What is known about the patient's experience of medical tourism? A scoping review

<p>Abstract</p> <p>Background</p> <p>Medical tourism is understood as travel abroad with the intention of obtaining non-emergency medical services. This practice is the subject of increasing interest, but little is known about its scope.</p> <p>Methods</p> <p>A comprehensive scoping review of published academic articles, media sources, and grey literature reports was performed to answer the question: what is known about the patient's experience of medical tourism? The review was accomplished in three steps: (1) identifying the question and relevant literature; (2) selecting the literature; (3) charting, collating, and summarizing the information. Overall themes were identified from this process.</p> <p>Results</p> <p>291 sources were identified for review from the databases searched, the majority of which were media pieces (<it>n </it>= 176). A further 57 sources were included for review after hand searching reference lists. Of the 348 sources that were gathered, 216 were ultimately included in this scoping review. Only a small minority of sources reported on empirical studies that involved the collection of primary data (<it>n </it>= 5). The four themes identified via the review were: (1) decision-making (e.g., push and pull factors that operate to shape patients' decisions); (2) motivations (e.g., procedure-, cost-, and travel-based factors motivating patients to seek care abroad); (3) risks (e.g., health and travel risks); and (4) first-hand accounts (e.g., patients' experiential accounts of having gone abroad for medical care). These themes represent the most discussed issues about the patient's experience of medical tourism in the English-language academic, media, and grey literatures.</p> <p>Conclusions</p> <p>This review demonstrates the need for additional research on numerous issues, including: (1) understanding how multiple information sources are consulted and evaluated by patients before deciding upon medical tourism; (2) examining how patients understand the risks of care abroad; (3) gathering patients' prospective and retrospective accounts; and (4) the push and pull factors, as well as the motives of patients to participate in medical tourism. The findings from this scoping review and the knowledge gaps it uncovered also demonstrate that there is great potential for new contributions to our understanding of the patient's experience of medical tourism.</p

Whole genome SNP-associated signatures of local adaptation in honeybees of the Iberian Peninsula

The availability of powerful high-throughput genomic tools, combined with genome scans, has helped identifying genes and genetic changes responsible for environmental adaptation in many organisms, including the honeybee. Here, we resequenced 87 whole genomes of the honeybee native to Iberia and used conceptually different selection methods (Samβada, LFMM, PCAdapt, iHs) together with in sillico protein modelling to search for selection footprints along environmental gradients. We found 670 outlier SNPs, most of which associated with precipitation, longitude and latitude. Over 88.7% SNPs laid outside exons and there was a significant enrichment in regions adjacent to exons and UTRs. Enrichment was also detected in exonic regions. Furthermore, in silico protein modelling suggests that several non-synonymous SNPs are likely direct targets of selection, as they lead to amino acid replacements in functionally important sites of proteins. We identified genomic signatures of local adaptation in 140 genes, many of which are putatively implicated in fitness-related functions such as reproduction, immunity, olfaction, lipid biosynthesis and circadian clock. Our genome scan suggests that local adaptation in the Iberian honeybee involves variations in regions that might alter patterns of gene expression and in protein-coding genes, which are promising candidates to underpin adaptive change in the honeybee.John C. Patton, Phillip San Miguel, Paul Parker, Rick Westerman, University of Purdue, resequenced the 87 whole genomes of IHBs. Jose Rufino provided computational resources at IPB. Analyses were performed using the computational resources at the Uppsala Multidisciplinary Center for Advanced Computational Science (UPPMAX), Uppsala University. DH was supported by a PhD scholarship (SFRH/BD/84195/2012) from the Portuguese Science Foundation (FCT). MAP is a member of and receives support from the COST Action FA1307 (SUPER-B). This work was supported by FCT through the programs COMPETE/QREN/EU (PTDC/BIA-BEC/099640/2008) and the 2013-2014 BiodivERsA/FACCE-JPI (joint call for research proposals, with the national funders FCT, Portugal, CNRS, France, and MEC, Spain) to MAP

RF BASED AUTOMATIC RAILWAY TRAFFIC CONTROL SYSTEM

With the amplified demand on railway services all over the globe as cheapest medium of transportation, overall railway infrastructure has been developing rapidly in the last two decades, including its communication system. In the past wired communications system were used for signaling and data communication in the railway industry. Radio wave systems become more reliable and cheaper; it becomes feasible to use ad-hoc radio communications as an additional layer of safety, for prevention of crashes between trains in a rail control system. This has led to the invention of new features for railway safety, high speed monitoring of railway conditions. Conventional methods of railroad maintenance and safety assurance are based on separate periodical inspections of track and equipment. These methods have many limitations like problems about signaling system caused by configuration, high construction cost, inefficiency about maintenance work, long downtime etc.[1

Rf Based Automatic Railway Traffic Control System

With the amplified demand on railway services all over the globe as cheapest medium of transportation, overall railway infrastructure has been developing rapidly in the last two decades, including its communication system. In the past wired communications system were used for signaling and data communication in the railway industry. Radio wave systems become more reliable and cheaper; it becomes feasible to use ad-hoc radio communications as an additional layer of safety, for prevention of crashes between trains in a rail control system. This has led to the invention of new features for railway safety, high speed monitoring of railway conditions. Conventional methods of railroad maintenance and safety assurance are based on separate periodical inspections of track and equipment. These methods have many limitations like problems about signaling system caused by configuration, high construction cost, inefficiency about maintenance work, long downtime etc.[1

Haridimos Tsoukas : understanding organizational change via philosophy and complexity

Haridimos (“Hari”) Tsoukas is a Greek organizational theorist whose work has been influential in introducing and popularizing a holistic, process-based conception of organizational change. Traditional accounts of change assume that entities (including organizations) are by nature static and only undergo change after external force is applied. In contrast, Tsoukas maintains that change is ever-present in the social world and that change itself is the intrinsic basis for organizing. As such for Tsoukas, organizations are not static entities but ongoing processes of organizing, embedded within social nexuses of practices and discourses, which are constantly mutating. He identifies two main sources of organizational change: (i) the world being an open-system and (ii) the reflexive agent. The assumptions and conclusions underlying his work have been strongly influenced by interpretative, phenomenological, and process philosophy, as well as complexity theory. To acquaint the reader with his ideas and work, the chapter is structured as follows: first it will describe Tsoukas’ background, secondly it will summarize his key contributions to understanding organizational change, and thirdly it will discuss new insights from his work and it will conclude with his work’s legacies and unfinished business

Ethnic ties, motivations, and home country entry strategy of transnational entrepreneurs

Based on 30 in-depth interviews with Indian transnational entrepreneurs (TEs) in the USA and their corresponding India heads of operations, we explore the influence of TEs’ ethnic ties on their motivations and entry strategy in the formation of transnational ventures in their home country. Our findings show the heterogeneity of TEs’ motivations (economic and emotional) and home country entry strategy (proactive and reactive). Further, we find that TEs’ entry strategy is contingent on their (a) use of professional and personal ethnic ties and (b) prior experience of doing business with the home country. These findings contribute to the transnational and immigrant entrepreneurship literatures