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Oral submucous fibrosis (OSF) is a chronic disorder prevalent in South and Southeast Asia and is mainly related to the habit of chewing betel quid. Although there are numerous South-Asian studies about OSF, there is no study that evaluates the awareness of OSF among expatriate populations of South-Asian origin. Evaluated the awareness of OSF among South-Asian expatriate patients reporting to a dental hospital in Sharjah. Prevalidated questionnaires were given to 150 expatriate patients of South-Asian origin with quid-chewing habit reporting to the teaching clinics of a dental hospital in the United Arab Emirates. Among the 150 patients, 103 responded to the questionnaire. Among the 103 respondents, 11.65% were aware of OSF. Respondents living in shared residency and labor camps had significantly (P = 0.43) lower awareness of OSF compared to respondents living with their families. The results of our study show that the awareness of OSF is lower among the respondents living in labor camps and shared residencies. The younger respondents had more awareness of OSMF and were more likely to quit the quid-chewing habit.

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BACKGROUND: The healthcare sector in the Middle East, particularly in Qatar, relies heavily on expatriate professionals. The successful adaptation of these expatriates to the local environment is crucial as it significantly affects their job satisfaction and the quality of care they deliver to patients. This study aimed to identify and analyze the key factors influencing the adjustment of healthcare expatriates in Qatar to their professional roles and the cultural context of the region. METHODOLOGY: This study involved the use of a cross-sectional survey approach targeting healthcare professionals in Qatar, with a targeted sample size of 385 participants selected to ensure a comprehensive representation of the expatriate workforce. The survey was disseminated through expatriate-specific WhatsApp groups from October 1, 2022, to December 31, 2022. It was structured to examine a variety of factors influencing expatriate adjustment, including age, gender, proficiency in the Arabic language, social support networks, job type, and length of stay in Qatar. The primary focus of this study is a thematic analysis of the respondents' free-text comments. These comments offer valuable insights into their experiences, both positive and negative, in adapting to life and work in Qatar. RESULTS: This study achieved a response rate of 51.69% (199 out of 385), with participants representing 10 nationalities, being predominantly aged between 35 and 44 years, and having spent four to seven years in Qatar. The majority of respondents were nurses and doctors, accounting for 83.9% of the sample. The following five main themes emerged from the analysis of 218 free-text comments: personal and family concerns, work-related matters, government and system-related challenges, social and cultural challenges, and Arabic language challenges. Although participants valued supportive employer practices in family relocation and professional environments, they encountered language barriers, bureaucratic complexities, and cultural adaptation challenges. CONCLUSION: The results of this study shed light on the multifaceted nature of expatriate adjustment in the healthcare sector of Qatar, highlighting the supportive elements and the obstacles encountered. They emphasize the need for comprehensive support mechanisms, including language training, streamlined bureaucratic processes, and cultural orientation programs, to facilitate successful and fulfilling expatriate experiences in the Middle Eastern healthcare context.

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BACKGROUND: Travel to Southeast Asia increases the likelihood of acquiring mosquito-borne Flavivirus infections such as dengue (DENV), Japanese encephalitis (JEV) and Zika viruses (ZIKV). Expatriates are long-term travellers who have a higher risk of mosquito-borne illness at their destination country. The purpose of this study was to evaluate the seroprevalence of DENV, JEV and ZIKV infections and the determinants contributing to seropositivity among expatriates living in Thailand. METHODS: A cross-sectional study was performed from December 2017 to February 2020. Expatriates from non-Flavivirus endemic countries were recruited. 5 mL of blood was collected for DENV 1-4, JEV and ZIKV antibody testing by plaque reduction neutralization test (PRNT50). Individuals with vaccination histories or diagnoses for dengue, Japanese encephalitis, yellow fever and tick-borne encephalitis were excluded. RESULTS: Among 254 participants, most participants (83.1%) were male, the mean age was 65 years and the median duration of stay in Thailand was 6 years. Seroprevalence rate of any Flavivirus, non-specific DENV, DENV1-4, JEV and ZIKV were 34.3, 30.7, 20.5, 18.1, 18.9, 10.6, 4.7 and 2.8%, respectively. The presence of neutralizing antibodies against DENV1-4 positively correlates with the duration of stay in Thailand. DENV seropositivity was associated with living in urban areas (aOR 2.75, 95% CI 1.36-5.57). Expatriates were unlikely to have detectable anti-JEV antibodies regardless of time spent in a JEV-endemic area. No risk factors were identified that were significantly associated with JEV or ZIKV seropositivity. Only 48.4% received pre-travel counselling services, while only 18.9% visited a travel medicine specialist. CONCLUSIONS: A high proportion (34.3%) of long-term expatriates living in Thailand were seropositive for flavivirus, mainly from dengue (30.7%). To minimize risk, travel medicine practitioners should provide adequate pre-travel health risk information on mosquito-borne flavivirus infection and offer advice on mosquito bite prevention strategies. Dengue vaccine might be considered in high-risk travellers such as long-term expatriate.

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Background: Diversity in clinical signs and symptoms are associated with soil transmitted diseases (STD), which are spread to humans by intestinal worms and transmitted in a variety of ways. There is a need for the present study, which aimed to investigate the prevalence of intestinal parasites and to compare between the common detection techniques for soil-transmitted helminths (STHs) among newly arrived expatriate labors in Jeddah, Saudi Arabia. Methods: A total of 188 stool samples were analyzed by macroscopic examination, and microscopic examination using direct iodine smear and the formal ether sedimentation technique. Trichrome and modified Kinyoun's stains were used to confirm the morphology of any detected protozoa stages and oocyst of Cryptosporidium, respectively. A chromatographic immunoassay kit was used for Entamoeba histolytica, Giardia lamblia and Cryptosporidium. In addition, real-time PCR was employed only to identify various STHs. Results: Out of 188, several types of parasites were detected in 35 samples (18.62%), of which some with multiple infections. Nine samples (4.79%) were positive for Entamoeba coli, seven samples (3.72%) for Trichuris trichiura, six samples (3.19%) for Necator americanus, four samples (2.13%) for Strongyloides stercoralis, four samples (2.13%) for Ascaris lumbricoides, four samples (2.13%) for E. histolytica, three samples (1.60%) for Blastocystis hominis and two samples (1.06%) for Ancylostoma duodenale. In comparison between laboratory techniques for STHs, real-time PCR was able to detect the DNA of 19 samples (10.1%) followed by Ritchie sedimentation technique (18, 9.6%), and direct smear (7, 3.7%) (p > 0.05). Conclusion: The high rate of newly arrived foreign workers infected with intestinal parasites could lead to a risk to society. Continuous and regular surveys are needed to deal with the occurrence of intestinal parasitic infections including STHs. To improve the identification of these infections, we recommend a supporting infrastructure for the application of concentration methods and molecular assays.

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AIM: To investigate the association between job resources, job satisfaction, and moderating effect of COVID-19 anxiety and practice setting among expatriate acute care nurses in Qatar. BACKGROUND: Expatriate nurses are more vulnerable to reduced job satisfaction. Increased COVID-19 anxiety and reduced perceived job resources among acute care nurses impact their job satisfaction more than that of general ward nurses. METHOD: An online survey was used to recruit 293 expatriate acute care nurses from four public hospitals in Qatar. Data were collected between June and October of 2021. Structural equation modeling was used for data analysis. We ensured to follow STROBE guidelines when doing this research. RESULTS: Job resources were a significant predictor of job satisfaction among expatriate acute care nurses (ß = 0.80, 95% CI: 0.73-0.85, p < 0.001). There was no significant moderating effect of COVID-19 anxiety (ß = 0.055, 95% CI: -0.61 to 0.151, p = 0.329) or workplace setting on this relationship (χ2  = 0.077, df = 1, p = 0.781). DISCUSSION: Our study found that the relationship between job resources and acute care nurses' job satisfaction is consistent across different workplace settings regardless of the level of COVID-19 anxiety. This is in line with previous studies that have highlighted the importance of job resources in determining nurses' job satisfaction. CONCLUSION: The study emphasizes the need for sufficient job resources for improved job satisfaction among expatriate acute care nurses in Qatar, especially during the COVID-19 pandemic. IMPLICATIONS FOR NURSING POLICY: Nursing leaders must prioritize adequate resources such as staffing, proper training, and policies that increase nurse autonomy to improve job satisfaction and reduce the negative effects of dissatisfaction.

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Introduction: Expatriates are facing more stressors, such as cross-cultural adjustment, global political instability, family separation, health concern. The black swan events of the pandemic and the Russian-Ukrainian war have posed significant challenges in the current international environment. Adapting to an expatriate environment as soon as possible is critical to expatriate success. This study aims to examine the factors that affect expatriate adjustment through psychological resilience. Methods: Guided by person-environment (p-e) fit theory, an expatriate adjustment framework based on psychological resilience is proposed, and 309 valid sample data are used for structural equation model (SEM) analysis. Results: The results show that expatriate adjustment is a psychological process based on the development of resilience. Social support plays a buffering role in dealing with environmental deviations induced stressors. The person-environment transactional process is the most critical adjustment process. Discussion: The development of expatriate adjustment is divided into four stages (shock, buffer, adjustment, mastery) consistent with resilience development. Project managers can take different expatriate management strategies from multiple aspects. Finally, this study proposes the U-curve hypothesis of expatriates' psychological resilience development aligned with the U-curve process of expatriate adjustment for future research.

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For dual-earner expatriate couples (DEECs), it is particularly challenging to achieve career satisfaction after relocating to another country and the associated career transitions. While studies have addressed the strenuous career pathways of individuals in DEECs, the identification and empirical analysis of resources that may contribute to the attainment of career satisfaction remains a desideratum. This research investigates the impact of self-enhancing humor and community embeddedness on individual career satisfaction and the crossover effects of humor on that of the partners in DEECs. Using data from 109 DEECs in Europe and Actor-Partner Interdependent Model (APIM), the results show that embeddedness in one's community mediated the relationship between humor and career satisfaction. The study also unfolded the crossover effects of humor within couples: Men's humor promoted their female partner's community embeddedness, which, in turn, promoted women's career satisfaction. This study entails fruitful implications for future research on DEECs and practical recommendations for relevant stakeholders to facilitate the careers of DEECs.

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Background: Population size and structure have a huge impact on health indicators. In countries with a high proportion of expatriates, there are some limitations in estimating, aggregating and reporting of the health indicators, and corrections may be required in the established estimation methodologies. We review the case of Qatar to see how its specific population characteristics affect its health indicators. Methods: We used routinely collected data and reviewed and calculated a selected list of health indicators for Qatari and non-Qatari populations residing in Qatar. Mortality and cancer incidence rates, stratified by nationality, were used for this purpose. Also, a direct method was used to estimate completeness of the death registry, compared to the mortuary data. Results: Age and sex distribution of Qatari and non-Qatari populations are completely different. Compared to the mortuary data, completeness of death registration for the total population was estimated at 98.9 and 94.3%, with and without considering overseas deaths, respectively. Both estimates were considerably higher than estimates from the indirect methods. Mortality patterns were different even after standardization of age and stratification of sex groups; male age-standardized mortality rates were 502.7 and 242.3 per 100,000 individuals, respectively for Qataris and non-Qataris. The rates were closer in female populations (315.6 and 291.5, respectively). The leading types of cancer incidents were different in Qataris and non-Qataris. Conclusions: Expatriates are a dynamic population with high-turnover, different from Qatari population in their age-sex structure and health status. They are more likely to be young or middle-aged and are less affected by age related diseases and cancers. Also, they might be at higher risks for specific diseases or injuries. Aggregating indicators of Qatari and non-Qatari populations might be mis-leading for policy making purposes, and common estimation correction approaches cannot alleviate the limitations. High-proportion of expatriate population also imposes significant errors to some of the key demographic estimates (such as completeness of death registry). We recommend a standardized approach to consider nationality in addition to age and sex distributions for analysis of health data in countries with a high proportion of expatriates.

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PURPOSE: Unrelieved pain among hospitalized children is a common problem that affects all aspects of children's health and their quality of life. Cultural and language differences between nurses and patients have been shown to impact the quality and safety of nursing care and management for children with pain. The aim of this study was to identify the cultural factors, barriers, and facilitators impacting the assessment and management of children's pain by expatriate nurses in Saudi Arabia. DESIGN AND METHODS: A qualitative descriptive design was employed in this study. A sample of 16 nurses was conveniently recruited and interviewed through face-to-face semistructured interviews. Each interview lasted between 30 and 60 min and was audio-recorded. Content analysis was used to analyze the transcripts. Transcripts were carefully read, significant statements were highlighted, coded, categorized, and clustered thematically. RESULTS: Three main themes were identified, namely, (I) low priority of children's pain, (II) culture and religious challenges, and (III) communication challenges. PRACTICE IMPLICATIONS: Cultural and language differences described by expatriate nurses hindered their care of children with pain. A systematic education for expatriate nurses, children, and families is urgently needed to enhance inter/cross-cultural understandings and improve childcare in Saudi Arabia. This study identifies the unique challenges faced by expatriate nurses in Saudi Arabia. The findings reveal how a lack of knowledge about cultural values and beliefs can lead to misunderstandings and conflicts between nurses, children, and families and can have an impact on childcare and pain. It also highlights the need to improve pain management practices in multicultural healthcare settings, similar to those of Saudi Arabia and neighboring Arab nations, and across the globe.

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Purpose: In the field of construction, it has been shown that individuals with higher emotional intelligence may perform better on the job. However, it is still a question worth exploring about how emotional intelligence affects expatriate performance in international construction projects. Therefore, this study aimed to verify the relationship between expatriates' emotional intelligence and expatriate performance and explore the mediating role of self-efficacy and psychological resilience. Methods: A cross-sectional study was conducted in June 2021. A non-probability sampling method was used to obtain data. A total of 315 Chinese construction expatriates in 67 countries and regions around the world were evaluated using four scales: the Wong and Law Emotional Intelligence Scale, the General Self-Efficacy Scale, the Connor-Davidson Resilience scale, and the Kraimer's expatriate's performance scale. The hypothesis model was tested using Partial Least Squares Structural Equation Modeling (PLS-SEM). Results: The results of the data analysis indicated that self-efficacy (ßIndirect effect = 0.175, p<0.05) and psychological resilience (ßIndirect effect = 0.112, p<0.05) served as fully mediating variables (ß Direct effect = 0.177, p=0.101), suggesting a way to explain how emotional intelligence affect the performance of contractor expatriates. The findings also suggest that self-efficacy and psychological resilience also play continuous and multiple mediating roles (ßIndirect effect = 0.143, p<0.05) between emotional intelligence and expatriate performance. Conclusion: This study attempted to investigate the mechanism of emotional intelligence's influence on expatriate performance from the perspective of individual psychological resources. The results of the study suggest that the emotional intelligence of expatriates may bring about an increase in performance levels by improving self-efficacy and psychological resilience levels. This provides a practical way to improve the performance of expatriates and a new management perspective for human resource management in international construction projects.

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This meta-analytic review examines the relationship between various dispositional characteristics and expatriate adjustment, including the Big Five constructs and other characteristics that have garnered more recent empirical attention (i.e., cultural empathy/flexibility, cognitive intelligence, emotional intelligence). Using 62 primary studies (n = 13,060), we found that the Big Five traits play an important role in expatriate adjustment; however, when assessing the relative influence of these predictors, characteristics such as cultural empathy, cultural intelligence (e.g., motivational CQ), and emotional intelligence appear to exert a stronger influence on adjustment outcomes. Various cultural variables (cultural distance, cultural tightness, gender inequality in the host country) and year of publication were found to moderate some relationships, indicating that sociocultural factors may temper some of these effects.

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BACKGROUND: Phenotypic differences in Parkinson's Disease (PD) among locals (Emiratis) and Expatriates (Expats) living in United Arab Emirates have not been described and could be important to unravel local aspects of clinical heterogenicity of PD pointing towards genetic and epigenetic variations. OBJECTIVE: To investigate the range and nature of motor and nonmotor clinical presentations of PD and its impact on time to diagnosis, local service provisions, and quality of life in Emiratis and Expats in UAE, as well as address the presence of current unmet needs on relation to care and etiopathogenesis of PD related to possible genetic and epigenetic factors. METHODS: a cross-sectional one point in time prospective, observational real-life study of 171 patients recruited from PD and Neurology clinics across United Arab Emirates from 2019-2021. Primary outcomes were sociodemographic data, motor and nonmotor symptoms (NMS), including cognition and sleep, and quality of life (QOL) assessments, Results: A total of 171 PD patients (52 Emiratis 119 Expats) were included with mean age (Emiratis 48.5 (13.1) Expats 64.15 (13.1)) and mean disease duration (Emiratis 4.8 (3.2) Expats 6.1 (2.9)). In the Emiratis, there was a significant mean delay in initiating treatment after diagnosis (Emiratis 1.2 (0.9) Expats 1.6 (1.1)), while from a clinical phenotyping aspect, there is a high percentage of akinesia 25 (48.1) or tremor dominant (22 (42.3)) phenotypes as opposed to mixed subtype 67 (56.3) in Expat cohorts; double tremor dominant, especially Emirati females (25%), had a predominant lower limb onset PD. Both Emirati (27.9 (24.0)) and Expat 29.4 (15.6) showed moderate NMS burden and the NMS profile is dominated by Sleep, Fatigue, Mood, Emotional well-being 3.0 (1.1) and Social Stigma 3.5 (0.9) aspects of PDQ8 SI measurements are predicted worse QOL in Emiratis, while lack of social support 2.3 (1.3) impaired QOL in Expat population. Awareness for advanced therapies was low and only 25% of Emiratis were aware of deep brain surgery (DBS), compared to 69% Expats. Only 2% of Emiratis, compared to 32% of Expats, heard of Apomorphine infusion (CSAI), and no (0%) Emiratis were aware of intrajejunal levodopa infusion (IJLI), compared to 13% of expats. CONCLUSION: Our pilot data suggest clinical phenotypic differences in presentation of PD in Emiratis population of UAE compared to expats. Worryingly, the data also show delayed treatment initiation, as well as widespread lack of knowledge of advanced therapies in the Emirati population.

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How did Hong Kong's transition from a largely free, semi-independent city to a full-blown Communist Party dictatorship affect its academic life? A watershed moment was Beijing's imposition, in June 2020, of a National Security Law. The author examines the impact of that law on the conduct of university senior managements, on local and expatriate faculty, and on students. Senior management responded to the new law by disciplining students, monitoring faculty, and cleansing universities of anything deemed hostile to the new order. Faculty rapidly capitulated to government and management edicts, though locals showed more grit than expatriates did. Students were the most defiant actors of all until university managements severed ties with their students' unions, effectively defunding them. A case of surveillance in Lingnan University, the author's former place of employment, is related and its implications considered. The author describes how, and explains why, journalists in Hong Kong acted with greater defiance than professors did. He suggests that Identity Politics, a Western import, is congenial to Chinese Communist Party rule in Hong Kong.

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INTRODUCTION: Expatriates working in low-and middle-income countries have unique health problems. Migration leads not only to an increase in individual health risk but also a risk of global impact, such as pandemics. Expatriates with no prior experience living in tropical settings have expressed greatest concern about infectious diseases and appropriate peri-travel consultation is essential to expatriates. The objective of this review is to describe infections and travel-related syndromes among expatriates living in low-and middle-income countries. METHODS: MEDLINE database since the year 2000 was searched for relevant literature. Search terms were "long-term travel", "expatriate", and "health problems". The additional references were obtained from hand-searching of selected articles. RESULTS: Up to 80% of expatriates suffered from gastrointestinal problems followed by dermatologic problems (up to 40%), and febrile systemic infection/vector-borne/parasitic infection (up to 34%) Expatriates living in Southeast Asia were at risk of vector-borne diseases including dengue and non-Plasmodium falciparum (pf) malaria while expatriates living in South Asia had a high prevalence of acute and chronic diarrhea. Staying long-term in Africa was related to an elevated risk for pf malaria and gastrointestinal infection. In Latin America, dermatologic problems were commonly reported illnesses among expatriates. CONCLUSION: Certain health risks for expatriates who are going to depart to specific regions should be the focus of pre-travel consultation. Specific health preparations may reduce the risk of disease throughout their time abroad. Disease and symptom awareness is essential for screening, early diagnosis, and better health outcomes for ill-expatriates.

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One of the leading causes for failing at expatriate assignments is the accompanying expatriate partners' (AEPs) unhappiness with life abroad or inability to adjust to the challenges of the host country. Strength-based therapeutic interventions have the potential to increase individuals' mental health and well-being. The current study formed part of a multimethod study consisting of three related but independent sub-studies. The first sub-study identified the strengths of Gratitude, Curiosity and Hope to be positively associated with AEPs' resilience and well-being. These results were used to construct a quantitative model that illustrates the interplay between these constructs. In the second sub-study, the proposed model was qualitatively reviewed by a smaller group of AEPs to inform and enrich our understanding of AEPs' personal experiences of these constructs. In the current study, a panel of practicing psychologists who provide counselling services for South African expatriates and AEPs were asked to qualitatively review a proposed quantitative model. A cross-sectional, interpretive descriptive research design, applying purposive sampling was used to identify and recruit participants. The objective for the current study was firstly to ascertain why participants thought strengths of Gratitude, Curiosity and Hope featured so prominently in the model. Secondly, the study aimed to determine how these participants would, from their experience in working with AEPs, enhance these strengths and AEPs' resilience in therapy, and ultimately facilitate greater well-being and successful adjustment abroad. Participants completed an online questionnaire consisting of two semi-structured, open-ended questions. The data were analyzed using primary and secondary cycle coding to ultimately develop themes. Results indicated that strengths of Curiosity, Gratitude and Hope featured prominently because these strengths include elements that form part of the process of expatriation. Participants were able to suggest practical strength-based therapeutic techniques which would assist in enhancement of strengths, resilience and ultimately well-being. It is proposed that the therapeutic techniques and approaches suggested in this study could contribute to the success rate of expatriate assignments.

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Digitalization and advanced technologies are replacing human jobs. Around the world, many people have lost their jobs due to increasing digitalization. Similarly, Chinese expatriates associated with the manufacturing sector in emerging countries such as Vietnam face similar challenges. Therefore, Chinese expatriates need to bring competitiveness in their competencies. This competitiveness brings sustainability to their career. The aim of this study is to investigate the impact of career competencies on career sustainability. Moreover, we test the mediating effect of lifelong learning in the relationship between career competencies and career sustainability. A questionnaire survey approach was used in this study. The target population was the Chinese expatriate managers working at China-invested manufacturing multinational organizations in Vietnam. To estimate the proposed relationships, we use structural equation modeling. The results are confirmed that in the direct relationship career competence has a positive impact on career sustainability. The findings of this study also indicate that career competencies have a positive impact on lifelong learning. Furthermore, outcomes confirmed that lifelong learning has a positive impact on career sustainability. Similarly, results are also confirmed that lifelong learning is positively mediating between career competencies and career sustainability. Therefore, the empirical results of this article identify that lifelong learning has a critical impact on sustainable careers. Specifically, this study is useful for mid-level managers who are associated with multinational organizations. At the end of this article, we also explained the practical implications, limitations, and future research directions.

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BACKGROUND: Studies on pediatric travelers' health rarely address expat or long-term travelers' children. METHOD: To investigate reasons for seeking care and adherence to pretravel preparation, we prospectively enrolled French children 0-15 years old, either expatriates or staying >6 months in tropical areas, who attended a French health center in Africa, Central America or Southern Pacific regions from October 01, 2011 to October 31, 2012. A standardized questionnaire was completed by a general practitioner at each visit, then anonymized and included in our database. RESULTS: 464 questionnaires were collected from 367 children (sex ratio M/F: 1:1). Median age was 6.4 years (IQR: 3.6; 10.3). Reasons for seeking care were mostly infections (n = 378), of which 12 (3.2%) were tropical. There were no deaths, but one child with tuberculosis was repatriated. Coverage was high for routine immunization, but less for travel-related vaccines. Personal antivectorial protection was significantly lower in children aged >5 y or in non-malarial areas. Where indicated, malarial chemoprophylaxis was prescribed to only one third of the children, of whom 60% were poorly compliant. Advice regarding measures against diarrhea was followed significantly more for stays <2 yrs. CONCLUSION: Mild cosmopolitan illnesses predominated but protection against tropical threats should be optimized before and during the stay.

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BACKGROUND: COVID-19 pandemic is a worldwide problem. Vaccination as primary prevention is necessary. Thailand is in the initial phase of the vaccination program. However, the demand for this vaccine among Thais and expatriates living in Thailand is still unknown. This study aims to assess acceptance, attitude, and determinants for COVID-19 vaccination among Thai people and expatriates living in Thailand. METHODS: This was a cross-sectional study conducted in Thailand during May 2021. An online survey (REDcap) was distributed through online social media platforms. Adult (>18 years old) Thai and expatriates living in Thailand were invited. Any person who already received any COVID-19 vaccine was excluded from this study. RESULT: One thousand sixty-six responses were collected in this survey. A total of 959 were available for analysis. Six hundred thirty-seven 637 responses were from Thais and 322 responses from expatriates living in Thailand. The acceptance rate was significantly higher among expatriates than local people (57.8% vs 41.8%, p-value < 0.001). The acceptance rate increased up to 89.0-91.3% if they could select the vaccine brand, and 80.7-83.2% when they were recommended by the health care professionals. Both groups had a similar mean attitude score toward COVID-19 vaccination. Being Thai, health care worker, good compliance to social distancing, accepting serious side effects at level 1 per 100,000, and having a good attitude toward COVID-19 vaccination were associated with vaccine acceptance. CONCLUSION: Thailand's COVID-19 vaccination program could improve the acceptance rate by informing the public about vaccine efficacy, vaccine benefit, and vaccine safety. Moreover, supplying free of charge high efficacy alternative vaccines and letting all people living in Thailand make their own vaccine choices could increase the acceptance rate.

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For two decades, individual motivations to expatriate have received substantial attention in the expatriation literature examining self-initiated and assigned expatriation. Recently, however, this literature has changed direction, demonstrating that prior to forming their actual motivations, individuals undergo a process wherein they actively form those motivations. No review has yet unraveled this motivation process, and this systematic literature review fills this gap. Using the Rubicon Action model that discusses the motivation process of expatriation, this article demonstrates that for self-initiated and assigned expatriation, individuals follow similar processes: expatriation expectations are formed; then, they are evaluated; and finally, preferences are built that result in motivations to expatriate. Findings for each stage are discussed in light of their contributions to the expatriation literature. For major gaps, new research suggestions are offered to advance our understanding of the individual motivation process that expats experience prior to forming their motivations to move abroad.