Medical Tourism: The Impact of Cost and Wait Time in Relation to Cardiac Surgeries Among Individuals in the United States

Introduction: Medical tourism has been defined as consumer movement whereby individuals travel abroad to get treatment, incur out-of-pocket and third-party payments. As American health care continues to face extraordinary increases in cost and long wait time. Medical tourism has made it possible for cardiac patients to do their surgeries at a more affordable rate with shorter wait times while achieving quality care. Methodology: The methodology of this study was a literature review used to examine the research. 5 electronic databases and government websites were utilized, with Only 42 sources referenced in the literature review. Results: The research showed how medical tourism has helped patients who sought cardiac care to save money. Also, have their surgery done in time, not having to wait months before being attended to, and also have access to vacation destinations during their recovery. Additionally, it was discovered that the impact of medical tourism has no adverse effect on the U.S. economy; neither do insurance companies face loss. Discussion/ Conclusion: High cost and long wait time have shown to have a negative impact on cardiac surgery patients in the United States. And but it does not negatively affect the U.S. economy and the insurance industry in the United States. Through medical tourism, patients have had more opportunity in saving and getting valued care equal to that of the U.S

EFFECT OF E-COUNSELLING ON CAREER DEVELOPMENT AMONG UNDERGRADUATE STUDENTS OF ENUGU STATE UNIVERSITY OF SCIENCE AND TECHNOLOGY (ESUT) NIGERIA

The researchers investigated the effect of e-counselling on career development among undergraduate students of Enugu State University of Science and Technology (ESUT), Nigeria. The pre-test, post-test, and control group quasi-experimental design was adopted for this study. Two research questions and two null hypothesis tested at a 0.05 level of significance guided the study. The population of this study comprised, 7,032 of 400 level students in Enugu State University of Science and Technology (ESUT), Nigeria. The researcher sampled 58 students for the study. The sampling techniques employed are purposive and cluster. Two instruments developed by the researcher were used for data collection, namely Students Career Identification Scale (SCIS) and Career Detecting Scale (CDS). The instruments were validated by experts in departments of measurement and valuation as well as Guidance and Counselling. The reliability of the instruments was ascertained through the test-retest method using Cronbach Alpha statistics which yielded reliability coefficients of 0.81 and 0.83 for SCIS and CDS respectively. Data collected were analyzed using mean score and standard deviation to answer the research questions. The hypothesis was tested using the analysis of covariance (ANCOVA) at a 5% level of significance. The findings revealed among others that ECM is significantly effective in career development among undergraduates at post-test and follow-up test from the above findings, it was recommended among others, that counsellors should make use of e-counselling in promoting career development among undergraduate students for higher productivity.  Article visualizations

Controlling phase fractions of 304L-SS in selective laser melting using cooling rate

This study examines the thermal profile and the ferrite-austenite phase fractions upon heating and cooling of 304- stainless steel powder via Selective Laser Melting (SLM). Experiments were performed to validate the ABAQUS finite element model, while the phase transformation simulation was performed using MatCalc and ThermoCalc. A correlation between the thermo-mechanical changes in ABAQUS and the microstructural changes from MatCalc was obtained by matching their cooling rates. The result indicates that cooling rate has a significant effect on the phase fractions of FCC and BCC formed in 304L stainless steel via the SLM process. The results also indicate that for high cooling rates (typically \u3e 105 K/s and consistent with laser powers ≥ 100W) the proportions of FCC and BCC were comparable, with FCC phase about 55% and BCC about 45% of the solidified matrix. This result was similar to the results predicted by the Scheil Gulliver model suggesting high cooling rates follow a diffusionless transformation process. For lower cooling rates, the fractions of FCC increased and that of BCC decreased progressively such that the phase fraction of FCC was greater than 91% with a cooling rate of 3400K/s which corresponds to a laser power of 40W. Such relatively low cooling rate around the phase transformation temperature (i.e. 900K to 450K) is an indication of possible diffusional transformation where the BCC (δ) phases transform to an FCC (γ) phase. A higher FCC grade stainless steel has better corrosion properties and produces less magnetic interference in certain critical applications and was another motivation for this study in addition to establishing a process of altering the phase fractions of metals by a cooling-rate only control in SLM --Abstract, page iii

Curbing Ebola infections among healthcare workers in West Africa: unconventional strategies needed

Letter to editor

FARM-HOUSEHOLD ANALYSIS OF POLICIES AFFECTING PEANUT PRODUCTION IN SENEGAL

A farm-level survey of 150 households was conducted in the peanut basin of Senegal, and a profit function system estimated, for the purpose of analyzing the effects of policies affecting the peanut sector. Producer price of peanuts has relatively little effect on production, but producer price of millet influences peanut seed demand.Agricultural and Food Policy, Demand and Price Analysis,

ARE EXTENSION EDUCATION PROGRAMS EFFECTIVE? IMPACTS OF A PROGRAM TO ASSIST LIMITED RESOURCE AND SOCIALLY DISADVANTAGED FARMERS

Teaching/Communication/Extension/Profession,

Techno-economic analysis of micro-algae bio-jet fuel production processes

The production of bio-fuel from autotrophic micro-algae are being extensively studied and documented. However very few focuses specifically on the production of bio-jet fuel, with even fewer that assesses both the environmental and economic state of micro-algal bio-jet fuel production through modelling efforts. In this research study, an integrated energy, techno-economic and life-cycle assessment deterministic model was successfully developed for the production of micro-algal bio-jet fuel. The developed model acts as a simple tool which can be used to assess the economic and environmental (Net energy ratio, greenhouse emission and water footprint) state of micro-algal bio-jet fuel production in Malaysia as well as for the identification of the key input parameters which influence these state. Prior to model construction, an initial economic investigation was carried out and compared some of the technologies/methods required for bio-jet fuel production. A base case process pathway was established based on this investigation, and formed the foundation of the process model. The integrated model simulates the major steps involved in bio-jet fuel production, which are; micro-algal cultivation, harvesting and dewatering, cell disruption and lipid extraction, lipid purification and upgrading to bio-jet fuel and an additional anaerobic digestion of residual biomass. Through the mass and energy balances and relevant equations, the material and net energy ratio (NER) are estimated with the aid of performance equations, Aspen plus, Matlab and reported data in literature. The economics of bio-jet fuel production process is evaluated by estimation of the capital and operating cost and discounted cash flow. Additionally, greenhouse (GHG) emissions and water resource consumption associated with the production of bio-jet fuel are assessed. Process model results indicates the minimum fuel-selling price (MFSP) of algal derived jet fuel would be $5.89/L, which is 14 times more than the market price of fossil derived jet fuel at$0.43/L. The NER of bio-jet fuel production was however positive, >1, more energy produced than used in the production process and CO2 is abated at a rate of -7.49tonnesCO2/L of bio-jet fuel produced. Results indicated that an additional membrane filtration process prior to centrifugation greatly reduces harvesting and dewatering energy consumption by 93%. Water usage is also estimated at 2702 tonnes/L of bio-jet fuel produced. Sensitivity analysis results indicated that lipid recovery efficiency is one of the most influential parameter and significantly influences the NER, GHG, MFSP and water usage for micro-algal bio-jet fuel production. Case scenario studies in addition to the sensitivity analysis showed algal lipid content and algal productivity significantly influences the MFSP. It was concluded that algal bio-jet fuel production plant would benefit from co-location with wastewater treatment plant and flue-gas producing sites in Kota Kinabalu, Malaysia. This includes exploitation of micro-algal species with high lipid fraction and productivity and cost effective technologies and combinations. The lowest possible MFSP achievable was $1.31/L based on an optimistic case scenario encompassing all the benefits aforementioned but still not sufficient in achieving an economically viable production process

The probabilistic reduction approach to specifying multinomial logistic regression models in health outcomes research

The paper provides a novel application of the probabilistic reduction (PR) approach to the analysis of multi-categorical outcomes. The PR approach, which systematically takes account of heterogeneity and functional form concerns, can improve the specification of binary regression models. However, its utility for systematically enriching the specification of and inference from models of multi-categorical outcomes has not been examined, while multinomial logistic regression models are commonly used for inference and, increasingly, prediction. Following a theoretical derivation of the PR-based multinomial logistic model (MLM), we compare functional specification and marginal effects from a traditional specification and a PR-based specification in a model of post-stroke hospital discharge disposition and find that the traditional MLM is misspecified. Results suggest that the impact on the reliability of substantive inferences from a misspecified model may be significant, even when model fit statistics do not suggest a strong lack of fit compared with a properly specified model using the PR approach. We identify situations under which a PR-based MLM specification can be advantageous to the applied researcher