The migration "carousel" for health workers - or human resources for health (HRH) - is a phenomenon ripe with opportunities and difficulties for its many stakeholders. With an in-depth literature review, the situation is put into context, in terms of the underlying factors that prompt workers to relocate, as well as the facilitating effects of globalization and worldwide HRH shortages. The possible outcomes are discussed, particularly the externalities that relate to source and recipient countries. The actual impact of worker shortages on the delivery of health care is further clarified. Policy options for modulating HRH flows and enhancing HRH stocks are thereafter drawn. Individual as well as country interests are taken into consideration in deriving a range of applicable policy instruments. Managed migration schemes for HRH flows appear to provide the greatest flexibility for most concerned parties. The application of the derived policy framework in a leading HRH "donor" country, the Philippines, is presented. 

Human ; Male ; Female ; Philippines ; Health Personnel ; Delivery Of Health Care ; Policy ; Internationality

The use of a locally prepared polyethylene glycol electrolyte lavage solution (PEG-ELS) for preoperative bowel preparation of pediatric patients undergoing colostomy/ileostomy closure was compared with a standard three day regimen.Twenty-three patients were randomly assigned to either PEG-ELS or a standard three day bowel preparation, For both groups,? there were no significant differences in the changes in the pre and post-prep body weights, hematocrit, and serum electrolytes.Patients did not exhibit? abdominal cramps nor vomiting with either preparation. Intra-operative assessment showed adequate cleansing of bowels in both procedures. Postoperative complications were?not related to the preparations.? This study shows that using a locally prepared polyethylene glycol?electrolye lavage solution may be an excellent alternative to the standard?three day bowel preparation in pediatric patients.

Human ; Male ; Female ; Ileostomy ; Colostomy ; Therapeutic Irrigation ; Polyethylene Glycols ; Colic ; Hematocrit ; Vomiting ; Postoperative Complications ; Cathartics

Introduction. The COVID-19 pandemic has not only resulted in a public health crisis but has also strained hospital services. The provision of surgical care should therefore also be guided by ethical, and whenever applicable, also legal, principles. Methods. An integrative approach that covers clinical and ethical dimensions, as well as spans the spectrum of surgical care, is therefore necessary. This action research involved three key steps: 1) identification of ethical dilemmas related to the provision of surgical care during the COVID-19 pandemic; 2) preparation of clinical scenarios that highlight these dilemmas; and 3) determination of the appropriate options for the said scenarios, based on the best available evidence as well as most applicable ethical principles. Results. Ethical theories included utilitarianism, human rights, and communitarianism. Ethical principles included non-maleficence, justice, autonomy, and beneficence. Values considered were duty, reciprocity, human life, efficiency, fairness, fidelity, ownership, social value, and fair innings. Also incorporated were informed consent, allocation principles, resource allocation, and triage. In terms of operational issues and surgical technical concerns, the following were considered: phased standards of care, categorization of interventions, prioritization, surgical approaches, infection control, diagnostics, patient welfare, staff welfare, operations protocols, surgical training, and communication. Key points derived from the ethical and technical considerations of surgical care delivery during the COVID-19 pandemic are presented. Conclusion. This action research involving a review of the literature and stakeholder engagement has provided a concise ethical and technical resource for surgical administrators, practitioners, and trainees.
COVID-19 ; Pandemics