracted and charted using a standardised data extraction form. The extracted data will be analysed descriptively using basic qualitative content analysis.
Ethical review is not required as scoping reviews are a form of secondary data analysis that synthesise data from publicly available sources. Our dissemination strategy includes peer review publication, presentation at conferences, and outreach to relevant stakeholders.
The results will be reported according to the PRISMA-ScR guidelines. An overview of the general data from the included studies will be presented in the form of graphs or tables showing the distribution of studies by year or period of publication, country of origin, and key ethical arguments. These results will be accompanied by a narrative summary describing how each included study or article relates to the aims of this review. Research gaps will be identified and limitations of the review will also be highlighted.
A paper summarising the findings from this review will be published in a peer-reviewed journal. In addition, a synthesis of the key findings will be disseminated to biomedical settings (e.g., conferences or workshops, potentially including ones linked to university hospitals) in the UK, USA, Türkiye, and Singapore. They will also be shared with the academic community and policy makers involved in the organ procurement organisations (OPO), which will potentially consider our recommendations in their decision-making processes regarding infant tissue/organ donation practice in these countries.
The use of a rigorous, well-established methodological framework will ensure the production of a high-quality scoping review that will contribute to the bioethics literature.A comprehensive search of disciplinary and cross-disciplinary databases will be undertaken to ensure coverage of all possible sources that meet the inclusion criteria for the review.This review will focus exclusively on infant tissue/organ procurement/use in biomedical contexts, providing a comprehensive and reliable source of ethical arguments for future debates on this sensitive topic.The review will be limited to articles published in English, which increases the risk of missing relevant sources published in other languages.The review will be limited to articles for which the full text is available, which increases the risk of missing relevant sources that otherwise may have been included in the scoping review had the full text been accessible.
Barış M
，Lim X
，T Almonte M
，Shaw D
，Brierley J
，Porsdam Mann S
，Nguyen T
，Menikoff J
，Wilkinson D
，Savulescu J
，Earp BD
... -
《-》
Unintended consequences of measures implemented in the school setting to contain the COVID-19 pandemic: a scoping review.
Throughout the COVID-19 pandemic, schools were a key setting for intervening with public health and social measures (PHSM) to reduce transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Consequently, there is a need to assess the varied unintended consequences associated with PHSM implemented in the school setting, for students, teachers, and school staff, as well as for families and the wider community. This is an update of a Cochrane scoping review first published in 2022.
To comprehensively identify and summarise the published literature on the unintended consequences of public health and social measures implemented in the school setting to reduce the spread of SARS-CoV-2. This will serve to identify critical knowledge gaps to inform future primary research and systematic reviews. It may also serve as a resource for future pandemic management.
We searched MEDLINE, Embase, CENTRAL, PsycINFO, ERIC, and Web of Science on 5 and 6 January 2023. We also searched two COVID-19-specific databases (Cochrane COVID-19 Study Register and WHO COVID-19 Global literature on coronavirus disease). Finally, we reviewed the included studies of all relevant systematic reviews and guidelines identified through the searches.
We included studies that empirically assessed the impact of PHSM implemented in the school setting to reduce the spread of SARS-CoV-2. We imposed no restrictions with regard to the types of populations and specific interventions. Outcomes of interest were consequences that were measured or experienced, but not anticipated consequences. This review focused on real-world evidence: empirical quantitative, qualitative, and mixed-method studies were eligible for inclusion, but modelling studies were ineligible.
The review was guided by a logic model. In line with the latest Cochrane effectiveness review of school measures to contain COVID-19 and a conceptual framework of PHSM, this logic model distinguishes between measures to make contacts safer (related to individual protection and the physical environment), measures to reduce contacts (related to social interactions, movement, and services) and surveillance and response measures. Unintended consequences comprise the following categories: health and well-being, health system and social welfare services, human and fundamental rights, acceptability and adherence, equality and equity, social and institutional, economic and resource, and ecological. The review team screened all titles and abstracts, then potentially eligible full-text articles, in duplicate. Across the included studies, we summarised and presented types of measures, consequences, and study designs using the predefined categories of the logic model, while allowing for emerging categories.
We included 60 studies (57 new to this update) from 25 countries. There were 31 quantitative studies, 17 qualitative studies, and 12 mixed-method studies. Most targeted either students (26 studies), teachers and school staff (11 studies), or students and school staff (12 studies). Others evaluated measures aimed at parents (2 studies), staff and parents (1 study), students and teachers (3 studies), or the whole school (5 studies). The measures were related to individual protection (26 studies), the physical environment (20 studies), social interactions (25 studies), services (1 study), movement (3 studies), surveillance (9 studies) and response (7 studies). Nine studies evaluated the combined effect of multiple measures. The main consequences assessed were from the categories health and well-being (29 studies), acceptability and adherence (31 studies), and social and institutional (23 studies). Fewer studies covered consequences from the categories equality and equity (2 studies), economic and resource (7 studies), and ecological (1 study). No studies examined consequences for the health system and social welfare services or for human and fundamental rights.
This scoping review provides an overview of the evidence on the unintended consequences of PHSM implemented in the school setting to reduce the spread of SARS-CoV-2. The 60 included studies describe a broad body of evidence and cover a range of measures and unintended consequences, primarily consequences for health and well-being, acceptability and adherence, social and institutional aspects, and economic aspects. The main gaps identified relate to consequences of school measures for the health system and social welfare services, human and fundamental rights, equality and equity, and the environment. Further research is needed to fill these gaps, making use of diverse methodological approaches. Future studies should explore unintended consequences - whether beneficial or harmful - in more depth and over longer time periods, in different population groups, and across different contexts. A more robust evidence base could inform and facilitate decisions about whether, how, and when to implement or terminate COVID-19 risk mitigation measures in school settings, and how to counter negative unintended consequences.
This publication was partially funded by the German Federal Ministry of Education and Research (BMBF) within the Network of University Medicine (NUM) 1.0, Grant No. 01KX2021 in the context of the project CEOsys, and NUM 2.0, Grant No. 01KX2121 in the context of the projects PREPARED and coverCHILD.
The protocol is registered on the Open Science Framework (osf.io/bsxh8). The previous review is published in the Cochrane Library (10.1002/14651858.CD015397).
Littlecott H
，Krishnaratne S
，Hummel J
，Orban E
，Heinsohn T
，Noel-Storr AH
，Strahwald B
，Jung-Sievers C
，Ravens-Sieberer U
，Rehfuess E
... -
《Cochrane Database of Systematic Reviews》
ResearchGate
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