In the Words of the Medical Tourist: An Analysis of Internet Narratives by Health Travelers to Turkey

Background: Patients regularly travel to the West for advanced medical care, but now the trend is also shifting in the opposite direction. Many people from Western countries now seek care outside of their country. This phenomenon has been labeled medical tourism or health travel. Information regarding health travelers’ actual outcomes, experiences, and perceptions is lacking or insufficient. However, advanced Internet technology and apps provide information on medical tourism and are a vehicle for patients to share their experiences. Turkey has a large number of internationally accredited hospitals, is a top tourism destination, and is positioning itself to attract international patients. Objective: The objective of this research was to identify the important individual characteristics of health travelers, outline the push and pull factors for seeking health care in Turkey, identify satisfaction with the outcomes and the results of these individuals’ treatments, and note positive and negative factors influencing their perceptions and overall experiences about patients’ health travel. Methods: This research uses qualitative data from Internet narratives of medical tourists to Turkey. Ethical considerations of using Internet narratives were reviewed. Narratives for analysis were obtained by using the Google search engine and using multiple search terms to obtain publicly posted blogs and discussion board postings of health travelers via purposeful sampling. Narratives were included if they were written in English, described travel to Turkey for health care, and were publicly accessible. Exclusion criteria included narratives that were on medical tourism facilitator or provider promotional websites, not in English, and did not describe an experience of a medical tourist. Medical tourists’ written words were analyzed in an iterative analytic process using narrative analysis theory principles. Three stages of coding (open, axial, and selective) were conducted to identify characteristics and themes using qualitative analysis software. Results: The narrative posts of 36 individuals undergoing 47 procedures who traveled to Turkey for medical care between 2007 and 2012 were analyzed. The narratives came from 13 countries, not including the narratives for which patient origin could not be determined. Travelers were predominantly from Europe (16/36, 44%) and North America (10/36, 28%). Factors driving travelers away from their home country (push factors) were cost and lack of treatment options or insufficient insurance coverage in their home country. Leading factors attracting patients to destination (pull factors) were lower costs, physician’s expertise and responsiveness, and familiarity or interest in Turkey. Health travelers to Turkey were generally satisfied with the outcomes of their procedures and care provided by their physicians, many noting intent to return. Communication challenges, food, transportation, and gaps in customer service emerged as key areas for improvement. Conclusions: This analysis provides an understanding of the insights of medical tourists through the words of actual health travelers. This nonintrusive methodology provides candid insights of common themes of health travelers and may be applied to study other patient experiences. The findings of this research expands the body of knowledge in medical tourism and serves as a platform for further qualitative and quantitative research on health travelers’ experiences

The metric tide: report of the independent review of the role of metrics in research assessment and management

This report presents the findings and recommendations of the Independent Review of the Role of Metrics in Research Assessment and Management. The review was chaired by Professor James Wilsdon, supported by an independent and multidisciplinary group of experts in scientometrics, research funding, research policy, publishing, university management and administration. This review has gone beyond earlier studies to take a deeper look at potential uses and limitations of research metrics and indicators. It has explored the use of metrics across different disciplines, and assessed their potential contribution to the development of research excellence and impact. It has analysed their role in processes of research assessment, including the next cycle of the Research Excellence Framework (REF). It has considered the changing ways in which universities are using quantitative indicators in their management systems, and the growing power of league tables and rankings. And it has considered the negative or unintended effects of metrics on various aspects of research culture. The report starts by tracing the history of metrics in research management and assessment, in the UK and internationally. It looks at the applicability of metrics within different research cultures, compares the peer review system with metric-based alternatives, and considers what balance might be struck between the two. It charts the development of research management systems within institutions, and examines the effects of the growing use of quantitative indicators on different aspects of research culture, including performance management, equality, diversity, interdisciplinarity, and the ‘gaming’ of assessment systems. The review looks at how different funders are using quantitative indicators, and considers their potential role in research and innovation policy. Finally, it examines the role that metrics played in REF2014, and outlines scenarios for their contribution to future exercises

An Orientation Program for Vertical Transfers in Engineering and Engineering Technology

This paper reports on a scholarship program funded by the National Science Foundation that focuses on students who transfer at the 3rd -year level from 2-year schools to the engineering and engineering technology BS programs at our university. The objectives of the program are to: (i) expand and diversify the engineering/technology workforce of the future, (ii) develop linkages and articulations with 2-year schools and their S-STEM (Scholarships in Science, Technology, Engineering and Mathematics) programs, (iii) provide increased career opportunities and job placement rates through mandatory paid co-op experiences, and (iv) serve as a model for other universities to provide vertical transfer students access to the baccalaureate degree. The program is in its third year. It recruited its first group of 25 students in Fall 2017, and another group of 27 students in Fall 2018. We hope to recruit 26 more students in Fall 2019 for a total of 78 vertical transfers. The goal is to retain and graduate at least 95% of these scholars. To enhance the success of these scholars, a zero-credit six-week orientation course was developed in Fall 2017 focusing on four dimensions of student wellness: academic, financial, social, and personal. This paper describes the development of this course, its content, and the modifications that were made to the course for Fall 2018. The paper will also address the research conducted in order to generate knowledge about the program elements that will be essential for the success of vertical transfer programs at other universities. Two research instruments are described: an online survey and a focus group interview that were developed, and administered to the transfer scholars in their first year. Initial findings concerning students’ experiences at their 2-year schools, their reason for transferring, their experience in transferring as well as their initial conceptions of what life at a 4-year institution will be like are presented

Scholarship Programs for Vertical Transfers in Engineering and Engineering Technology

This paper introduces two scholarship projects funded by the National Science Foundation that focus on students who transfer at the 3rd year level from 2-year schools to the engineering and engineering technology BS programs at our university. The objectives of both the projects are: (i) to expand and diversify the engineering/technology workforce of the future, (ii) to develop linkages and articulations with 2-year schools and their S-STEM programs, (iii) to provide increased career opportunities and job placement rates through mandatory paid co-op experiences, and (iv) to serve as a model for other universities to provide vertical transfer students access to the baccalaureate degree. The Transfer Pipeline (TiPi) project awarded 25 new scholarships per year from 2012 to 2014 to a total of 75 engineering and engineering technology transfer students. By the end of Fall 2017, 66 (88%) scholars have graduated, 5 (7%) are in process of completing their degrees, and only 4 (5%) left our university, for a 95% retention rate. The paper describes our successes and challenges. The Vertical Transfer Access to the Baccalaureate (VTAB) project recruited its first group of 25 students in Fall 2017 with the goal of recruiting a total of 78 vertical transfers over the next three years. An additional goal of the VTAB project is to conduct research and generate knowledge about the VTAB project elements that will be essential for the success of vertical transfer programs at other universities. The paper describes the research instruments, and the results from an online survey and a focus group interview of the first cohort of VTAB scholars

Molecular-Level Control over Ionic Conduction and Ionic Current Direction by Designing Macrocycle-Based Ionomers

Poor ionic conductivity of the catalyst-binding, submicrometer- thick ionomer layers in energy conversion and storage devices is a huge challenge. However, ionomers are rarely designed keeping in mind the specific issues associated with nanoconfinement. Here, we designed nature-inspired ionomers (calix-2) having hollow, macrocyclic, calix[4]arene-based repeat units with precise, sub-nanometer diameter. In ≤100 nm-thick films, the in-plane proton conductivity of calix-2 was up to 8 times higher than the current benchmark ionomer Nafion at 85% relative humidity (RH), while it was 1−2 orders of magnitude higher than Nafion at 20−25% RH. Confocal laser scanning microscopy and other synthetic techniques allowed us to demonstrate the role of macrocyclic cavities in boosting the proton conductivity. The systematic self-assembly of calix-2 chains into ellipsoids in thin films was evidenced from atomic force microscopy and grazing incidence small-angle X-ray scattering measurements. Moreover, the likelihood of alignment and stacking of macrocyclic units, the presence of one-dimensional water wires across this macrocycle stacks, and thus the formation of long-range proton conduction pathways were suggested by atomistic simulations. We not only did see an unprecedented improvement in thin-film proton conductivity but also saw an improvement in proton conductivity of bulk membranes when calix-2 was added to the Nafion matrices. Nafion−calix-2 composite membranes also took advantage of the asymmetric charge distribution across calix[4]arene repeat units collectively and exhibited voltage-gating behavior. The inclusion of molecular macrocyclic cavities into the ionomer chemical structure can thus emerge as a promising design concept for highly efficient ion-conducting and ion-permselective materials for sustainable energy applications

The Grizzly, April 12, 2012

Fong Inauguration Approaching • UCDC Mixing Up Spring Routine • Housing Lottery Anxiety Addressed • Cuts for a Cause on Campus This Weekend • Ursinus Alumni Return to Work at Alma Mater • UC Students Travel to National Model UN Competition in NYC • Hart Interns at Great Wall Club in Beijing, China • Opinion: Saying No is Man\u27s Responsibility, Too; Delphi was a Positive Experience Despite Criticism • Men\u27s Lacrosse Battles #18 Gettysburg • Seniors Wrapping up Athletic Careershttps://digitalcommons.ursinus.edu/grizzlynews/1858/thumbnail.jp

Youth Savings Groups in Africa: They’re a Family Affair

Based on fieldwork in Tanzania, Zambia, Uganda, and Ghana, in the paper we provide new evidence that young people’s engagement with savings groups in Africa is deeply embedded in networks of family and social relations. Savings group members rely on money that is given to them by partners and family members to make savings contributions to the groups, while they also transfer some of their share-outs and loans to family members and friends. This is particularly true for younger members. As such we argue that the socially embedded nature of young people's engagement with savings group needs to be taken into account. The tension between the primary focus on the individual within youth saving programming, and the socially embedded nature of their engagement, has important implications for programme design, implementation and evaluation

Tracking and imaging gamma ray experiment (TIGRE) for 1 to 100 MEV gamma ray astronomy

A large international collaboration from the high energy astrophysics community has proposed the Tracking and Imaging Gamma Ray Experiment (TIGRE) for future space observations. TIGRE will image and perform energy spectroscopy measurements on celestial sources of gamma rays in the energy range from 1 to 100 MeV. This has been a difficult energy range experimentally for gamma ray astronomy but is vital for the future considering the recent exciting measurements below 1 and above 100 MeV. TIGRE is both a double scatter Compton and gamma ray pair telescope with direct imaging of individual gamma ray events. Multi‐layers of Si strip detectors are used as Compton and pair converters CsI(Tl) scintillation detectors are used as a position sensitive calorimeter. Alternatively, thick GE strip detectors may be used for the calorimeter. The Si detectors are able to track electrons and positrons through successive Si layers and measure their directions and energy losses. Compton and pair events are completely reconstructed allowing each event to be imaged on the sky. TIGRE will provide an order‐of‐magnitude improvement in discrete source sensitivity in the 1 to 100 MeV energy range and determine spectra with excellent energy and excellent angular resolutions. It’s wide field‐of‐view of π sr permits observations of the entire sky for extended periods of time over the life of the mission

Dynamics of aerosol size during inhalation : Hygroscopic growth of commercial nebulizer formulations

We thank the Elizabeth Blackwell Institute (EBI) for financial support through the EBI Early Career Research Fellowship awarded to AEH, and the EPSRC for financial support through a Leadership Fellowship awarded to JPR (grant reference EP/G007713/1). This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution and reproduction in any medium, provided the original author and source are creditedThe size of aerosol particles prior to, and during, inhalation influences the site of deposition within the lung. As such, a detailed understanding of the hygroscopic growth of an aerosol during inhalation is necessary to accurately model the deposited dose. In the first part of this study, it is demonstrated that the aerosol produced by a nebulizer, depending on the airflows rates, may experience a (predictable) wide range of relative humidity prior to inhalation and undergo dramatic changes in both size and solute concentration. A series of sensitive single aerosol analysis techniques are then used to make measurements of the relative humidity dependent thermodynamic equilibrium properties of aerosol generated from four common nebulizer formulations. Measurements are also reported of the kinetics of mass transport during the evaporation or condensation of water from the aerosol. Combined, these measurements allow accurate prediction of the temporal response of the aerosol size prior to and during inhalation. Specifically, we compare aerosol composed of pure saline (150 mM sodium chloride solution in ultrapure water) with two commercially available nebulizer products containing relatively low compound doses: Breath, consisting of a simple salbutamol sulfate solution (5 mg/2.5 mL; 1.7 mM) in saline, and Flixotide Nebules, consisting of a more complex stabilized fluticasone propionate suspension (0.25 mg/mL; 0.5 mM in saline. A mimic of the commercial product Tobi (60 mg/mL tobramycin and 2.25 mg/mL NaC1, pH 5.5-6.5) is also studied, which was prepared in house. In all cases, the presence of the pharmaceutical was shown to have a profound effect on the magnitude, and in some cases the rate, of the mass flux of water to and from the aerosol as compared to saline. These findings provide physical chemical evidence supporting observations from human inhalation studies, and suggest that using the growth dynamics of a pure saline aerosol in a lung inhalation model to represent nebulizer formulations may not be representative of the actual behavior of the aerosolized drug solutions. (C) 2014 Published by Elsevier B.V.Peer reviewe