Medical tourism by Indian-South Africans to India: An exploratory investigation

Medical tourism is a well-established sector in developing countries, and attracts a significant number of tourists from developed countries. Medical tourism is a strong driver of economic growth, but some argue that this kind of tourism promotes inequality in terms of access to healthcare facilities in both developing and developed countries. Whilst research has been conducted on medical tourists travelling to South Africa, no research has focused on the geography of South Africans travelling abroad for medical tourist activities. This study therefore sought to obtain first-hand information from Indian-South African citizens who have partaken in medical tourism in India. Data was gathered through personal, semi-structured interviews conducted with 54 individuals. It was ascertained that the majority of the individuals interviewed in this study travelled to India primarily for medical treatment, while tourist activities were a secondary objective. A smaller proportion of interviewees travelled to India for vacation, with medical care being a secondary motivation, or an impulse due to the low cost of treatment and convenience. Medical tourism by Indian-South Africans travelling to India highlights various shortfalls in South African medical care, including a lack of treatment availability, a poorer quality of service, medical expertise abroad, and the higher cost incurred locally.SP201

Time-evolving measures and macroscopic modeling of pedestrian flow

This paper deals with the early results of a new model of pedestrian flow, conceived within a measure-theoretical framework. The modeling approach consists in a discrete-time Eulerian macroscopic representation of the system via a family of measures which, pushed forward by some motion mappings, provide an estimate of the space occupancy by pedestrians at successive time steps. From the modeling point of view, this setting is particularly suitable to treat nonlocal interactions among pedestrians, obstacles, and wall boundary conditions. In addition, analysis and numerical approximation of the resulting mathematical structures, which is the main target of this work, follow more easily and straightforwardly than in case of standard hyperbolic conservation laws, also used in the specialized literature by some Authors to address analogous problems.Comment: 27 pages, 6 figures -- Accepted for publication in Arch. Ration. Mech. Anal., 201

Resident tourists and the local 'other'

Recent years have witnessed growing numbers of residents exploring their own cities as tourist destinations. This phenomenon challenges academic understandings and definitions of who is defined as a tourist, and what differentiates tourists from residents when both display the same behaviours linked with spectacle and consumption. Of particular interest in these developments are situations where the emergence of ‘resident tourists’ involves residents transgressing boundaries of territorial stigma and fear to visit previously-avoided urban areas. Safety and security concerns and continued territorial stigma towards the Johannesburg inner city has isolated a generation of suburbanites from this urban space. Recent years have witnessed the emergence of various – often online – social media-driven (particularly Instagram) initiatives to bring these suburbanites into the inner city as resident tourists. Drawing survey data from 200 such visitors to Johannesburg’s inner city, this paper reflects on the implications for defining (proximate) tourism in terms of social or psychological rather than spatial (Euclidian) distance/proximity. In so doing, we reflect upon the role of new touristic gaze practices, inspired not only by curiosity but by a concern with self-promotion and social media self-branding. Our argument is that by rethinking emergent practices of collective consumption (facilitated in this instance by social media), we can understand how new forms of tourism occur within the locale of residence. These challenge trends towards the enclaving of daily life and mediated tourist consumption

The valuation of European financial firms

We extend the recent literature concerning accounting based valuation models to investigate financial firms from six European countries with substantial financial sectors: France, Germany, Italy, Netherlands, Switzerland and the UK. Not only are these crucial industries worthy of study in their own right, but unusual accounting practices, and inter-country differences in those accounting practices, provide valuable insights into the accounting-value relationship. Our sample consists of 7,714 financial firm/years observations from 1,140 companies drawn from 1989-2000. Sub-samples include 1,309 firm/years for banks, 650 for insurance companies, 1,705 for real estate firms, and 3,239 for investment companies. In most countries we find that the valuation models work as well or better in explaining cross-sectional variations in the market-to-book ratio for financial firms as they do for industrial and commercial firms in the same countries, although Switzerland is an exception to this generalization. As expected, the results are sensitive to industrial differences, accounting regulation and accounting practices. In particular, marking assets to market value reduces the relevance of earnings figures and increases that of equity

Left-ventricular epi- and endocardium extraction from 3D ultrasound images using an automatically constructed 3D ASM

© 2014 Taylor & Francis.In this paper, we propose an automatic method for constructing an active shape model (ASM) to segment the complete cardiac left ventricle in 3D ultrasound (3DUS) images, which avoids costly manual landmarking. The automatic construction of the ASM has already been addressed in the literature; however, the direct application of these methods to 3DUS is hampered by a high level of noise and artefacts. Therefore, we propose to construct the ASM by fusing the multidetector computed tomography data, to learn the shape, with the artificially generated 3DUS, in order to learn the neighbourhood of the boundaries. Our artificial images were generated by two approaches: a faster one that does not take into account the geometry of the transducer, and a more comprehensive one, implemented in Field II toolbox. The segmentation accuracy of our ASM was evaluated on 20 patients with left-ventricular asynchrony, demonstrating plausibility of the approach

‘Whispered in corridors’: intra‐national politics and practices of knowledge production in South African Human Geography

Reflections on the state of Geography around the globe have noted multiple challenges and opportunities—including a call for the reconfiguring of the discipline as a critical space of care and praxis (Daya, Transactions of the Institute of British Geographers, 47, 9, 2022). Such a call is indelibly connected to broader conversations on the politics of knowledge production and critical engagements with cultures of knowledge production. In order to realise the reconfiguring of the discipline, it is imperative to engage with the multi-scalar politics and practices of knowledge production, to look beyond global inequalities and critically examine the intra-national inequities and structural biases of knowledge production. Through a focus on South African Human Geography and detailed analysis of publication data and interviews with staff at universities across the country, we critically examine how the ‘haunting’ of apartheid legacies contributes to a double-peripheralisation of staff at historically disadvantaged institutions while critical conversations remain ‘whispered in corridors’. This more granular engagement with the politics and practices of knowledge production highlights the entwining of intra- and inter-national privilege which produces a mosaic of ‘cores’ and ‘peripheries’ in the uneven landscape of knowledge production that requires critical scholars to engage with on multiple scales in order to realise a more just and equitable knowledge economy

Tissue identification with micro-magnetic resonance imaging in a caprine spinal fusion model

Nonunion is a major complication of spinal interbody fusion. Currently X-ray and computed tomography (CT) are used for evaluating the spinal fusion process. However, both imaging modalities have limitations in judgment of the early stages of this fusion process, as they only visualize mineralized bone. Magnetic resonance imaging (MRI) could be of great value as it is able to discriminate between different types of tissue. A feasibility study was performed in nine animals from a goat spinal fusion study, to evaluate the detection capacity of different tissues with micro-MRI. In this study bioresorbable polylactic acid cages were used. Six- and 12-months follow-up specimens were scanned in a 6.3 T micro-MRI scanner. After scanning, the specimens were processed for histology. Different types of tissue as well as the degradable cage material were identified in the fusion zone and designated as regions of interest (ROIs). Subsequently, the location of these ROIs was determined on the corresponding micro- MRI image, and average signal intensities of every individual ROI were measured. An excellent match was seen between the histological sections and micro-MRI images. The micro-MRI images showed quantifiable differences in signal intensity between bone with adipose marrow, bone with hematopoietic marrow, fibrocartilage, fibrous tissue, and degradable implant material. In time the signal intensity of bone with adipose marrow, bone with hematopoietic red marrow, and of fibrous tissue remained relatively constant. On the other hand, the signal intensity of the degradable implant material and the fibrocartilage changed significantly in time, indicating change of structure and composition. In conclusion, in our model using bioresorbable cages the MRI provides us with detailed information about the early fusion process and may therefore, allow early diagnosis of non-union

Disjunct perceptions? Climate change threats in two-low lying South African coastal towns.

Coastal towns rely heavily on the quality and expanse of their beaches to attract tourists. Climate is an important tourism determinant, controlling the length and timing of peak arrivals. South African tourism is particularly reliant on these factors. Perceptions of tourists and tourist accommodation establishment regarding climate change threats to tourism are explored for the towns of St Francis Bay and Cape St Francis. Tourism accommodation establishments were predominantly concerned with day-to-day changes in weather, investing in small-scale infrastructural changes to improve the comfort of their guests. By contrast, tourists demonstrated greater concern for the risk of flooding, sea-level rise and the degeneration of the beaches. This reflects concerning disjunctures between perceptions of tourists and accommodation establishments regarding climate change threats. This may portray to tourists insufficient investment in adaptation at accommodation establishments, resulting in decreased tourist visitations in the short-term in favour of destinations perceived as better prepared.SP201

Transdiagnostic factors predicting the 2-year disability outcome in patients with anxiety and depressive disorders

Background: Both anxiety and depressive disorders are associated with significant long-term disability. Since experienced impairments vary between patients independent of diagnosis and disease severity, identifying transdiagnostic factors that predict the course of disability may provide new targets to reduce disability. This study examines transdiagnostic factors predicting the 2-year disability outcome in patients with anxiety and/or depressive disorders (ADD), focusing on potentially malleable factors.Methods: Six hundred fifteen participants with a current diagnosis of ADD from the Netherlands Study of Depression and Anxiety (NESDA) were included. Disability was assessed at baseline and after 2 years of follow-up, using the 32-item WHODAS II questionnaire. Transdiagnostic predictors of 2-year disability outcome were identified using linear regression analysis.Results: In univariable analyses, transdiagnostic factors associated with the 2-year disability outcome were locus of control (standardized β = -0.116, p = 0.011), extraversion (standardized β = -0.123 p = 0.004) and experiential avoidance (standardized β = 0.139, p = 0.001). In multivariable analysis, extraversion had a unique predictive value (standardized β = -0.143 p = 0.003). A combination of sociodemographic, clinical and transdiagnostic variables resulted in an explained variance (R2) of 0.090). The explained variance of a combination of transdiagnostic factors was 0.050.Conclusion: The studied transdiagnostic variables explain a small but unique part of variability in the 2-year disability outcome. Extraversion is the only malleable transdiagnostic factor predictive of the course of disability independent of other variables. Due to the small contribution to the variance in the disability outcome, the clinical relevance of targeting extraversion seems limited. However, its predictive value is comparable to that of accepted disease severity measures, supporting the importance of looking beyond using disease severity measures as predictors. Furthermore, studies including extraversion in combination with other transdiagnostic and environmental factors may elucidate the unexplained part of variability of the course of disability in patients with ADD.</p