Sample records for cross border care

  1. Unresolved legal questions in cross-border health care in Europe: liability and data protection.

    PubMed

    van der Molen, I N; Commers, M J

    2013-11-01

    Directive 2011/24/EU was designed to clarify the rights of EU citizens in evaluating, accessing and obtaining reimbursement for cross-border care. Based on three regional case studies, the authors attempted to assess the added value of the Directive in helping clarify issues in to two key areas that have been identified as barriers to cross-border care: liability and data protection. Qualitative case study employing secondary data sources including research of jurisprudence, that set up a Legal framework as a base to investigate liability and data protection in the context of cross-border projects. By means of three case studies that have tackled liability and data protection hurdles in cross-border care implementation, this article attempts to provide insight into legal certainty and uncertainty regarding cross-border care in Europe. The case studies reveal that the Directive has not resolved core uncertainties related to liability and data protection issues within cross-border health care. Some issues related to the practice of cross-border health care in Europe have been further clarified by the Directive and some direction has been given to possible solutions for issues connected to liability and data protection. Directive 2011/24/EU is clearly a transposition of existing regulations on data protection and ECJ case law, plus a set of additional, mostly, voluntary rules that might enhance regional border cooperation. Therefore, as shown in the case studies, a practical and case by case approach is still necessary in designing and providing cross-border care. © 2013 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  2. Quality requirements for cross-border care in Europe: a qualitative study of patients’, professionals’ and healthcare financiers’ views

    PubMed Central

    Groene, O; Poletti, P; Vallejo, P; Cucic, C; Klazinga, N; Suñol, R

    2009-01-01

    Background: In the past decade the issue of patient mobility has emerged on the European health policy agenda. Although the volume of patients crossing borders to obtain healthcare is low, it is increasing continuously and, due to its legal, financial and medical implications, has generated considerable interest among health policy and other decision makers. However, there is little information available on the safety and patient-centredness of cross-border care and neither governments nor citizens have an explicit basis for comparing healthcare delivery in Europe. Methods: This study investigated the viewpoints of patients, professionals and healthcare financiers on the safety and patient-centredness of cross-border care. Qualitative interviews were carried out during 2005 and early 2006 with 40 patients, 30 professionals (doctors, nurses and managers) and 3 healthcare-financing bodies. Results: Although cross-border care has become a common issue in many European countries, there remain uncertainties on the side of each of the parties addressed—patients, professionals and financiers—with regard to the provision of cross-border care. One of the most striking results of this project is the current lack of research on systematic knowledge on the quality of cross-border care. Conclusion: Many of the issues identified through this research may have a potential impact on the quality and safety of cross-border care and will support further investigation and help shape the health policy agenda on patients crossing borders in European Union countries. PMID:19188456

  3. Implementation of the Cross-border Care Directive in EU Member States: Luxembourg.

    PubMed

    Schwebag, Mike

    2014-03-01

    The Cross-border Care Directive sets up basic patient rights in case of cross-border healthcare. These rights concern both the country of affiliation and the country of treatment of the patient. The article briefly describes the state of the transposition in Luxembourg, with a focus on the draft act on patients' rights and obligations. This new act on patient rights and obligations will apply without distinction to domestic and cross-border patients, thus transposing most of Luxembourg's obligations as a country of treatment of a cross-border patient.

  4. Reprint of: Dream vs. reality: seven case-studies on the desirability and feasibility of cross-border hospital collaboration in Europe.

    PubMed

    Glinos, Irene A; Baeten, Rita

    2015-01-01

    Despite being a niche phenomenon, cross-border health care collaboration receives a lot of attention in the EU and figures visibly on the policy agenda, in particular since the policy process which eventually led to the adoption of Directive 2011/24/EU. One of the underlying assumptions is that cross-border collaboration is desirable, providing justification to both the European Commission and to border-region stakeholders for promoting it. The purpose of this paper is to question this assumption and to examine the role of actors in pushing (or not) for cross-border collaboration. The analysis takes place in two parts. First, the EU policies to promote cross-border collaboration and the tools employed are examined, namely (a) use of European funds to sponsor concrete border-region collaboration projects, (b) use of European funds to sponsor research which gives visibility to cross-border collaboration, and (c) use of the European Commission's newly acquired legal mandate to encourage "Member States to cooperate in cross-border health care provision in border-regions" (Art. 10) and support "Member States in the development of European reference networks between health care providers and centres of expertise" (Art. 12). Second, evidence gathered in 2011-2013 from seven European border-regions on hospital cross-border collaboration is systematically reviewed to assess the reality of cross-border collaboration - can it work and when, and why do actors engage in cross-border collaboration? The preliminary findings suggest that while the EU plays a prominent role in some border-region initiatives, cross-border collaboration needs such a specific set of circumstances to work that it is questionable whether it can effectively be promoted. Moreover, local actors make use of the EU (as a source of funding, legislation or legitimisation) to serve their needs. Copyright © 2014. Published by Elsevier Ltd.

  5. Dream vs. reality: seven case-studies on the desirability and feasibility of cross-border hospital collaboration in Europe.

    PubMed

    Glinos, Irene A; Baeten, Rita

    2014-09-01

    Despite being a niche phenomenon, cross-border health care collaboration receives a lot of attention in the EU and figures visibly on the policy agenda, in particular since the policy process which eventually led to the adoption of Directive 2011/24/EU. One of the underlying assumptions is that cross-border collaboration is desirable, providing justification to both the European Commission and to border-region stakeholders for promoting it. The purpose of this paper is to question this assumption and to examine the role of actors in pushing (or not) for cross-border collaboration. The analysis takes place in two parts. First, the EU policies to promote cross-border collaboration and the tools employed are examined, namely (a) use of European funds to sponsor concrete border-region collaboration projects, (b) use of European funds to sponsor research which gives visibility to cross-border collaboration, and (c) use of the European Commission's newly acquired legal mandate to encourage "Member States to cooperate in cross-border health care provision in border-regions" (Art. 10) and support "Member States in the development of European reference networks between health care providers and centres of expertise" (Art. 12). Second, evidence gathered in 2011-2013 from seven European border-regions on hospital cross-border collaboration is systematically reviewed to assess the reality of cross-border collaboration - can it work and when, and why do actors engage in cross-border collaboration? The preliminary findings suggest that while the EU plays a prominent role in some border-region initiatives, cross-border collaboration needs such a specific set of circumstances to work that it is questionable whether it can effectively be promoted. Moreover, local actors make use of the EU (as a source of funding, legislation or legitimisation) to serve their needs. Copyright © 2014. Published by Elsevier Ltd.

  6. Cross-border reproductive care: a committee opinion.

    PubMed

    2013-09-01

    Cross-border reproductive care (CBRC) is a growing worldwide phenomenon, raising questions about why assisted reproductive technology (ART) patients travel abroad, what harms and benefits may result, and what duties health care providers may have in advising and treating patients who travel for reproductive services. Cross-border care offers benefits and poses harms to ART stakeholders, including patients, offspring, providers, gamete donors, gestational carriers, and local populations in destination countries. Copyright © 2013 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  7. Cross-border reproductive care: a phenomenon expressing the controversial aspects of reproductive technologies.

    PubMed

    Ferraretti, Anna Pia; Pennings, Guido; Gianaroli, Luca; Natali, Francesca; Magli, M Cristina

    2010-02-01

    Cross-border reproductive care, also called reproductive tourism, refers to the travelling of citizens from their country of residence to another country in order to receive fertility treatment through assisted reproductive technology. Several reasons account for cross-border reproductive care: (i) a certain kind of treatment is forbidden by law in the couple's own country or is inaccessible to the couple because of their demographic or social characteristics; (ii) foreign centres report higher success rates compared with those of the centres in the country of residence; (iii) a specific treatment may be locally unavailable because of a lack of expertise or because the treatment is considered experimental or insufficiently safe; and (iv) limited access to the treatment in the couple's home country because of long waiting lists, excessive distance from a centre or high costs. Although cross-border reproductive care can be viewed as a safety valve, the phenomenon is often associated with a high risk of health dangers, frustration and disparities. Solutions to these problematic effects need to be considered in the light of the fact that cross-border reproductive care is a growing phenomenon. 2009 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

  8. The pluralism problem in cross-border reproductive care.

    PubMed

    Storrow, R F

    2010-12-01

    Outlawing well established forms of assisted reproduction places obstacles in the path of couples who wish to attain their reproductive goals with medical assistance. One effect of restrictive reproductive laws that has received widespread attention is cross-border reproductive travel. In Europe, such travel is permitted by the policy of free movement of persons that is a cornerstone of the democratic and economic stability of the European Union. Cross-border reproductive travel fails to promote moral and political pluralism in democratic states for three primary reasons. First, the opportunity for patients to go abroad for treatment tempers organized resistance to the law and allows government to pass stricter regulations than it otherwise might. Second, cross-border reproductive care has been shown to have deleterious extraterritorial effects that undermine the articulated rationales behind restrictive reproductive laws. Third, laws that generate demand for cross-border reproductive care often fail to satisfy the standard of proportionality that restrictions on human reproduction must meet.

  9. Cross-border reproductive care: an Ethics Committee opinion.

    PubMed

    2016-12-01

    Cross-border reproductive care (CBRC) is a growing worldwide phenomenon, raising questions about why assisted reproductive technology (ART) patients travel abroad, what harms and benefits may result, and what duties health-care providers may have in advising and treating patients who travel for reproductive services. Cross-border care offers benefits and poses harms to ART stakeholders, including patients, offspring, providers, gamete donors, gestational carriers, and local populations in destination countries. This document replaces the previous document of the same name, last published in 2013 (Fertil Steril 2013;100:645-50). Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  10. Cross-Border Utilization of Health Care: Evidence from a Population-Based Study in South Texas

    PubMed Central

    Su, Dejun; Richardson, Chad; Wen, Ming; Pagán, José A

    2011-01-01

    Objective To assess the prevalence of health care utilization in Mexico by Texas border residents and to identify the main contributing factors to their cross-border utilization of health care services. Data and Methods This study used primary data from a population-based telephone survey that was conducted in the whole Texas border area in 2008. The survey included responses from 1,405 adults. Multivariate logistic regression models were estimated to determine predictors of utilizing a wide range of health care services in Mexico. Principal Findings Forty-nine percent of the sample reported having ever purchased medications in Mexico, followed by 41 percent for dentist visits, 37.3 percent for doctor visits, and 6.7 percent for inpatient care. The most significant predictors of health care utilization in Mexico were lack of U.S. health insurance coverage, dissatisfaction with the quality of U.S. health care, and poor self-rated health status. Conclusions The high prevalence of use of health care services in Mexico by Texas border residents is suggestive of unmet needs in health care on the U.S. side of the border. Addressing these unmet needs calls for a binational approach to improve the affordability, accessibility, and quality of health care in the U.S.–Mexico border region. PMID:21158855

  11. Minimum package for cross-border TB control and care in the WHO European region: a Wolfheze consensus statement

    PubMed Central

    Dara, Masoud; de Colombani, Pierpaolo; Petrova-Benedict, Roumyana; Centis, Rosella; Zellweger, Jean-Pierre; Sandgren, Andreas; Heldal, Einar; Sotgiu, Giovanni; Jansen, Niesje; Bahtijarevic, Rankica; Migliori, Giovanni Battista

    2012-01-01

    The World Health Organization (WHO) European region estimates that more than 400,000 tuberculosis (TB) cases occur in Europe, a large proportion of them among migrants. A coordinated public health mechanism to guarantee TB prevention, diagnosis, treatment and care across borders is not in place. A consensus paper describing the minimum package of cross-border TB control and care was prepared by a task force following a literature review, and with input from the national TB control programme managers of the WHO European region and the Wolfheze 2011 conference. A literature review focused on the subject of TB in migrants was carried out, selecting documents published during the 11-yr period 2001–2011. Several issues were identified in cross-border TB control and care, varying from the limited access to early TB diagnosis, to the lack of continuity of care and information during migration, and the availability of, and access to, health services in the new country. The recommended minimum package addresses the current shortcomings and intends to improve the situation by covering several areas: political commitment (including the implementation of a legal framework for TB cross-border collaboration), financial mechanisms and adequate health service delivery (prevention, infection control, contact management, diagnosis and treatment, and psychosocial support). PMID:22653772

  12. Cross-border care and healthcare quality improvement in Europe: the MARQuIS research project

    PubMed Central

    Suñol, R; Garel, P; Jacquerye, A

    2009-01-01

    Citizens are increasingly crossing borders within the European Union (EU). Europeans have always been free to travel to receive care abroad, but if they wished to benefit from their statutory social protection scheme, they were subject to their local or national legislation on social protection. This changed in 1991 with the European Court of Justice defining healthcare as a service, starting a debate on the right balance between different principles in European treaties: movement of persons, goods and services, versus the responsibility of member states to organise their healthcare systems. Simultaneously, cross-border cooperation has developed between member states. In this context, patient mobility has become a relevant issue on the EU’s agenda. The EU funded a number of Scientific Support to Policies (SSP) activities within the Sixth Framework Programme, to provide the evidence needed by EU policy makers to deal with issues that European citizens face due to enhanced mobility in Europe. One SSP project “Methods of Assessing Response to Quality Improvement Strategies” (MARQuIS), focused on cross-border care. It aimed to assess the value of different quality strategies, and to provide information needed when: (1) countries contract care for patients moving across borders; and (2) individual hospitals review the design of their quality strategies. This article describes the European context related to healthcare, and its implications for cross-border healthcare in Europe. The background information demonstrates a need for further research and development in this area. PMID:19188459

  13. Acculturation and cross-border utilization of health services.

    PubMed

    Su, Dejun; Wang, Daphne

    2012-08-01

    Health services from Mexico constitute an important source of care for U.S. residents living along the U.S.-Mexico border. Data from The Cross-Border Utilization of Health Care Survey (n = 966) were used to estimate logit models that related acculturation, as measured by generational status, to the use of medication, physician, dental, and inpatient services from Mexico by U.S. residents in the Texas border region. Relative to first-generation Mexican immigrants, later-generation Mexican-Americans were progressively less likely to go to Mexico for health services. This finding holds with or without adjusting for the effects of selected demographic and socioeconomic variables. Addressing unmet needs in medical care in the southwestern U.S. border area should go beyond a simple expansion of health insurance coverage--it is also important to deliver health services that are sensitive to generational differences within the population in terms of linguistic and cultural barriers to health care access.

  14. Civic stratification and the exclusion of undocumented immigrants from cross-border health care*

    PubMed Central

    Torres, Jacqueline M.; Waldinger, Roger

    2016-01-01

    This paper proposes a theoretical framework and an empirical example of the relationship between the civic stratification of immigrants in the United States, and their access to healthcare. We use the 2007 Pew/RWJF Hispanic Healthcare Survey, a nationally representative survey of U.S. Latinos (n=2783 foreign-born respondents) and find that immigrants who are not citizens or legal permanent residents are significantly more likely to be excluded from care in both the U.S. and across borders. Legal status differences in cross-border care utilization persisted after controlling for health status, insurance coverage, and other potential demographic and socio-economic predictors of care. Exclusion from care on both sides of the border was associated with reduced rates of receiving timely preventive services. Civic stratification, and political determinants broadly speaking, should be considered alongside social determinants of population health and healthcare. PMID:26582512

  15. Cross-border dental care: 'dental tourism' and patient mobility.

    PubMed

    Turner, L

    2008-05-24

    Patient mobility is increasing. 'Dental tourism' is driven by numerous factors. These factors include the high cost of local care, delays in obtaining access to local dentists, competent care at many international clinics, inexpensive air travel, and the Internet's capacity to link 'customers' to 'sellers' of health-related services. Though dental tourism will benefit some patients, increased patient mobility comes with numerous risks. Lack of access to affordable and timely local care plays a significant role in prompting patients to cross borders and receive dental care outside their local communities.

  16. [Geriatric health care structures in Germany. The cross-border cooperation in geriatric medicine as a needs-driven further development].

    PubMed

    van den Heuvel, D; Veer, A; Greuel, H-W

    2014-01-01

    To cover future needs of specialised geriatric patient-centred care, existing structures need to be developed further. Taking into account regional structures of providing care, the Federal Association of Geriatric Medicine in Germany developed the concept of Cross-Border Cooperation in Geriatric Medicine. This concept combines specific geriatric expertise provided by inpatient health care with specialised networking in ambulatory treatment of elderly with a typical geriatric profile. The objective is to provide geriatric patients with a holistic and specific care and case management that overcomes existing limitations.

  17. Responsive regulation of cross-border assisted reproduction.

    PubMed

    Millbank, Jenni

    2015-12-01

    This article considers the question: how might Australian regulators constructively respond to the dynamic and complex challenges posed by cross-border assisted reproduction? To begin, the article summarises the available international scholarship and outlines what little we know about Australian cross-border reproductive travel. Of the three generally proposed responses to cross-border reproductive care (prohibition, harm minimisation and harmonisation), the article summarily rejects the first approach, and instead discusses a mixture of the latter two. The article proposes the beginnings of an immediate policy response aimed not at stopping cross-border practices per se, but rather at understanding and reducing the risks associated with them, as well as flagging the pursuit of more ambitious meta-goals such as developing more equitable and accessible treatment frameworks for assisted reproductive technology and encouraging domestic self-sufficiency in reproduction.

  18. [Cross-border cooperation in Europe: what are Euregios?].

    PubMed

    Wolf, U; Hollederer, A; Brand, H

    2006-11-01

    In cross-border cooperation, much importance has been attributed to the so-called "Euregios", synonymously also called "Euroregions". These are cross-border structures in which, above all, local and regional authorities have joined together across one or several national borders. As early as 1958, the first Euregio was established along the German-Dutch border. Meanwhile many other Euregios have been set up. Euregios provide the testing ground for pilot projects to examine practical solutions of cooperation. Euregios are therefore also called "laboratories of Europe" or "testing laboratories of European integration". Also in the health sector, several cross-border projects are being and have already been carried out. According to what has been found out so far, above all Euregios with long years of experience in cross-border cooperation seem to commit themselves to the health issue. A huge number of the projects is co-financed by the European Union. Compared to other thematic areas, in some border regions the health issue has, on the whole been, underrepresented in cross-border cooperation. In this respect, there is potential for development. Information on existing projects as well as their experiences can facilitate the successful implementation of health-relevant cross-border projects also in those regions which have up to now not carried out any or only a few projects of this kind. The EU-funded Euregio project, carried out by lögd NRW, is the first project in which a systematic inventory analysis of cross-border health care projects will be drawn up.

  19. Cross-border mobility and social networks: Laotians seeking medical treatment along the Thai border.

    PubMed

    Bochaton, Audrey

    2015-01-01

    Drawing upon research conducted on cross-border patients living in Laos and seeking care in Thailand, this paper examines the important role played by social networks in patients' decision-making and on the itineraries they choose to seek treatment on the Thai side of the border. Due to the vastly contrasting situations between the two countries in terms of healthcare supply, and considering Laotians' increasing demand for high quality healthcare, a number of them have managed to satisfy their needs by combining cross-border treatment with the use of the healthcare facilities provided by their own country. This study consisted first of household surveys conducted in five border areas (2006-2007) in Laos in order to quantify and map out cross-border healthcare-related travel patterns. Afterwards, interviews were conducted with cross-border patients (55), Laotian and Thai medical doctors (6), Thai social workers (5), and officials working in public institutions (12). While socioeconomic and spatial factors partly explain cross-border mobility, patients' social networks significantly influence treatment itineraries throughout the decision-making process, including logistical and financial considerations. The social networks existing at different geographical levels (neighbourhood, regional and global) are therefore a powerful analytical tool not only for understanding the emergence of these cross-border movements but also for justifying them in an authoritarian political environment such as Lao PDR's. Copyright © 2014 Elsevier Ltd. All rights reserved.

  20. Crossing the border for health care: access and primary care characteristics for young children of Latino farm workers along the US-Mexico border.

    PubMed

    Seid, Michael; Castañeda, Donna; Mize, Ronald; Zivkovic, Mirjana; Varni, James W

    2003-01-01

    To examine prevalence and correlates of cross-border health care for children of Latino farm workers in counties near the US-Mexico border and to compare access and primary care in the United States and Mexico. Two hundred ninety-seven parents at Head Start centers in San Diego and Imperial counties were surveyed regarding percentage of health care received in Mexico and the United States, access, and primary care characteristics. More than half of all health care was reported as received in Mexico. Reasons for Mexican use revolved around cost, accessibility, and perceptions of effectiveness. Parents of insured children reported slightly more US care, yet even this group reported approximately half of health care in Mexico. Insurance status was related to having a regular source of care, while uninsured children reporting most care in Mexico were less likely than uninsured children in the United States to have had a routine health care visit. Primary care characteristics were related to insurance status and source of care. Uninsured children reporting most care in Mexico fared better in some aspects of primary care than uninsured children reporting most care in the United States and as well as children with insurance receiving care in the United States or Mexico. Children of farm workers living along the US-Mexico border, almost irrespective of insurance status, receive a large proportion of care in Mexico. Especially for uninsured children, parent reports of Mexican care characteristics compare favorably with that received in the United States. Mexican health care might be a buffer against vulnerability to poor health outcomes for these children.

  1. Continuity of care in the cross-border context: insights from a survey of German patients treated abroad.

    PubMed

    Panteli, Dimitra; Wagner, Caroline; Verheyen, Frank; Busse, Reinhard

    2015-08-01

    Continuity of care is important for outcomes and patient satisfaction and includes additional considerations in the context of cross-border health care. Although this has been discussed in research and was picked up in the recently transposed Directive on patients' rights (2011/24/EU), there is limited evidence about related issues actually encountered by patients crossing borders. An anonymous postal survey was carried out by the Techniker Krankenkasse, one of the largest sickness funds in Germany. The questionnaire was sent to 45 189 individuals who had received treatment in EU/EEA countries and included items on relational, management and informational continuity. The survey had a response rate of 41% (n = 17 543). Of those respondents who had travelled for care (n = 3307), ∼19% (n = 570) did so due to a relationship of trust with a given provider. Only 8% of all respondents required emergency follow-up services due to complications, the majority of which was obtained back in Germany. Twelve percentage of those who were prescribed medication abroad (n = 4208) reported problems, spanning unknown products, dispensation and reimbursement. Information exchange between providers across borders was rare and largely carried out by the patients themselves. Although relational continuity may be important to specific groups of patients travelling for care, it is primarily informational continuity and its interrelation with management continuity that need to be addressed in the cross-border context. Information exchange should be endorsed at European level. Additional focus is required on informing patients about documentation rights and requirements and providing health records that are comprehensive and comprehensible. © The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

  2. Healthcare provider perspectives on barriers to HIV-care access and utilisation among Latinos living with HIV in the US-Mexico border.

    PubMed

    Servin, Argentina E; Muñoz, Fátima A; Zúñiga, María Luisa

    2014-01-01

    Latinos living with HIV residing in the US-Mexico border region frequently seek care on both sides of the border. Given this fact, a border health perspective to understanding barriers to care is imperative to improve patient health outcomes. This qualitative study describes and compares experiences and perceptions of Mexican and US HIV care providers regarding barriers to HIV care access for Latino patients living in the US-Mexico border region. In 2010, we conducted in-depth qualitative interviews with HIV care providers in Tijuana (n = 10) and San Diego (n = 9). We identified important similarities and differences between Mexican and US healthcare provider perspectives on HIV care access and barriers to service utilisation. Similarities included the fact that HIV-positive Latino patients struggle with access to ART medication, mental health illness, substance abuse and HIV-related stigma. Differences included Mexican provider perceptions of medication shortages and US providers feeling that insurance gaps influenced medication access. Differences and similarities have important implications for cross-border efforts to coordinate health services for patients who seek care in both countries.

  3. Assisted reproduction on treacherous terrain: the legal hazards of cross-border reproductive travel.

    PubMed

    Storrow, Richard F

    2011-11-01

    The growing phenomenon of cross-border reproductive travel has four significant legal dimensions. First, laws that ban or inhibit access to assisted reproductive procedures in one country lead patients and physicians to travel to other countries to acquire, to contribute to or to provide assisted reproductive services. Such laws may include provisions that criminalize those who assist or advise patients to undertake such travel. Second, the law may expressly criminalize crossing borders to obtain, to be a donor for or to perform certain procedures. Third, the law may interfere with the ultimate goal of reproductive travellers by refusing to recognize them as the parents of the child they have crossed borders to conceive. Finally, facilitating cross-border reproductive travel may expose physicians, attorneys and brokers to malpractice or other civil liability. This article explores these legal dimensions of cross-border reproductive care and uses the legal doctrines of proportionality, extraterritoriality and comity to assess the legality and normative validity of governmental efforts to curb or limit assisted reproductive practices. Copyright © 2011 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

  4. Cross-border collaboration for improved tuberculosis prevention and care: policies, tools and experiences.

    PubMed

    Dara, M; Sulis, G; Centis, R; D'Ambrosio, L; de Vries, G; Douglas, P; Garcia, D; Jansen, N; Zuroweste, E; Migliori, G B

    2017-07-01

    As tuberculosis (TB) spreads beyond borders with people movements, several interventions ensuring the continuity of care are essential, although difficult to put in place in the absence of well-defined agreements allowing data sharing and easy referral of patients to appropriate health facilities. This article first sets out general principles for cross-border collaboration and continuity of care. It then presents a series of case studies. Policies and practices on cross-border collaboration in selected low-incidence countries (Australia, Italy, Norway, The Netherlands, the United Kingdom and the United States) are described and critically appraised. Details of the World Health Organization's (WHO's) European Respiratory Society TB Consilium for transborder migration and those of the Health Network's TBNet activities are described. With increasing population movement, including migrants and travellers, it is time to build on good practices and existing tools and to remove legal, financial and social barriers to ensure early diagnosis, full treatment and continuity of care across our world. Data sharing between the sending and the receiving countries is of utmost importance and must be conducted in line with privacy protection rules. Successful implementation of these interventions is key to being on track with the WHO's End TB strategy targets for 2030.

  5. Cross-border-assisted reproduction: a qualitative account of UK travellers' experiences.

    PubMed

    Hudson, Nicky; Culley, Lorraine; Blyth, Eric; Norton, Wendy; Pacey, Allan; Rapport, Frances

    2016-06-01

    Surveys on patients' experiences of cross-border fertility treatment have reported a range of positive and challenging features. However, the number of such studies is limited, and there is no detailed qualitative account of the experiences of UK patients who travel overseas for fertility treatment. The present study used a cross-sectional, qualitative design and in-depth interviews. Fifty-one participants (41 women and 10 men, representing 41 treatment 'cases') participated in semi-structured interviews. The experiences reported were broadly positive with a large proportion of participants (39 cases, 95%) citing a favourable overall experience with only two cases (5%) reporting a more negative experience. Thematic analysis revealed 6 major categories and 20 sub-categories, which described the positive and challenging aspects of cross-border fertility travel. The positive aspects were represented by the categories: 'access', 'control' and 'care and respect'. The more challenging aspects were categorized as 'logistics and coordination of care', 'uncertainty' and 'cultural dissonance'. The study confirms findings from others that despite some challenges, there is a relatively high level of patient satisfaction with cross-border treatment with participants able to extend the boundaries of their fertility-seeking trajectories and in some cases, regain a sense of control over their treatment.

  6. Modeling cross-border care in the EU using a principal-agent framework.

    PubMed

    Crivelli, L; Zweifel, P

    1998-01-01

    Cross-border care is likely to become a major issue among EU countries because patients have the option of obtaining treatment abroad under Community Regulations 1408/71. This paper develops a model formalizing both the patient's decision to apply for cross-border care and the authorizing physician's decision to admit a patient to the program. The patient is assumed to maximize expected utility, which depends on the quality of care and the length of waiting in the home country and the host country, respectively. Not all patients qualifying for the EU program present themselves to the authorizing physician because of the transaction cost involved. The physician in her turn shapes effective demand for authorization through her rate of refusal, which constitutes information to potential applicants about the probability of obtaining treatment abroad. The authorizing physician thus acts as an agent serving two principals, her patient and her national government, trading off the perceived utility loss of patients who are rejected against her commitment to domestic health policy. The model may be used to explain existing patient flows between EU countries.

  7. Healthcare provider perspectives on barriers to HIV-care access and utilisation among Latinos living with HIV in the US-Mexico border

    PubMed Central

    Servin, Argentina E.; Muñoz, Fátima A.; Zúñiga, María Luisa

    2015-01-01

    Latinos living with HIV residing in the US-Mexico border region frequently seek care on both sides of the border. Given this fact, a border health perspective to understanding barriers to care is imperative to improve patient health outcomes. This qualitative study describes and compares experiences and perceptions of Mexican and US HIV care providers regarding barriers to HIV care access for Latino patients living in the US-Mexico border region. In 2010, we conducted in-depth qualitative interviews with HIV care providers in Tijuana (n = 10) and San Diego (n = 9). We identified important similarities and differences between Mexican and US healthcare provider perspectives on HIV care access and barriers to service utilisation. Similarities included the fact that HIV-positive Latino patients struggle with access to ART medication, mental health illness, substance abuse and HIV-related stigma. Differences included Mexican provider perceptions of medication shortages and US providers feeling that insurance gaps influenced medication access. Differences and similarities have important implications for cross-border efforts to coordinate health services for patients who seek care in both countries. PMID:24592920

  8. Implementation of the cross-border healthcare directive in Poland: How not to encourage patients to seek care abroad?

    PubMed

    Kowalska-Bobko, Iwona; Mokrzycka, Anna; Sagan, Anna; Włodarczyk, W Cezary; Zabdyr-Jamróz, Michał

    2016-11-01

    In October 2014, after over 12 months of delay, Poland finally implemented directive 2011/24/EU on the application of patients' rights in cross-border healthcare. The implementing legislation in the area of cost reimbursement and prior authorization is very restrictive. The goal is to either defer the public payer's expenses into the future or to discourage patients from seeking care abroad or from seeking care altogether. The Polish government and the Ministry of Health, the key stakeholders in the implementation process, seemed to overlook the potential monetary benefits that the implementation of the directive could bring, for example, by promoting Poland as a destination for health tourism. Other stakeholders, such as patients and healthcare providers, had no real influence on the policy process. So far, the number of applications for planned treatment abroad has been very low and the majority of them were actually turned down as they did not meet the formal requirements. This number is likely to remain low in the future as accessing such care is cumbersome and not affordable for many patients. Overall, while the directive does not aim to encourage patients to seek cross-border healthcare, the current national regulations in Poland do not seem to facilitate access to cross-border healthcare, which is the main goal of the directive. Copyright © 2016 The Author(s). Published by Elsevier Ireland Ltd.. All rights reserved.

  9. Transnational health care: from a global terminology towards transnational health region development.

    PubMed

    Mainil, Tomas; Van Loon, Francis; Dinnie, Keith; Botterill, David; Platenkamp, Vincent; Meulemans, Herman

    2012-11-01

    Within European cross-border health care, recent studies have identified several types of international patients. Within the Anglo-Saxon setting, the specific terminology of medical tourism is used. The analytical purpose of the paper is to resolve this semantic difference by suggesting an alternative terminology, 'transnational health care' that is understood as a 'context-controlled and coordinated network of health services'. For demand-driven trans-border access seekers and cross-border access searchers, there is a need to opt for regional health-policy strategies. For supply-driven sending context actors and receiving context actors, there would be organizational benefits to these strategies. Applying the terminology of trans-border access seekers, cross-border access searchers, sending context and receiving context actors results in a transnational patient mobility typology of twelve types of international patients, based on the criteria of geographical distance, cultural distance and searching efforts, public/private/no cover and private/public provision of health services. Finally, the normative purpose of the paper is to encourage the use of this terminology to promote a policy route for transnational health regions. It is suggested that the development of transnational health regions, each with their own medical and supportive service characteristics, could enhance governmental context-controlled decision power in applying sustainable health destination management. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  10. A Qualitative study of language barriers between South African health care providers and cross-border migrants.

    PubMed

    Hunter-Adams, Jo; Rother, Hanna-Andrea

    2017-01-31

    Communication with health care providers represents an essential part of access to health care for the over 230 million cross-border migrants around the world. In this article, we explore the complexity of health communication from the perspective of cross-border migrants seeking antenatal care in Cape Town, South Africa in order to highlight the importance of high quality medical interpretation. As part of a broader study of migrant maternal and infant nutrition, we conducted a secondary data analysis of semi-structured in-depth interviews (N = 23) with Congolese (n = 7), Somali (n = 8) and Zimbabwean (n = 8) women living in Cape Town, as well as nine focus group discussions (including men: n = 3 and women: n = 6) were conducted with migrant Somalis, Congolese, and Zimbabweans (N = 48). We first used content analysis to gather all data related to language and communication. We then analysed this data thematically. Zimbabwean participants described how the inability to speak the local South African language (IsiXhosa) gave rise to labelling and stereotyping by healthcare staff. Congolese and Somali participants described medical procedures, including tubal ligation, which were performed without consent. Partners often tried to play the role of interpreter, which resulted in loss of income and non-professional medical interpretation. Participants' highlighted fears over unwanted procedures or being unable to access care. Challenges of communication without a common language (and without professional medical interpretation), rather than outright denial of care by healthcare professionals, mediated these encounters. Although there are several factors impeding cross-border migrants' access to health care, effective communication is a prerequisite for quality care. Free-to-patient professional medical interpretation would not only benefit migrant populations but would benefit the broader community where language and health literacy are barriers to accessing health care. Novel approaches to language access may include technology-enabled professional interpretation.

  11. A typology of cross-border patient mobility.

    PubMed

    Glinos, Irene A; Baeten, Rita; Helble, Matthias; Maarse, Hans

    2010-11-01

    Based on systematic observation and analysis of available evidence, we propose a typology of cross-border patient mobility (rather than the so-called 'medical tourism') defined as the movement of a patient travelling to another country to seek planned health care. The typology is constructed around two dimensions based on the questions 'why do patients go abroad for planned health care?' and 'how is care abroad paid for?' Four types of patient motivations and two funding types have been identified. Combined in a matrix, they make eight possible scenarios of patient mobility each illustrated with international examples. Copyright © 2010 Elsevier Ltd. All rights reserved.

  12. Recent trends in reproductive tourism and international surrogacy: ethical considerations and challenges for policy.

    PubMed

    Deonandan, Raywat

    2015-01-01

    Reproductive tourism, or "cross-border reproductive care", is the phenomenon of people crossing international borders to access reproductive technologies. One of the fastest-growing categories of cross-border reproductive care is international surrogacy, the act of infertile clients traveling internationally to engage the paid services of foreign surrogates to carry their babies to term. It is a multibillion-dollar global industry presenting unique legal, ethical, and risk-management challenges. Clients tend to be price-sensitive, middle-income individuals seeking services from surrogates who in the global market are thought to be of quite low socioeconomic status. Risks are experienced by all parties involved in the transaction, including the client's countries of origin and destination. The risks to the surrogate evolve from the potential to exploit her economic vulnerability in order to encourage both consent and unfair pricing. Opportunities for policy development are explored.

  13. The impact of cross-border reproductive care or 'fertility tourism' on NHS maternity services.

    PubMed

    McKelvey, A; David, A L; Shenfield, F; Jauniaux, E R

    2009-10-01

    High order multiple pregnancies have substantial morbidity and mortality. Fertility treatment is commonly responsible for their conception and is available globally with variable regulation. We investigated cross-border fertility treatment in these pregnancies in a UK fetal medicine unit, recording mode of conception, country of fertility treatment, reason for non-UK treatment and fetal reduction. Over an 11-year period, 109 women had a high order multiple pregnancy. Ninety-four women (86%) conceived with fertility treatment of whom 24 (26%) had this performed overseas. Cross-border fertility treatment poses an increasing challenge to obstetricians. National data on its occurrence is urgently needed.

  14. Medicare spending by state: the border-crossing adjustment.

    PubMed

    Basu, J; Lazenby, H C; Levit, K R

    1995-01-01

    As the first step in a pioneering effort by the Health Care Financing Administration (HCFA) to measure interstate border crossing for services used by both Medicare and non-Medicare beneficiaries, the authors study the spending behavior of Medicare beneficiaries for 10 Medicare-covered services. Based on interstate flow-of-expenditure data developed for calendar year 1991, the authors analyze the spending patterns of State residents by studying the inflow and outflow rates and the netflow ratios of expenditures incurred by Medicare patients. The report also provides per capita expenditure estimates with residence-based adjustments and evaluates the impact of the border-crossing adjustment for individual services and States.

  15. Uninsurance, underinsurance, and health care utilization in Mexico by US border residents.

    PubMed

    Su, Dejun; Pratt, William; Stimpson, Jim P; Wong, Rebeca; Pagán, José A

    2014-08-01

    Using data from the 2008 Cross-Border Utilization of Health Care Survey, we examined the relationship between United States (US) health insurance coverage plans and the use of health care services in Mexico by US residents of the US-Mexico border region. We found immigrants were far more likely to be uninsured than their native-born counterparts (63 vs. 27.8 %). Adults without health insurance coverage were more likely to purchase medications or visit physicians in Mexico compared to insured adults. However, adults with Medicaid coverage were more likely to visit dentists in Mexico compared to uninsured adults. Improving health care access for US residents in the southwestern border region of the country will require initiatives that target not only providing coverage to the large uninsured population but also improving access to health care services for the large underinsured population.

  16. Crossing borders for fertility treatment: motivations, destinations and outcomes of UK fertility travellers.

    PubMed

    Culley, L; Hudson, N; Rapport, F; Blyth, E; Norton, W; Pacey, A A

    2011-09-01

    There are few systematic studies of the incidence of cross-border fertility care and even fewer reports of qualitative research with those undertaking treatment outside their country of origin. This paper reports findings from a qualitative study of UK residents with experience of cross-border care: the socio-demographic characteristics of UK travellers; their reasons for seeking treatment abroad; the treatments they sought; the destinations they chose and the outcomes of their treatment. Data regarding cross-border fertility treatment were collected from a purposive sample of 51 people by means of in-depth, semi-structured interviews between May 2009 and June 2010. Data were analysed using a systematic thematic coding method and also subjected to quantitative translation. Patient motivations for travelling abroad are complex. A desire for timely and affordable treatment with donor gametes was evident in a high number of cases (71%). However, most people gave several reasons, including: the cost of UK treatment; higher success rates abroad; treatment in a less stressful environment and dissatisfaction with UK treatment. People travelled to 13 different countries, the most popular being Spain and the Czech Republic. Most organized their own treatment and travel. The mean age of women seeking treatment was 38.8 years (range 29-46 years) and the multiple pregnancy rate was 19%. UK residents have diverse reasons for, and approaches to, seeking overseas treatment and do not conform to media stereotypes. Further research is needed to explore implications of cross-border treatment for donors, offspring and healthcare systems.

  17. Canadian physicians’ responses to cross border health care

    PubMed Central

    2014-01-01

    Background The idea for this survey emanated from desk research and two meetings for researchers that discussed medical tourism and out-of-country health care, which were convened by some of the authors of this article (VR, CP and RL). Methods A Cross Border Health Care Survey was drafted by a number of the authors and administered to Canadian physicians via the Canadian Medical Association’s e-panel. The purpose of the survey was to gain an understanding of physicians’ experiences with and views of their patients acquiring health care out of country, either as medical tourists (paying out-of-pocket for their care) or out-of-country care patients funded by provincial/territorial public health insurance plans. Quantitative and qualitative results of the survey were analyzed. Results 631 physicians responded to the survey. Diagnostic procedures were the top-ranked procedure for patients either as out-of-country care recipients or medical tourists. Respondents reported that the main reason why patients sought care abroad was because waiting times in Canada were too long. Some respondents were frustrated with a lack of information about out-of-country procedures upon their patients’ return to Canada. The majority of physician respondents agreed that it was their responsibility to provide follow-up care to medical travellers on return to Canada, although a substantial minority disagreed that they had such a responsibility. Conclusions Cross-border health care, whether government-sanctioned (out-of-country-care) or patient-initiated (medical tourism), is increasing in Canada. Such flows are thought likely to increase with aging populations. Government-sanctioned outbound flows are less problematic than patient-initiated flows but are constrained by low approval rates, which may increase patient initiation. Lack of information and post-return complications pose the greatest concern to Canadian physicians. Further research on both types of flows (government-sanctioned and patient-initiated), and how they affect the Canadian health system, can contribute to a more informed debate about the role of cross-border health care in the future, and how it might be organized and regulated. PMID:24708810

  18. Canadian physicians' responses to cross border health care.

    PubMed

    Runnels, Vivien; Labonté, Ronald; Packer, Corinne; Chaudhry, Sabrina; Adams, Owen; Blackmer, Jeff

    2014-04-03

    The idea for this survey emanated from desk research and two meetings for researchers that discussed medical tourism and out-of-country health care, which were convened by some of the authors of this article (VR, CP and RL). A Cross Border Health Care Survey was drafted by a number of the authors and administered to Canadian physicians via the Canadian Medical Association's e-panel. The purpose of the survey was to gain an understanding of physicians' experiences with and views of their patients acquiring health care out of country, either as medical tourists (paying out-of-pocket for their care) or out-of-country care patients funded by provincial/territorial public health insurance plans. Quantitative and qualitative results of the survey were analyzed. 631 physicians responded to the survey. Diagnostic procedures were the top-ranked procedure for patients either as out-of-country care recipients or medical tourists. Respondents reported that the main reason why patients sought care abroad was because waiting times in Canada were too long. Some respondents were frustrated with a lack of information about out-of-country procedures upon their patients' return to Canada. The majority of physician respondents agreed that it was their responsibility to provide follow-up care to medical travellers on return to Canada, although a substantial minority disagreed that they had such a responsibility. Cross-border health care, whether government-sanctioned (out-of-country-care) or patient-initiated (medical tourism), is increasing in Canada. Such flows are thought likely to increase with aging populations. Government-sanctioned outbound flows are less problematic than patient-initiated flows but are constrained by low approval rates, which may increase patient initiation. Lack of information and post-return complications pose the greatest concern to Canadian physicians. Further research on both types of flows (government-sanctioned and patient-initiated), and how they affect the Canadian health system, can contribute to a more informed debate about the role of cross-border health care in the future, and how it might be organized and regulated.

  19. Quality in health care and globalization of health services: accreditation and regulatory oversight of medical tourism companies.

    PubMed

    Turner, Leigh G

    2011-02-01

    Patients are crossing national borders in search of affordable and timely health care. Many medical tourism companies are now involved in organizing cross-border health services. Despite the rapid expansion of the medical tourism industry, few standards exist to ensure that these businesses organize high-quality, competent international health care. Addressing the regulatory vacuum, 10 standards are proposed as a framework for regulating the medical tourism industry. Medical tourism companies should have to undergo accreditation review. Care should be arranged only at accredited international health-care facilities. Standards should be established to ensure that clients of medical tourism companies make informed choices. Continuity of care needs to become an integral feature of cross-border care. Restrictions should be placed on the use of waiver of liability forms by medical tourism companies. Medical tourism companies must ensure that they conform to relevant legislation governing privacy and confidentiality of patient information. Restrictions must be placed on the types of health services marketed by medical tourism companies. Representatives of medical tourism agencies should have to undergo training and certification. Medical travel insurance and medical complications insurance should be included in the health-care plans of patients traveling for care. To protect clients from financial losses, medical tourism companies should be mandated to contribute to compensation funds. Establishing high standards for the operation of medical tourism companies should reduce risks facing patients when they travel abroad for health care.

  20. Freedom of movement across the EU: legal and ethical issues for children with chronic disease.

    PubMed

    Mercieca, Cecilia; Aquilina, Kevin; Pullicino, Richard; Borg, Andrew A

    2012-11-01

    While freedom of movement has been one of the most highly respected human right across the EU, there are various aspects which come into play which still need to be resolved for this to be achieved in practice. One of these key issues is cross border health care. Indeed, there is an increasing awareness of standardisation of health service provision and cross border collaboration in the EU. However, certain groups particularly children may be at risk of suboptimal treatment as a result. We present the case of a child patient which highlights the complexity of this matter spanning family law, health law, social security law as well as ethical issues. EU legislation needs to ensure that children patients have access to high quality care across the EU borders.

  1. Utilization of physician health care services in Mexico by U.S. Hispanic border residents.

    PubMed

    Landeck, Michael; Garza, Cecilia

    2002-01-01

    One of the most controversial topics in the U.S. is the issue of accessibility to health services by U.S. residents. This issue is most critical to U.S. Hispanic residents living along the U.S.-Mexico border who have been identified as having low health standards and low socio-economic conditions when compared to the rest of the state and the country. The availability of lower cost health services across the U.S. border in Mexico is, therefore, perceived as a viable economic alternative source of health care. This study is derived from a health needs assessment survey of 1,100 households residing in Laredo, Texas, the largest land port along the 2,000-miles long U.S.-Mexico border. The major result of this study indicates that about 41.2 percent of the Laredo U.S. Hispanic residents are utilizing cross border physician health care services in Mexico.

  2. Migration status, work conditions and health utilization of female sex workers in three South African cities.

    PubMed

    Richter, Marlise; Chersich, Matthew F; Vearey, Jo; Sartorius, Benn; Temmerman, Marleen; Luchters, Stanley

    2014-02-01

    Intersections between migration and sex work are underexplored in southern Africa, a region with high internal and cross-border population mobility, and HIV prevalence. Sex work often constitutes an important livelihood activity for migrant women. In 2010, sex workers trained as interviewers conducted cross-sectional surveys with 1,653 female sex workers in Johannesburg (Hillbrow and Sandton), Rustenburg and Cape Town. Most (85.3%) sex workers were migrants (1396/1636): 39.0% (638/1636) internal and 46.3% (758/1636) cross-border. Cross-border migrants had higher education levels, predominately worked part-time, mainly at indoor venues, and earned more per client than other groups. They, however, had 41% lower health service contact (adjusted odds ratio = 0.59; 95% confidence interval = 0.40-0.86) and less frequent condom use than non-migrants. Police interaction was similar. Cross-border migrants appear more tenacious in certain aspects of sex work, but require increased health service contact. Migrant-sensitive, sex work-specific health care and health education are needed.

  3. DataView: Medicare Spending by State: The Border-Crossing Adjustment

    PubMed Central

    Basu, Joy; Lazenby, Helen C.; Levit, Katharine R.

    1995-01-01

    As the first step in a pioneering effort by the Health Care Financing Administration (HCFA) to measure interstate border crossing for services used by both Medicare and non-Medicare beneficiaries, the authors study the spending behavior of Medicare beneficiaries for 10 Medicare-covered services. Based on interstate flow-of-expenditure data developed for calendar year 1991, the authors analyze the spending patterns of State residents by studying the inflow and outflow rates and the net flow ratios of expenditures incurred by Medicare patients. The report also provides per capita expenditure estimates with residence-based adjustments and evaluates the impact of the border-crossing adjustment for individual services and States. PMID:10157375

  4. Cross-border reproductive care in North America: a pilot study testing a prospective data collection program for in vitro fertilization clinics in Canada and the United States.

    PubMed

    Hughes, Edward G; Sawyer, Angie; DeJean, Deirdre; Adamson, G David

    2016-03-01

    To develop and test a nonidentifying prospective data collection system for cross-border reproductive care (CBRC) in Canada and the United States (U.S.). Survey and cross-sectional study. Fertility clinics. Women traveling to and from Canada and the U.S. for reproductive care. None. Patients' home country, reason for crossing borders, and type of care received. Of 32 Canadian and 440 U.S. clinics contacted, seven and 46, respectively, responded to the initial questionnaire. Three out of seven Canadian and 44 out of 46 U.S. clinics reported providing CBRC. Seventy five percent agreed that nonidentifying data on country of origin and reason for travel should be collected. However, only one of seven Canadian and none of 46 U.S. clinics that expressed initial interest actually collected data, despite multiple communications. Although CBRC is a major component of assisted reproductive technology in North America (3%-10% of IVF cycles are provided to out-of-country patients in Canada and the U.S.), clinicians are not motivated to collect the simplest of data regarding CBRC patients. Despite this, reliable data are needed to help better understand the reasons for and impact of CBRC. Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  5. Egg Production and Donation: A New Frontier in the Global Landscape of Cross-Border Reproductive Care: Ethical Concerns.

    PubMed

    Neri, Margherita; Turillazzi, Emanuela; Pascale, Natasha; Riezzo, Irene; Pomara, Cristoforo

    2016-01-01

    Cross-border reproductive care (CBRC) is a multifaceted phenomenon. It may involve both the movement of patients to undertake assisted reproductive treatment through technologies otherwise denied and the movement of assisted reproduction professionals, egg and sperm donors and surrogates, as well as the importing and exporting of gametes. The reasons for CBRC vary between countries. In this global landscape, the search for donor oocytes is one of the main reasons for patients seeking cross-border reproductive care. The egg market has led to ethical and political concerns about the means of procuring donor oocytes, the possibility of exploiting economically underprivileged women mainly in poor countries, and the issue of the responsibility and accountability of medical doctors and fertility clinics. Ethical concerns relating to international egg donation are discussed with special focus on the issues of compensation/ reimbursement, the health and welfare of women donating eggs, informed consent to donation, the possible conflict of interest for physicians involved in egg donation programmes, and equity in the distribution of economic resources from CBRC. Finally, the need for global solutions to this global issue is underlined.

  6. Public health and terrorism preparedness: cross-border issues.

    PubMed

    Olson, Debra; Leitheiser, Aggie; Atchison, Christopher; Larson, Susan; Homzik, Cassandra

    2005-01-01

    On December 15, 2003, the Centers for Public Health Preparedness at the University of Minnesota and the University of Iowa convened the "Public Health and Terrorism Preparedness: Cross-Border Issues Roundtable." The purpose of the roundtable was to gather public health professionals and government agency representatives at the state, provincial, and local levels to identify unmet cross-border emergency preparedness and response needs and develop strategies for addressing these needs. Representatives from six state and local public health departments and three provincial governments were invited to identify cross-border needs and issues using a nominal group process. The result of the roundtable was identification of the needs considered most important and most doable across all the focus groups. The need to collaborate on and exchange plans and protocols among agencies was identified as most important and most doable across all groups. Development of contact protocols and creation and maintenance of a contact database was also considered important and doable for a majority of groups. Other needs ranked important across the majority of groups included specific isolation and quarantine protocols for multi-state responses; a system for rapid and secure exchange of information; specific protocols for sharing human resources across borders, including emergency credentials for physicians and health care workers; and a specific protocol to coordinate Strategic National Stockpile mechanisms across border communities.

  7. Cross-border reproductive care in Belgium.

    PubMed

    Pennings, G; Autin, C; Decleer, W; Delbaere, A; Delbeke, L; Delvigne, A; De Neubourg, D; Devroey, P; Dhont, M; D'Hooghe, T; Gordts, S; Lejeune, B; Nijs, M; Pauwels, P; Perrad, B; Pirard, C; Vandekerckhove, F

    2009-12-01

    Cross-border reproductive care indicates the cross-border movements made by patients to obtain infertility treatment they cannot obtain at home. The problem at present is that empirical data on the extent of the phenomenon are lacking. This article presents the data on infertility patients going to Belgium for treatment. A survey was conducted among the centres for reproductive medicine that are allowed to handle oocytes and create embryos (B-centres). Data were collected on the nationality of patients and the type of treatment for which they attended during the period 2000-2007. Sixteen of 18 centres responded to the questionnaire. The flow of foreign patients has stabilized since 2006 at approximately 2100 patients per year. The majority of foreign nationals seeking treatment in Belgium were French women for sperm donation. The next highest group was patients entering the country to obtain ICSI with ejaculated sperm. There are clear indications that numerous movements are motivated by the wish to evade legal restrictions in one's home country, either because the technology is prohibited or because the patients have characteristics, which exclude them from treatment in their own countries.

  8. Dutch citizens of Turkish origin who utilize healthcare services in Turkey: a qualitative study on motives and contextual factors.

    PubMed

    Şekercan, Aydın; Woudstra, Anke J; Peters, Ron J G; Lamkaddem, Majda; Akgün, Seval; Essink-Bot, Marie-Louise

    2018-04-17

    Dutch residents of Turkish origin frequently utilize healthcare in Turkey. To investigate their motives for doing so, we conducted a qualitative study among these healthcare users using semi-structured interviews. We complemented this with informal conversations with Turkish healthcare providers and observations at the registration offices and waiting rooms of outpatient clinics in several Turkish hospitals. Respondents believed their perceived needs for referral to specialist care and diagnostic assessments to quantify their health were not being met in the Netherlands. These mismatches in expectations of what constitutes "good care" led to dissatisfaction with Dutch primary care. Consequently, respondents utilized healthcare in Turkey if the opportunity arose, and were encouraged in this by their social networks. Establishing cross-border communication between healthcare providers is necessary, because there is currently no continuity of care for cross-border patients.

  9. [Transnational solidarity? Cross-border heath-care in the European Union].

    PubMed

    Schmucker, R

    2010-03-01

    The responsibilities of the European Union surrounding public health are concentrated on co-ordinating and complementary practices. A mandatory European harmonization of standards and policies is in effect in only a few areas such as pharmaceutical authorization and health protection at the workplace. The implementation of single market rights over the national health-care systems (negative integration) is growing at the European level. This has ambivalent repercussions. Whilst the rights of patients on the basis of the four fundamental freedoms in the context of cross-border health-care have got stronger, national governments see themselves confronted with a limitation of scope for their health-care policies. The basic principles of the integration project place European pressure on national governments. They are subject to sanctions if their policies are not directly in accordance with the single market concept. Georg Thieme Verlag KG Stuttgart. New York.

  10. The relationship between violence in Northern Mexico and potentially avoidable hospitalizations in the USA-Mexico border region.

    PubMed

    Geissler, Kimberley; Stearns, Sally C; Becker, Charles; Thirumurthy, Harsha; Holmes, George M

    2016-03-01

    Substantial proportions of US residents in the USA-Mexico border region cross into Mexico for health care; increases in violence in northern Mexico may have affected this access. We quantified associations between violence in Mexico and decreases in access to care for border county residents. We also examined associations between border county residence and access. We used hospital inpatient data for Arizona, California and Texas (2005-10) to estimate associations between homicide rates and the probability of hospitalization for ambulatory care sensitive (ACS) conditions. Hospitalizations for ACS conditions were compared with homicide rates in Mexican municipalities matched by patient residence. A 1 SD increase in the homicide rate of the nearest Mexican municipality was associated with a 2.2 percentage point increase in the probability of being hospitalized for an ACS condition for border county patients. Residence in a border county was associated with a 1.3 percentage point decrease in the probability of being hospitalized for an ACS condition. Increased homicide rates in Mexico were associated with increased hospitalizations for ACS conditions in the USA, although residence in a border county was associated with decreased probability of being hospitalized for an ACS condition. Expanding access in the border region may mitigate these effects by providing alternative sources of care. © The Author 2015. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  11. Cross-border reproductive care for law evasion: should physicians be allowed to help infertility patients evade the law of their own country?

    PubMed

    Van Hoof, Wannes; Pennings, Guido; De Sutter, Petra

    2016-07-01

    There are fundamental differences between countries with regard to legislation on assisted reproduction. Many infertility patients are looking to evade the law of their own country and make use of reproductive services abroad. The role of the local physician in cross-border reproductive care for law evasion has been characterized as "channeling local patients to foreign medical establishments" and "against the spirit and essence of the law". The logical view is that by supporting CBRC for law evasion, physicians are essentially supporting immoral behavior. We will tackle this position on two levels. First, we will argue that governments should generally be tolerant toward people with different positions on assisted reproduction. Second, we will show that contributing to cross-border reproductive care for law evasion is not necessarily immoral, because the prima facie wrongness of complicity in law evasion can be outweighed by the fact that physicians should act in the best interest of the patient. Several countries have tried to prevent local physicians from helping patients to make use of reproductive services abroad, but they should rather leave it up to the individual physicians to decide whether or not to support a particular patient. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  12. Cross border health care provision: who gains, who loses.

    PubMed

    Levaggi, Rosella; Menoncin, Francesco

    2014-01-01

    The diffusion of the welfare state has produced a widespread involvement of the public sector in financing the production of private goods for paternalistic reasons. In this chapter we model the production of health care as a merit impure local public good whose consumption is subsidized and whose access is free, but not unlimited. The impure local public good aspect means that the production of health care spreads its benefits beyond the geographical boundaries of the Region where it is produced. Finally, we include the (optional) provision of an equalization grant that allows reduction of fiscal imbalance among Regions. In this framework we study the possible effects of cross border provision of health care. We assume that information is complete and symmetric and that there is no comparative advantage in local provision. In this context devolution is always suboptimal for the whole community: the lack of coordination means that the impure public good is under-provided. However, more efficient Regions may be better off because of the impure public good nature of health care.

  13. Not a flat world: the future of cross-border reproductive care.

    PubMed

    Franklin, Sarah

    2011-12-01

    Cross-border reproductive care (CBRC) raises new issues for both medicine and social science, as well as analytical and methodological challenges. On the one hand, this phenomenon extends well-established practices, such as family formation, in new ways, for example through new technologies. Similarly, CBRC could be described as a form of globalization. Yet this sector also departs from established patterns of reproductivity, for example by combining reproductive services and substances transnationally. In this way, CBRC also changes the understanding of globalization, revealing that it is not necessarily producing a newly 'flat' world, but instead reproducing a traditionally stratified one. These aspects of CBRC must be kept in mind in the struggle to define best practice. Copyright © 2011. Published by Elsevier Ltd.

  14. The impact of the EU Directive on patients' rights and cross border health care in Malta.

    PubMed

    Azzopardi-Muscat, Natasha; Aluttis, Christoph; Sorensen, Kristine; Pace, Roderick; Brand, Helmut

    2015-10-01

    The patients' rights and cross-border health care directive was implemented in Malta in 2013. Malta's transposition of the directive used the discretionary elements allowable to retain national control on cross-border care to the fullest extent. This paper seeks to analyse the underlying dynamics of this directive on the Maltese health care system through the lens of key health system stakeholders. Thirty-three interviews were conducted. Qualitative content analysis of the interviews reveals six key themes: fear from the potential impact of increased patient mobility, strategies employed for damage control, opportunities exploited for health system reform, moderate enhancement of patients' rights, negligible additional patient mobility and unforeseen health system reforms. The findings indicate that local stakeholders expected the directive to have significant negative effects and adopted measures to minimise these effects. In practice the directive has not affected patient mobility in Malta in the first months following its implementation. Government appears to have instrumentalised the implementation of the directive to implement certain reforms including legislation on patients' rights, a health benefits package and compulsory indemnity insurance. Whilst the Maltese geo-demographic situation precludes automatic generalisation of the conclusions from this case study to other Member States, the findings serve to advance our understanding of the mechanisms through which European legislation on health services is influencing health systems, particularly in small EU Member States. Copyright © 2015 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

  15. Current depression among women in California according to residence in the California-Mexico border region.

    PubMed

    Ryan-Ibarra, Suzanne; Epstein, Joan Faith; Induni, Marta; Wright, Michael A

    2012-05-01

    To estimate the prevalence of current depression; examine the relationship between current depression and immigration, health status, health care access, and health behaviors; and assess differences by California-Mexico border region (Imperial and San Diego Counties) among women in California. Using a cross-sectional, representative sample of adult women from the California Women's Health Survey (n = 13 454), a statewide telephone survey, prevalence of current depression and predictors of depression were examined in California and according to border region residence. Depression was assessed with the eight-item Patient Health Questionnaire. The prevalence of current depression for women in California was 12.0%. It was similar in the border (13.0%) and the nonborder (11.9%) regions. Odds of current depression in women were lower among recent immigrants (< 5 years or 5 to < 10 years in the United States) than in women born in the United States and in immigrants who had been living in the United States for 10 to < 15 years or longer (P < 0.05). Odds ratios for current depression and health status, health care access, and binge drinking were larger in the border region than outside the border region. Similar prevalences of current depression were observed among those who live in the border region of California and in those who do not, but the relationship between depression and health status, health care access, and binge drinking varied by border region residence. Ideally, future surveillance of depression and its predictors along the Mexico-California border will be conducted binationally to inform interventions and tracking such as the Healthy Border Program's objectives.

  16. Implementing a good practice guide for CBRC: perspectives from the ESHRE Cross-Border Reproductive Care Taskforce.

    PubMed

    Shenfield, Françoise

    2011-11-01

    This article sets out views about cross-border reproductive care (CBRC) from the point of view of a professional clinicians' group. After publishing the first international European dataset measuring the phenomenon of CBRC in six European countries in June 2010, the European Society for Human Reproduction and Embryology (ESHRE) Taskforce on CBRC set out to write a good practice guide, which aims at advising clinicians and professionals dealing with patients interested in seeking fertility treatment outside their country of residence. The background, outline and possible means of implementation of this guide are discussed here. The aims of the guide are to ensure quality of care and safety for all concerned, from patients to their future offspring, via gamete donors and surrogates if involved. Patient centredness is also an important aspect, as well as fair treatment of all parties, based on appropriate and intelligible information. Copyright © 2011. Published by Elsevier Ltd.

  17. Recent trends in reproductive tourism and international surrogacy: ethical considerations and challenges for policy

    PubMed Central

    Deonandan, Raywat

    2015-01-01

    Reproductive tourism, or “cross-border reproductive care”, is the phenomenon of people crossing international borders to access reproductive technologies. One of the fastest-growing categories of cross-border reproductive care is international surrogacy, the act of infertile clients traveling internationally to engage the paid services of foreign surrogates to carry their babies to term. It is a multibillion-dollar global industry presenting unique legal, ethical, and risk-management challenges. Clients tend to be price-sensitive, middle-income individuals seeking services from surrogates who in the global market are thought to be of quite low socioeconomic status. Risks are experienced by all parties involved in the transaction, including the client’s countries of origin and destination. The risks to the surrogate evolve from the potential to exploit her economic vulnerability in order to encourage both consent and unfair pricing. Opportunities for policy development are explored. PMID:26316832

  18. 'Know before you go': information-seeking behaviour of German patients receiving health services abroad in light of the provisions of Directive 2011/24/EU.

    PubMed

    Panteli, Dimitra; Wagner, Caroline; Verheyen, Frank; Busse, Reinhard

    2015-07-01

    While Directive 2011/24/EU on cross-border patient mobility makes specific provisions in relation to information availability and accessibility, little empirical evidence exists to guide best practice. This paper explores the information-seeking behaviour of German patients who received planned care abroad. A postal survey among German patients treated in other European countries was carried out by Techniker Krankenkasse, a major German sickness fund. The influence of certain predictors on whether patients informed themselves before travelling for care was investigated using multiple logistic regression. Types and sources of information were analysed using descriptive statistics. Information activity was contingent on patients' level of education, type of service, regularity of treatment abroad and awareness of entitlement to cross-border services. Respondents most frequently enquired about elements of reimbursement, entitlement to services and cost-saving, and consulted their sickness fund for information. Differences in both content and medium of choice were observed between patient groups. A structured and inclusive approach to information provision should be adopted. National Contact Points should collaborate with a range of stakeholders, who will vary depending on the health care system; however, patient organizations, health professionals and third-party payers should always be represented. Dynamically monitoring cross-border movements can help determine the range, medium and language of relevant information. © The Author(s) 2015.

  19. [The health of migrants at the Greece-Macedonia border].

    PubMed

    Moutamalle, Raphaël

    2016-01-01

    At the border between Greece and Macedonia, a transit camp for refugees is turning into a permanent camp. The management of the health emergency is assured by international teams from several humanitarian organisations, including the French Red Cross. The organisation of the care team, the cultural differences and the lack of resources are just some of the factors to be considered. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  20. Extraterritoriality for cross-border reproductive care: should states act against citizens travelling abroad for illegal infertility treatment?

    PubMed

    Van Hoof, Wannes; Pennings, Guido

    2011-11-01

    Since the development of assisted reproduction technologies, there has been discussion on which people should have access to these technologies and which treatments and techniques are morally acceptable. However, national legislation can no longer determine what citizens do. Some countries react to their citizens going abroad to evade restrictions by implementing even more restrictive laws. Turkey has recently become the first state to ban reproductive travel in pursuit of donor gametes. Several states in Australia have enacted or are considering laws that prohibit international commercial surrogacy. This article investigates the consistency and morality of several state reactions to cross-border reproductive care (CBRC), including extraterritorial regulation. The only widespread existing extraterritorial regulation of private life concerns female genital cutting (FGC), sex with children and (largely in the past) abortion. This discussion develops an analogy with these cross-border crimes to evaluate the morality of similar legislation in cases of CBRC. The dissimilarity in these analogies shows that extraterritoriality is a radical position that is generally inappropriate in the case of CBRC. Subsequently, several potential state reactions to CBRC for law evasion are considered. It is concluded that legislation of CBRC should be modest, tolerant and nuanced. Copyright © 2011 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

  1. How to address the ethics of reproductive travel to developing countries: a comparison of national self-sufficiency and regulated market approaches.

    PubMed

    Crozier, G K D; Martin, Dominique

    2012-04-01

    One of the areas of concern raised by cross-border reproductive travel regards the treatment of women who are solicited to provide their ova or surrogacy services to foreign consumers. This is particularly troublesome in the context of developing countries where endemic poverty and low standards for both medical care and informed consent may place these women at risk of exploitation and harm. We explore two contrasting proposals for policy development regarding the industry, both of which seek to promote ethical outcomes and social justice: While one proposal advocates efforts to minimize cross-border demand for female reproductive resources through the pursuit of national self-sufficiency, the other defends cross-border trade as a means for meeting the needs of vulnerable groups. Despite the conflicting objectives of the proposed strategies, the paper identifies common values and points of agreement between the two, including the importance of regulations to safeguard those providing ova or surrogacy services. © 2012 Blackwell Publishing Ltd.

  2. Heterotopic pregnancy in a cross border oocyte donation patient: the importance of cooperation between centers.

    PubMed

    Mancini, Fulvia; Clua, Elisabet; Martínez, Francisca; Battaglia, Cesare; Veiga, Anna; Barri, Pedro N

    2011-06-01

    To report a case of tubal heterotopic pregnancy after oocyte donation in a cross border patient. Case report. Private University Clinic, Spain, and Public University Hospital, Italy. A woman with a tubal heterotopic pregnancy after oocyte donation. Oocyte donation and ET (Spain), laparoscopic removal of the tubal heterotopic pregnancy (Italy). Diagnosis and treatment of the heterotopic pregnancy. Laparoscopic treatment of the heterotopic pregnancy resulting in a single ongoing intrauterine pregnancy. Cross border reproductive care is increasing in Europe. When patients go back to their respective countries of origin they may not inform their doctors about having undergone fertility treatments abroad. This can lead to a delayed diagnosis in case of complications arising after treatment or during pregnancy. It is of vital importance that clinicians are aware of this possibility to speed up the diagnosis and treatment of potentially fatal situations such as the one described in the present case report. Copyright © 2011 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  3. The impact of Border policy effect on cross-border ethnic areas

    NASA Astrophysics Data System (ADS)

    Bie, Q. L.; Zhou, S. Y.; Li, C. S.

    2013-11-01

    Boundary effect analysis is related to border policy making in the cross-border ethnic area. The border effect literatures show that geographic boundaries have obvious impacts on economic, social and cultural relations in both sides of a nation border. Particularly in cross-border ethnic areas, each ethnic group has strong internal spatial structure relevance, and the boundary effect is more obvious. However, most of China's border areas are cross-border ethnic areas, each of border issues is unique. Under this perspective, we analyze the border effects of various boundaries can provide basis for formulating border management policies. For small scale of cross-border ethnic minority areas, how to formulate the boundary management policy is a good question to explore. This paper is demonstrated by a study of the impact of border management policies in Dehong Dai and Jingpo Autonomous Prefecture in Yunnan Province at the border area to Burma. The comparative method is used to analysis the border management policies in past 50 decades for the border area of Yunnan Province .This research aims to define trends within border policy and its influences to national security. This paper also examines Wendy Brown's liberal theory of border management policy. We found that it is not suitable for Sino-Burma border area. The conclusion is that the changes or instability of international economic and political situation has more influence to this cross-border ethnic area, and only innovative policy will be effective in cross-border ethnic area. So the border management policies should reflect the change of international context.

  4. The green grass on the other side: crossing borders to obtain infertility treatment

    PubMed Central

    Pennings, G.

    2009-01-01

    Background: Cross-border reproductive care, also known as reproductive tourism, is a growing phenomenon. More and more treatments, or parts thereof, are taking place in countries other than the patient’s home country. Results: The phenomenon is presented as a safety valve that takes the pressure of the restrictive legislation and simultaneously allows people to obtain the treatment they desire. These movements also hold a number of risks, both for the travelling patients and for the gamete donors and infertile couples in the country of destination. Finally, the possible role of patient organisations and medical professional societies is discussed. PMID:25478065

  5. Use of cross-border healthcare services among ethnic Danes, Turkish immigrants and Turkish descendants in Denmark: a combined survey and registry study

    PubMed Central

    2012-01-01

    Background Healthcare obtained abroad may conflict with care received in the country of residence. A special concern for immigrants has been raised as they may have stronger links to healthcare services abroad. Our objective was to investigate use of healthcare in a foreign country in Turkish immigrants, their descendants, and ethnic Danes. Methods The study was based on a nationwide survey in 2007 with 372 Turkish immigrants, 496 descendants, and 1,131 ethnic Danes aged 18–66. Data were linked to registry data on socioeconomic factors. Using logistic regression models, use of doctor, specialist doctor, hospital, dentist in a foreign country as well as medicine from abroad were estimated. Analyses were adjusted for socioeconomic factors and health symptoms. Results Overall, 26.6% among Turkish immigrants made use of cross-border healthcare, followed by 19.4% among their descendants to 6.7% among ethnic Danes. Using logistic regression models with ethnic Danes as the reference group, Turkish immigrants were seen to have made increased use of general practitioners, specialist doctors, hospitals, and dentists in a foreign country (odds ratio (OR), 5.20-6.74), while Turkish descendants had made increased use of specialist doctors (OR, 4.97) and borderline statistically significant increased use of hospital (OR, 2.48) and dentist (OR, 2.17) but not general practitioners. For medicine, we found no differences among the men, but women with an immigrant background made considerably greater use, compared with ethnic Danish women. Socioeconomic position and health symptoms had a fairly explanatory effect on the use in the different groups. Conclusions Use of cross-border healthcare may have consequences for the continuity of care, including conflicts in the medical treatment, for the patient. Nonetheless, it may be aligned with the patient’s preferences and thereby beneficial for the patient. We need more information about reasons for obtaining cross-border healthcare among immigrants residing in European countries, and the consequences for the patient and the healthcare systems, including the quality of care. The Danish healthcare system needs to be aware of the significant healthcare consumption by immigrants, especially medicine among women, outside Denmark’s borders. PMID:23148550

  6. Coutts/Sweetgrass automated border crossing : phase I

    DOT National Transportation Integrated Search

    1999-03-01

    The Coutts/Sweetgrass Automated Border Crossing Project was intended to improve operational efficiency of this rural border crossing facility using ITS applications. Phase I of the Coutts/Sweetgrass Automated Border Crossing Project was intended to r...

  7. Telemedicine and advances in urban and rural healthcare delivery in Africa.

    PubMed

    Mars, Maurice

    2013-01-01

    Telecardiology holds great promise for Africa, from tele-echocardiography and tele-ECG s, to home monitoring and text messaging for medication adherence monitoring. The burden of disease is great and there is an extreme shortage of health professionals. Telemedicine can provide access to scarce specialist care, improve the quality of care in rural areas and reduce the need for rural patients to travel to seek medical attention. International cross border service can alleviate the shortage of doctors. But telecardiology, and telemedicine uptake in general, has been poor in Africa. Legal and ethical issues around local and cross border telemedicine have not been resolved. The literature was reviewed and obstacles to telemedicine in Africa and current telemedicine activities in Africa, are described. There are few sustained telemedicine services in Africa with the exception of tele-education. There is an expectation that mobile phones will facilitate a range of telemedicine activities in Africa. Africa needs telemedicine. © 2013.

  8. The role of basic data registers in cross-border interconnection of eHealth solutions.

    PubMed

    Kregar, Mirjana; Marčun, Tomaž; Dovžan, Irma; Cehovin, Lojzka

    2011-01-01

    The increasingly closer international business cooperation in the areas of production, trade, transport and activities such as tourism and education is promoting the mobility of people. This increases the need for the provision of health care services across borders. In order to provide increasingly safer and effective treatment that is of ever higher quality in these cases as well, it is necessary to ensure that data accompanies patients even when they travel to other regions, countries or continents. eHealth solutions are one of the key tools for achieving such objectives. When building these solutions, it is necessary to take into account the different aspects and limitations brought about by the differences in the environments where such a treatment of a patient takes place. In the debates on the various types of cross-border interoperability of eHealth solutions, it is necessary to bring to attention the necessity of suitable management and interconnection of data registers that form the basis of every information system: data on patients, health care service providers and basic code tables. It is necessary to promote well-arranged and quality data in the patient's domestic environment and the best possible options for transferring and using those data in the foreign environment where the patient is receiving medical care at a particular moment. Many of the discussions dealing with conditions for the interoperability of health care information systems actually start with questions of how to ensure the interconnectivity of basic data registers.

  9. Purchasing health services abroad: practices of cross-border contracting and patient mobility in six European countries.

    PubMed

    Glinos, Irene A; Baeten, Rita; Maarse, Hans

    2010-05-01

    Contracting health services outside the public, statutory health system entails purchasing capacity from domestic non-public providers or from providers abroad. Over the last decade, these practices have made their way into European health systems, brought about by performance-oriented reforms and EU principles of free movement. The aim of the article is to explain the development, functioning, purposes and possible implications of cross-border contracting. Primary and secondary sources on purchasing from providers abroad have been collected in a systematic way and analysed in a structured frame. We found practices in six European countries. The findings suggest that purchasers from benefit-in-kind systems contract capacity abroad when this responds to unmet demand; pressures domestic providers; and/or offers financial advantages, especially where statutory purchasers compete. Providers which receive patients tend to be located in countries where treatment costs are lower and/or where providers compete. The modalities of purchasing and delivering care abroad vary considerably depending on contracts being centralised or direct, the involvement of middlemen, funding and pricing mechanisms, cross-border pathways and volumes of patient flows. The arrangements and concepts which cross-border contracting relies on suggest that statutory health purchasers, under pressure to deliver value for money and striving for cost-efficiency, experiment with new ways of organising health services for their populations. Copyright (c) 2009 Elsevier Ireland Ltd. All rights reserved.

  10. 22 CFR 41.32 - Nonresident alien Mexican border crossing identification cards; combined border crossing...

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... identification cards; combined border crossing identification cards and B-1/B-2 visitor visas. 41.32 Section 41.32 Foreign Relations DEPARTMENT OF STATE VISAS VISAS: DOCUMENTATION OF NONIMMIGRANTS UNDER THE... crossing identification cards; combined border crossing identification cards and B-1/B-2 visitor visas. (a...

  11. 22 CFR 41.32 - Nonresident alien Mexican border crossing identification cards; combined border crossing...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... identification cards; combined border crossing identification cards and B-1/B-2 visitor visas. 41.32 Section 41.32 Foreign Relations DEPARTMENT OF STATE VISAS VISAS: DOCUMENTATION OF NONIMMIGRANTS UNDER THE... crossing identification cards; combined border crossing identification cards and B-1/B-2 visitor visas. (a...

  12. 22 CFR 41.32 - Nonresident alien Mexican border crossing identification cards; combined border crossing...

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... identification cards; combined border crossing identification cards and B-1/B-2 visitor visas. 41.32 Section 41.32 Foreign Relations DEPARTMENT OF STATE VISAS VISAS: DOCUMENTATION OF NONIMMIGRANTS UNDER THE... crossing identification cards; combined border crossing identification cards and B-1/B-2 visitor visas. (a...

  13. 22 CFR 41.32 - Nonresident alien Mexican border crossing identification cards; combined border crossing...

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... identification cards; combined border crossing identification cards and B-1/B-2 visitor visas. 41.32 Section 41.32 Foreign Relations DEPARTMENT OF STATE VISAS VISAS: DOCUMENTATION OF NONIMMIGRANTS UNDER THE... crossing identification cards; combined border crossing identification cards and B-1/B-2 visitor visas. (a...

  14. 22 CFR 41.32 - Nonresident alien Mexican border crossing identification cards; combined border crossing...

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... identification cards; combined border crossing identification cards and B-1/B-2 visitor visas. 41.32 Section 41.32 Foreign Relations DEPARTMENT OF STATE VISAS VISAS: DOCUMENTATION OF NONIMMIGRANTS UNDER THE... crossing identification cards; combined border crossing identification cards and B-1/B-2 visitor visas. (a...

  15. Patient mobility and health care quality when regions and patients differ in income.

    PubMed

    Brekke, Kurt R; Levaggi, Rosella; Siciliani, Luigi; Straume, Odd Rune

    2016-12-01

    We study the effects of cross-border patient mobility on health care quality and welfare when income varies across and within regions. We use a Salop model with a high-, middle-, and low-income region. In each region, a policy maker chooses health care quality to maximise the utility of its residents when health care costs are financed by general income taxation. In equilibrium, regions with higher income offer better quality, which creates an incentive for patient mobility from lower- to higher-income regions. Assuming a prospective payment scheme based on DRG-pricing, we find that lower non-monetary (administrative) mobility costs have (i) no effect on quality or welfare in the high-income region; (ii) a negative effect on quality but a positive effect on welfare for the middle-income region; and (iii) ambiguous effects on quality and welfare for the low-income region. Lower monetary mobility costs (copayments) might reduce welfare in both the middle- and low-income region. Thus, health policies that stimulate cross-border patient mobility can be counterproductive when regions differ in income. Copyright © 2016 Elsevier B.V. All rights reserved.

  16. Realization of the international human right to health in an economically integrated North America.

    PubMed

    Kinney, Eleanor D

    2009-01-01

    With the North American Free Trade Agreement (NAFTA), the health care sectors of the United States, Canada, and Mexico are becoming more economically integrated. NAFTA poses major challenges to the realization of the international human right. These include: (1) Cross Border Trade in Medical Products, (2) Cross Border Trade in Medical Services, and the attendant investment protections, (3) Portability and Comparability of Health Insurance Coverage, and (4) Protection of Public Health Insurance Programs. The United States, Mexico, and Canada all provide public health insurance programs either to the entire population as in Canada or to vulnerable groups as in the United States. In none of these countries have private, for-profit providers and insurers been able to provide universal and affordable health coverage and care in a truly free market. Private insurers and for-profit providers should not profit from the care of the healthy and wealthy in ways that compromise the public programs that serve the poor and seriously ill. Nor should they be allowed to use NAFTA processes to compromise public programs. Policy makers must consider implications of NAFTA and move toward assuring access to affordable health care for all people on the North American continent.

  17. Cross-border reproductive care for law evasion: a qualitative study into the experiences and moral perspectives of French women who go to Belgium for treatment with donor sperm.

    PubMed

    Van Hoof, Wannes; Pennings, Guido; De Sutter, Petra

    2015-01-01

    One consequence of the legal diversity in Europe is that legal restrictions on treatments can be evaded by going abroad. Many French lesbian couples and single women are crossing the border to Belgium because they are denied access to treatments with donor sperm at home. This is the first qualitative research study into the experiences and moral perspectives of these women. Between June 2012 and May 2013, 11 lesbian couples and 2 single women were recruited at the department of reproductive medicine at Ghent University Hospital. The data from the semi-structured interviews was analysed using inductive thematic analysis. The results show that these women face several additional challenges to the already difficult process of cross-border treatment. Before they can start the treatment, they can only obtain information from the internet or from stories of friends who also went abroad for treatment with donor sperm. During the treatment, they need to find local clinics or physicians to monitor their cycle. Several women managed to game the French system to ensure partial reimbursement for their treatment when they were successful in finding a physician who was willing to prescribe drugs and perform tests. Most women had difficulties justifying their absence from work. In general these women felt that they were discriminated against and that their rights were not protected because of who they are. In that regard, the lack of legal recognition of the genetically unrelated partner in their country was particularly hard to cope with for the lesbian couples. These women have to develop many different strategies to deal with the difficulties they face during cross-border reproductive care. It is concluded that it is very important that they find a physician who is willing to support them in their 'baby project'. Copyright © 2014 Elsevier Ltd. All rights reserved.

  18. Considerations for clinics and practitioners treating foreign patients with assisted reproductive technology: lessons from experiences at Ghent University Hospital, Belgium.

    PubMed

    De Sutter, Petra

    2011-11-01

    Cross-border reproductive care (CBRC) is not a new concept, having been around since the beginning of assisted reproductive technology. Countries having taken the lead in developing new technologies have seen an influx of patients from other countries, because of legal limitations or the unavailability of good-quality care in their home country. This paper describes the experience of the Ghent University Hospital fertility centre with Dutch and French patients and tries to set out standards of care for CBRC patients. Dutch patients usually have longer histories, more complex pathology and are better informed, more outspoken and more financially secure. Thus, the care for these patients is challenging. The standards of care should be the same for local patients and CBRC patients; however, the nature of the complexity of the problems they come with will necessitate more time investment. Experience shows that many patients who have no access to treatment in their own country obtain reasonably good results. Some of them, however, are beyond possible help and these patients need a high standard of psychological care. All should be done to avoid that cross-border patients compromise the local care system. Special arrangements should be taken to manage possible complications following treatment. Copyright © 2011 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

  19. Cross-border collaboration in the field of highly contagious livestock diseases: a general framework for policy support.

    PubMed

    Hop, G E; Mourits, M C M; Oude Lansink, A G J M; Saatkamp, H W

    2014-08-01

    This paper analyses the potential gains and the main challenges for increased cross-border collaboration in the control of highly contagious livestock diseases in regions with cross-border reliance on production and consumption of livestock commodities. The aim of this intensification of cross-border collaboration is to retain the economic advantages of cross-border trade in livestock and livestock commodities while maintaining a low risk of highly contagious livestock diseases. From these two foci, possibilities for future policy making with respect to highly contagious livestock diseases are discussed: peacetime cross-border cooperation to improve the cost-effectiveness of routine veterinary measures and crisis time cross-border harmonization of current disease control strategies. A general disease management framework was used to describe the way in which these two fields are related to and affect the epidemiological system and, consequently, how they impact the stakeholders. In addition to this framework, the importance of a good understanding of influencing factors, that is, the production structure of livestock, was stressed because these factors are important determinants of the frequency and magnitude of highly contagious livestock diseases and their economic impact. The use of the suggested integrated approach was illustrated for the extended cross-border region of the Netherlands and Germany, that is, North Rhine Westphalia and Lower Saxony. For this region, current difficulties in cross-border trade in livestock and livestock commodities and possibilities for future cross-border collaboration were examined. The concepts and ideas presented in this paper should foster future development of cross-border collaboration in animal health control. © 2012 Blackwell Verlag GmbH.

  20. Referral Regions for Time-Sensitive Acute Care Conditions in the United States.

    PubMed

    Wallace, David J; Mohan, Deepika; Angus, Derek C; Driessen, Julia R; Seymour, Christopher M; Yealy, Donald M; Roberts, Mark M; Kurland, Kristen S; Kahn, Jeremy M

    2018-03-24

    Regional, coordinated care for time-sensitive and high-risk medical conditions is a priority in the United States. A necessary precursor to coordinated regional care is regions that are actionable from clinical and policy standpoints. The Dartmouth Atlas of Health Care, the major health care referral construct in the United States, uses regions that cross state and county boundaries, limiting fiscal or political ownership by key governmental stakeholders in positions to create incentive and regulate regional care coordination. Our objective is to develop and evaluate referral regions that define care patterns for patients with acute myocardial infraction, acute stroke, or trauma, yet also preserve essential political boundaries. We developed a novel set of acute care referral regions using Medicare data in the United States from 2011. For acute myocardial infraction, acute stroke, or trauma, we iteratively aggregated counties according to patient home location and treating hospital address, using a spatial algorithm. We evaluated referral political boundary preservation and spatial accuracy for each set of referral regions. The new set of referral regions, the Pittsburgh Atlas, had 326 distinct regions. These referral regions did not cross any county or state borders, whereas 43.1% and 98.1% of all Dartmouth Atlas hospital referral regions crossed county and state borders. The Pittsburgh Atlas was comparable to the Dartmouth Atlas in measures of spatial accuracy and identified larger at-risk populations for all 3 conditions. A novel and straightforward spatial algorithm generated referral regions that were politically actionable and accountable for time-sensitive medical emergencies. Copyright © 2018 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

  1. Doctors on the move: a European case study on the key characteristics of national recertification systems

    PubMed Central

    Govaerts, Marjan J; Mitchell, Sharon; Rohde, Gernot G U; Smeenk, Frank W J M; Driessen, Erik W

    2018-01-01

    Objectives With increased cross-border movement, ensuring safe and high-quality healthcare has gained primacy. The purpose of recertification is to ensure quality of care through periodically attesting doctors’ professional proficiency in their field. Professional migration and facilitated cross-border recognition of qualifications, however, make us question the fitness of national policies for safeguarding patient care and the international accountability of doctors. Design and setting We performed document analyses and conducted 19 semistructured interviews to identify and describe key characteristics and effective components of 10 different European recertification systems, each representing one case (collective case study). We subsequently compared these systems to explore similarities and differences in terms of assessment criteria used to determine process quality. Results Great variety existed between countries in terms and assessment formats used, targeting cognition, competence and performance (Miller’s assessment pyramid). Recertification procedures and requirements also varied significantly, ranging from voluntary participation in professional development modules to the mandatory collection of multiple performance data in a competency-based portfolio. Knowledge assessment was fundamental to recertification in most countries. Another difference concerned the stakeholders involved in the recertification process: while some systems exclusively relied on doctors’ self-assessment, others involved multiple stakeholders but rarely included patients in assessment of doctors’ professional competence. Differences between systems partly reflected different goals and primary purposes of recertification. Conclusion Recertification systems differ substantially internationally with regard to the criteria they apply to assess doctors’ competence, their aims, requirements, assessment formats and patient involvement. In the light of professional mobility and associated demands for accountability, we recommend that competence assessment includes patients’ perspectives, and recertification practices be shared internationally to enhance transparency. This can help facilitate cross-border movement, while guaranteeing high-quality patient care. PMID:29666131

  2. Changing Destinations: Ideal Attraction and Actual Movement of Cross-Border Tertiary Students from Mainland China

    ERIC Educational Resources Information Center

    Ghazarian, Peter G.

    2014-01-01

    Globalization has driven growth in the market for cross-border students. Mainland China, with a burgeoning economy and the largest national population, has become an important source of cross-border students. This study identifies ideal attraction in mainland China to destinations for cross-border tertiary education, as expressed by ideal first…

  3. Discourses of Volunteer/Service Work and Their Discontents: Border Crossing, Construction of Hierarchy, and Paying Dues

    ERIC Educational Resources Information Center

    Doerr, Neriko Musha

    2017-01-01

    This article examines four discourses of volunteer/service work--charity, leisure, citizenship, and border crossing--in terms of how they construct relationships between those who serve and those who are served. Specifically, it analyzes the discourse of border crossing, which assumes White middle-class students crossing a border to work in…

  4. The net effect: spanning diseases, crossing borders—highlights from the fourth triennial APCA conference and annual HPCA conference for palliative care

    PubMed Central

    Downing, J; Namisango, E; Kiyange, F; Luyirika, E; Gwyther, L; Enarson, S; Kampi, J; Sithole, Z; Kemigisha-Ssali, E; Masclee, M; Mukasa, I

    2013-01-01

    The African Palliative Care Association (APCA) jointly hosted its triennial palliative care conference for Africa with the Hospice and Palliative Care Association of South Africa (HPCA) on 17–20 September 2013 in Johannesburg, South Africa. At the heart of the conference stood a common commitment to see patient care improved across the continent. The theme for the conference, ‘The Net Effect: Spanning Diseases, Crossing Borders’, reflected this joint vision and the drive to remember the ‘net effect’ of our work in palliative care—that is, the ultimate impact of the care that we provide for our patients and their families across the disease and age spectrum and across the borders of African countries. The conference, held in Johannesburg, brought together 471 delegates from 34 countries. The key themes and messages from the conference are encapsulated in ten ‘C’s of commitment to political will and support at the highest levels of governance; engaging national, regional, and international bodies; collaboration; diversity; palliative care for children; planning for human resources and capacity building; palliative care integration at all levels; developing an evidence base for palliative care in Africa; using new technologies; and improved quality of care. Participants found the conference to be a forum that challenged their understanding of the topics presented, as well as enlightening in terms of applying best practice in their own context. Delegates found a renewed commitment and passion for palliative care and related health interventions for children and adults with life-limiting and life-threatening illnesses within the region. This conference highlighted many of the developments in palliative care in the region and served as a unique opportunity to bring people together and serve as a lynchpin for palliative care provision and development in Africa. The delegates were united in the fact that together we can ‘span diseases,’ ‘cross borders,’ and realise the ‘African Dream’ for palliative care. PMID:24222787

  5. Managing healthcare services in the global marketplace.

    PubMed

    Fried, Bruce J; Harris, Dean M

    2007-01-01

    The world is getting "flatter"; people, information, technology, and ideas are increasingly crossing national borders. U.S. healthcare is not immune from the forces of globalization. Competition from medical tourism and the rapid growth in the number of undocumented aliens requiring care represent just two challenges healthcare organizations face. An international workforce requires leaders to confront the legal, financial, and ethical implications of using foreign-trained personnel. Cross-border institutional arrangements are emerging, drawing players motivated by social responsibility, globalization of competitors, growth opportunities, or an awareness of vulnerability to the forces of globalization. Forward-thinking healthcare leaders will begin to identify global strategies that address global pressures, explore the opportunities, and take practical steps to prepare for a flatter world.

  6. The global landscape of cross-border reproductive care: twenty key findings for the new millennium.

    PubMed

    Inhorn, Marcia C; Patrizio, Pasquale

    2012-06-01

    Cross-border reproductive care (CBRC), also known as procreative tourism, fertility tourism, or reproductive tourism, is an increasing global phenomenon. This article reviews the expanding scholarly literature on CBRC, with 2010-2011 representing watershed years for CBRC scholarship and activism. Terminological debates, missing data, and lack of international monitoring plague the study of CBRC. Nonetheless, it is widely acknowledged that CBRC is a growing industry, with new global hubs, new intermediaries, new media, and new spaces of interaction. Religious bans and legal restrictions have created a patchwork of 'restrictive' and 'permissive' countries, with law evasion being a primary driver of CBRC. Yet, patient motivations for CBRC are diverse and patients' levels of satisfaction with CBRC and its outcomes are generally high. Thus, scholarly concern with CBRC as law evasion must be tempered with qualitative studies of positive patient experiences. CBRC can be considered a form of 'global gynecology' in which reproductive medicine, tourism, and commerce are converging in the second decade of the new millennium.

  7. The Migrant Border Crossing Study: A methodological overview of research along the Sonora-Arizona border.

    PubMed

    Martínez, Daniel E; Slack, Jeremy; Beyerlein, Kraig; Vandervoet, Prescott; Klingman, Kristin; Molina, Paola; Manning, Shiras; Burham, Melissa; Walzak, Kylie; Valencia, Kristen; Gamboa, Lorenzo

    2017-07-01

    Increased border enforcement efforts have redistributed unauthorized Mexican migration to the United States (US) away from traditional points of crossing, such as San Diego and El Paso, and into more remote areas along the US-Mexico border, including southern Arizona. Yet relatively little quantitative scholarly work exists examining Mexican migrants' crossing, apprehension, and repatriation experiences in southern Arizona. We contend that if scholars truly want to understand the experiences of unauthorized migrants in transit, such migrants should be interviewed either at the border after being removed from the US, or during their trajectories across the border, or both. This paper provides a methodological overview of the Migrant Border Crossing Study (MBCS), a unique data source on Mexican migrants who attempted an unauthorized crossing along the Sonora-Arizona border, were apprehended, and repatriated to Nogales, Sonora in 2007-09. We also discuss substantive and theoretical contributions of the MBCS.

  8. A Bumpy Border Crossing into the Teaching Culture on a U.S. Campus: Experience of a Chinese Faculty Member

    ERIC Educational Resources Information Center

    Cheng, Qiang; Wang, Jian; Zhang, Shaoan

    2013-01-01

    Guided by cultural border crossing and teacher identity development theories, this case study explores the bumpy process of a junior Chinese faculty member's border crossing into the U.S. teaching culture and analyzes the challenges, coping strategies, and consequences of his border crossing on teaching and teacher identity development. The…

  9. Measuring cross-border travel times for freight : Otay Mesa international border crossing.

    DOT National Transportation Integrated Search

    2010-09-01

    Cross border movement of people and goods is a vital part of the North American economy. Accurate real-time data on travel times along the US-Mexico border can help generate a range of tangible benefits covering improved operations and security, lowe...

  10. Border Jumping: Strategic and Operational Considerations in Planning Cross-Border Raids Against Insurgent Sanctuaries

    DTIC Science & Technology

    2013-06-01

    POLITICAL COSTS .......25 D. THE OVERALL TIMING OF NICARAGUAN CROSS-BORDER OFFENSIVES...27 E. THE TERMINATION OF NICARAGUAN CROSS-BORDER RAIDS...Exploit, and Analyze FARC Revolutionary Armed Forces of Colombia FDN Nicaraguan Democratic Force FLN Front de Libération Nationale FSLN Sandinista

  11. 76 FR 66872 - International Services Surveys: Amendments to the BE-150, Quarterly Survey of Cross-Border Credit...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-28

    ...-Border Credit, Debit, and Charge Card Transactions AGENCY: Bureau of Economic Analysis, Commerce. ACTION... information on the BE-150, Quarterly Survey of Cross-Border Credit, Debit, and Charge Card Transactions... change the survey title from Quarterly Survey of Cross-Border Credit, Debit, and Charge Card Transactions...

  12. Washington state--British Columbia international mobility and trade corridor (IMTC) : ITS-CVO border crossing deployment, evaluation draft report : executive summary

    DOT National Transportation Integrated Search

    2003-10-01

    The Washington state-British Columbia international mobility and trade corridor (IMTC) ITS-CVO Border Crossing Deployment is allowing for the completion of a bi-national freight border crossing ITS system at the border, and is a follow-on effort t...

  13. Health care system change and the cross-border transfer of ideas: influence of the Dutch model on the 2007 German health reform.

    PubMed

    Leiber, Simone; Gress, Stefan; Manouguian, Maral-Sonja

    2010-08-01

    To increase understanding of the cross-border transfer of ideas through a case study of the 2007 German health reform, this article draws on Kingdon's approach of streams and follows two main objectives: first, to understand the extent to which the German health reform was actually influenced by the Dutch model and, second, in theoretical terms, to inform inductively on how ideas from abroad enter government agendas. The results show that the streams of problem recognition and policy proposals have not been predominantly influenced by the cross-border transfer of ideas from the Netherlands to Germany. The Dutch experience was taken into consideration only after a policy window opened by a shift in politics in the third, the political, stream: the change of government in 2005. In many respects, the way Germany learned from the Netherlands in this case sharply contrasts with an image of solving policy problems by either lesson drawing or transnational deliberation. Instead, the process was dominated by problem solving in the sphere of politics, that is, finding a way to prove the grand coalition was capable of acting.

  14. 'The bloke can be a bit hazy about what's going on': men and cross-border reproductive treatment.

    PubMed

    Hudson, Nicky; Culley, Lorraine

    2013-09-01

    While social science research has begun to demonstrate the significant impact of infertility and involuntary childlessness for men, far fewer studies have specifically explored the male experience of, or men's involvement in, infertility treatment-seeking and there are few published studies which specifically describe men's experiences with cross-border reproduction. This paper presents data from the first UK study of transnational treatment-seeking and specifically explores men's involvement in this process. Data from interviews with 10 men and 34 women who were seeking treatment abroad are organized according to three themes: 'going along with it'; 'being a rock'; and 'doing their bit'. The paper argues that gender is an important aspect of the cross-border treatment experience and that both traditional and emergent gender identities are expressed in the process of treatment-seeking. Healthcare providers need to actively explore men's perspectives of the treatment process in all locations, to improve quality of care by reducing men's feelings of marginalization and enhancing their experience of treatment, especially but not exclusively, around the issue of semen collection. Copyright © 2013 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

  15. Cross-border reproductive care: a clinician's perspective.

    PubMed

    Forman, Robert

    2011-12-01

    Cross-border reproductive care (CBRC) is a means to an end. Nearly all patients' reproductive journeys are designed to deliver them a child, which, for the multitude of reasons discussed in the last issue of this journal, has not been proven possible for them in their home country. Their journey pathways look like the route maps in airline in-flight magazines, but at the end of their flight a medical procedure awaits, often involving a third-party donor or surrogate. Clinicians therefore are tightly involved in the delivery of CBRC, whether as service providers or service facilitators, and have a unique ethical responsibility to ensure that appropriate standards of care are provided to all those receiving treatment, be they patients or third-party providers. Several authors in the symposium issue are rightly critical of exploitation of third parties, particularly in the global south, although some are critical of the use of third-party fertility treatment in principle. However, CBRC and the subsequent fragmentation of fertility treatment is likely to increase and doctors must be drivers for improvement of standards of reproductive medical care in the developing world, and elsewhere, as more countries and clinics seek to benefit economically from the expanding market in medical consumerism. Copyright © 2011. Published by Elsevier Ltd.

  16. 77 FR 10958 - International Services Surveys: BE-150, Quarterly Survey of Cross-Border Credit, Debit, and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-24

    ...-Border Credit, Debit, and Charge Card Transactions, to change the survey title, and to collect data in... from Quarterly Survey of Cross-Border Credit, Debit, and Charge Card Transactions to Quarterly Survey... Survey of Cross-Border Credit, Debit, and Charge Card Transactions to Quarterly Survey of Payment Card...

  17. Ambassador Bridge Border Crossing System (ABBCS) : field operational test

    DOT National Transportation Integrated Search

    2000-05-01

    The purpose of the Ambassador Bridge Border Crossing System (ABBCS) field operational test (FOT) was to demonstrate the ability of ITS technology to expedite safe and legal international border crossings between Detroit, Michigan, and Windsor, Ontari...

  18. ESHRE's good practice guide for cross-border reproductive care for centers and practitioners.

    PubMed

    Shenfield, F; Pennings, G; De Mouzon, J; Ferraretti, A P; Goossens, V

    2011-07-01

    This paper outlines ESHRE's guidance for centers and physicians providing fertility treatment to foreign patients. This guide aims to ensure high-quality and safe assisted reproduction treatment, taking into account the patients, their future child and the interests of third-party collaborators such as gametes donors and surrogates. This is achieved by including considerations of equity, safety, efficiency, effectiveness (including evidence-based care), timeliness and patient centeredness.

  19. A joint cross-border investigation of a cluster of multidrug-resistant tuberculosis in Austria, Romania and Germany in 2014 using classic, genotyping and whole genome sequencing methods: lessons learnt

    PubMed Central

    Fiebig, Lena; Kohl, Thomas A; Popovici, Odette; Mühlenfeld, Margarita; Indra, Alexander; Homorodean, Daniela; Chiotan, Domnica; Richter, Elvira; Rüsch-Gerdes, Sabine; Schmidgruber, Beatrix; Beckert, Patrick; Hauer, Barbara; Niemann, Stefan; Allerberger, Franz; Haas, Walter

    2017-01-01

    Molecular surveillance of multidrug-resistant tuberculosis (MDR-TB) using 24-loci MIRU-VNTR in the European Union suggests the occurrence of international transmission. In early 2014, Austria detected a molecular MDR-TB cluster of five isolates. Links to Romania and Germany prompted the three countries to investigate possible cross-border MDR-TB transmission jointly. We searched genotyping databases, genotyped additional isolates from Romania, used whole genome sequencing (WGS) to infer putative transmission links, and investigated pairwise epidemiological links and patient mobility. Ten isolates from 10 patients shared the same 24-loci MIRU-VNTR pattern. Within this cluster, WGS defined two subgroups of four patients each. The first comprised an MDR-TB patient from Romania who had sought medical care in Austria and two patients from Austria. The second comprised patients, two of them epidemiologically linked, who lived in three different countries but had the same city of provenance in Romania. Our findings strongly suggested that the two cases in Austrian citizens resulted from a newly introduced MDR-TB strain, followed by domestic transmission. For the other cases, transmission probably occurred in the same city of provenance. To prevent further MDR-TB transmission, we need to ensure universal access to early and adequate therapy and collaborate closely in tuberculosis care beyond administrative borders. PMID:28106529

  20. Socioeconomic and country variations in cross-border cigarette purchasing as tobacco tax avoidance strategy. Findings from the ITC Europe Surveys.

    PubMed

    Nagelhout, Gera E; van den Putte, Bas; Allwright, Shane; Mons, Ute; McNeill, Ann; Guignard, Romain; Beck, François; Siahpush, Mohammad; Joossens, Luk; Fong, Geoffrey T; de Vries, Hein; Willemsen, Marc C

    2014-03-01

    Legal tobacco tax avoidance strategies such as cross-border cigarette purchasing may attenuate the impact of tax increases on tobacco consumption. Little is known about socioeconomic and country variations in cross-border purchasing. To describe socioeconomic and country variations in cross-border cigarette purchasing in six European countries. Cross-sectional data from adult smokers (n=7873) from the International Tobacco Control (ITC) Surveys in France (2006/2007), Germany (2007), Ireland (2006), The Netherlands (2008), Scotland (2006) and the rest of the UK (2007/2008) were used. Respondents were asked whether they had bought cigarettes outside their country in the last 6 months and how often. In French and German provinces/states bordering countries with lower cigarette prices, 24% and 13% of smokers, respectively, reported purchasing cigarettes frequently outside their country. In non-border regions of France and Germany, and in Ireland, Scotland, the rest of the UK and The Netherlands, frequent purchasing of cigarettes outside the country was reported by 2-7% of smokers. Smokers with higher levels of education or income, younger smokers, daily smokers, heavier smokers and smokers not planning to quit smoking were more likely to purchase cigarettes outside their country. Cross-border cigarette purchasing is more common in European regions bordering countries with lower cigarette prices and is more often reported by smokers with higher education and income. Increasing taxes in countries with lower cigarette prices, and reducing the number of cigarettes that can be legally imported across borders could help to avoid cross-border purchasing.

  1. "Bottleneck study" : transportation infrastructure and traffic management analysis of cross border bottlenecks.

    DOT National Transportation Integrated Search

    2004-11-01

    The motivation behind the Transportation Infrastructure and Traffic Management Analysis of : Cross Border Bottlenecks study was generated by the U.S.-Mexico Border Partnership Action : Plan (Action item #2 of the 22-Point Smart Border Action Plan: De...

  2. Cross-border Ties and Arab American Mental Health

    PubMed Central

    Samari, Goleen

    2016-01-01

    Due to increasing discrimination and marginalization, Arab Americans are at a greater risk for mental health disorders. Social networks that include ties to the country of origin could help promote mental well-being in the face of discrimination. The role of countries of origin in immigrant mental health receives little attention compared to adjustment in destination contexts. This study addresses this gap by analyzing the relationship between nativity, cross-border ties, and psychological distress and happiness for Arab Americans living in the greater Detroit Metropolitan Area (N=896). I expect that first generation Arab Americans will have more psychological distress compared to one and half, second, and third generations, and Arab Americans with more cross-border ties will have less psychological distress and more happiness. Data come from the 2003 Detroit Arab American Study, which includes measures of nativity, cross-border ties – attitudes, social ties, media consumption, and community organizations, and the Kessler-10 scale of psychological distress and self-reported happiness. Ordered logistic regression analyses suggest that psychological distress and happiness do not vary much by nativity alone. However, cross-border ties have both adverse and protective effects on psychological distress and happiness. For all generations of Arab Americans, cross-border attitudes and social ties are associated with greater odds of psychological distress and for first generation Arab Americans, media consumption is associated with greater odds of unhappiness. In contrast, for all generations, involvement in cross-border community organizations is associated with less psychological distress and for the third generation, positive cross-border attitudes are associated with higher odds of happiness. These findings show the complex relationship between cross-border ties and psychological distress and happiness for different generations of Arab Americans. PMID:26999416

  3. Cross-border ties and Arab American mental health.

    PubMed

    Samari, Goleen

    2016-04-01

    Due to increasing discrimination and marginalization, Arab Americans are at a greater risk for mental health disorders. Social networks that include ties to the country of origin could help promote mental well-being in the face of discrimination. The role of countries of origin in immigrant mental health receives little attention compared to adjustment in destination contexts. This study addresses this gap by analyzing the relationship between nativity, cross-border ties, and psychological distress and happiness for Arab Americans living in the greater Detroit Metropolitan Area (N = 896). I expect that first generation Arab Americans will have more psychological distress compared to one and half, second, and third generations, and Arab Americans with more cross-border ties will have less psychological distress and more happiness. Data come from the 2003 Detroit Arab American Study, which includes measures of nativity, cross-border ties--attitudes, social ties, media consumption, and community organizations, and the Kessler-10 scale of psychological distress and self-reported happiness. Ordered logistic regression analyses suggest that psychological distress and happiness do not vary much by nativity alone. However, cross-border ties have both adverse and protective effects on psychological distress and happiness. For all generations of Arab Americans, cross-border attitudes and social ties are associated with greater odds of psychological distress and for first generation Arab Americans, media consumption is associated with greater odds of unhappiness. In contrast, for all generations, involvement in cross-border community organizations is associated with less psychological distress and for the third generation, positive cross-border attitudes are associated with higher odds of happiness. These findings show the complex relationship between cross-border ties and psychological distress and happiness for different generations of Arab Americans. Copyright © 2016 Elsevier Ltd. All rights reserved.

  4. Regulating the helping hand: improving legal preparedness for cross-border disaster medicine.

    PubMed

    Fisher, David

    2010-01-01

    Medical care is a highly regulated field in nearly every country. Therefore, it is not surprising that legal issues regularly arise in cross-border disaster operations that have with the potential to profoundly impact the effectiveness of international assistance. Little attention has been paid to preparing for and addressing these kinds of issues. This paper will report on research by the International Federation of Red Cross and Red Crescent Societies (IFRC) on International Disaster Response Law, and discuss new developments in the international legal framework for addressing these issues. For seven years, the IFRC has studied legal issues in cross-border disaster assistance. Its activities have included several dozen case studies, a global survey of governments and humanitarian stakeholders, and a series of meetings and high-level conferences. The IFRC has found a consistent set of regulatory problems in major disaster relief operations related to the entry and regulation of international relief. These include some issues specific to the health field, such as the regulation of drug donations and the recognition of foreign medical qualifications. To address the gaps in domestic and international regulatory structures, the IFRC spearheaded the development of new international guidelines. The legal risks for international health providers in disaster settings are real and should be better integrated into program planning. Governments must become more proactive in ensuring that legal frameworks are flexible enough to mitigate these problems.

  5. Crossing the line: the legal and ethical problems of foreign surrogacy.

    PubMed

    Gamble, Natalie

    2009-08-01

    UK law has for many years taken a careful approach to surrogacy, neither banning it nor allowing it to develop unrestrictedly. This careful middle approach seeks to balance permitting what may be a last hope for infertile couples against a wider public policy that bars commercialized reproduction: surrogacy is allowed in the UK, provided it is consensual and involves the payment of no more than reasonable expenses. But in an increasingly globalized world, patients are crossing borders for treatment, often to places where such restrictions on the commerciality or enforceability of surrogacy arrangements do not apply. The resulting conflicts of law can be a minefield, and this makes the maintenance of the UK's careful legal balance increasingly untenable.

  6. Assisted reproductive travel: UK patient trajectories.

    PubMed

    Hudson, Nicky; Culley, Lorraine

    2011-11-01

    Media reporting of 'fertility tourism' tends to portray those who travel as a cohesive group, marked by their desperation and/or selfishness and propensity towards morally questionable behaviour. However, to date little has been known about the profile of those leaving the UK for treatment. This paper discusses the first UK-based study of patient assisted reproduction travel that was designed to explore individual travel trajectories. It is argued that existing ways of conceptualizing cross-border reproductive care as 'fertility or reproductive tourism' are in danger of essentializing what the data suggest are diverse, complex and often ambiguous motivations for reproductive travel. The concept of seriality is used to suggest that, whilst 'reproductive tourists' share some characteristics, they also differ in significant ways. This paper argues that, through an examination of the personal landscapes of fertility travel, the diverse processes involved in reproductive travel can be better understood and policymakers can be assisted to avoid what might be regarded as simplistic responses to cross-border reproductive care. Copyright © 2011 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

  7. Expansion of the border crossing information system : final report, March 15, 2009.

    DOT National Transportation Integrated Search

    2009-03-15

    There is no reliable system in place to measure and report border crossing times to either commercial : trade or travelers planning to cross the U.S.-Mexico border. This research project, in combination with : three other already funded and ongoing p...

  8. "Bottleneck study" : transportation infrastructure and traffic management analysis of cross border bottlenecks. [Executive summary].

    DOT National Transportation Integrated Search

    2004-11-01

    The motivation behind the Transportation Infrastructure and Traffic Management Analysis of : Cross Border Bottlenecks study was generated by the U.S.-Mexico Border Partnership Action : Plan (Action item #2 of the 22-Point Smart Border Action Plan: De...

  9. Transnational ties and the health of sub-Saharan African migrants: The moderating role of gender and family separation.

    PubMed

    Afulani, Patience A; Torres, Jacqueline M; Sudhinaraset, May; Asunka, Joseph

    2016-11-01

    Recent scholarship has focused on the role that cross-border social and economic ties play in shaping health outcomes for migrant populations. Nevertheless, the extant empirical work on this topic has paid little attention to the health impacts of cross-border separation from close family members. In this paper we examine the association between cross-border ties-and cross-border separation-with the health of sub-Saharan African (SSA) migrant adults living in metropolitan France using data from the nationally representative "Trajectoire et Origines" survey (n = 1980 SSA migrants). In logistic regression analyses we find that remitting money and having a child abroad are each associated with poor health among women, but not men. The effect of remittances on health is also modified by the location of one's children: remittance sending is associated with poor health only for SSA-migrants separated from their children. These findings underscore the importance of examining both cross-border connection and cross-border separation in studies of immigrant health, and also underscore the heterogeneous relationships between cross-border ties and health for men and women. This is the first study to our knowledge that examines the relationship between cross-border ties and health for migrants in Europe, with a focus on SSA-migrants in France. These findings have important implications for the health of the growing immigrant and refugee populations in Europe and around the globe. Copyright © 2016 Elsevier Ltd. All rights reserved.

  10. Cross-border ties, nativity, and inflammatory markers in a population-based prospective study of Latino adults.

    PubMed

    Torres, Jacqueline M; Epel, Elissa S; To, Tu My; Lee, Anne; Aiello, Allison E; Haan, Mary N

    2018-05-16

    Even after migration, immigrants and their descendants may continue to have ties to family and friends who remain in places of origin. Recent research suggests that these cross-border social ties have implications for health, although this scholarship has been limited to self-reported outcomes. Using data from the Sacramento Area Latino Study on Aging (SALSA), we estimate associations between cross-border social ties and inflammatory biomarkers among Latino adults (n = 1786). We find that immigrants who maintained any cross-border connection to family and friends in Latin America had significantly lower levels of baseline interleukin-6 (IL-6) and C-reactive protein (CRP) compared to their US-born counterparts with no cross-border ties. These results held for values of CRP at five-year follow-up for men only. In contrast, US-born women with cross-border ties to family and friends in Latin America had both significantly higher levels of CRP and significantly lower levels of tumor necrosis factor-alpha (TNF-α) at five-year follow-up relative to their US-born counterparts with no cross-border ties. We find descriptively that men who have cross-border ties are also less likely to be socially isolated within local contexts. Considering place-of-origin social connections may contribute critical nuance to studies of immigrant health, including disparities in inflammatory markers that may serve as indicators of underlying chronic disease. Copyright © 2018 Elsevier Ltd. All rights reserved.

  11. "The perfect business": human trafficking and Lao-Thai cross-border migration.

    PubMed

    Molland, Sverre

    2010-01-01

    Over the past few years some governments and development organizations have increasingly articulated cross-border mobility as "trafficking in persons". The notion of a market where traffickers prey on the "supply" of migrants that flows across international borders to meet the "demand" for labour has become a central trope among anti-trafficking development organizations. This article problematizes such economism by drawing attention to the oscillating cross-border migration of Lao sex workers within a border zone between Laos and Thailand. It illuminates the incongruity between the recruitment of women into the sex industry along the Lao-Thai border and the market models that are employed by the anti-trafficking sector. It discusses the ways in which these cross-border markets are conceived in a context where aid programming is taking on an increasingly important role in the politics of borders. The author concludes that allusions to ideal forms of knowledge (in the guise of classic economic theory) and an emphasis on borders become necessary for anti-trafficking programmes in order to make their object of intervention legible as well as providing post-hoc rationalizations for their continuing operation.

  12. Implementation of the Patients' Rights in Cross-border Healthcare directive in Latvia.

    PubMed

    Olsena, Solvita

    2014-03-01

    Latvia, being one of the EU Member States, has an obligation to implement the rules stated by the Directive 2011/24/EU on Patients' Rights in Cross-border Healthcare (hereinafter--the Directive) before 25 October 2013 in existing national legislation and practice. Implementation was carried out under pressured circumstances. A National Contact Point has been established, information is provided for patients in Latvian and to some extent in English, the Medical Treatment Risk Fund will start operations to provide compensation for harm, and the restrictions and procedure for prior authorisation have been stated. The need to secure quality of care and patient safety and well as privacy protection are the most challenging tasks for Latvia. It can be concluded that some progress in patients' rights can be achieved, but it is doubtful if patients' mobility will be stimulated.

  13. Doctors on the move: a European case study on the key characteristics of national recertification systems.

    PubMed

    Sehlbach, Carolin; Govaerts, Marjan J; Mitchell, Sharon; Rohde, Gernot G U; Smeenk, Frank W J M; Driessen, Erik W

    2018-04-17

    With increased cross-border movement, ensuring safe and high-quality healthcare has gained primacy. The purpose of recertification is to ensure quality of care through periodically attesting doctors' professional proficiency in their field. Professional migration and facilitated cross-border recognition of qualifications, however, make us question the fitness of national policies for safeguarding patient care and the international accountability of doctors. We performed document analyses and conducted 19 semistructured interviews to identify and describe key characteristics and effective components of 10 different European recertification systems, each representing one case (collective case study). We subsequently compared these systems to explore similarities and differences in terms of assessment criteria used to determine process quality. Great variety existed between countries in terms and assessment formats used, targeting cognition, competence and performance (Miller's assessment pyramid). Recertification procedures and requirements also varied significantly, ranging from voluntary participation in professional development modules to the mandatory collection of multiple performance data in a competency-based portfolio. Knowledge assessment was fundamental to recertification in most countries. Another difference concerned the stakeholders involved in the recertification process: while some systems exclusively relied on doctors' self-assessment, others involved multiple stakeholders but rarely included patients in assessment of doctors' professional competence. Differences between systems partly reflected different goals and primary purposes of recertification. Recertification systems differ substantially internationally with regard to the criteria they apply to assess doctors' competence, their aims, requirements, assessment formats and patient involvement. In the light of professional mobility and associated demands for accountability, we recommend that competence assessment includes patients' perspectives, and recertification practices be shared internationally to enhance transparency. This can help facilitate cross-border movement, while guaranteeing high-quality patient care. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  14. Socioeconomic and country variations in cross-border cigarette purchasing as tobacco tax avoidance strategy. Findings from the ITC Europe Surveys

    PubMed Central

    Nagelhout, Gera E.; van den Putte, Bas; Allwright, Shane; Mons, Ute; McNeill, Ann; Guignard, Romain; Beck, François; Siahpush, Mohammad; Joossens, Luk; Fong, Geoffrey T.; de Vries, Hein; Willemsen, Marc C.

    2014-01-01

    Background Legal tobacco tax avoidance strategies such as cross-border cigarette purchasing may attenuate the impact of tax increases on tobacco consumption. Little is known about socioeconomic and country variations in cross-border purchasing. Objective To describe socioeconomic and country variations in cross-border cigarette purchasing in six European countries. Methods Cross-sectional data from adult smokers (n = 7,873) from the International Tobacco Control (ITC) Surveys in France (2006/7), Germany (2007), Ireland (2006), the Netherlands (2008), Scotland (2006), and the rest of the United Kingdom (2007/8) were used. Respondents were asked whether they had bought cigarettes outside their country in the last six months and how often. Findings In French and German provinces/states bordering countries with lower cigarette prices, 24% and 13% of smokers respectively reported purchasing cigarettes frequently outside their country. In non-border regions of France and Germany and in Ireland, Scotland, the rest of the United Kingdom, and the Netherlands, frequent purchasing of cigarettes outside the country was reported by 2% to 7% of smokers. Smokers with higher levels of education or income, younger smokers, daily smokers, heavier smokers, and smokers not planning to quit smoking were more likely to purchase cigarettes outside their country. Conclusion Cross-border cigarette purchasing is more common in European regions bordering countries with lower cigarette prices and is more often reported by smokers with higher education and income. Increasing taxes in countries with lower cigarette prices and reducing the number of cigarettes that can be legally imported across borders could help to avoid cross-border purchasing. PMID:23644287

  15. Intended parents' motivations and information and support needs when seeking extraterritorial compensated surrogacy.

    PubMed

    Hammarberg, Karin; Stafford-Bell, Martyn; Everingham, Sam

    2015-11-01

    Cross-border reproductive care (CBRC) is becoming increasingly common. Little is known about the motivations and information and support needs of people who cross borders to access surrogacy. This study aimed to explore: how those considering or undertaking extraterritorial surrogacy reach their decision; what other avenues they have considered and tried to have children; their sources of information and support; and perceptions of how others view their decision. Members of two Australian parenting support forums completed an anonymous online survey. Of the 249 respondents, 51% were gay men, 43% heterosexual women and 7% heterosexual men. Most heterosexual respondents had tried to conceive spontaneously and with assisted reproductive technology before considering surrogacy. Most respondents felt supported in their decision to try extraterritorial surrogacy by close family and friends. Surrogacy-related information was mostly sourced online and from other parents through surrogacy. Few sought information from a local general practitioner or IVF clinic and those who did reported IVF clinic staff were significantly (P < 0.001) more likely than other groups to communicate negative reactions to their decision to seek surrogacy. The apparent negative attitudes to cross-border surrogacy among health professionals warrants further research into health professionals' knowledge, beliefs and attitudes relating to surrogacy. Copyright © 2015 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

  16. Reverse traffic: intersecting inequalities in human egg donation.

    PubMed

    Nahman, Michal

    2011-11-01

    The paper examines a case of cross-border reproductive care that happens in reverse by looking at Israeli--Romanian transnational ova traffic. The state of Israel claims to have the most IVF clinics per capita in the world, some of the highest success rates in the use of assisted reproductive technology, very liberal regulation of these technologies and the most heavily subsidized IVF in the world. This support and the government's demographic policies are designed to encourage the growth of the Jewish population in its demographic race against Palestinians. Yet transnational egg donation is very costly and reimbursement to patients a slow and involved process. Hence, while transnational ova donation is increasing in Israel, only a few can afford to participate in this border crossing. Further, new laws are meant to forbid cross-religious donation in Israel, hardening the borders of the Jewish State. Romanian ova donors are part of the global majority, exploited by markets' incursions into new niches in bodies. The history of Romanian oppression of women's reproduction makes today's women willing to undergo invasive treatment for very little compensation, even when there is the possibility of injury. This paper documents reverse traffic reproduction, which maintains, rather than addresses, inequalities. Copyright © 2011 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

  17. Cross-Border Mobility and Critical Cosmopolitanism among South Texas University Students

    ERIC Educational Resources Information Center

    O'Connor, Brendan H.

    2018-01-01

    Background/Context: A growing body of literature addresses the experiences of transnational students, but relatively little research has focused on students who negotiate international border crossings on a regular basis. This study documents the role of cross-border mobility in the lives of university students in Brownsville, Texas…

  18. Cross-border injection drug use and HIV and hepatitis C virus seropositivity among people who inject drugs in San Diego, California.

    PubMed

    Horyniak, Danielle; Wagner, Karla D; Armenta, Richard F; Cuevas-Mota, Jazmine; Hendrickson, Erik; Garfein, Richard S

    2017-09-01

    The prevalence of HIV and Hepatitis C Virus (HCV) are significantly lower among people who inject drugs (PWID) in San Diego, CA, USA compared with PWID in Tijuana, Mexico, located directly across the border. We investigated associations between cross-border injection drug use (IDU), HIV and HCV seroprevalence and engagement in injecting risk behaviours while on each side of the border. Using baseline interviews and serologic testing data from STAHR II, a longitudinal cohort study of PWID in San Diego, bivariate and multivariable logistic regression analyses examined associations between recent (past six months) cross-border IDU and HIV and HCV antibody seropositivity, socio-demographics, drug use characteristics, and participants' connections to, and perceptions about Mexico. Chi-squared tests and McNemar tests examined associations between cross-border IDU and injecting risk behaviours. Of the 567 participants (93% U.S.-born, 73% male, median age 45 years), 86 (15%) reported recent cross-border IDU. Cross-border IDU was not associated with HIV (OR: 0.85, 95% CI: 0.37-1.95) or HCV seropositivity (OR: 1.01, 95% CI: 0.62-1.65). Age, identifying as Hispanic or Latino/a, and being concerned about risk of violence when travelling to Mexico were independently associated with decreased odds of recent cross-border IDU. Injecting cocaine at least weekly, having ever lived in Mexico and knowing PWID who reside in Mexico were associated with increased odds of recent cross-border IDU. PWID who reported cross-border IDU were significantly less likely to engage in receptive needle sharing, equipment sharing, and public injection while in Mexico compared with in San Diego (all p<0.001). Prevalence of HIV and HCV infection was similar among PWID who had and had not injected in Mexico, possibly due to practising safer injecting while in Mexico. Research is needed to elucidate contextual factors enabling U.S. PWID to inject safely while in Mexico. Copyright © 2017 Elsevier B.V. All rights reserved.

  19. Patterns of HIV prevalence among injecting drug users in the cross-border area of Lang Son Province, Vietnam, and Ning Ming County, Guangxi Province, China.

    PubMed

    Des Jarlais, Don C; Johnston, Patrick; Friedmann, Patricia; Kling, Ryan; Liu, Wei; Ngu, Doan; Chen, Yi; Hoang, Tran V; Donghua, Meng; Van, Ly K; Tung, Nguyen D; Binh, Kieu T; Hammett, Theodore M

    2005-08-24

    To assess patterns of injecting drug use and HIV prevalence among injecting drug users (IDUs) in an international border area along a major heroin trans-shipment route. Cross-sectional surveys of IDUs in 5 sites in Lang Son Province, Vietnam (n = 348) and 3 sites in Ning Ming County, Guangxi Province, China (n = 308). Respondents were recruited through peer referral ("snowball") methods in both countries, and also from officially recorded lists of IDUs in Vietnam. A risk behavior questionnaire was administered and HIV counseling and testing conducted. Participants in both countries were largely male, in their 20s, and unmarried. A majority of subjects in both countries were members of ethnic minority groups. There were strong geographic gradients for length of drug injecting and for HIV seroprevalence. Both mean years injecting and HIV seroprevalence declined from the Vietnamese site farthest from the border to the Chinese site farthest from the border. 10.6% of participants in China and 24.5% of participants in Vietnam reported crossing the international border in the 6 months prior to interview. Crossing the border by IDUs was associated with (1) distance from the border, (2) being a member of an ethnic minority group, and (3) being HIV seropositive among Chinese participants. Reducing the international spread of HIV among IDUs will require programs at the global, regional, national, and "local cross border" levels. At the local cross border level, the programs should be coordinated on both sides of the border and on a sufficient scale that IDUs will be able to readily obtain clean injection equipment on the other side of the border as well as in their country of residence.

  20. Patterns of HIV prevalence among injecting drug users in the cross-border area of Lang Son Province, Vietnam, and Ning Ming County, Guangxi Province, China

    PubMed Central

    Des Jarlais, Don C; Johnston, Patrick; Friedmann, Patricia; Kling, Ryan; Liu, Wei; Ngu, Doan; Chen, Yi; Hoang, Tran V; Donghua, Meng; Van, Ly K; Tung, Nguyen D; Binh, Kieu T; Hammett, Theodore M

    2005-01-01

    Background To assess patterns of injecting drug use and HIV prevalence among injecting drug users (IDUs) in an international border area along a major heroin trans-shipment route. Methods Cross-sectional surveys of IDUs in 5 sites in Lang Son Province, Vietnam (n = 348) and 3 sites in Ning Ming County, Guangxi Province, China (n = 308). Respondents were recruited through peer referral ("snowball") methods in both countries, and also from officially recorded lists of IDUs in Vietnam. A risk behavior questionnaire was administered and HIV counseling and testing conducted. Results Participants in both countries were largely male, in their 20s, and unmarried. A majority of subjects in both countries were members of ethnic minority groups. There were strong geographic gradients for length of drug injecting and for HIV seroprevalence. Both mean years injecting and HIV seroprevalence declined from the Vietnamese site farthest from the border to the Chinese site farthest from the border. 10.6% of participants in China and 24.5% of participants in Vietnam reported crossing the international border in the 6 months prior to interview. Crossing the border by IDUs was associated with (1) distance from the border, (2) being a member of an ethnic minority group, and (3) being HIV seropositive among Chinese participants. Conclusion Reducing the international spread of HIV among IDUs will require programs at the global, regional, national, and "local cross border" levels. At the local cross border level, the programs should be coordinated on both sides of the border and on a sufficient scale that IDUs will be able to readily obtain clean injection equipment on the other side of the border as well as in their country of residence. PMID:16120225

  1. Cross-border issues in the development of medical tourism in Malaysia: legal challenges and opportunities.

    PubMed

    Nemie, Puteri; Kassim, Jahn

    2009-08-01

    Strategically located at the crossroads of Asia, Malaysia has become one of the key players in the fast-growing and lucrative market for health care services in Asia. Medical travel across international boundaries has been made possible through affordable airfares and the favourable exchange rates of the Malaysian ringgit has contributed to the rise of the "medical tourism phenomenon" where medical travel is combined with visiting popular tourist destinations in Malaysia. Further, competitive medical fees and modern medical facilities have also made Malaysia a popular destination for medical tourists. Nevertheless, the increased number of foreign patients has opened up possibilities of Malaysian health care providers being subjected to malpractice claims and triggering a myriad of cross-border legal issues. Presently, there is no internationally accepted legal framework to regulate medical tourism and issues of legal redress in relation to unsatisfactory provision of treatment across international boundaries. The economic benefits of medical tourism must be based upon a solid legal regulatory framework and strong ethical standards as well as upon high-quality medical and health care services. It is therefore important to assess the existing legal framework affecting the development of medical tourism in Malaysia in order to explore the gaps, deficiencies and possibilities for legal and regulatory reform.

  2. Novel Cross-Border Approaches to Optimise Identification of Asymptomatic and Artemisinin-Resistant Plasmodium Infection in Mobile Populations Crossing Cambodian Borders

    PubMed Central

    Edwards, Hannah M.; Canavati, Sara E.; Rang, Chandary; Ly, Po; Sovannaroth, Siv; Canier, Lydie; Khim, Nimol; Menard, Didier; Ashton, Ruth A.; Meek, Sylvia R.; Roca-Feltrer, Arantxa

    2015-01-01

    Background Human population movement across country borders presents a real challenge for malaria control and elimination efforts in Cambodia and its neighbouring countries. To quantify Plasmodium infection among the border-crossing population, including asymptomatic and artemisinin resistant (AR) parasites, three official border crossing points, one from each of Cambodia's borders with Thailand, Laos and Vietnam, were selected for sampling. Methods and Findings A total of 3206 participants (of 4110 approached) were recruited as they crossed the border, tested for malaria and interviewed. By real-time polymerase chain reaction (RT-PCR), 5.4% of all screened individuals were found to harbour Plasmodium parasites. The proportion was highest at the Laos border (11.5%). Overall there were 97 P. vivax (55.7%), 55 P. falciparum (31.6%), two P. malariae (1.1%) and 20 mixed infections (11.5%). Of identified infections, only 20% were febrile at the time of screening. Of the 24 P. falciparum samples where a further PCR was possible to assess AR, 15 (62.5%) had mutations in the K13 propeller domain gene, all from participants at the Laos border point. Malaria rapid diagnostic test (RDT) pLDH/HRP-2 identified a positivity rate of 3.2% overall and sensitivity compared to RT-PCR was very low (43.1%). Main individual risk factors for infection included sex, fever, being a forest-goer, poor knowledge of malaria prevention methods and previous malaria infection. Occupation, day of the week and time of crossing (morning vs. afternoon) also appeared to play an important role in predicting positive cases. Conclusions This study offers a novel approach to identify asymptomatic infections and monitor AR parasite flow among mobile and migrant populations crossing the borders. Similar screening activities are recommended to identify other hot borders and characterise potential hot spots of AR. Targeted “customised” interventions and surveillance activities should be implemented in these sites to accelerate elimination efforts in the region. PMID:26352262

  3. 22 CFR 41.33 - Nonresident alien Canadian border crossing identification card (BCC).

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 22 Foreign Relations 1 2012-04-01 2012-04-01 false Nonresident alien Canadian border crossing... Nonresident alien Canadian border crossing identification card (BCC). (a) Validity of Canadian BCC. A Canadian....122, or if the consular or immigration officer determines that the alien to whom any such document was...

  4. 22 CFR 41.33 - Nonresident alien Canadian border crossing identification card (BCC).

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 22 Foreign Relations 1 2011-04-01 2011-04-01 false Nonresident alien Canadian border crossing... Nonresident alien Canadian border crossing identification card (BCC). (a) Validity of Canadian BCC. A Canadian....122, or if the consular or immigration officer determines that the alien to whom any such document was...

  5. 22 CFR 41.33 - Nonresident alien Canadian border crossing identification card (BCC).

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 22 Foreign Relations 1 2013-04-01 2013-04-01 false Nonresident alien Canadian border crossing... Nonresident alien Canadian border crossing identification card (BCC). (a) Validity of Canadian BCC. A Canadian....122, or if the consular or immigration officer determines that the alien to whom any such document was...

  6. 22 CFR 41.33 - Nonresident alien Canadian border crossing identification card (BCC).

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 22 Foreign Relations 1 2014-04-01 2014-04-01 false Nonresident alien Canadian border crossing... Nonresident alien Canadian border crossing identification card (BCC). (a) Validity of Canadian BCC. A Canadian....122, or if the consular or immigration officer determines that the alien to whom any such document was...

  7. Managing the Quality of Cross-Border Higher Education in Zimbabwe

    ERIC Educational Resources Information Center

    Garwe, Evelyn Chiyevo

    2015-01-01

    A study on investigating the issues of quality associated with cross-border higher education was carried out using the case study approach focusing on Zimbabwe. The methodology involved document analysis of the cases of regulation and accreditation of cross-border higher education providers and assessment of qualifications acquired from foreign…

  8. Cross-border ties as a source of risk and resilience: Do cross-border ties moderate the relationship between migration-related stress and psychological distress among Latino migrants in the United States?

    PubMed Central

    Torres, Jacqueline M.; Alcántara, Carmela; Rudolph, Kara E.; Viruell-Fuentes, Edna A.

    2017-01-01

    Few studies have examined the associations between health and the cross-border ties that migrants maintain with their family members in communities of origin. We draw on theory related to social ties, ethnic identity, and mental health to examine cross-border ties as potential moderators of the association between migration-related stress and psychological distress among Latino migrants. Using data from the National Latino and Asian American Survey, we find that remittance sending is associated with significantly lower levels of psychological distress for Cuban migrants, and difficulty visiting home is associated with significantly greater psychological distress for Puerto Rican migrants. There were significant associations between migration-related stressors and psychological distress, although these associations fell to non-significance after accounting for multiple testing. We found little evidence that cross-border ties either buffer or exacerbate the association between migration-related stressors and psychological distress. We consider the findings within the current political and historical context of cross-border ties and separation. PMID:27803264

  9. Cross-border Ties as Sources of Risk and Resilience: Do Cross-border Ties Moderate the Relationship between Migration-related Stress and Psychological Distress for Latino Migrants in the United States?

    PubMed

    Torres, Jacqueline M; Alcántara, Carmela; Rudolph, Kara E; Viruell-Fuentes, Edna A

    2016-12-01

    Few studies have examined the associations between health and the cross-border ties that migrants maintain with their family members in communities of origin. We draw on theory related to social ties, ethnic identity, and mental health to examine cross-border ties as potential moderators of the association between migration-related stress and psychological distress among Latino migrants. Using data from the National Latino and Asian American Survey, we find that remittance sending is associated with significantly lower levels of psychological distress for Cuban migrants, and difficulty visiting home is associated with significantly greater psychological distress for Puerto Rican migrants. There were significant associations between migration-related stressors and psychological distress, although these associations fell to nonsignificance after accounting for multiple testing. We found little evidence that cross-border ties either buffer or exacerbate the association between migration-related stressors and psychological distress. We consider the findings within the current political and historical context of cross-border ties and separation. © American Sociological Association 2016.

  10. Crisis in Mexico: Assessing the Merida Initiative and its Impact on Us-Mexican Security

    DTIC Science & Technology

    2009-04-01

    s poor economic conditions to extort large amounts of cash from individuals wishing to cross the US-Mexican border in search of a job and a better...people crossed the US-Mexican border illegally in 2001. 31 The US State Department‟s Trafficking in Persons Report classifies Mexico as a Tier 2 in...southern borders. 33 Mexico estimates that approximately 400,000 illegal immigrants cross the Mexican-Guatemalan border each year. President

  11. Binational utilization and barriers to care among Mexican American border residents with diabetes.

    PubMed

    de Heer, Hendrik D; Salinas, Jennifer; Lapeyrouse, Lisa M; Heyman, Josiah; Morera, Osvaldo F; Balcazar, Hector G

    2013-09-01

    To assess whether U.S.-Mexico border residents with diabetes 1) experience greater barriers to medical care in the United States of America versus Mexico and 2) are more likely to seek care and medication in Mexico compared to border residents without diabetes. A stratified two-stage randomized cross-sectional health survey was conducted in 2009 - 2010 among 1 002 Mexican American households. Diabetes rates were high (15.4%). Of those that had diabetes, most (86%) reported comorbidities. Compared to participants without diabetes, participants with diabetes had slightly greater difficulty paying US$ 25 (P = 0.002) or US$ 100 (P = 0.016) for medical care, and experienced greater transportation and language barriers (P = 0.011 and 0.014 respectively) to care in the United States, but were more likely to have a person/place to go for medical care and receive screenings. About one quarter of participants sought care or medications in Mexico. Younger age and having lived in Mexico were associated with seeking care in Mexico, but having diabetes was not. Multiple financial barriers were independently associated with approximately threefold-increased odds of going to Mexico for medical care or medication. Language barriers were associated with seeking care in Mexico. Being confused about arrangements for medical care and the perception of not always being treated with respect by medical care providers in the United States were both associated with seeking care and medication in Mexico (odds ratios ranging from 1.70 - 2.76). Reporting modifiable barriers to medical care was common among all participants and slightly more common among 1) those with diabetes and 2) those who sought care in Mexico. However, these are statistically independent phenomena; persons with diabetes were not more likely to use services in Mexico. Each set of issues (barriers facing those with diabetes, barriers related to use of services in Mexico) may occur side by side, and both present opportunities for improving access to care and disease management.

  12. Inernational research in health care management: its need in the 21st century, methodological challenges, ethical issues, pitfalls, and practicalities.

    PubMed

    Buttigieg, Sandra C; Rathert, Cheryl; D'Aunno, Thomas A; Savage, Grant T

    2015-01-01

    This commentary argues in favor of international research in the 21st century. Advances in technology, science, communication, transport, and infrastructure have transformed the world into a global village. Industries have increasingly adopted globalization strategies. Likewise, the health sector is more internationalized whereby comparisons between diverse health systems, international best practices, international benchmarking, cross-border health care, and cross-cultural issues have become important subjects in the health care literature. The focus has now turned to international, collaborative, cross-national, and cross-cultural research, which is by far more demanding than domestic studies. In this commentary, we explore the methodological challenges, ethical issues, pitfalls, and practicalities within international research and offer possible solutions to address them. The commentary synthesizes contributions from four scholars in the field of health care management, who came together during the annual meeting of the Academy of Management to discuss with members of the Health Care Management Division the challenges of international research. International research is worth pursuing; however, it calls for scholarly attention to key methodological and ethical issues for its success. This commentary addresses salient issues pertaining to international research in one comprehensive account.

  13. A joint cross-border investigation of a cluster of multidrug-resistant tuberculosis in Austria, Romania and Germany in 2014 using classic, genotyping and whole genome sequencing methods: lessons learnt.

    PubMed

    Fiebig, Lena; Kohl, Thomas A; Popovici, Odette; Mühlenfeld, Margarita; Indra, Alexander; Homorodean, Daniela; Chiotan, Domnica; Richter, Elvira; Rüsch-Gerdes, Sabine; Schmidgruber, Beatrix; Beckert, Patrick; Hauer, Barbara; Niemann, Stefan; Allerberger, Franz; Haas, Walter

    2017-01-12

    Molecular surveillance of multidrug-resistant tuberculosis (MDR-TB) using 24-loci MIRU-VNTR in the European Union suggests the occurrence of international transmission. In early 2014, Austria detected a molecular MDR-TB cluster of five isolates. Links to Romania and Germany prompted the three countries to investigate possible cross-border MDR-TB transmission jointly. We searched genotyping databases, genotyped additional isolates from Romania, used whole genome sequencing (WGS) to infer putative transmission links, and investigated pairwise epidemiological links and patient mobility. Ten isolates from 10 patients shared the same 24-loci MIRU-VNTR pattern. Within this cluster, WGS defined two subgroups of four patients each. The first comprised an MDR-TB patient from Romania who had sought medical care in Austria and two patients from Austria. The second comprised patients, two of them epidemiologically linked, who lived in three different countries but had the same city of provenance in Romania. Our findings strongly suggested that the two cases in Austrian citizens resulted from a newly introduced MDR-TB strain, followed by domestic transmission. For the other cases, transmission probably occurred in the same city of provenance. To prevent further MDR-TB transmission, we need to ensure universal access to early and adequate therapy and collaborate closely in tuberculosis care beyond administrative borders. This article is copyright of The Authors, 2017.

  14. Cross-Border Collaboration in History among Nordic Students: A Case Study about Creating Innovative ICT Didactic Models

    ERIC Educational Resources Information Center

    Spante, Maria; Karlsen, Asgjerd Vea; Nortvig, Anne-Mette; Christiansen, Rene B.

    2014-01-01

    Gränsöverskridande Nordisk Undervisning/Utdanelse (GNU, meaning Cross-Border Nordic Education), the larger Nordic project, under which this case study was carried out, aims at developing innovative, cross-border teaching models in different subject domains in elementary school, including mathematics, language, science, social studies and history.…

  15. TECHNIQUES TO ASSESS CROSS-BORDER AIR POLLUTION AND APPLICATION TO A U.S.-MEXICO BORDER REGION

    EPA Science Inventory

    A year-long assessment of cross-border air pollution was conducted in the eastmost section of the US-Mexico border region, known as the Lower Rio Grande Valley, in South Texas. Measurements were conducted on the US side and included fine particle mass (PM2.5) and elemental com...

  16. Implicit memory for novel figure-ground displays includes a history of cross-border competition.

    PubMed

    Peterson, Mary A; Lampignano, Daniel W

    2003-08-01

    When configural cues specify that a figure lies on opposite sides of a repeated border in prime andprobe shapes, probe latencies are longer than when prime and probe borders are unrelated. Do such results reflect negative priming for the shape of the prime ground or cross-border competition from figure memory? The present study tested these alternatives by adding partial closure as a competing cue and reducing the similarity between the prime ground and the shape of the probe. Results supported the cross-border competition interpretation. Additional findings were that partial closure is a configural cue and that response effects can emerge from the potential shape on the ground side of a border. One prior experience was sufficient for these effects.

  17. Does smoke cross the border? Cigarette tax avoidance in France.

    PubMed

    Ben Lakhdar, Christian; Vaillant, Nicolas Gérard; Wolff, François-Charles

    2016-12-01

    This paper examines the impact on cigarette sales of the successive increases in cigarette prices in France from 2002 to 2004. Since the price differential between France and neighboring countries increased over the period in question, cross-border purchases became more financially attractive for smokers living near borders. Results from difference-in-differences estimates indicate that the decrease in cigarette sales observed in French border departments was around 20 % higher from 2004 to 2007 compared to non-border departments. The loss of fiscal revenue due to cross-border shopping since the tax increase amounts to 2 billion euros over the period 2002-2007. Our findings highlight the need for improved coordination of policies aimed at reducing tobacco consumption across European Union countries.

  18. Feasibility Analysis of Developing Cross-border Network Education in China

    NASA Astrophysics Data System (ADS)

    Lan, Jun

    In the era of economic globalization, strengthen of international cooperation on network education is a general trend. Although China has not made commitments about the market access and national treatment of cross-border supply in Schedule of Specific Commitments on Services, the basic conditions of network education development in China have been met. The Chinese government should formulate strategies for the development of cross-border network education and take relevant measures to implement them. In the near future, the carrying out of cross-border network education in China will become an irreversible trend, and will possess broad prospect with the advance of globalization of Chinese education.

  19. Measuring border delay and crossing times at the US-Mexico border : part II. Step-by-step guidelines for implementing a radio frequency identification (RFID) system to measure border crossing and wait times.

    DOT National Transportation Integrated Search

    2012-06-01

    The purpose of these step-by-step guidelines is to assist in planning, designing, and deploying a system that uses radio frequency identification (RFID) technology to measure the time needed for commercial vehicles to complete the northbound border c...

  20. Cross-Border Cholera Outbreaks in Sub-Saharan Africa, the Mystery behind the Silent Illness: What Needs to Be Done?

    PubMed Central

    Mwesawina, Maurice; Baluku, Yosia; Kanyanda, Setiala S. E.; Orach, Christopher Garimoi

    2016-01-01

    Introduction Cross-border cholera outbreaks are a major public health problem in Sub-Saharan Africa contributing to the high annual reported cholera cases and deaths. These outbreaks affect all categories of people and are challenging to prevent and control. This article describes lessons learnt during the cross-border cholera outbreak control in Eastern and Southern Africa sub-regions using the case of Uganda-DRC and Malawi-Mozambique borders and makes recommendations for future outbreak prevention and control. Materials and Methods We reviewed weekly surveillance data, outbreak response reports and documented experiences on the management of the most recent cross-border cholera outbreaks in Eastern and Southern Africa sub-regions, namely in Uganda and Malawi respectively. Uganda-Democratic Republic of Congo and Malawi-Mozambique borders were selected because the countries sharing these borders reported high cholera disease burden to WHO. Results A total of 603 cross-border cholera cases with 5 deaths were recorded in Malawi and Uganda in 2015. Uganda recorded 118 cases with 2 deaths and CFR of 1.7%. The under-fives and school going children were the most affected age groups contributing 24.2% and 36.4% of all patients seen along Malawi-Mozambique and Uganda-DRC borders, respectively. These outbreaks lasted for over 3 months and spread to new areas leading to 60 cases with 3 deaths, CRF of 5%, and 102 cases 0 deaths in Malawi and Uganda, respectively. Factors contributing to these outbreaks were: poor sanitation and hygiene, use of contaminated water, floods and rampant cross-border movements. The outbreak control efforts mainly involved unilateral measures implemented by only one of the affected countries. Conclusions Cross-border cholera outbreaks contribute to the high annual reported cholera burden in Sub-Saharan Africa yet they remain silent, marginalized and poorly identified by cholera actors (governments and international agencies). The under-fives and the school going children were the most affected age groups. To successfully prevent and control these outbreaks, guidelines and strategies should be reviewed to assign clear roles and responsibilities to cholera actors on collaboration, prevention, detection, monitoring and control of these epidemics. PMID:27258124

  1. Cross border reproductive care (CBRC): a growing global phenomenon with multidimensional implications (a systematic and critical review).

    PubMed

    Salama, Mahmoud; Isachenko, Vladimir; Isachenko, Evgenia; Rahimi, Gohar; Mallmann, Peter; Westphal, Lynn M; Inhorn, Marcia C; Patrizio, Pasquale

    2018-05-28

    Many people travel abroad to access fertility treatments. This growing phenomenon is known as cross border reproductive care (CBRC) or fertility tourism. Due to its complex nature and implications worldwide, CBRC has become an emerging dilemma deserving more attention on the global healthcare agenda. According to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a systematic review of the literature was performed for all relevant full-text articles published in PubMed in English during the past 18 years to explore CBRC phenomenon in the new millennium. Little is known about the accurate magnitude and scope of CBRC around the globe. In this systematic and critical review, we identify three major dimensions of CBRC: legal, economic, and ethical. We analyze each of these dimensions from clinical and practical perspectives. CBRC is a growing reality worldwide with potential benefits and risks. Therefore, it is very crucial to regulate the global market of CBRC on legal, economic, and ethical bases in order to increase harmonization and reduce any forms of exploitation. Establishment of accurate international statistics and a global registry will help diminish the current information gap surrounding the CBRC phenomenon.

  2. Simulation of Cross-border Impacts Resulting from Classical Swine Fever Epidemics within the Netherlands and Germany.

    PubMed

    Hop, G E; Mourits, M C M; Oude Lansink, A G J M; Saatkamp, H W

    2016-02-01

    The cross-border region of the Netherlands (NL) and the two German states of North Rhine Westphalia (NRW) and Lower Saxony (LS) is a large and highly integrated livestock production area. This region increasingly develops towards a single epidemiological area in which disease introduction is a shared veterinary and, consequently, economic risk. The objectives of this study were to examine classical swine fever (CSF) control strategies' veterinary and direct economic impacts for NL, NRW and LS given the current production structure and to analyse CSF's cross-border causes and impacts within the NL-NRW-LS region. The course of the epidemic was simulated by the use of InterSpread Plus, whereas economic analysis was restricted to calculating disease control costs and costs directly resulting from the control measures applied. Three veterinary control strategies were considered: a strategy based on the minimum EU requirements, a vaccination and a depopulation strategy based on NL and GER's contingency plans. Regardless of the veterinary control strategy, simulated outbreak sizes and durations for 2010 were much smaller than those simulated previously, using data from over 10 years ago. For example, worst-case outbreaks (50th percentile) in NL resulted in 30-40 infected farms and lasted for two to four and a half months; associated direct costs and direct consequential costs ranged from €24.7 to 28.6 million and €11.7 to 26.7 million, respectively. Both vaccination and depopulation strategies were efficient in controlling outbreaks, especially large outbreaks, whereas the EU minimum strategy was especially deficient in controlling worst-case outbreaks. Both vaccination and depopulation strategies resulted in low direct costs and direct consequential costs. The probability of cross-border disease spread was relatively low, and cross-border spread resulted in small, short outbreaks in neighbouring countries. Few opportunities for further cross-border harmonization and collaboration were identified, including the implementation of cross-border regions (free and diseased regions regardless of the border) in case of outbreaks within close proximity of the border, and more and quicker sharing of information across the border. It was expected, however, that collaboration to mitigate the market effects of an epidemic will create more opportunities to lower the impact of CSF outbreaks in a cross-border context. © 2014 Blackwell Verlag GmbH.

  3. Quality in Cross-Border Higher Education and Challenges for the Internationalization of National Quality Assurance Agencies in the Asia-Pacific Region: The Taiwanese Experience

    ERIC Educational Resources Information Center

    Hou, Angela Yung-chi

    2014-01-01

    Cross-border higher education has created a need to build capacity -- particularly in the internationalization dimension -- for national quality assurance agencies to evaluate cross-border education provided by foreign educational providers, or jointly by local and foreign institutions. This is quickly becoming a key issue in the Asia-Pacific…

  4. Higher Education Crossing Borders. A Guide to the Implications of the General Agreement on Trade in Services (GATS) for Cross-Border Education

    ERIC Educational Resources Information Center

    Knight, Jane

    2006-01-01

    This Guide examines the different dimensions of cross-border education within the context of General Agreement on Trade in Services (GATS): the present landscape, opportunities and challenges and the implications for policy and practice in higher education. It is meant for a range of stakeholders: policymakers, senior academic leaders, faculty…

  5. Myofilament dysfunction contributes to impaired myocardial contraction in the infarct border zone

    PubMed Central

    Shimkunas, Rafael; Makwana, Om; Spaulding, Kimberly; Bazargan, Mona; Khazalpour, Michael; Takaba, Kiyoaki; Soleimani, Mehrdad; Myagmar, Bat-Erdene; Lovett, David H.; Simpson, Paul C.; Ratcliffe, Mark B.

    2014-01-01

    After myocardial infarction, a poorly contracting nonischemic border zone forms adjacent to the infarct. The cause of border zone dysfunction is unclear. The goal of this study was to determine the myofilament mechanisms involved in postinfarction border zone dysfunction. Two weeks after anteroapical infarction of sheep hearts, we studied in vitro isometric and isotonic contractions of demembranated myocardium from the infarct border zone and a zone remote from the infarct. Maximal force development (Fmax) of the border zone myocardium was reduced by 31 ± 2% versus the remote zone myocardium (n = 6/group, P < 0.0001). Decreased border zone Fmax was not due to a reduced content of contractile material, as assessed histologically, and from myosin content. Furthermore, decreased border zone Fmax did not involve altered cross-bridge kinetics, as assessed by muscle shortening velocity and force development kinetics. Decreased border zone Fmax was associated with decreased cross-bridge formation, as assessed from muscle stiffness in the absence of ATP where cross-bridge formation should be maximized (rigor stiffness was reduced 34 ± 6%, n = 5, P = 0.011 vs. the remote zone). Furthermore, the border zone myocardium had significantly reduced phosphorylation of myosin essential light chain (ELC; 41 ± 10%, n = 4, P < 0.05). However, for animals treated with doxycycline, an inhibitor of matrix metalloproteinases, rigor stiffness and ELC phosphorylation were not reduced in the border zone myocardium, suggesting that doxycycline had a protective effect. In conclusion, myofilament dysfunction contributes to postinfarction border zone dysfunction, myofilament dysfunction involves impaired cross-bridge formation and decreased ELC phosphorylation, and matrix metalloproteinase inhibition may be beneficial for limiting postinfarct border zone dysfunction. PMID:25128171

  6. Facilitating cultural border crossing in urban secondary science classrooms: A study of inservice teachers

    NASA Astrophysics Data System (ADS)

    Monteiro, Anna Karina

    Research acknowledges that if students are to be successful science, they must learn to navigate and cross cultural borders that exist between their own cultures and the subculture of science. This dissertation utilized a mixed methods approach to explore how inservice science teachers working in urban schools construct their ideas of and apply the concepts about the culture of science and cultural border crossing as relevant to the teaching and learning of science. The study used the lenses of cultural capital, social constructivism, and cultural congruency in the design and analysis of each of the three phases of data collection. Phase I identified the perspectives of six inservice science teachers on science culture, cultural border crossing, and which border crossing methods, if any, they used during science teaching. Phase II took a dialectical approach as the teachers read about science culture and cultural border crossing during three informal professional learning community meetings. This phase explored how teachers constructed their understanding of cultural border crossing and how the concept applied to the teaching and learning of science. Phase III evaluated how teachers' perspectives changed from Phase I. In addition, classroom observations were used to determine whether teachers' practices in their science classrooms changed from Phase I to Phase III. All three phases collected data through qualitative (i.e., interviews, classroom observations, and surveys) and quantitative (Likert items) means. The findings indicated that teachers found great value in learning about the culture of science and cultural border crossing as it pertained to their teaching methods. This was not only evidenced by their interviews and surveys, but also in the methods they used in their classrooms. Final conclusions included how the use of student capital resources (prior experiences, understandings and knowledge, ideas an interests, and personal beliefs), if supported by science practices and skills increases student cultural capital. With a greater cultural capital, the students experience cultural congruency between their cultures and the culture of science, enabling them to cross such borders in the science classroom. The implications such findings have on teacher training programs and professional development are discussed.

  7. Application of smart phone in "Better Border Healthcare Program": a module for mother and child care.

    PubMed

    Kaewkungwal, Jaranit; Singhasivanon, Pratap; Khamsiriwatchara, Amnat; Sawang, Surasak; Meankaew, Pongthep; Wechsart, Apisit

    2010-11-03

    To assess the application of cell phone integrating into the healthcare system to improve antenatal care (ANC) and expanded programme on immunization (EPI) services for the under-served population in border area. A module combining web-based and mobile technology was developed to generate ANC/EPI visit schedule dates in which the healthcare personnel can cross-check, identify and update the mother's ANC and child's EPI status at the healthcare facility or at the household location when performing home visit; with additional feature of sending appointment reminder directly to the scheduled mother in the community. The module improved ANC/EPI coverage in the study area along the country border including for both Thai and non-Thai mothers and children who were either permanent resident or migrants; numbers of ANC and EPI visit on-time as per schedule significantly increased; there was less delay of antenatal visits and immunizations. The module integrated and functioned successfully as part of the healthcare system; it is proved for its feasibility and the extent to which community healthcare personnel in the low resource setting could efficiently utilize it to perform their duties.

  8. [Cross-border healthcare in European Union and Czech Republic].

    PubMed

    Barták, Miroslav; Rogalewicz, Vladimír; Jílková, Jiřina; Jeřábková, Silvie

    Currently, the cross-border healthcare still represents a marginal part of the Czech healthcare system's performance, though. Compared to the total healthcare expenditures in the Czech Republic that accounted for CZK 299.9 billion in 2014, the costs of the treatment provided to Czech patients abroad constitute mere 0.27%, and the (subsequently refunded) costs of the treatment provided to foreign patients in the Czech Republic 0.24%.Although data on changes in the volume and reimbursements of healthcare due to the Directive 2011/24/EU have not been published yet, we can expect rather evolutionary than revolutionary development of cross-border healthcare volumes. Taking into account all available data, we can conclude that the cross-border healthcare, as specified by the directive currently in force, is important in our conditions above all in relation to our neighbours, i. e. Germany, Austria, Slovakia and Poland.Key words: cross-border healthcare, patient mobility, international reimbursements EU health policy, Directive 2011/24/EU.

  9. Cross-Border Higher Education for Labor Market Needs: Mobility of Public-Funded Malaysian Students to Japan over Years. JICA-RI Working Paper. No. 29

    ERIC Educational Resources Information Center

    Koda, Yoshiko; Yuki, Takako; Hong, Yeeyoung

    2011-01-01

    As globalization and the knowledge economy spreads, the demand for highly skilled workers has increased and developing countries are engaged in cross-border higher education to develop high level human resources for their nations. Using data on a cross-border higher education program between Malaysia and Japan, namely the Higher Education Loan…

  10. The way to win in cross-border alliances.

    PubMed

    Bleeke, J; Ernst, D

    1991-01-01

    Global competition has paved the way to new corporate combinations--and opened up new pitfalls along the way. In "The Way to Win in Cross-Border Alliances," Joel Bleeke and David Ernst offer the unconventional lessons of their study of 49 cross-border alliances. For example, alliances between a weak and a strong company usually don't work; but fifty-fifty ownership of joint ventures actually improves decision making.

  11. Life on the Hardened Border

    ERIC Educational Resources Information Center

    Miller, Bruce Granville

    2012-01-01

    The many Coast Salish groups distributed on both sides of the United States-Canada border on the Pacific coast today face significant obstacles to cross the international border, and in some cases are denied passage or intimidated into not attempting to cross. The current situation regarding travel by Aboriginal people reflects the…

  12. The International Research Training Group (GRK532): Practicing Cross-Border Postgraduate Education

    ERIC Educational Resources Information Center

    Ehses, Markus; Veith, Michael

    2009-01-01

    In 1999, the International Research Training Group "GRK532" was founded as a pilot project for cross-border European postgraduate education along the German/French/Luxembourg borders. The project consists of an interdisciplinary research programme on synthesis, isolation and characterization of new materials accompanied by an ambitious…

  13. Measuring border delay and crossing times at the US-Mexico border : final report on automated crossing and wait time measurement.

    DOT National Transportation Integrated Search

    2012-08-01

    A pilot test implemented a radio frequency identification (RFID) system to automatically measure travel times of US-bound commercial vehicles at a selected Port of Entry (POE) on the USMexico border under long-term, real-world conditions. The init...

  14. Secondary stroke prevention services in Canada: a cross-sectional survey and geospatial analysis of resources, capacity and geographic access

    PubMed Central

    Jewett, Lauren; Harroud, Adil; Hill, Michael D.; Côté, Robert; Wein, Theodore; Smith, Eric E.; Gubitz, Gord; Demchuk, Andrew M.; Sahlas, Demetrios J.; Gladstone, David J.; Lindsay, M. Patrice

    2018-01-01

    Background: Rapid assessment and management of transient ischemic attacks and nondisabling strokes by specialized stroke prevention services reduces the risk of recurrent stroke and improves outcomes. In Canada, with its vast geography and with 16.8% of the population living in rural areas, access to these services is challenging, and considerable variation in access to care exists. The purpose of this multiphase study was to identify sites across Canada providing stroke prevention services, evaluate resource capacity and determine geographic access for Canadians. Methods: We developed a Stroke Prevention Services Resource Inventory that contained 22 questions on the organization and delivery of stroke prevention services and quality monitoring. The inventory ran from November 2015 to January 2016 and was administered online. We conducted a geospatial analysis to estimate access by drive times. Considerations were made for hours of operation and access within and across provincial borders. Results: A total of 123 stroke prevention sites were identified, of which 119 (96.7%) completed the inventory. Most (95) are designated stroke prevention or rapid assessment clinics. Of the 119 sites, 68 operate full time, and 39 operate less than 2.5 days per week. A total of 87.3% of the Canadian population has access to a stroke prevention service within a 1-hour drive; however, only 69.2% has access to a service that operates 5-7 days a week. Allowing provincial border crossing improves access (< 6-h drive) for those who are beyond a 6-hour drive within their home province (3.4%). Interpretation: Most Canadians have reasonable geographic access to stroke prevention services. Allowing patients to cross borders improves the existing access for many, particularly some remote communities along the Ontario-Quebec and British Columbia-Alberta borders. PMID:29472251

  15. Smuggling and cross border shopping of tobacco in Europe.

    PubMed

    Joossens, L; Raw, M

    1995-05-27

    Governments have recently become concerned about cross border shopping and smuggling because it can decrease tax revenue. The tobacco industry predicted that, with the removal of border controls in the European Union, price differences between neighbouring countries would lead to a diversion of tobacco trade, legally and illegally, to countries with cheaper cigarettes. According to them this diversion would be through increased cross border shopping for personal consumption or through increased smuggling of cheap cigarettes from countries with low tax to countries with high tax, where cigarettes are more expensive. These arguments have been used to urge governments not to increase tax on tobacco products. The evidence suggests, however, that cross border shopping is not yet a problem in Europe and that smuggling is not of cheap cigarettes to expensive countries. Instead, more expensive "international" brands are smuggled into northern Europe and sold illegally on the streets of the cheaper countries of southern Europe.

  16. Smuggling and cross border shopping of tobacco in Europe.

    PubMed Central

    Joossens, L.; Raw, M.

    1995-01-01

    Governments have recently become concerned about cross border shopping and smuggling because it can decrease tax revenue. The tobacco industry predicted that, with the removal of border controls in the European Union, price differences between neighbouring countries would lead to a diversion of tobacco trade, legally and illegally, to countries with cheaper cigarettes. According to them this diversion would be through increased cross border shopping for personal consumption or through increased smuggling of cheap cigarettes from countries with low tax to countries with high tax, where cigarettes are more expensive. These arguments have been used to urge governments not to increase tax on tobacco products. The evidence suggests, however, that cross border shopping is not yet a problem in Europe and that smuggling is not of cheap cigarettes to expensive countries. Instead, more expensive "international" brands are smuggled into northern Europe and sold illegally on the streets of the cheaper countries of southern Europe. PMID:7787549

  17. Walls and Laws: Proximity, Distance and the Doubleness of the Border

    ERIC Educational Resources Information Center

    Papastephanou, Marianna

    2011-01-01

    In this article, I explore the way in which proximity and distance have been made relevant to cosmopolitanism and I discuss the significance contemporary theory attributes to border crossing. By employing colonial border crossing and its rationalization as an example, and by drawing from Alain Badiou's critique of political philosophy, I expose…

  18. Organizational Learning and the Transnationalization of Further Education: Pedagogical Research on Cross-Border Organizations

    ERIC Educational Resources Information Center

    Göhlich, Michael; Engel, Nicolas; Höhne, Thomas

    2014-01-01

    With the processes of migration, globalization and (in our research context: especially) European unification, not only territorial borders but also cultural traditions become fragile (Eberhard et al., 2009). The daily challenges, as well as the opportunities afforded by crossing national, cultural, and linguistic borders, are growing (Beyer &…

  19. Truck freight crossing the Canada-U.S. border : an analysis of the cross-border component of the 1999 Canadian National Roadside Study

    DOT National Transportation Integrated Search

    2002-09-23

    The United States and Canada are each others largest trading partner. Trade and traffic between the countries, especially by land transportation, has been increasing at a rapid rate over the past 25 years. This study, produced by the Eastern Border T...

  20. Teachers' Inclusive Strategies to Accommodate 5th Grade Pupils' Crossing of Cultural Borders in Two Greek Multicultural Science Classrooms

    NASA Astrophysics Data System (ADS)

    Piliouras, Panagiotis; Evangelou, Odysseas

    2012-04-01

    The demographic changes in Greek schools underline the need for reconsidering the way in which migrant pupils move from their everyday culture into the culture of school science (a process known as "cultural border crossing"). Migrant pupils might face difficulties when they attempt to transcend cultural borders and this may influence their progress in science as well as the construction of suitable academic identities as a means of promoting scientific literacy. In the research we present in this paper, adopting the socioculturally driven thesis that learning can be viewed and studied as a meaning-making, collaborative inquiry process, we implemented an action research program (school year 2008-2009) in cooperation with two teachers, in a primary school of Athens with 85% migrant pupils. We examined whether the two teachers, who became gradually acquainted with cross-cultural pedagogy during the project, act towards accommodating the crossing of cultural borders by implementing a variety of inclusive strategies in science teaching. Our findings reveal that both teachers utilized suitable cross-border strategies (strategies concerning the establishment of a collaborative inquiry learning environment, and strategies that were in accordance with a cross-border pedagogy) to help students cross smoothly from their "world" to the "world of science". A crucial key to the teachers' expertise was their previous participation in collaborative action research (school years 2004-2006), in which they analyzed their own discourse practices during science lessons in order to establish more collaborative inquiry environments.

  1. Recent advances to address European Union Health Security from cross border chemical health threats.

    PubMed

    Duarte-Davidson, R; Orford, R; Wyke, S; Griffiths, M; Amlôt, R; Chilcott, R

    2014-11-01

    The European Union (EU) Decision (1082/2013/EU) on serious cross border threats to health was adopted by the European Parliament in November 2013, in recognition of the need to strengthen the capacity of Member States to coordinate the public health response to cross border threats, whether from biological, chemical, environmental events or events which have an unknown origin. Although mechanisms have been in place for years for reporting cross border health threats from communicable diseases, this has not been the case for incidents involving chemicals and/or environmental events. A variety of collaborative EU projects have been funded over the past 10 years through the Health Programme to address gaps in knowledge on health security and to improve resilience and response to major incidents involving chemicals. This paper looks at the EU Health Programme that underpins recent research activities to address gaps in resilience, planning, responding to and recovering from a cross border chemical incident. It also looks at how the outputs from the research programme will contribute to improving public health management of transnational incidents that have the potential to overwhelm national capabilities, putting this into context with the new requirements as the Decision on serious cross border threats to health as well as highlighting areas for future development. Crown Copyright © 2014. Published by Elsevier Ltd. All rights reserved.

  2. Commercial border crossing and wait time measurement at the Pharr-Reynosa International Bridge.

    DOT National Transportation Integrated Search

    2010-11-01

    The objective of the research described in this report is to install and implement radio frequency : identification (RFID) technology to measure border crossing time and travel delay for : commercial trucks crossing from Mexico into Texas at the Phar...

  3. Analysis of the First 100 Patients From the Syrian Civil War Treated in an Israeli District Hospital.

    PubMed

    Biswas, Seema; Waksman, Igor; Baron, Shay; Fuchs, David; Rechnitzer, Hagai; Dally, Najib; Kassis, Shokrey; Hadary, Amram

    2016-01-01

    An analysis of the injuries and treatment of the first 100 patients from the Syrian civil war was conducted to monitor quality of care and outcome. As reports of the collapse of health care systems in regions within Syria reach the media, patients find themselves crossing the border into Israel for the treatment of war injuries. Among these patients are combatants, noncombatants, women, and children. Treatment, that is free at the point of care, is a humanitarian imperative for war wounded, and this paper reports the care in an Israeli district hospital of the first 100 patients received. With ethics committee approval, data from the Trauma Registry and electronic patient records were collected and analyzed. No identifying data are presented. Most patients (94) were male. Seventeen patients were younger than the age of 18 years; 52 patients were in their twenties. Most injuries were the results of gunshot or blast injury (50 and 29 patients, respectively). Two multiple-trauma patients died, 8 were transferred for specialist care, and 90 patients returned from Ziv Hospital to Syria after discharge. The experience of the care of patients across a hostile border has been unprecedented. Hospital protocols required adjustment to deliver quality clinical and social care to patients suffering from both the acute and chronic effects of civil war.

  4. Measuring border delay and crossing times at the US-Mexico border : part II. Guidebook for analysis and dissemination of border crossing time and wait time data.

    DOT National Transportation Integrated Search

    2012-06-01

    The purpose of this guidebook is to describe to local, regional, and State agencies how to analyze and disseminate data collected by a radio frequency identification (RFID)-based system to measure travel times of commercial vehicles, which is referre...

  5. Effort to test, evaluate and deploy technologies to automate the measurement of real-time border wait times at United States-Canada land border crossings.

    DOT National Transportation Integrated Search

    2011-09-01

    The United States and Canada share the largest bi-national trading relationship in the world. An efficient and cost-effective border crossing system for both freight and passenger vehicle traffic is thus vital to the economic well-being and security ...

  6. Banning reproductive travel: Turkey's ART legislation and third-party assisted reproduction.

    PubMed

    Gürtin, Zeynep B

    2011-11-01

    In March 2010, Turkey became the first country to legislate against the cross-border travel of its citizens seeking third-party reproductive assistance. Although the use of donor eggs, donor spermatozoa and surrogacy had been illegal in Turkey since the introduction of a regulatory framework for assisted reproductive treatment in 1987, men and women were free to access these treatments in other jurisdictions. In some cases, such travel for cross-border reproductive care (CBRC) was even facilitated by sophisticated arrangements between IVF clinics in Turkey and in other countries, particularly in Cyprus. However, new amendments to Turkey's assisted reproduction legislation specifically forbid travel for the purposes of third-party assisted reproduction. This article outlines the cultural context of assisted reproductive treatment in Turkey; details the Turkish assisted reproduction legislation, particularly as it pertains to third-party reproductive assistance; explores Turkish attitudes towards donor gametes and surrogacy; assesses the existence and extent of CBRC prior to March 2010; and discusses some of the legal, ethical and practical implications of the new legislation. As CBRC becomes an increasingly pertinent issue, eliciting debate and discussion at both national and international levels, it is important to carefully consider the particular circumstances and potential consequences of this unique example. Copyright © 2011 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

  7. Trade in health services.

    PubMed Central

    Chanda, Rupa

    2002-01-01

    In light of the increasing globalization of the health sector, this article examines ways in which health services can be traded, using the mode-wise characterization of trade defined in the General Agreement on Trade in Services. The trade modes include cross- border delivery of health services via physical and electronic means, and cross-border movement of consumers, professionals, and capital. An examination of the positive and negative implications of trade in health services for equity, efficiency, quality, and access to health care indicates that health services trade has brought mixed benefits and that there is a clear role for policy measures to mitigate the adverse consequences and facilitate the gains. Some policy measures and priority areas for action are outlined, including steps to address the "brain drain"; increasing investment in the health sector and prioritizing this investment better; and promoting linkages between private and public health care services to ensure equity. Data collection, measures, and studies on health services trade all need to be improved, to assess better the magnitude and potential implications of this trade. In this context, the potential costs and benefits of trade in health services are shaped by the underlying structural conditions and existing regulatory, policy, and infrastructure in the health sector. Thus, appropriate policies and safeguard measures are required to take advantage of globalization in health services. PMID:11953795

  8. Cross-border reproductive care: market forces in action or market failure? An economic perspective.

    PubMed

    Connolly, Mark

    2011-12-01

    From an economist's perspective, cross-border reproductive care (CBRC) reflects a global market economy bringing together the needs of patients and skills of doctors at an agreed price. From this perspective CBRC is neither wrong nor right, rather it reflects rational economic behaviour of couples to maximize their wellbeing. The major economic criticism of CBRC relates to the costs and risks of multiple pregnancies, as couples paying out-of-pocket may have more embryos transferred than is desirable to optimize their chances of having a live birth. This criticism is valid, suggesting a need to communicate the hidden costs of failing to adequately fund fertility services. However, under some circumstances health authorities may be willing to bear these additional costs if the savings from not providing fertility services are sufficiently large enough to warrant a no-funding policy. Because infertility is often viewed as a low health priority, the likelihood of CBRC persisting is real, particularly as many health services adjust to the challenges of ageing populations and decreased public financing. To counter funding challenges, there is a need to communicate the medical benefits of assisted reproduction and the economic benefits that these children will offer in an era of austerity and ageing populations. Copyright © 2011 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

  9. Legal perspectives on cross-border reproductive care.

    PubMed

    Crockin, Susan L

    2011-12-01

    Global cross-border reproductive care (CBRC), and the challenges accompanying it, are here to stay. A recent issue of this journal devoted to CBRC provides an extraordinary array of insights into multiple facets, with a focus on the legal dimensions of practices by restrictive countries such as Turkey and Italy. The articles identify restrictive laws that challenge and create vulnerabilities for both citizens and providers involved in CBRC, and call instead for more modest and nuanced legislation and the closing paper presents a thoughtful and ambitious outline for a future research agenda. This commentary reflects on the implications of these legal dimensions, including their applicability to countries with more permissive CBRC policies, discusses three specific examples of legal concerns that have arisen in the USA and identifies numerous legal issues meriting future study. Together with the nuanced, more modest legislation recommended for restrictive countries, consistent legal and judicial principles for CBRC in permissive countries would respect varying perspectives on family building while attempting to address a central legal concern of CBRC, the protection of families, third-parties and providers. Any future agenda should include research and recommendations on the legal dimensions of CBRC in both restrictive and permissive countries. Copyright © 2011 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

  10. Cross-border reproductive care: a review of the literature.

    PubMed

    Hudson, Nicky; Culley, Lorraine; Blyth, Eric; Norton, Wendy; Rapport, Frances; Pacey, Allan

    2011-06-01

    Cross-border reproductive care (CBRC) has attracted considerable attention in media and professional publications. The aim of this review is to present a critical narrative overview of the published evidence on CBRC. A systematic search of key academic databases was undertaken with no time restrictions set for publication. This was supplemented by additional searches of key websites, reference chaining and enquiries to people working in the field. A total of 54 items are included in the review, including both empirical research studies (18) and debate papers (36). The key themes discussed are: terminology and definitions; incidence; experiences; explanations; implications; and policy responses. Significant methodological limitations and gaps in the literature are identified. Evidence on incidence is scant, though it suggests that CBRC is increasing. The literature suggests legal, social and political drivers, which vary in importance geographically and between individuals. Limited findings on patient perceptions suggest a broadly positive patient experience. Suggested policy responses include prohibition, regulatory harmonization and harm minimization. There is a need for better international data collection tools and both quantitative and qualitative work which encompasses views of patients, donors, surrogates and professionals and which explores the implications for healthcare services in sending countries. Copyright © 2011 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

  11. Cross-border marriage and disparities in early childhood development in a population-based birth cohort study: the mediation of the home environment.

    PubMed

    Wu, J C-L; Bradley, R H; Chiang, T-L

    2012-07-01

    Taiwan has experienced a large influx of cross-border marriage migrants in recent years. The majority have been women in their childbearing ages and have come from countries with lower average standards of living than Taiwan. This trend has changed the ethnic composition of children who live in Taiwan, and it has generated considerable social concern over the future health status of Taiwan's citizens. This study aimed to examine: (1) whether there are disparities in development between children reared in families characterized by cross-border marriages and children reared in families with two Taiwanese-born parents; and (2) whether the quality of home environment explains the group differences in early childhood development. Data came from the Taiwan Birth Cohort Study. A total of 19,499 participants who completed 6-month, 18-month and 3-year surveys were included for analysis. Cross-border marriage status was defined by mother's original nationality and categorized into three broad groups: Taiwanese-born, Chinese cross-border and South-East Asian (SEA) cross-border. Early childhood development was measured at age 3 years, and covered the domains of gross motor, fine motor, language and socio-emotional competence. Hierarchical linear regressions were used to examine the mediation effects of the home environment. Children of Chinese and SEA cross-border groups scored lower in fine motor, language and socio-emotional competence than those of their Taiwanese-born counterpart at age 3 years. Chinese-Taiwanese group differences in all three developmental domains became insignificant after the addition of home environment, while SEA-Taiwanese group differences in fine motor and language development remained, yet were noticeably reduced. The mediation of home environment was further confirmed using the Sobel test. Home environment plays a central role in reducing the disparities in developmental outcomes among children of different marriage groups. Interventions should be directed towards enhancing the quality of early home environment for children reared in families of cross-border marriages. © 2011 Blackwell Publishing Ltd.

  12. Impact of cigarette price differences across the entire European Union on cross-border purchase of tobacco products among adult cigarette smokers.

    PubMed

    Agaku, Israel T; Blecher, Evan; Filippidis, Filippos T; Omaduvie, Uyoyo T; Vozikis, Athanassios; Vardavas, Constantine I

    2016-05-01

    We investigated the impact of cigarette price differences across the European Union (EU) on cross-border tobacco purchasing because of cheaper price among current cigarette smokers. Individual-level tobacco-related data (including cross-border tobacco purchasing behavior) were from the Special Eurobarometer 385 (V.77.1), a cross-sectional survey of persons aged ≥15 years from 27 EU Member States during 2012. Country-specific weighted average prices (WAP) per 1000 cigarettes (as of 1 July 2012) were obtained from the European Commission, and divided by 50 to yield WAP per cigarette pack. The dispersion in EU cigarette prices was measured with the coefficient of variation. Multivariate logistic regression was applied to measure the relationship between EU-wide cigarette price differential and cross-border tobacco purchasing because of cheaper price among current cigarette smokers (n=6896). The coefficient of variation for cigarette WAP within the EU was 0.39 (mean price=€3.99/pack). Of all current cigarette smokers in the EU, 26.2% (27.5 million persons) engaged in a cross-border tobacco purchase within the past 12 months, of which 56.3% did so because of cheaper price in another country. EU-wide cigarette price differential was significantly associated with making a cross-border tobacco purchase because of cheaper price (adjusted OR=1.34; 95% CI 1.22 to 1.47). Reducing differences in cigarette tax and price within the EU, coupled with a stricter limitation on the quantity of cigarettes that it is possible to carry from one Member State to another, may help reduce cross-border tax avoidance strategies. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  13. Prospects for the Cross-Border Cooperation between Russia and Poland in the Field of Tourism

    ERIC Educational Resources Information Center

    Zaitseva, Natalia A.; Korneevets, Valentin S.; Semenova, Lyudmila V.

    2016-01-01

    The relevance of the research topic is driven by the increasing role of cross-border cooperation for economic development of regions of the neighbouring countries located in the immediate vicinity to the border, as well as for the tourism development. The purpose of scientific research, the results of which are presented in the article, was the…

  14. Growing families in a shrinking world: legal and ethical challenges in cross-border surrogacy.

    PubMed

    Crockin, Susan L

    2013-12-01

    Crossing national borders to have children is a rapidly growing phenomenon, fuelled by restrictions on access and technologies in some countries and for some patients, by high costs in others, and all generating a burgeoning multibillion dollar international industry. Cross-border gestational surrogacy is one form of family building that challenges legal, policy and ethical norms between countries and puts both intended parents and gestational surrogates at risk, and can leave the offspring of these arrangements vulnerable in a variety of ways, including parent-child, immigration and citizenship status. The widely varying political, religious and legal views amongst countries make line drawing and rule making challenging. This article reviews recent court decisions about and explores the legal dimensions of cross-border surrogacy. Copyright © 2013 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

  15. What would an ideal mental health service for primary care look like?

    PubMed Central

    2011-01-01

    The creation of GP commissioning consortia offers potential opportunities for GPs to challenge a number of divisions and distinctions that are currently taken for granted in mental health services, but may be neither necessary nor logical. I examine a range of these and suggest what GPs and patients might reasonably expect if we challenged them in order to imagine and commission an ideal mental health service for primary care. Among its features, an ideal service would cross the boundaries of mental and physical care, individual and family care, and the mental, social and economic domains. It would also transcend mental health ideologies, geographical borders and the artificial distinction between making a diagnosis, offering treatment and holding a therapeutic conversation. PMID:25949648

  16. Ideational Border Crossings: Rethinking the Politics of Knowledge within and across Disciplines

    ERIC Educational Resources Information Center

    Evans, John

    2014-01-01

    This article explores the merits, possibilities and difficulties of making intra and trans-disciplinary"border crossings" essentially of an ideational kind. Drawing ideas from complexity literature, the article lauds the potential of "concept studies" as means of making such crossings and addressing enduring issues (e.g., of…

  17. Commercial border crossing and wait time measurement at Laredo World Trade Bridge and the Colombia-Solidarity Bridge.

    DOT National Transportation Integrated Search

    2012-03-01

    This research is to establish a baseline and on-going measurement of border crossing times and : delay by measuring travel times for commercial trucks crossing the port of entry (POE) from : Mexico into Texas at the Laredo World Trade Bridge and the ...

  18. Introduction: Training in reproductive endocrinology and infertility: meeting worldwide needs.

    PubMed

    de Ziegler, Dominique; Meldrum, David R

    2015-07-01

    Training in reproductive endocrinology (REI) and its male variant, andrology, has been profoundly influenced by the central role captured by assisted reproductive technologies (ART). The marked differences in financial, regulatory, and societal/ethical restrictions on ART in different countries of the world also prominently influence the clinical management of infertility. Training should strive for comprehensive teaching of all medically indicated procedures, even if only to optimize cross-border care. Better international standardization of infertility practices and training would benefit worldwide infertility care and should be promoted by international societies. Copyright © 2015. Published by Elsevier Inc.

  19. Cross-Border Healthcare Requests to Publicly Funded Healthcare Insurance: Empirical Analysis.

    PubMed

    Stewart Ferreira, Lydia

    2016-02-01

    Despite the legal authority to confirm, override or modify healthcare insurance decisions made by physicians and government officials, health tribunal decisions have not been empirically analyzed. Using a novel quantitative methodology, all 387 Health Services Appeal and Review Board written and publicly available electronic decisions released over a five-year time period were statistically analyzed with respect to Ontario public health insurance requests for global cross-border healthcare. The statistical results found that patients knew their diagnosis prior to requesting cross-border healthcare, and 84% of patients requested specific northern US facilities for specific treatment. Two specific healthcare facilities in the US were requested for either surgery or assessments. A significant number of patients were seeking cross-border healthcare for pain treatment. This research challenges the assumption that cross-border treatment requests result only from domestic delay when instead patients are seeking specific treatments at specific facilities. This novel quantitative research methodology and data source of written and publicly available electronic Health Services Appeal and Review Board decisions should be used to inform policy decision regarding the utilization and evaluation of Canada's healthcare system and publicly funded healthcare insurance. Copyright © 2016 Longwoods Publishing.

  20. Microsensors for border patrol applications

    NASA Astrophysics Data System (ADS)

    Falkofske, Dwight; Krantz, Brian; Shimazu, Ron; Berglund, Victor

    2005-05-01

    A top concern in homeland security efforts is the lack of ability to monitor the thousands of miles of open border with our neighbors. It is not currently feasible to continually monitor the borders for illegal intrusions. The MicroSensor System (MSS) seeks to achieve a low-cost monitoring solution that can be efficiently deployed for border patrol applications. The modifications and issues regarding the unique requirements of this application will be discussed and presented. The MicroSensor System was developed by the Defense Microelectronics Activity (DMEA) for military applications, but border patrol applications, with their unique sensor requirements, demand careful adaptation and modification from the military application. Adaptation of the existing sensor design for border applications has been initiated. Coverage issues, communications needs, and other requirements need to be explored for the border patrol application. Currently, border patrol has a number of deficiencies that can be addressed with a microsensor network. First, a distributed networked sensor field could mitigate the porous border intruder detection problem. Second, a unified database needs to be available to identify aliens attempting to cross into the United States. This database needs to take unique characteristics (e.g. biometrics, fingerprints) recovered from a specialized field unit to reliably identify intruders. Finally, this sensor network needs to provide a communication ability to allow border patrol officers to have quick access to intrusion information as well as equipment tracking and voice communication. MSS already addresses the sensing portion of the solution, including detection of acoustic, infrared, magnetic, and seismic events. MSS also includes a low-power networking protocol to lengthen the battery life. In addition to current military requirements, MSS needs a solar panel solution to extend its battery life to 5 years, and an additional backbone communication link. Expanding the capabilities of MSS will go a long way to improving the security of the nation's porous borders.

  1. Transcending Borders and Traversing Boundaries: A Systematic Review of the Literature on Transnational, Offshore, Cross-Border, and Borderless Higher Education

    ERIC Educational Resources Information Center

    Kosmützky, Anna; Putty, Rahul

    2016-01-01

    This article is a review of the literature concerned with transnational, offshore, cross-border, and borderless higher education, which together form a new thematic field within higher education research from the early 2000s onwards. The review places emphasis on the development of this field as well as its most cited contributions. The literature…

  2. Establishing Trafficking in Human Beings for the Purpose of Organ Removal and Improving Cross-Border Collaboration in Criminal Cases: Recommendations.

    PubMed

    Holmes, Paul; Rijken, Conny; D'Orsi, Sergio; Esser, Luuk; Hol, Floor; Gallagher, Anne; Greenberg, Galit; Helberg, Louis; Horvatits, Lisa; McCarthy, Sean; Ratel, Jonathan; Scheper-Hughes, Nancy; Forsythe, John

    2016-02-01

    In this short summary report on the legal definition of trafficking in human beings for the purpose of organ removal and improving cross-border collaboration in criminal cases, challenges, and recommendations in the areas of defining the crime, criminal investigation and prosecution, and cross-border cooperation are made. These are the outcomes of a working group discussion during the writers' conference of the HOTT project, a European Union-funded project against trafficking in human beings for the purpose of organ removal.

  3. Cross-border healthcare in Spain and the implementation of the Directive 2011/24/EU on the Application of Patient's Rights in Cross-border Healthcare.

    PubMed

    Requejo, M Teresa

    2014-03-01

    This work describes and assesses the implementation of the Cross-border Healthcare Directive in Spain. Although implementation has not yet taken place, the Government has already adopted a draft implementing regulation, on which this article is based. In addition, this article deals with a number of other rules that have been adopted in Spain, which are not strictly aimed at the implementation of the Directive but which are expected to facilitate its implementation and to help cement its effectiveness.

  4. "Is it worth risking your life?" Ethnography, risk and death on the U.S.-Mexico border.

    PubMed

    Holmes, Seth M

    2013-12-01

    Every year, several hundred people die attempting to cross the border from Mexico into the United States, most often from dehydration and heat stroke though snake bites and violent assaults are also common. This article utilizes participant observation fieldwork in the borderlands of the US and Mexico to explore the experience of structural vulnerability and bodily health risk along the desert trek into the US. Between 2003 and 2005, the ethnographer recorded interviews and conversations with undocumented immigrants crossing the border, border patrol agents, border activists, borderland residents, and armed civilian vigilantes. In addition, he took part in a border crossing beginning in the Mexican state of Oaxaca and ending in a border patrol jail in Arizona after he and his undocumented Mexican research subjects were apprehended trekking through the borderlands. Field notes and interview transcriptions provide thick ethnographic detail demonstrating the ways in which social, ethnic, and citizenship differences as well as border policies force certain categories of people to put their bodies, health, and lives at risk in order for them and their families to survive. Yet, metaphors of individual choice deflect responsibility from global economic policy and US border policy, subtly blaming migrants for the danger - and sometimes death - they experience. The article concludes with policy changes to make US-Mexico labor migration less deadly. Copyright © 2013 Elsevier Ltd. All rights reserved.

  5. Neighborhoods, Social and Cultural Correlates of Obesity Risk among Latinos living on the U.S.-Mexico border in Southern California.

    PubMed

    Baquero, Barbara; Molina, Marisa; Elder, John P; Norman, Gregory J; Ayala, Guadalupe X

    2016-01-01

    We explored the relationship between obesity and neighborhood-related, social, and cultural variables and possible moderation by acculturation and cross-national practices. We obtained data from the 2009 San Diego Prevention Research Center's community survey, which used multistage sampling methods to recruit 397 adult respondents and conducted multilevel logistic analytic methods. Nearly half of the respondents were obese. Respondents had low acculturation scores and reported crossing the U.S.-Mexico border about three times per month, mostly to visit family and friends. Neighborhoods where respondents lived were predominantly Latino and had 27% home ownership. A significant cross-level interaction emerged: those who reported crossing the border and reported higher levels of collective efficacy were more likely to be obese than those who had not crossed. Study findings provide evidence of the complex relationship among obesity risk factors in a U.S.-Mexico border community that warrant further examination to prevent and control obesity.

  6. Reformulation of controlled-release oxycodone and pharmacy dispensing patterns near the US-Canada border.

    PubMed

    Gomes, Tara; Paterson, J Michael; Juurlink, David N; Dhalla, Irfan A; Mamdani, Muhammad M

    2012-01-01

    In August 2010, a tamper-resistant formulation of controlled-release oxycodone (OxyContin-OP) was introduced in the United States but not in Canada. Our objective was to determine whether introduction of OxyContin-OP in the United States influenced prescription volumes for the original controlled-release oxycodone formulation (OxyContin) at Canadian pharmacies near the international border. We conducted a population-based, serial, cross-sectional study of prescriptions dispensed from pharmacies in the 3 cities with the highest volume of US-Canada border crossings in Ontario: Niagara Falls, Windsor and Sarnia. We analyzed data on all outpatient prescriptions for OxyContin dispensed by Canadian pharmacies near each border crossing between 2010 Apr. 1 and 2012 Feb. 29. We calculated and compared monthly prescription rates, adjusted per 1000 population and stratified by tablet strength. The number of tablets dispensed near 4 border crossings in the 3 Canadian cities remained stable over the study period. However, the rate of dispensing at pharmacies near the Detroit-Windsor Tunnel increased roughly 4-fold between August 2010 and February 2011, from 505 to 1969 tablets per 1000 population. By April 2011, following warnings to prescribers and pharmacies regarding drug-seeking behaviour, the dispensing rate declined to 1683 tablets per 1000 population in this area. By November 2011, the rate had returned to levels observed in early 2010. Our analyses suggest that 242 075 excess OxyContin tablets were dispensed near the Detroit-Windsor Tunnel between August 2010 and October 2011. Prescribing of the original formulation of controlled-release oxycodone rose substantially near a major international border crossing following the introduction of a tamper-resistant formulation in the United States. It is possible that the restriction of this finding to the area surrounding the Detroit-Windsor Tunnel reflects specific characteristics of this border crossing, including its high traffic volume, direct access to the downtown core and drug-trafficking patterns in the Detroit area. Our findings highlight the potential impact of cross-border differences in medication availability on drug-seeking behaviour.

  7. Development of statistical models to forecast crossing times of commercial vehicles.

    DOT National Transportation Integrated Search

    2011-07-01

    Border crossing time measurement systems for commercial vehicles are being implemented throughout : the U.S.-Mexico border. These systems are based on radio frequency identification (RFID) technology. : With funding from the Federal Highway Administr...

  8. Study on the Flexibility in Cross-Border Water Resources Cooperation Governance

    NASA Astrophysics Data System (ADS)

    Liu, Zongrui; Wang, Teng; Zhou, Li

    2018-02-01

    Flexible strategy is very important to cross-border cooperation in international rivers water resources, which may be employed to reconcile contradictions and ease conflicts. Flexible characters of cross-border cooperation in international rivers water resources could be analyzed and revealed, using flexible strategic management framework, by taking international cooperation protocols related to water from Transboundary Freshwater Disputes Database (TFDD) as samples from the number of cooperation issues, the amount of management layers and regulator agencies in cooperation organization and the categories of income (cost) distribution (allocation) mode. The research demonstrates that there are some flexible features of cross-border cooperation in international rivers water resources: Riparian countries would select relative diversification strategies related to water, tend to construct a flexible cooperation organization featured with moderate hierarchies from vertical perspective and simplified administrations from horizontal perspective, and adopt selective inducement modes to respect ‘joint and several liability’.

  9. 8 CFR 212.6 - Border crossing identification cards.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... or pleasure without a visa and passport, must apply to the DOS on Form DS-156, Visitor Visa... border crossing card (or similar stamp in a passport). (i) A Canadian citizen or other person sharing... crossing card (or similar stamp in a passport) issued by the DOS prior to April 1, 1998, that does not...

  10. 8 CFR 212.6 - Border crossing identification cards.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... or pleasure without a visa and passport, must apply to the DOS on Form DS-156, Visitor Visa... border crossing card (or similar stamp in a passport). (i) A Canadian citizen or other person sharing... crossing card (or similar stamp in a passport) issued by the DOS prior to April 1, 1998, that does not...

  11. 8 CFR 212.6 - Border crossing identification cards.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... or pleasure without a visa and passport, must apply to the DOS on Form DS-156, Visitor Visa... border crossing card (or similar stamp in a passport). (i) A Canadian citizen or other person sharing... crossing card (or similar stamp in a passport) issued by the DOS prior to April 1, 1998, that does not...

  12. 8 CFR 212.6 - Border crossing identification cards.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... or pleasure without a visa and passport, must apply to the DOS on Form DS-156, Visitor Visa... border crossing card (or similar stamp in a passport). (i) A Canadian citizen or other person sharing... crossing card (or similar stamp in a passport) issued by the DOS prior to April 1, 1998, that does not...

  13. 8 CFR 212.6 - Border crossing identification cards.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... or pleasure without a visa and passport, must apply to the DOS on Form DS-156, Visitor Visa... border crossing card (or similar stamp in a passport). (i) A Canadian citizen or other person sharing... crossing card (or similar stamp in a passport) issued by the DOS prior to April 1, 1998, that does not...

  14. Border Crossings: Engaging Students in Diversity Work and Intergroup Relations

    ERIC Educational Resources Information Center

    Rose, Susan D.; Bylander, Joyce

    2007-01-01

    As an innovative model for diversity education, Dickinson College designed the "Crossing Borders" program to encourage culturally diverse students to live, work, and study together in multiple contexts both within the United States and abroad. Envisioning a series of crossings, the program brings together up to 20 students from Dickinson…

  15. Professional Development for Cross-Border Managers: New Growth Opportunities for Executive Education

    ERIC Educational Resources Information Center

    Scalberg, Ernest J.

    2013-01-01

    The need of business enterprises for professionals trained for the challenges of cross-border assignments will increase exponentially through the decade. Business schools will be hard pressed to deliver programs with the scope, scale, and effectiveness necessary to address the unique competencies required for cross-cultural understanding and…

  16. Quality of life, anxiety and depression of German, Italian and French couples undergoing cross-border oocyte donation in Spain.

    PubMed

    Madero, S; Gameiro, S; García, D; Cirera, D; Vassena, R; Rodríguez, A

    2017-09-01

    What is the quality of life (QoL) and mental health of infertile heterosexual couples from different nations (Italy, Germany and France) undergoing cross-border oocyte donation (OD) in Spain? Women have lower QoL and more anxiety than their male partners; overall French couples have lower QoL than their Italian and German counterparts. In Europe, thousands of couples move across national borders annually to seek ARTs, primarily OD, driven mainly by legal restrictions in their countries of origin. Most research shows that infertility and ARTs affect patients' mental health and QoL. The decision to undergo reproductive care abroad might add further emotional and practical complexity. Reliable information on how this experience affects the mental health and QoL of cross-border reproductive care (CBRC) patients is lacking. Moreover, most research has focused on women, and further research on male partners and intercultural differences is needed. Cross-sectional study including 548 heterosexual individuals (347 women, 201 men) from Italy, Germany and France seeking IVF with donated oocytes in Barcelona, Spain between March and November 2013. A total of 432 couples were invited to participate and handed a questionnaire set. Questionnaires were answered separately and anonymously by each member of the couple on the day of embryo transfer. The questionnaire set included the Fertility Quality of Life (FertiQoL) instrument, the generic Hospital Anxiety and Depression Scale (HADS) instrument and three close-ended questions assessing perceived usefulness, desire, and use of psychological support. The overall response rate was 63.4%. Men reported significantly higher scores than women in the emotional (+13.74; P < 0.001), mind-body (+13.39; P < 0.001) and social (+4.11; P < 0.01) FertiQoL domains, at multilevel analysis controlled for confounder factors. Intercultural differences in QoL of couples were seen. French individuals had significantly lower emotional (-6.44; P < 0.01), mind-body (-7.41; P < 0.001) and relational scores (-6.41; P < 0.001) compared to Italians. Germans showed higher social scores (+6.41; P < 0.001) but lower relational scores (-8.94; P < 0.002) than Italians. Men reported significantly lower anxiety scores for the HADS than their partners (-1.38; P < 0.001), and German couples reported lower anxiety (-1.70; P = 0.003) and depression than their Italian counterparts (-1.56; P < 0.001). French patients were more likely to have required support by a mental health professional due to fertility problems in the past (+0.19; P < 0.001). The scope of this study is limited to heterosexual couples undergoing cross-border OD. Caution on the interpretation of the results in men is advised, mainly because only three men for every five women completed the questionnaire. These findings call for further work to identify the true nature of the differences in QoL and mental health observed. None. © The Author 2017. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com

  17. Identifying Complex Cultural Interactions in the Instructional Design Process: A Case Study of a Cross-Border, Cross-Sector Training for Innovation Program

    ERIC Educational Resources Information Center

    Russell, L. Roxanne; Kinuthia, Wanjira L.; Lokey-Vega, Anissa; Tsang-Kosma, Winnie; Madathany, Reeny

    2013-01-01

    The purpose of this research is to identify complex cultural dynamics in the instructional design process of a cross-sector, cross-border training environment by applying Young's (2009) Culture-Based Model (CBM) as a theoretical framework and taxonomy for description of the instructional design process under the conditions of one case. This…

  18. DOE Office of Scientific and Technical Information (OSTI.GOV)

    Medeiros, Eduardo, E-mail: emedeiros@campus.ul.pt

    The use of territorial impact assessment procedures is gaining increasing relevance in the European Union policy evaluation processes. However, no concrete territorial impact assessment tools have been applied to evaluating EU cross-border programmes. In this light, this article provides a pioneering analysis on how to make use of territorial impact assessment procedures on cross-border programmes. More specifically, it assesses the main territorial impacts of the Inner Scandinavian INTERREG-A sub-programme, in the last 20 years (1996–2016). It focuses on its impacts on reducing the barrier effect, in all its main dimensions, posed by the presence of the administrative border. The resultsmore » indicate a quite positive impact of the analysed cross-border cooperation programme, in reducing the barrier effect in all its main dimensions. The obtained potential impact values for each analysed dimension indicate, however, that the ‘economy-technology’ dimension was particularly favoured, following its strategic intervention focus in stimulating the economic activity and the attractiveness of the border area. - Highlights: • A territorial impact assessment method to assess cross-border cooperation is proposed. • This method rationale is based on the main dimensions of the barrier effect. • This method identified positive impacts in all analysed dimensions. • The economy-technological dimension was the most positively impacted one.« less

  19. Measuring and documenting truck activity times at international border crossings.

    DOT National Transportation Integrated Search

    2014-04-01

    Documenting the times trucks incur when crossing an international border facility is : valuable both to the private freight industry and to gateway facility operators and planners. : Members of the project team previously developed and implemented an...

  20. The U.S.-Mexico Border Infectious Disease Surveillance Project: Establishing Binational Border Surveillance

    PubMed Central

    Waterman, Stephen; Lucas, Carlos Alvarez; Falcon, Veronica Carrion; Morales, Pablo Kuri; Lopez, Luis Anaya; Peter, Chris; Gutiérrez, Alejandro Escobar; Gonzalez, Ernesto Ramirez; Flisser, Ana; Bryan, Ralph; Valle, Enrique Navarro; Rodriguez, Alfonso; Hernandez, Gerardo Alvarez; Rosales, Cecilia; Ortiz, Javier Arias; Landen, Michael; Vilchis, Hugo; Rawlings, Julie; Leal, Francisco Lopez; Ortega, Luis; Flagg, Elaine; Conyer, Roberto Tapia; Cetron, Martin

    2003-01-01

    In 1997, the Centers for Disease Control and Prevention, the Mexican Secretariat of Health, and border health officials began the development of the Border Infectious Disease Surveillance (BIDS) project, a surveillance system for infectious diseases along the U.S.-Mexico border. During a 3-year period, a binational team implemented an active, sentinel surveillance system for hepatitis and febrile exanthems at 13 clinical sites. The network developed surveillance protocols, trained nine surveillance coordinators, established serologic testing at four Mexican border laboratories, and created agreements for data sharing and notification of selected diseases and outbreaks. BIDS facilitated investigations of dengue fever in Texas-Tamaulipas and measles in California–Baja California. BIDS demonstrates that a binational effort with local, state, and federal participation can create a regional surveillance system that crosses an international border. Reducing administrative, infrastructure, and political barriers to cross-border public health collaboration will enhance the effectiveness of disease prevention projects such as BIDS. PMID:12533288

  1. Language and use of cancer screening services among border and non-border Hispanic Texas women.

    PubMed

    Fernández, Leticia E; Morales, Alfonso

    2007-06-01

    Compared to other groups, Mexican American women screen less frequently for cervical and breast cancer. The most significant barriers reported by previous researchers include not having a usual source of care, lacking health insurance and English-language difficulties. In this paper we document and examine the factors associated with disparities in cancer screening between border and non-border residents by language of interview (Spanish or English) among Texas Hispanic women. We hypothesize that, controlling for socioeconomic and demographic characteristics, border residents are more likely to utilize screening services than non-border residents because of the greater presence of bilingual services in border counties. We follow the framework of the Behavioral Model for Vulnerable Populations proposed by Gelberg et al. (Health Services Research, vol. 34, no. 6, pp. 1273-1302, 2000). This model conceptualizes use of health care as an outcome of the interplay of predisposing, enabling and need factors and recognizes that vulnerable groups face additional barriers to health care utilization. Data come from the 2000, 2002 and 2004 Texas Behavioral Risk Factor Surveillance surveys. Group differences in cancer screenings are explained largely by socioeconomic characteristics and structural barriers to access. The significance of language of interview and of border residence disappear after controlling for factors such as health insurance, income and a usual source of care. Women who selected to be interviewed in Spanish were less likely to report age-appropriate cancer examinations, health insurance and a regular health care provider than those who selected to be interviewed in English. Disparities in cancer screenings among vulnerable Hispanic populations could be reduced by promoting the establishment of a regular health care provider.

  2. Palliating inside the lines: The effects of borders and boundaries on palliative care in rural Canada.

    PubMed

    Giesbrecht, Melissa; Crooks, Valorie A; Castleden, Heather; Schuurman, Nadine; Skinner, Mark; Williams, Allison

    2016-11-01

    We draw lines to divide our world into specific places, territories, and categories. Although borders and boundaries are dynamic and socially constructed, their existence creates many broad impacts on our lives by geographically distinguishing between groups (e.g., us/them; here/there; inside/outside) at various scales from the national down to the personal spaces of the individual. Particularly, borders and boundaries can be used to define a variety of differing spaces such as the familial, social, economic, political, as well as issues of access - including access to health services. Despite the implicit connection between borders, boundaries, and health, little research has investigated this connection from a health geography perspective. As such, this secondary thematic analysis contributes to addressing this notable gap by examining how borders and boundaries are experienced and perceived to impact access to palliative care in rural Canada from the perspectives of the formal and informal providers of such care. Drawing upon data from qualitative interviews (n = 40) with formal and informal palliative caregivers residing in four different rural Canadian communities, five forms of borders and boundaries were found to directly impact care delivery/receipt: political; jurisdictional; geographical; professional; and cultural. Implicitly and explicitly, participants discussed these borders and boundaries while sharing their experiences of providing palliative care in rural Canada. We conclude by discussing the implications of our findings for palliative care in rural Canada, while also emphasizing the need for more health geography, and related social science, researchers to recognize the significance of borders and boundaries in relation to health and healthcare delivery. Lastly, we emphasize the transferability of these findings to other health sectors, geographical settings, and disciplines. Copyright © 2016 Elsevier Ltd. All rights reserved.

  3. Pedagogical Border Crossings: "Testimonio y Reflexiones de una Mexicana Académica"

    ERIC Educational Resources Information Center

    Flores Carmona, Judith

    2018-01-01

    I am an assistant professor at New Mexico State University; however, the path to getting to this position has been about crossing borders, about learning in and from the borderlands. The borderlands that my body has had to cross, physically and figuratively, have left many "heridas abiertas" (open wounds) but have also provided me with…

  4. Cross-Border Higher Education in China: How the Field of Research Has Developed

    ERIC Educational Resources Information Center

    Qin, Yunyun; Te, Alice Y. C.

    2016-01-01

    The aim of the research was to investigate how the field of cross-border Chinese higher education has developed from 1990 to 2015. Ninety-five articles in international journals and 470 articles in national journals were collected and analyzed in terms of authorship pattern, thematic clusters, and research methods. Results show that cross-border…

  5. Diagnostic performance of CareStart™ malaria HRP2/pLDH (Pf/pan) combo test versus standard microscopy on falciparum and vivax malaria between China-Myanmar endemic borders

    PubMed Central

    2013-01-01

    Background Rapid diagnostic test (RDT) is becoming an alternative way of establishing quickly the diagnosis of malaria infections, by detecting specific malaria antigens in suspected patients’ blood between the China-Myanmar endemic borders areas, towards achieving the National Malaria Elimination programme by 2020. The objective of this study is to evaluate the performance of CareStart™ Malaria Pf/Pan RDT kit for the diagnosis of malaria infections in suspected patients. Blood examination by microscopy was taken as gold standard to evaluate CareStart™ kit’s sensitivity, specificity and predictive value and corrected with PCR assay. Results Overall 126 of 241 (52.28%) malaria cases were detected by microscopy compared to 115 of 241(47.72%) CareStart™ kit and 128 of 241 (53.11%) PCR corrected assay. CareStart™ kit’s sensitivity and specificity for the diagnosis of malaria were 89.68% and 98.26% respectively, compared to standard microscopy, whereas the sensitivity and specificity for falciparum malaria were 88.52% and 98.26%, and for vivax malaria: 90.77% and 100%. The CareStart™ positive predictive values were 98.26% (93.88-99.52%, 95% CI) compared to 100% (96.77-100%, 95% CI) for PCR-corrected, and the negative predictive values of 89.68% (83.15-93.87%, 95% CI) were the same in microscopy as PCR-corrected. The diagnostic accuracy of CareStart™ kit versus microscopy and PCR were 93.78% (89.99-96.19%, 95% CI) and 94.61% (90.99-96.82%, 95% CI) respectively. The likelihood of diagnostic of malaria positive was almost similar between microscopy and CareStart™ kit, with an entropy reduction of 60.0% compared to a weak likelihood of misdiagnosis of 0.10 (0.09-0.12, 95% CI), with an entropy reduction of 36.01%. Conclusion The accuracy of CareStart™ kit is comparable to gold standard microscopy in these areas, it is easy to perform and suitable for cross-border diagnosis and monitoring of local or imported malaria patterns by any local health staff in endemic remotes. PMID:23294729

  6. Diagnostic performance of CareStart™ malaria HRP2/pLDH (Pf/pan) combo test versus standard microscopy on falciparum and vivax malaria between China-Myanmar endemic borders.

    PubMed

    Xiaodong, Sun; Tambo, Ernest; Chun, Wei; Zhibin, Cheng; Yan, Deng; Jian, Wang; Jiazhi, Wang; Xiaonong, Zhou

    2013-01-07

    Rapid diagnostic test (RDT) is becoming an alternative way of establishing quickly the diagnosis of malaria infections, by detecting specific malaria antigens in suspected patients' blood between the China-Myanmar endemic borders areas, towards achieving the National Malaria Elimination programme by 2020. The objective of this study is to evaluate the performance of CareStart™ Malaria Pf/Pan RDT kit for the diagnosis of malaria infections in suspected patients. Blood examination by microscopy was taken as gold standard to evaluate CareStart™ kit's sensitivity, specificity and predictive value and corrected with PCR assay. Overall 126 of 241 (52.28%) malaria cases were detected by microscopy compared to 115 of 241(47.72%) CareStart™ kit and 128 of 241 (53.11%) PCR corrected assay. CareStart™ kit's sensitivity and specificity for the diagnosis of malaria were 89.68% and 98.26% respectively, compared to standard microscopy, whereas the sensitivity and specificity for falciparum malaria were 88.52% and 98.26%, and for vivax malaria: 90.77% and 100%. The CareStart™ positive predictive values were 98.26% (93.88-99.52%, 95% CI) compared to 100% (96.77-100%, 95% CI) for PCR-corrected, and the negative predictive values of 89.68% (83.15-93.87%, 95% CI) were the same in microscopy as PCR-corrected. The diagnostic accuracy of CareStart™ kit versus microscopy and PCR were 93.78% (89.99-96.19%, 95% CI) and 94.61% (90.99-96.82%, 95% CI) respectively. The likelihood of diagnostic of malaria positive was almost similar between microscopy and CareStart™ kit, with an entropy reduction of 60.0% compared to a weak likelihood of misdiagnosis of 0.10 (0.09-0.12, 95% CI), with an entropy reduction of 36.01%. The accuracy of CareStart™ kit is comparable to gold standard microscopy in these areas, it is easy to perform and suitable for cross-border diagnosis and monitoring of local or imported malaria patterns by any local health staff in endemic remotes.

  7. Establishing Trafficking in Human Beings for the Purpose of Organ Removal and Improving Cross-Border Collaboration in Criminal Cases: Recommendations

    PubMed Central

    Holmes, Paul; Rijken, Conny; D'Orsi, Sergio; Esser, Luuk; Hol, Floor; Gallagher, Anne; Greenberg, Galit; Helberg, Louis; Horvatits, Lisa; McCarthy, Sean; Ratel, Jonathan; Scheper-Hughes, Nancy; Forsythe, John

    2016-01-01

    Abstract In this short summary report on the legal definition of trafficking in human beings for the purpose of organ removal and improving cross-border collaboration in criminal cases, challenges, and recommendations in the areas of defining the crime, criminal investigation and prosecution, and cross-border cooperation are made. These are the outcomes of a working group discussion during the writers' conference of the HOTT project, a European Union-funded project against trafficking in human beings for the purpose of organ removal. PMID:27500251

  8. Quantifying the negative impact of brain drain on the integration of European science

    PubMed Central

    Doria Arrieta, Omar A.; Pammolli, Fabio; Petersen, Alexander M.

    2017-01-01

    The 2004/2007 European Union (EU) enlargement by 12 member states offers a unique opportunity to quantify the impact of EU efforts to expand and integrate the scientific competitiveness of the European Research Area (ERA). We apply two causal estimation schemes to cross-border collaboration data extracted from millions of academic publications from 1996 to 2012, which are disaggregated across 14 subject areas and 32 European countries. Our results illustrate the unintended consequences following the 2004/2007 enlargement, namely, its negative impact on cross-border collaboration in science. First, we use the synthetic control method to show that levels of European cross-border collaboration would have been higher without EU enlargement, despite the 2004/2007 EU entrants gaining access to EU resources incentivizing cross-border integration. Second, we implement a difference-in-difference panel regression, incorporating official intra-European high-skilled mobility statistics, to identify migration imbalance—principally from entrant to incumbent EU member states—as a major factor underlying the divergence in cross-border integration between Western and Eastern Europe. These results challenge central tenets underlying ERA integration policies that unifying labor markets will increase the international competitiveness of the ERA, thereby calling attention to the need for effective home-return incentives and policies. PMID:28439544

  9. Analysing arrangements for cross-border mobility of patients in the European Union: a proposal for a framework.

    PubMed

    Legido-Quigley, Helena; Glinos, Irene A; Baeten, Rita; McKee, Martin; Busse, Reinhard

    2012-11-01

    This paper proposes a framework for analyzing arrangements set up to facilitate cross-border mobility of patients in the European Union. Exploiting both conceptual analysis and data from a range of case studies carried out in a number of European projects, and building on Walt and Gilson's model of policy analysis, the framework consists of five major components, each with a subset of categories or issues: (1) The actors directly and indirectly involved in setting up and promoting arrangements, (2) the content of the arrangements, classified into four categories (e.g. purchaser-provider and provider-provider or joint cross-border providers), (3) the institutional framework of the arrangements (including the underlying European and national legal frameworks, health systems' characteristics and payment mechanisms), (4) the processes that have led to the initiation and continuation, or cessation, of arrangements, (5) contextual factors (e.g. political or cultural) that impact on cross-border patient mobility and thus arrangements to facilitate them. The framework responds to what is a clearly identifiable demand for a means to analyse these interrelated concepts and dimensions. We believe that it will be useful to researchers studying cross-border collaborations and policy makers engaging in them. Crown Copyright © 2012. Published by Elsevier Ireland Ltd. All rights reserved.

  10. Quantifying the negative impact of brain drain on the integration of European science.

    PubMed

    Doria Arrieta, Omar A; Pammolli, Fabio; Petersen, Alexander M

    2017-04-01

    The 2004/2007 European Union (EU) enlargement by 12 member states offers a unique opportunity to quantify the impact of EU efforts to expand and integrate the scientific competitiveness of the European Research Area (ERA). We apply two causal estimation schemes to cross-border collaboration data extracted from millions of academic publications from 1996 to 2012, which are disaggregated across 14 subject areas and 32 European countries. Our results illustrate the unintended consequences following the 2004/2007 enlargement, namely, its negative impact on cross-border collaboration in science. First, we use the synthetic control method to show that levels of European cross-border collaboration would have been higher without EU enlargement, despite the 2004/2007 EU entrants gaining access to EU resources incentivizing cross-border integration. Second, we implement a difference-in-difference panel regression, incorporating official intra-European high-skilled mobility statistics, to identify migration imbalance-principally from entrant to incumbent EU member states-as a major factor underlying the divergence in cross-border integration between Western and Eastern Europe. These results challenge central tenets underlying ERA integration policies that unifying labor markets will increase the international competitiveness of the ERA, thereby calling attention to the need for effective home-return incentives and policies.

  11. Cultural border crossing in three urban classrooms: A mixed methods study

    NASA Astrophysics Data System (ADS)

    Roopnarine, Rupnarain

    This study examined the effects of the instruction of four youth cultural border crossing behaviors: flexibility, being at ease, playfulness, and citizenship as an intervention aimed at helping students to transition across three borders, student to student, student to science, and student to teacher. The research involved 12 ninth- and 10th-grade students in a large urban school district in three diverse classrooms, A, B, and C. Four students in each classroom volunteered for the study. The students in Groups A and B were in 9th grade Living Environment and students in Group B were in 10th grade chemistry. These students participated in this instructional intervention for three months. The study was conducted using both quantitative and qualitative methods based on participant observations, interviews, and questionnaire. The result indicated that there was no significant effect of the cultural border crossing instructions on the students' interactions across the three borders examined. However, the instructions helped Group A and Group B to be more flexible but not group C. Also, the instructions helped Group A to be more playful and at ease but not Group B and C. The instructions also helped Group A to show more citizenship but not Group B and C. In addition, there was no difference between the pretest and posttest cultural bother crossing behavior. Moreover, qualitative data analysis showed that the participants were more flexible, at ease, and playful among peers than across student to teacher and student to science borders. Also, the use of citizenship in the three groups showed no effect on the participants' interaction with peers. Although, the findings showed no effect of cultural border crossing instructions on students' interactions, it is suggested that we continue to find ways to help students feel more comfortable in science.

  12. Motivations and experiences of patients seeking cross-border reproductive care: the Australian and New Zealand context.

    PubMed

    Rodino, Iolanda S; Goedeke, Sonja; Nowoweiski, Sarah

    2014-11-01

    To explore the motivations, clinical care, counseling, and support experiences of Australian and New Zealand participants considering or having participated in cross-border reproductive care (CBRC). Questionnaire-based study. Not applicable. One hundred thirty-seven Australian and New Zealand participants aged 23-53 years. None. Quantitative and qualitative responses to an anonymously completed online questionnaire. Quantitative responses from participants indicated that motivations for engaging in CBRC included limited availability of gamete donors in their home state, difficulty in meeting treatment eligibility criteria, and treatment being legally prohibited. Experiences of CBRC were generally rated positively in terms of medical needs (91.2%), safety (89.4%), and costs (85.7%), although rated more conservatively to emotional needs being met (57.9%). Less than half the sample (47.5%) had accessed some form of CBRC-related counseling. Themes identified in qualitative analysis reflected gamete supply and demand issues, the importance of donor information and disclosure, the personal impact of legislation, and ongoing support needs after CBRC treatment. A greater percentage of participants agreed that their CBRC clinic satisfied their overall medical needs and treatment expectations in comparison with overall emotional needs. Participants indicated access to post-treatment support counseling particularly with regard to their emotional well-being and disclosure issues to donor-conceived children would be useful. The implications of our findings for the provision of best-practice psychosocial counseling support and development of counseling guidelines are highlighted. Copyright © 2014 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  13. Traffic pollutant exposures experienced by pedestrians waiting to enter the U.S. at a major U.S.-Mexico border crossing

    NASA Astrophysics Data System (ADS)

    Galaviz, V. E.; Yost, M. G.; Simpson, C. D.; Camp, J. E.; Paulsen, M. H.; Elder, J. P.; Hoffman, L.; Flores, D.; Quintana, P. J. E.

    2014-05-01

    Pedestrians waiting to cross into the US from Mexico at Ports of Entry experience long wait times near idling vehicles. The near-road environment is associated with elevated pollutant levels and adverse health outcomes. This is the first exposure assessment conducted to quantify northbound pedestrian commuter exposure to traffic-related air pollutants at the U.S.-Mexico border San Ysidro Port of Entry (SYPOE). Seventy-three persons who regularly crossed the SYPOE in the pedestrian line and 18 persons who did not cross were recruited to wear personal air monitors for 24-h to measure traffic pollutants particulate matter less than 2.5 μm (PM2.5), 1-nitropyrene (1-NP) - a marker for diesel exhaust - and carbon monoxide (CO). Fixed site concentrations were collected at SYPOE and occurred during the time subjects were crossing northbound to approximate their exposure to 1-NP, ultrafine particles (UFP), PM2.5, CO, and black carbon (BC) while standing in line during their border wait. Subjects who crossed the border in pedestrian lanes had a 6-fold increase in exposure to 1-NP, a 3-fold increase in exposure to CO, and a 2-fold increase in exposure to gravimetric PM2.5, vs. non-border commuters. Univariate regression analysis for UFP (median 40,000 # cm-3) found that border wait time for vehicles explained 21% of variability and relative humidity 13%, but when modeled together neither predictor remained significant. Concentrations at the SYPOE of UFP, PM2.5, CO, and BC are similar to those in other near-roadway studies that show associations with acute and chronic adverse health effects. Although results are limited by small sample numbers, these findings warrant concern for adverse health effects experienced by pedestrian commuters waiting in a long northbound queue at SYPOE and demonstrates a potential health benefit of reduced wait times at the border.

  14. UNIVERSITY OF ARIZONA CROSS-BORDER WATER TECHNOLOGY COLLABORATION

    EPA Science Inventory

    The outcome of Phase I of the University of Arizona Cross-border Water Technology Collaboration project was the development and testing of solar distillation designs and selection of the final design for implementation that could be built in a developing country...

  15. Strategic assessment of the Highway Performance Monitoring System

    DOT National Transportation Integrated Search

    1995-02-01

    The appendix contains a series of border crossing profiles covering the major, and in some cases, minor crossings in the border frontier. The frontier itself is a definition created for the 6015 Study to aid in the analysis of trade and traffic flows...

  16. The United Nations recommendations and data efforts: international migration statistics.

    PubMed

    Simmons, A B

    1987-01-01

    This article reviews the UN's efforts to improve international migration statistics. The review addresses the challenges faced by the UN, the direction in which this effort is going, gaps in the current approach, and priorities for future action. The content of the UN recommendations has changed in the past and seems to be moving toward further changes. At each stage, the direction of change corresponds broadly to earlier shifts in the overall context of world social-economic affairs and related transformations in international travel and migration patterns. Early (1953) objectives were vaguely stated in terms of social, economic, and demographic impacts of long term settlement. 1976 recommendations continued the focus on long term resettlement and, at the same time, gave more attention to at least 1 kind of short term (work-related) movement. Most recent recommendations have given more attention to other classes of short term travellers, such as refugees and contract workers. Recommendations on the measures and data sources have changed over time, also. The 1953 recommendations were limited to flow data from international border statistics. 1976 recommendations drew attention to stock data and the use of civil registration data to supplement border crossing data. Recent UN reflections recognize that the volume of border crossings has now reached the point where many countries simply refuse to gather data on all travellers, choosing instead to make estimates. It is implied that either sample surveys at border points and/or visas and entry permits may be the best way of counting various specific kinds of migrants. Future recommendations corresponding to contemporary and emerging concerns will require that the guidelines be restructured: 1) to give more explicit attention in international migration statistics to citizenship and access to political and welfare benefits; 2) to distinguish more carefully various sub-classes of movers; 3) to expand objectives of data collection to include an assessment of social impacts to complement the current focus on demographic and economic impacts; 4) and to give more careful attention to ways of estimating undocumented migrants and workers within large streams of other travellers.

  17. Quantifying cross-border movements and migrations for guiding the strategic planning of malaria control and elimination

    PubMed Central

    2014-01-01

    Background Identifying human and malaria parasite movements is important for control planning across all transmission intensities. Imported infections can reintroduce infections into areas previously free of infection, maintain ‘hotspots’ of transmission and import drug resistant strains, challenging national control programmes at a variety of temporal and spatial scales. Recent analyses based on mobile phone usage data have provided valuable insights into population and likely parasite movements within countries, but these data are restricted to sub-national analyses, leaving important cross-border movements neglected. Methods National census data were used to analyse and model cross-border migration and movement, using East Africa as an example. ‘Hotspots’ of origin-specific immigrants from neighbouring countries were identified for Kenya, Tanzania and Uganda. Populations of origin-specific migrants were compared to distance from origin country borders and population size at destination, and regression models were developed to quantify and compare differences in migration patterns. Migration data were then combined with existing spatially-referenced malaria data to compare the relative propensity for cross-border malaria movement in the region. Results The spatial patterns and processes for immigration were different between each origin and destination country pair. Hotspots of immigration, for example, were concentrated close to origin country borders for most immigrants to Tanzania, but for Kenya, a similar pattern was only seen for Tanzanian and Ugandan immigrants. Regression model fits also differed between specific migrant groups, with some migration patterns more dependent on population size at destination and distance travelled than others. With these differences between immigration patterns and processes, and heterogeneous transmission risk in East Africa and the surrounding region, propensities to import malaria infections also likely show substantial variations. Conclusion This was a first attempt to quantify and model cross-border movements relevant to malaria transmission and control. With national census available worldwide, this approach can be translated to construct a cross-border human and malaria movement evidence base for other malaria endemic countries. The outcomes of this study will feed into wider efforts to quantify and model human and malaria movements in endemic regions to facilitate improved intervention planning, resource allocation and collaborative policy decisions. PMID:24886389

  18. Operation safe crossing: using science within a community intervention.

    PubMed

    Voas, Robert B; Tippetts, A Scott; Johnson, Mark B; Lange, James E; Baker, James

    2002-09-01

    To evaluate a large drunk-driving enforcement program at the US/Mexican border to reduce the number of youths crossing the border to drink in Tijuana. This paper also describes the research data used to develop and manage the program. Data from a border breath-test survey were used to dramatize the problem and gain public support for action. The data were also used to help design the enforcement effort and measure progress in reducing the cross-border drinking problem. The number of news events generated around the occurrence of special enforcement efforts were used to measure project activity and to predict changes in the numbers of youths crossing into Mexico, their returning BACs and reductions in alcohol-related crashes during a 3-year period. An urban county on the Mexican border. Underage youths aged 18-20 years and young adults aged 21-30 years residing in San Diego County. Immigration and Naturalization Services provided population counts of the number of individuals crossing each weekend night from Tijuana into the United States through the San Ysidro border facility. Breath-test surveys of a random sample of these returning crossers provided data on the number of US residents visiting bars and nightclubs in Tijuana and on alcohol consumption at Tijuana bars and nightclubs. Night-time had-been-drinking crash data involving young drivers in several California counties served as an outcome measure of public health and safety. Analysis of data involving more than 2 million pedestrians returning from Tijuana indicated that the Operation Safe Crossing program reduced the number of late-night crossers by 31.6%. Effective use of data through media advocacy programs to support an enforcement effort can reduce alcohol-related crashes.

  19. Ofrendas/BorderCrossings: A Studio-Based Model for Cross Cultural Traveling.

    ERIC Educational Resources Information Center

    Congdon, Kristin G.

    While creating an art form which is foreign to an artist's cultural expression may seem like taking a risk in today's world, it may provide a way to successfully negotiate a fulfilling living and working space on this diverse planet. Movement into a foreign space, often referred to as a border crossing, can be understood as a central meeting…

  20. 77 FR 76346 - Opening of Boquillas Border Crossing and Update to the Class B Port of Entry Description

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-28

    ... southern border in recent years, drug cartels will view the crossing as a ``back-door'' to the United..., criminals, drugs, or other contraband out of the country. On the other hand, a few commenters noted that CBP... the village of Boquillas used the crossing to trade goods, buy food, and visit relatives. One...

  1. Evaluation of health literacy among Spanish-speaking primary care patients along the US--Mexico border.

    PubMed

    Penaranda, Eribeth; Diaz, Marco; Noriega, Oscar; Shokar, Navkiran

    2012-07-01

    Health literacy (HL) is a measure of the communication skills that are needed by an individual to effectively navigate the healthcare system. Hispanic adults have lower average levels of HL than any other racial/ethnic group; however, the prevalence of adequate HL among Hispanics along the US-Mexico border is unknown. We performed a cross-sectional survey of 200 adult primary care patients who attended four low-income community clinics along the US-Mexico border. Patients were included in the study if they were self-described Hispanics whose first language was Spanish or bilingual patients who reported that they were primarily Spanish speakers. Adequate HL was defined as having a score of ≥38 on the Short Assessment of Health Literacy for Spanish Adults-50. Three patients (1.5%) had inadequate HL. Because of the high proportion of patients having adequate HL, we found no statistical differences between patients with adequate HL versus inadequate HL by age, sex, educational attainment, health coverage, or self-reported health status; however, all three patients with inadequate HL were found to be 60 years old or older and had less than a high school education. The results of HL assessment varied according to the tool and setting used in measuring Spanish-speaking Hispanics. In certain clinical scenarios, current tools may underestimate the actual prevalence of adequate HL. Further development and assessment of HL tools appropriate for Spanish-speaking Hispanics is needed as a first step in developing interventions to limit disparities in health care among all Americans.

  2. Patients' rights in a technology and market driven-Europe.

    PubMed

    Abbing, Henriette D C Roscam

    2010-03-01

    This article deals with the impact on patients' rights of medical and technological advances in a market oriented (European) society: what are the advantages and risks, what are the challenges that lay ahead of us? After introducing the subject matter, the first part deals with risks for patients' rights in the European cross border context (health care, direct to the public screening offers and biomedical research). The second part sketches some of the implications of innovation in health care and medical technology for patients' rights to autonomy and private life, particularly when third party interests are involved. The article ends with some suggestions on how best to protect patients' rights in the perspective of innovation in health care and medical research.

  3. Rights of dental patients in the EU - a legal assessment.

    PubMed

    Van den Bossche, Anne-Marie; Ploscar, Paula

    2012-11-30

    This contribution presents the legal framework for intra-European mobility of dental patients. After presenting the EU competences in respect of healthcare and a brief look into the various routes of patient mobility, the article sets out the rules for access to dental care, treatment abroad and reimbursement through social security. In addition, we focus on the impact of European Union (EU) law upon national systems in respect of professional insurance, complaints procedures and information mechanisms. In conclusion, we reflect on the development in EU law of an independent set of rights to cross-border dental care and its consequences for financing and reimbursement of care, as well as for national practices in respect of professional liability and insurance.

  4. Cross border hospital use: analysis using data linkage across four Australian states.

    PubMed

    Spilsbury, Katrina; Rosman, Diana; Alan, Janine; Boyd, James H; Ferrante, Anna M; Semmens, James B

    2015-06-15

    To determine the quality and effectiveness of national data linkage capacity by performing a proof-of-concept project investigating cross-border hospital use and hospital-related deaths. Analysis of person-level linked hospital separation and death registration data of all public and private hospital patients in New South Wales, Queensland and Western Australia and of public hospital patients in South Australia, totalling 7.7 million hospital patients from 1 July 2004 to 30 June 2009. Counts and proportions of hospital stays and patient movement patterns. 223 262 patients (3.0%) travelled across a state border to attend hospitals, in particular, far northern and western NSW patients travelling to Queensland and SA hospitals, respectively. A further 48 575 patients (0.6%) moved their place of residence interstate between hospital visits, particularly to and from areas associated with major mining and tourism industries. Over 11 000 cross-border hospital transfers were also identified. Of patients who travelled across a state border to hospital, 2800 (1.3%) died in that hospital. An additional 496 deaths recorded in one jurisdiction occurred within 30 days of hospital separation from another jurisdiction. Access to person-level data linked across jurisdictions identified geographical hot spots of cross-border hospital use and hospital-related deaths in Australia. This has implications for planning of health service delivery and for longitudinal follow-up studies, particularly those involving mobile populations.

  5. Selected Resources and Bibliography

    ERIC Educational Resources Information Center

    New Directions for Higher Education, 2011

    2011-01-01

    This chapter provides an annotated bibliography of resources pertaining to international branch campuses (IBCs). This collection of references has been selected to represent the breadth of emerging scholarship on cross-border higher education and is intended to provide further resources on a range of concerns surrounding cross-border higher…

  6. The Changing Debate on Internationalisation of Higher Education

    ERIC Educational Resources Information Center

    Teichler, Ulrich

    2004-01-01

    "Internationalisation", the growing border-crossing activities between national systems of higher education is losing ground to "globalisation", increasing border-crossing activities of blurred national systems which is often employed to depict world-wide trends and growing global competition. This article addresses recent issues of knowledge…

  7. Documenting and determining distributions, trends, and relations in truck times at international border crossing facilities.

    DOT National Transportation Integrated Search

    2017-01-20

    Documenting the times trucks incur when crossing an international border facility is valuable both to the private freight industry and to gateway facility operators and planners. : Members of the project team previously developed and implemented an a...

  8. A new paradigm for quarantine and public health activities at land borders: opportunities and challenges.

    PubMed

    Waterman, Stephen H; Escobedo, Miguel; Wilson, Todd; Edelson, Paul J; Bethel, Jeffrey W; Fishbein, Daniel B

    2009-01-01

    The Institute of Medicine (IOM) report Quarantine Stations at Ports of Entry: Protecting the Public's Health focused almost exclusively on U.S. airports and seaports, which served 106 million entries in 2005. IOM concluded that the primary function of these quarantine stations (QSs) should shift from providing inspection to providing strategic national public health leadership. The large expanse of our national borders, large number of crossings, sparse federal resources, and decreased regulation regarding conveyances crossing these borders make land borders more permeable to a variety of threats. To address the health challenges related to land borders, the QSs serving such borders must assume unique roles and partnerships to achieve the strategic leadership and public health research roles envisioned by the IOM. In this article, we examine how the IOM recommendations apply to the QSs that serve the land borders through which more than 319 million travelers, immigrants, and refugees entered the U.S. in 2005.

  9. Acute viral hepatitis in the United States-Mexico border region: data from the Border Infectious Disease Surveillance (BIDS) Project, 2000-2009.

    PubMed

    Spradling, Philip R; Xing, Jian; Phippard, Alba; Fonseca-Ford, Maureen; Montiel, Sonia; Guzmán, Norma Luna; Campuzano, Roberto Vázquez; Vaughan, Gilberto; Xia, Guo-liang; Drobeniuc, Jan; Kamili, Saleem; Cortés-Alcalá, Ricardo; Waterman, Stephen H

    2013-04-01

    Little is known about the characteristics of acute viral hepatitis cases in the United States (US)-Mexico border region. We analyzed characteristics of acute viral hepatitis cases collected from the Border Infectious Disease Surveillance Project from January 2000-December 2009. Over the study period, 1,437 acute hepatitis A, 311 acute hepatitis B, and 362 acute hepatitis C cases were reported from 5 Mexico and 2 US sites. Mexican hepatitis A cases most frequently reported close personal contact with a known case, whereas, US cases most often reported cross-border travel. Injection drug use was common among Mexican and US acute hepatitis B and C cases. Cross-border travel during the incubation period was common among acute viral hepatitis cases in both countries. Assiduous adherence to vaccination and prevention guidelines in the US is needed and strategic implementation of hepatitis vaccination and prevention programs south of the border should be considered.

  10. Intermodal transportation system for asian goods to U.S. via Mexico : an analysis.

    DOT National Transportation Integrated Search

    2010-06-01

    U.S. shares more than 2000 miles of international border with Mexico. In Fig. 1 we present the : major border ports on either side of the U.S. Mexico border and it can be seen that Texas has : more number of border crossing ports than any other state...

  11. Truck activity and wait times at international border crossings : USDOT Region V Regional University Transportation Center final report.

    DOT National Transportation Integrated Search

    2016-11-30

    Documenting the times trucks incur when crossing an international border facility is valuable both to the private freight industry and to gateway facility operators and planners. Members of the project team previously developed and implemented an app...

  12. 78 FR 909 - Further Proposed Guidance Regarding Compliance With Certain Swap Regulations

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-07

    ... establish a new regulatory framework for swaps. The legislation was enacted to reduce systemic risk... increase understanding of each other's regulatory approaches and to harmonize the cross-border approaches... may lead to divergent approaches to cross-border activities. The Commission also recognizes the...

  13. Engaging in cross-border power exchange and trade via the Arab Gulf states power grid

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Fraser, Hamish; Al-Asaad, Hassan K.

    2008-12-15

    When construction is complete in 2010, an interconnector established among the Gulf states will enhance their electricity infrastructure while increasing reliability and security of power supply. The interconnector will also foster exchanges of energy and facilitate cross-border trade. (author)

  14. Shifting Institutional Boundaries through Cross-Border Higher Education

    ERIC Educational Resources Information Center

    Amaral, Alberto; Tavares, Orlanda; Cardoso, Sónia; Sin, Cristina

    2016-01-01

    Cross-border higher education (CBHE) has been changing the organizational boundaries of higher education institutions (HEIs). This study aims to analyze the shifting boundaries of Portuguese HEIs through the lens of the identity concept in organization theories, considering three contexts with different levels of regulation: African…

  15. Seasonal influenza vaccination among Mexican migrants traveling through the Mexico-U.S. border region

    PubMed Central

    Ejebe, Ifna H.; Zhang, Xiao; Rangel, Maria Gudelia; Martinez-Donate, Ana P.

    2014-01-01

    Objective Mobile populations are at high risk for communicable diseases and can serve as a bridge between sending and receiving communities. The objective of this study is to determine the rates of, and factors associated with, seasonal influenza vaccination among Mexican migrants traveling through the US-Mexico border. Methods We used a 2013 cross-sectional population-based survey of adult mobile Mexican migrants traveling through the Mexico-U.S. border region (N = 2,313; weighted N = 652,500). We performed a multivariable logistic regression analysis to model the odds of receiving an influenza vaccination in the past year by sociodemographics, migration history, health status, and access to health care. Results The seasonal influenza vaccination rate in this population was 18.6%. Gender, health status, and health insurance were associated with the likelihood to receive an influenza vaccination. Conclusion Overall, the rates of seasonal influenza vaccination in circular Mexican migrants are low compared to adults in Mexico and the U.S. Efforts are needed to increase influenza vaccination among this highly mobile population, particularly in adults with chronic conditions. PMID:25514546

  16. Seasonal influenza vaccination among Mexican migrants traveling through the Mexico-US border region.

    PubMed

    Ejebe, Ifna H; Zhang, Xiao; Rangel, Maria Gudelia; Martinez-Donate, Ana P

    2015-02-01

    Mobile populations are at high risk for communicable diseases and can serve as a bridge between sending and receiving communities. The objective of this study is to determine the rates of, and factors associated with, seasonal influenza vaccination among Mexican migrants traveling through the US-Mexico border. We used a 2013 cross-sectional population-based survey of adult mobile Mexican migrants traveling through the Mexico-US border region (N=2313; weighted N=652,500). We performed a multivariable logistic regression analysis to model the odds of receiving an influenza vaccination in the past year by sociodemographics, migration history, health status, and access to health care. The seasonal influenza vaccination rate in this population was 18.6%. Gender, health status, and health insurance were associated with the likelihood to receive an influenza vaccination. Overall, the rates of seasonal influenza vaccination in circular Mexican migrants are low compared to adults in Mexico and the US Efforts are needed to increase influenza vaccination among this highly mobile population, particularly in adults with chronic conditions. Copyright © 2014 Elsevier Inc. All rights reserved.

  17. Crossing Pedagogical Borders in the Yucatan Peninsula

    ERIC Educational Resources Information Center

    Willhauck, Susan

    2009-01-01

    A challenging intercultural teaching experience provided an opportunity for engaging embodied pedagogies that facilitated border crossings of language, age, gender, and experience. Influenced by the work of Augusto Boal, the author describes how improvisation, role-play, music, and drawing led seminary students in Mexico into sacred time and space…

  18. The "1+1:Life & Love" Simultaneous Exhibition: Cross-Border Collaboration in the Western Balkans

    ERIC Educational Resources Information Center

    Walters, Diana

    2012-01-01

    This article describes and analyzes a cross-border, "simultaneous exhibition" collaborative project in six post-conflict western Balkan countries. Through a process of collaboration, active learning, and audience development, professional and personal trust developed among eleven museums. Previously identified barriers were overcome and…

  19. U.S.-Mexico border : better planning coordination needed to handle growing commercial traffic

    DOT National Transportation Integrated Search

    2000-03-01

    Trade between the United States and Mexico has more than doubled since the North American Free Trade Agreement went into effect. Most of this trade crosses the border by truck, and in fiscal year 1998 there were nearly 4 million truck crossings into ...

  20. Faculty Perceptions of Success in Cross-Border University-to-University Partnerships

    ERIC Educational Resources Information Center

    Wilson, Elisabeth Anne

    2012-01-01

    In international development the strategy of cross-border university-to-university partnerships is drawing more attention. Funders such as U.S. Agency for International Development are offering large amounts of financial support for the development of university partnerships, networks, and consortiums. Despite the money that is going into…

  1. Cross-Border Partnerships in Higher Education: Strategies and Issues. International Studies in Higher Education

    ERIC Educational Resources Information Center

    Sakamoto, Robin, Ed.; Chapman, David, Ed.

    2012-01-01

    "Cross-border Partnerships in Higher Education" looks beyond student and faculty exchanges to examine the myriad ways international colleges and universities work together as institutions. These partnerships have involved the creation of branch campuses, joint research and technology initiatives, collaboration in strengthening…

  2. Border Crossing in the Classroom through Performed Ethnography

    ERIC Educational Resources Information Center

    Goldstein, Tara

    2016-01-01

    In this essay I share the ways I have used performed ethnography to explore the notion of border crossing in an undergraduate course called "Equity and Activism in Education." Performed ethnography involves turning the findings of ethnographic research into a play script. My students read two performed ethnographies, "Harriet's…

  3. Border Crossings and Multimodal Composition in the Arts

    ERIC Educational Resources Information Center

    Morrison, Andrew

    2005-01-01

    Developmental and development-oriented learning with digital media are discussed in relation to the concepts border crossings and multimodal composition. The first concept refers to a transveral of disciplines and recombinations of elements from them. Local-global relations in knowledge building are covered. The second refers to the collaborative…

  4. Border Crossing Knowledge Systems: A PNG Teacher's Autoethnography

    ERIC Educational Resources Information Center

    Reta, Medi

    2010-01-01

    Narratives have always been integral to Indigenous knowledge transfer. In this autoethnography the author shares her border crossings between her Indigenous knowledge systems and the often dominant Western knowledge system. Pertinent to these experiences are the stark contrasts that exist between the two knowledge systems and their educational…

  5. Caught on the Mexican-US Border: The Insecurity and Desire of Collaboration between Two Universities

    ERIC Educational Resources Information Center

    Maldonado-Maldonado, Alma; Cantwell, Brendan

    2008-01-01

    Understandings of cross-border university collaboration are often informed by a concept of internationalisation that privileges the rationales of university administrators. A case study of two asymmetric universities along the border of Mexico and the United States--one of the most active and problematic borders in the world--found that, rather…

  6. Cross-border health and productivity effects of alcohol policies.

    PubMed

    Johansson, Per; Pekkarinen, Tuomas; Verho, Jouko

    2014-07-01

    This paper studies the cross-border health and productivity effects of alcohol taxes. We estimate the effect of a large cut in the Finnish alcohol tax on mortality, alcohol-related illnesses and work absenteeism in Sweden. This tax cut led to large differences in the prices of alcoholic beverages between these two countries and to a considerable increase in cross-border shopping. The effect is identified using differences-in-differences strategy where changes in these outcomes in regions near the Finnish border are compared to changes in other parts of northern Sweden. We use register data where micro level data on deaths, hospitalisations and absenteeism is merged to population-wide micro data on demographics and labour market outcomes. Our results show that the Finnish tax cut did not have any clear effect on mortality or alcohol-related hospitalisations in Sweden. However, we find that workplace absenteeism increased by 9% for males and by 15% for females near the Finnish border as a result of the tax cut. Copyright © 2014 Elsevier B.V. All rights reserved.

  7. People Crossing Borders: An Analysis of U.S. Border Protection Policies

    DTIC Science & Technology

    2010-05-13

    evaluate the policies that have been pursued in providing border protection, especially as these policies might impact other elements of the U.S. border...evaluate the impact of the current framework. Lastly, this report offers some policy options—both short-term and long-term—for addressing the...to account for the commercial consequences of ever-climbing levels of security at the U.S. border. In the end, balancing the economic impact of

  8. Quantitative and qualitative estimates of cross-border tobacco shopping and tobacco smuggling in France.

    PubMed

    Lakhdar, C Ben

    2008-02-01

    In France, cigarette sales have fallen sharply, especially in border areas, since the price increases of 2003 and 2004. It was proposed that these falls were not due to people quitting smoking but rather to increased cross-border sales of tobacco and/or smuggling. This paper aims to test this proposition. Three approaches have been used. First, cigarette sales data from French sources for the period 1999-2006 were collected, and a simulation of the changes seen within these sales was carried out in order to estimate what the sales situation would have looked like without the presence of foreign tobacco. Second, the statements regarding tobacco consumed reported by the French population with registered tobacco sales were compared. Finally, in order to identify the countries of origin of foreign tobacco entering France, we collected a random sample of cigarette packs from a waste collection centre. According to the first method, cross-border shopping and smuggling of tobacco accounted for 8635 tones of tobacco in 2004, 9934 in 2005, and 9930 in 2006, ie, between 14% and 17% of total sales. The second method gave larger results: the difference between registered cigarette sales and cigarettes declared as being smoked was around 12,000 to 13,000 tones in 2005, equivalent to 20% of legal sales. The collection of cigarette packs at a waste collection centre showed that foreign cigarettes accounted for 18.6% of our sample in 2005 and 15.5% in 2006. France seems mainly to be a victim of cross-border purchasing of tobacco products, with the contraband market for tobacco remaining modest. in order to avoid cross-border purchases, an increased harmonization of national policies on the taxation of tobacco products needs to be envisaged by the European Union.

  9. Effectiveness and impact of the cross-border healthcare model as implemented by non-governmental organizations: case study of the malaria control programs by health poverty action on the China-Myanmar border.

    PubMed

    Zhang, Jun; Dong, Jia-Qiang; Li, Jia-Ying; Zhang, Yue; Tian, Yang-Hui; Sun, Xiao-Ying; Zhang, Guang-Yun; Li, Qing-Pu; Xu, Xiao-Yu; Cai, Tao

    2016-09-01

    In the Yunnan province of China, 18 counties in six prefectures border Myanmar. Due to its particular combination of geographic features, climate conditions, and cultural landscape, the area provides a suitable environment for the spread of insect-borne diseases such as malaria. In five identified Myanmar Special Regions along the China-Myanmar border, economic development is lagging, people live in extreme poverty, and the healthcare system is fragile. Coupled with political and other reasons, this precludes malaria control work to be effectively carried out in Myanmar, resulting in a heavy burden of the disease. Frequent population movements and favorable conditions for malaria transmission on the border fuel difficulties in controlling and eliminating the spread of the disease in the area. To reduce the prevalence of malaria in the China-Myanmar border area and improve healthcare services for local residents in this particular environment, Health Poverty Action (HPA) has provided malaria aid in the area since the beginning of 2006, as a sub-recipient of the China Global Fund Malaria Programs. In this case study, we examined HPA's activities as part of its malaria control programs in the area, analyzed and summarized the effectiveness and impact of the cross-border healthcare model as implemented by non-governmental organizations, and put forward suggestions for cross-border health aid models and for the prevention of malaria transmission in the Greater Mekong Subregion. HPA had carried out a great quantity of successful malaria control activities in border areas between China and Myanmar, strengthened the partnership and established the collaboration, coordination and cooperation channels among stakeholders. HPA has laid good groundwork and developed its valuable model that could be highlighted and referenced.

  10. Cross-border cooperation potential in fostering redevelopment of degraded border areas - a case study approach.

    NASA Astrophysics Data System (ADS)

    Alexandre Castanho, Rui; Ramírez, Beatriz; Loures, Luis; Fernández-Pozo, Luis; Cabezas, José

    2017-04-01

    Border interactions have reached unprecedented levels in recent decades, not only due to their potential for territorial integration but also considering their role in supranational processes, such as landscape reclamation, infrastructure development and land use planning on European territory. In this scenario, successful examples related to the redevelopment of degraded areas have been showing positive impacts at several levels, such as the social, economic, environmental and aesthetic ones which have ultimately related this process, positively, to sustainability issues. However, concerning to border areas, and due to their inherent legislative and bureaucratic conflicts, the intervention in these areas is more complex. Still, and taking into account previously developed projects and strategies of cross-border cooperation (CBC) in European territory it is possible to identified that the definition of common master plans and common objectives are critical issues to achieve the desired territorial success. Additionally, recent studies have put forward some noteworthy ideas highlighting that it is possible to establish a positive correlation between CBC processes and an increasing redevelopment of degraded border areas, with special focus on the reclamation of derelict landscapes fostering soil reuse and redevelopment. The present research, throughout case study analysis at the Mediterranean level - considering case studies from Portugal, Spain, Monaco and Italy - which presents specific data on border landscape redevelopment, enables us to conclude that CBC processes have a positive influence on the potential redevelopment of degraded border areas, considering not only urban but also rural land. Furthermore, this paper presents data obtained through a public participation process which highlights that these areas present a greater potential for landscape reclamation, fostering resource sustainability and sustainable growth. Keywords: Spatial planning; Land degradation; Redevelopment; Cross-border cooperation (CBC); Land use.

  11. Challenge theme 7: Information support for management of border security and environmental protection: Chapter 9 in United States-Mexican Borderlands: Facing tomorrow's challenges through USGS science

    USGS Publications Warehouse

    Parcher, Jean W.; Page, William R.

    2013-01-01

    Historically, international borders were located far from the major political and economic capitals of their countries and rarely received adequate planning or infrastructure development. Today, as a result of global economics and increased movement of goods between nations, border regions play a much greater role in commerce, tourism, and transportation. For example, Mexico is the second largest destination for United States exports (Woodrow Wilson Center Mexico Institute, 2009). The rapid population and economic growth along the United States–Mexican border, undocumented human border crossings, and the unique natural diversity of resources in the Borderlands present challenges for border security and environmental protection. Assessing risks and implementing sustainable growth policies to protect the environment and quality of life greatly increase in complexity when the issues cross an international border, where social services, environmental regulations, lifestyles, and cultural beliefs are unique for each country. Shared airsheds, water and biological resources, national security issues, and disaster management needs require an integrated binational approach to assess risks and develop binational management strategies.

  12. Cross-Border University Networks as a Development Strategy: Lessons from Three University Networks Focused on Emerging Pandemic Threats

    ERIC Educational Resources Information Center

    Chapman, David W.; Pekol, Amy; Wilson, Elisabeth

    2014-01-01

    Cross-border university networks have recently been advocated as an effective strategy for addressing national and regional development needs while simultaneously strengthening the capacity of the participating institutions. While university-to-university partnerships generally involve two institutions collaborating to accomplish a particular…

  13. The Changing Nature of Volunteering and the Cross-Border Mobility: Where Does Learning Come from?

    ERIC Educational Resources Information Center

    Pantea, Maria-Carmen

    2013-01-01

    This paper revisits the more conventional approaches of volunteering, by looking into the experiences of young people involved in long-term cross-border volunteering in Romania. Drawing on qualitative interviews with European Voluntary Service volunteers, the paper examines how this experience is intersecting their learning trajectories. The…

  14. Postglobal Teacher Preparation: Border Thinking along the Global South through International Cross-Cultural Experiences

    ERIC Educational Resources Information Center

    Rahatzad, Jubin; Sasser, Hannah L.; Phillion, JoAnn; Karimi, Nastaran; Deng, Yuwen; Akiyama, Reiko; Sharma, Suniti

    2013-01-01

    Preservice teachers' international cross-cultural experiences can provide opportunities for the exploration of epistemic frontiers. In this article we suggest that postglobal teacher preparation take a critically reflective approach that engages preservice teachers in border thinking, which allows for other ways of knowing while studying abroad.…

  15. School Engagement and Parental Involvement: The Case of Cross-Border Students in Singapore

    ERIC Educational Resources Information Center

    Yuen, Celeste Y. M.; Cheung, Alan C. K.

    2014-01-01

    The primary purpose of this paper is to examine the mutual relationship between school engagement of cross-border students (CBS) from Malaysia in Singapore and parental involvement in education. Focus-group interviews were conducted with school personnel, CBS and their non-local counterparts to provide a comprehensive understanding of the…

  16. Regulating Cross-Border Higher Education: A Case Study of the United States

    ERIC Educational Resources Information Center

    Lane, Jason E.; Kinser, Kevin; Knox, Daniel

    2013-01-01

    In an increasing number of nations, foreign education providers are becoming part of the educational landscape. This aspect of cross-border higher education raises many questions about how such activities are regulated, particularly the role of the importing and exporting governments. Drawing on a principal-agent framework, this study uses the…

  17. Reconsidering Privatization in Cross-Border Engagements: The Sometimes Public Nature of Private Activity

    ERIC Educational Resources Information Center

    Lane, Jason E.; Kinser, Kevin

    2011-01-01

    Privatization trends in higher education have typically been analyzed from the perspective of the institution and its relationship with the sponsoring state. The recent phenomenon of international cross-border higher education, however, represents a more complicated picture of privatization. Geographic separation from the sponsoring state is an…

  18. Cross-Border Higher Education: Global and Local Tensions within Competition and Economic Development

    ERIC Educational Resources Information Center

    Owens, Taya L.; Lane, Jason E.

    2014-01-01

    In this chapter, the authors explore various types of cross-border higher education, considering equity and quality issues within these developments. With a particular focus on international branch campuses, the authors discuss the ways in which global competition for knowledge and economic development interact with tensions at the local level.

  19. Borders to Cross: Identifying Sources of Tension in Mentor-Intern Relationships

    ERIC Educational Resources Information Center

    Bradbury, Leslie Upson; Koballa, Thomas R., Jr.

    2008-01-01

    We used border crossing as a theoretical framework to explore the tensions that developed between two mentor-intern pairs during the course of a yearlong internship in high schools in the United States. Interviews with mentors and interns, and observations of planning sessions, teaching episodes, and follow-up conferences indicated that differing…

  20. A Multifaceted Approach to Cross-Border Programmes: Expanding Educational Boundaries

    ERIC Educational Resources Information Center

    Harkins, Mary Jane; Nobes, Carolyn

    2008-01-01

    This paper examines how a small university in eastern Canada implemented a form of cross-border education with several partnerships in Bermuda and the Caribbean. The university made the transition from a campus-based university to a more inclusive, global institution. Capacity-building at the institution increased during this time of rapidly…

  1. Information Analysis Methodology for Border Security Deployment Prioritization and Post Deployment Evaluation

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Booker, Paul M.; Maple, Scott A.

    2010-06-08

    Due to international commerce, cross-border conflicts, and corruption, a holistic, information driven, approach to border security is required to best understand how resources should be applied to affect sustainable improvements in border security. The ability to transport goods and people by land, sea, and air across international borders with relative ease for legitimate commercial purposes creates a challenging environment to detect illicit smuggling activities that destabilize national level border security. Smuggling activities operated for profit or smuggling operations driven by cross border conflicts where militant or terrorist organizations facilitate the transport of materials and or extremists to advance a causemore » add complexity to smuggling interdiction efforts. Border security efforts are further hampered when corruption thwarts interdiction efforts or reduces the effectiveness of technology deployed to enhance border security. These issues necessitate the implementation of a holistic approach to border security that leverages all available data. Large amounts of information found in hundreds of thousands of documents can be compiled to assess national or regional borders to identify variables that influence border security. Location data associated with border topics of interest may be extracted and plotted to better characterize the current border security environment for a given country or region. This baseline assessment enables further analysis, but also documents the initial state of border security that can be used to evaluate progress after border security improvements are made. Then, border security threats are prioritized via a systems analysis approach. Mitigation factors to address risks can be developed and evaluated against inhibiting factor such as corruption. This holistic approach to border security helps address the dynamic smuggling interdiction environment where illicit activities divert to a new location that provides less resistance to smuggling activities after training or technology is deployed at a given location. This paper will present an approach to holistic border security information analysis.« less

  2. Towards tuberculosis elimination: an action framework for low-incidence countries

    PubMed Central

    Lönnroth, Knut; Migliori, Giovanni Battista; Abubakar, Ibrahim; D'Ambrosio, Lia; de Vries, Gerard; Diel, Roland; Douglas, Paul; Falzon, Dennis; Gaudreau, Marc-Andre; Goletti, Delia; González Ochoa, Edilberto R.; LoBue, Philip; Matteelli, Alberto; Njoo, Howard; Solovic, Ivan; Story, Alistair; Tayeb, Tamara; van der Werf, Marieke J.; Weil, Diana; Zellweger, Jean-Pierre; Abdel Aziz, Mohamed; Al Lawati, Mohamed R.M.; Aliberti, Stefano; Arrazola de Oñate, Wouter; Barreira, Draurio; Bhatia, Vineet; Blasi, Francesco; Bloom, Amy; Bruchfeld, Judith; Castelli, Francesco; Centis, Rosella; Chemtob, Daniel; Cirillo, Daniela M.; Colorado, Alberto; Dadu, Andrei; Dahle, Ulf R.; De Paoli, Laura; Dias, Hannah M.; Duarte, Raquel; Fattorini, Lanfranco; Gaga, Mina; Getahun, Haileyesus; Glaziou, Philippe; Goguadze, Lasha; del Granado, Mirtha; Haas, Walter; Järvinen, Asko; Kwon, Geun-Yong; Mosca, Davide; Nahid, Payam; Nishikiori, Nobuyuki; Noguer, Isabel; O'Donnell, Joan; Pace-Asciak, Analita; Pompa, Maria G.; Popescu, Gilda G.; Robalo Cordeiro, Carlos; Rønning, Karin; Ruhwald, Morten; Sculier, Jean-Paul; Simunović, Aleksandar; Smith-Palmer, Alison; Sotgiu, Giovanni; Sulis, Giorgia; Torres-Duque, Carlos A.; Umeki, Kazunori; Uplekar, Mukund; van Weezenbeek, Catharina; Vasankari, Tuula; Vitillo, Robert J.; Voniatis, Constantia; Wanlin, Maryse; Raviglione, Mario C.

    2015-01-01

    This paper describes an action framework for countries with low tuberculosis (TB) incidence (<100 TB cases per million population) that are striving for TB elimination. The framework sets out priority interventions required for these countries to progress first towards “pre-elimination” (<10 cases per million) and eventually the elimination of TB as a public health problem (less than one case per million). TB epidemiology in most low-incidence countries is characterised by a low rate of transmission in the general population, occasional outbreaks, a majority of TB cases generated from progression of latent TB infection (LTBI) rather than local transmission, concentration to certain vulnerable and hard-to-reach risk groups, and challenges posed by cross-border migration. Common health system challenges are that political commitment, funding, clinical expertise and general awareness of TB diminishes as TB incidence falls. The framework presents a tailored response to these challenges, grouped into eight priority action areas: 1) ensure political commitment, funding and stewardship for planning and essential services; 2) address the most vulnerable and hard-to-reach groups; 3) address special needs of migrants and cross-border issues; 4) undertake screening for active TB and LTBI in TB contacts and selected high-risk groups, and provide appropriate treatment; 5) optimise the prevention and care of drug-resistant TB; 6) ensure continued surveillance, programme monitoring and evaluation and case-based data management; 7) invest in research and new tools; and 8) support global TB prevention, care and control. The overall approach needs to be multisectorial, focusing on equitable access to high-quality diagnosis and care, and on addressing the social determinants of TB. Because of increasing globalisation and population mobility, the response needs to have both national and global dimensions. PMID:25792630

  3. Welcome to the wild west: protecting access to cross border fertility care in the United States.

    PubMed

    Mutcherson, Kimberley M

    2012-01-01

    As has been the case with other types of medical tourism, the phenomenon of cross border fertility care ("CBFC") has sparked concern about the lack of global or even national harmonization in the regulation of the fertility industry. The diversity of laws around the globe leads would-be parents to forum shop for a welcoming place to make babies. Focusing specifically on the phenomenon of travel to the United States, this Article takes up the question of whether there should be any legal barriers to those who come to the United States seeking CBFC. In part, CBFC suffers from the same general concerns raised about the use of fertility treatment in general, but it is possible to imagine a subset of arguments that would lead to forbidding or at least discouraging people from coming to the United States for CBFC, either as a matter of law or policy. This paper stands in opposition to any such effort and contemplates the moral and ethical concerns about CBFC and how, and if, those concerns warrant expression in law. Part I describes the conditions that lead some couples and individuals to leave their home countries to access fertility treatments abroad and details why the United States, with its comparatively liberal regulation of ART, has become a popular CBFC destination for travelers from around the world. Part II offers and refutes arguments supporting greater domestic control over those who seek to satisfy their desires for CBFC in the United States by reasserting the importance of the right of procreation while also noting appropriate concerns about justice and equality in the market for babies. Part III continues the exploration of justice by investigating the question of international cooperation in legislating against perceived wrongs. This Part concludes that consistent legislation across borders is appropriate where there is consensus about the wrong of an act, but it is unnecessary and inappropriate where there remain cultural conflicts about certain practices—in this case assisted reproduction.

  4. Responding to Communicable Diseases in Internationally Mobile Populations at Points of Entry and along Porous Borders, Nigeria, Benin, and Togo

    PubMed Central

    Rogers, Kimberly; Ward, Sarah; Ojo, Olubumni; Kakaī, Clement Glele; Agbeko, Tamekloe Tsidi; Garba, Hassan; MacGurn, Amanda; Oppert, Marydale; Kone, Idrissa; Bamsa, Olutola; Schneider, Dana; Brown, Clive

    2017-01-01

    Recent multinational disease outbreaks demonstrate the risk of disease spreading globally before public health systems can respond to an event. To ensure global health security, countries need robust multisectoral systems to rapidly detect and respond to domestic or imported communicable diseases. The US Centers for Disease Control and Prevention International Border Team works with the governments of Nigeria, Togo, and Benin, along with Pro-Health International and the Abidjan-Lagos Corridor Organization, to build sustainable International Health Regulations capacities at points of entry (POEs) and along border regions. Together, we strengthen comprehensive national and regional border health systems by developing public health emergency response plans for POEs, conducting qualitative assessments of public health preparedness and response capacities at ground crossings, integrating internationally mobile populations into national health surveillance systems, and formalizing cross-border public health coordination. Achieving comprehensive national and regional border health capacity, which advances overall global health security, necessitates multisectoral dedication to the aforementioned components. PMID:29155668

  5. Responding to Communicable Diseases in Internationally Mobile Populations at Points of Entry and along Porous Borders, Nigeria, Benin, and Togo.

    PubMed

    Merrill, Rebecca D; Rogers, Kimberly; Ward, Sarah; Ojo, Olubumni; Kakaī, Clement Glele; Agbeko, Tamekloe Tsidi; Garba, Hassan; MacGurn, Amanda; Oppert, Marydale; Kone, Idrissa; Bamsa, Olutola; Schneider, Dana; Brown, Clive

    2017-12-01

    Recent multinational disease outbreaks demonstrate the risk of disease spreading globally before public health systems can respond to an event. To ensure global health security, countries need robust multisectoral systems to rapidly detect and respond to domestic or imported communicable diseases. The US Centers for Disease Control and Prevention International Border Team works with the governments of Nigeria, Togo, and Benin, along with Pro-Health International and the Abidjan-Lagos Corridor Organization, to build sustainable International Health Regulations capacities at points of entry (POEs) and along border regions. Together, we strengthen comprehensive national and regional border health systems by developing public health emergency response plans for POEs, conducting qualitative assessments of public health preparedness and response capacities at ground crossings, integrating internationally mobile populations into national health surveillance systems, and formalizing cross-border public health coordination. Achieving comprehensive national and regional border health capacity, which advances overall global health security, necessitates multisectoral dedication to the aforementioned components.

  6. Traffic pollutants measured inside vehicles waiting in line at a major US-Mexico Port of Entry.

    PubMed

    Quintana, Penelope J E; Khalighi, Mehdi; Castillo Quiñones, Javier Emmanuel; Patel, Zalak; Guerrero Garcia, Jesus; Martinez Vergara, Paulina; Bryden, Megan; Mantz, Antoinette

    2018-05-01

    At US-Mexico border Ports of Entry, vehicles idle for long times waiting to cross northbound into the US. Long wait times at the border have mainly been studied as an economic issue, however, exposures to emissions from idling vehicles can also present an exposure risk. Here we present the first data on in-vehicle exposures to driver and passengers crossing the US-Mexico border at the San Ysidro, California Port of Entry (SYPOE). Participants were recruited who regularly commuted across the border in either direction and told to drive a scripted route between two border universities, one in the US and one in Mexico. Instruments were placed in participants' cars prior to commute to monitor-1-minute average levels of the traffic pollutants ultrafine particles (UFP), black carbon (BC) and carbon monoxide (CO) in the breathing zone of drivers and passengers. Location was determined by a GPS monitor. Results reported here are for 68 northbound participant trips. The highest median levels of in-vehicle UFP were recorded during the wait to cross at the SYPOE (median 29,692particles/cm 3 ) significantly higher than the portion of the commute in the US (median 20,508particles/cm 3 ) though not that portion in Mexico (median 22, 191particles/cm 3 ). In-vehicle BC levels at the border were significantly lower than in other parts of the commute. Our results indicate that waiting in line at the SYPOE contributes a median 62.5% (range 15.5%-86.0%) of a cross-border commuter's exposure to UFP and a median 44.5% (range (10.6-79.7%) of exposure to BC inside the vehicle while traveling in the northbound direction. Reducing border wait time can significantly reduce in-vehicle exposures to toxic air pollutants such as UFP and BC, and these preventable exposures can be considered an environmental justice issue. Copyright © 2017 Elsevier B.V. All rights reserved.

  7. Regional incentives and patient cross-border mobility: evidence from the Italian experience

    PubMed Central

    Brenna, Elenka; Spandonaro, Federico

    2015-01-01

    Background: In recent years, accreditation of private hospitals followed by decentralisation of the Italian National Health Service (NHS) into 21 regional health systems has provided a good empirical ground for investigating the Tiebout principle of "voting with their feet". We examine the infra-regional trade-off between greater patient choice (due to an increase in hospital services supply) and financial equilibrium, and we relate it to the significant phenomenon of Cross-Border Mobility (CBM) between Italian regions. Focusing on the rules supervising the financial agreements between regional authorities and providers of hospital care, we find incentives for private accredited providers in attracting patient inflows. Methods: The analysis is undertaken from an institutional, regulatory and empirical perspective. We select a sample of five regions with higher positive CBM balance and we examine regional regulations governing the contractual agreements between purchasers and providers of hospital care. According to this sample, we provide a statistical analysis of CBM and apply a Regional Attraction Ability Index (RAAI), aimed at testing patient preferences for private/public accredited providers. Results: We find that this index is systematically higher for private providers, both in the case of distance/boundary patients and of excellence/general hospitals. Conclusion: Conclusions address both financial issues regarding the coverage of regional healthcare systems and equity issues on patient healthcare access. They also raise concerns on the new European Union (EU) directive inherent to patient mobility across Europe. PMID:26029895

  8. First trimester initiation of prenatal care in the US-Mexico border region.

    PubMed

    McDonald, Jill A; Argotsinger, Brittany; Mojarro, Octavio; Rochat, Roger; Amatya, Anup

    2015-08-01

    To systematically examine prevalence of first trimester prenatal care (FTPNC) in the 44 US counties and 80 Mexican municipios of the binational border region; and to describe disparities between border and nonborder areas within states, border states, and countries. We combined 2009 records of singleton live births from the 10 US-Mexico border states (N=1,370,206) into a single file. We included FTPNC; county/municipio, state, and country of maternal residence; and demographic variables common to all records. We computed prevalence of FTPNC for border and nonborder residents by state and country. Using multivariable regression, we computed adjusted prevalence ratios (aPR) for FTPNC in border relative to nonborder residents, states relative to one another, and the US relative to Mexico. In 2009, 68.8% of US-Mexico border mothers and 72.9% of nonborder mothers received FTPNC. After adjustment, nonborder residents had higher prevalence of FTPNC than border residents in Sonora, New Mexico, Arizona, Coahuila, and Chihuahua (aPR=1.09-124). In US states, prevalence was 13%-36% higher in New Mexico, Arizona, and California than Texas. In Mexico, when compared with Coahuila, adjusted prevalence was 12%-20% higher in neighboring states. Between countries, FTPNC prevalence in border counties/municipios was higher in Mexico among women with low parity/low education and in the United States among women with high parity/high education. In the US and Mexico, women in border counties/municipios receive less timely prenatal care than their nonborder counterparts, but the magnitude of the disparity varies by state. Lack of a consistent, binational approach to birth data collection requires cautious interpretation of findings.

  9. Modeling the value of integrated U.S. and Canadian power sector expansion

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Beiter, Philipp; Cole, Wesley J.; Steinberg, Daniel C.

    The U.S.-Canadian power system has evolved into a highly integrated grid. Cross-border transmission and coordination of system operations create an interconnected power system with combined imports and exports of electricity of greater than 77 TWh per year. Currently, more than 5 GW of new international transmission lines are in various stages of permitting and development. These transmission lines may enable even greater integration and coordination of the U.S. and Canadian systems, which can in turn increase the reliability and flexibility of North America's electricity grid and help address challenges associated with integrating high levels of variable renewables. Using a versionmore » of the National Renewable Energy Laboratory's Regional Energy Deployment System (ReEDS) model that incorporates Canada, this analysis quantifies the differences in the evolution of the power system under scenarios in which cross-border transmission capacity is restricted to today's levels, and scenarios in which new transmission is less restricted. These impacts are analyzed under a 'business-as-usual' reference scenario and a scenario in which deep cuts in power sector carbon dioxide emissions levels are achieved. A set of key impact metrics is analyzed, including 1) the composition of generating capacity by technology, 2) system costs, 3) wholesale electricity prices, 4) international electricity exports and imports, 5) transmission capacity, and 6) carbon dioxide emission levels. When new cross-border transmission is not allowed, the United States needs additional capacity (primarily natural gas and renewable energy) to meet domestic needs, while total Canadian capacity is lower because less capacity is needed to export to the United States. This effect is amplified under the carbon cap scenario. Impacts vary on a regional basis, largely due to the different relative sizes of the generation portfolio between countries and regions and the relative impact from cross-border electricity trade. The total impact from restricting cross-border trade on carbon emissions and average wholesale electricity prices is limited, due to the relative size of the domestic power systems and the cross-border trade volume. Lastly, cross-border transmission capacity is projected to more than double under the unrestricted transmission capacity scenarios, which exceeds the rate of projected domestic transmission capacity additions in each country.« less

  10. Modeling the value of integrated U.S. and Canadian power sector expansion

    DOE PAGES

    Beiter, Philipp; Cole, Wesley J.; Steinberg, Daniel C.

    2017-03-15

    The U.S.-Canadian power system has evolved into a highly integrated grid. Cross-border transmission and coordination of system operations create an interconnected power system with combined imports and exports of electricity of greater than 77 TWh per year. Currently, more than 5 GW of new international transmission lines are in various stages of permitting and development. These transmission lines may enable even greater integration and coordination of the U.S. and Canadian systems, which can in turn increase the reliability and flexibility of North America's electricity grid and help address challenges associated with integrating high levels of variable renewables. Using a versionmore » of the National Renewable Energy Laboratory's Regional Energy Deployment System (ReEDS) model that incorporates Canada, this analysis quantifies the differences in the evolution of the power system under scenarios in which cross-border transmission capacity is restricted to today's levels, and scenarios in which new transmission is less restricted. These impacts are analyzed under a 'business-as-usual' reference scenario and a scenario in which deep cuts in power sector carbon dioxide emissions levels are achieved. A set of key impact metrics is analyzed, including 1) the composition of generating capacity by technology, 2) system costs, 3) wholesale electricity prices, 4) international electricity exports and imports, 5) transmission capacity, and 6) carbon dioxide emission levels. When new cross-border transmission is not allowed, the United States needs additional capacity (primarily natural gas and renewable energy) to meet domestic needs, while total Canadian capacity is lower because less capacity is needed to export to the United States. This effect is amplified under the carbon cap scenario. Impacts vary on a regional basis, largely due to the different relative sizes of the generation portfolio between countries and regions and the relative impact from cross-border electricity trade. The total impact from restricting cross-border trade on carbon emissions and average wholesale electricity prices is limited, due to the relative size of the domestic power systems and the cross-border trade volume. Lastly, cross-border transmission capacity is projected to more than double under the unrestricted transmission capacity scenarios, which exceeds the rate of projected domestic transmission capacity additions in each country.« less

  11. Border-wide assessment of intelligent transportation system (ITS) technology : current and future concepts.

    DOT National Transportation Integrated Search

    2012-07-01

    The purpose of this effort was to conduct a border-wide assessment of the use of intelligent transportation systems (ITS) technologies and operational concepts at and near land border crossings between the U.S. and Mexico. The work focused on tolling...

  12. Exploring the Association of Homicides in Northern Mexico and Healthcare Access for US Residents.

    PubMed

    Geissler, Kimberley H; Becker, Charles; Stearns, Sally C; Thirumurthy, Harsha; Holmes, George M

    2015-08-01

    Many legal residents in the United States (US)-Mexico border region cross from the US into Mexico for medical treatment and pharmaceuticals. We analyzed whether recent increases in homicides in Mexico are associated with reduced healthcare access for US border residents. We used data on healthcare access, legal entries to the US from Mexico, and Mexican homicide rates (2002-2010). Poisson regression models estimated associations between homicide rates and total legal US entries. Multivariate difference-in-difference linear probability models evaluated associations between Mexican homicide rates and self-reported measures of healthcare access for US residents. Increased homicide rates were associated with decreased legal entries to the US from Mexico. Contrary to expectations, homicides did not have significant associations with healthcare access measures for legal residents in US border counties. Despite a decrease in border crossings, increased violence in Mexico did not appear to negatively affect healthcare access for US border residents.

  13. A Spatial Analysis of Acute Myocardial Infarction Rates in New York State in Relation to Hospitals Along State Jurisdictional Borders.

    PubMed

    Stamm, Abigail J; Savadatti, Sanghamitra S; Kumar, Sanjaya; Hwang, Syni-An

    Patients experiencing acute myocardial infarction (AMI) are likely to visit the nearest hospital providing appropriate services since timely care is a critical determinant in the treatment and progression of AMI. We comparatively examined AMI rates in border and nonborder census tracts. The New York State (NYS) Environmental Public Health Tracking (EPHT) program, in conjunction with the Statewide Planning and Research Cooperative System, will work on developing memoranda of understanding with neighboring states to be able to more comprehensively access NYS residents' out-of-state health records. To determine whether AMI rates in the NYS border census tracts differ from AMI rates in nonborder census tracts as a preliminary exploration of the utilization of out-of-state care for acute health conditions by NYS border residents. We reviewed data on inpatient and emergency department visits in NYS with discharge dates from 2005 to 2014 retrospectively. We used the NYS EPHT tier 1 system database to locate hospitals. We geocoded all cases to NYS 2010 census tracts. We mapped differences between border and nonborder tracts and analyzed resulting spatial patterns. We computed tract-level AMI rates and differences between border and nonborder AMI rates. The age-adjusted AMI rates differed by 8.2 cases per 10 000 people (95% confidence interval, 6.94-12.60). Maps showed patterns of differences in AMI rates, especially along the NYS border with New England and other geographically closer out-of-state hospitals. AMI rates that were geographically closer to out-of-state hospitals were lower, suggesting that people residing in border census tracts are utilizing out-of-state care. Our study adds to literature on the geographical component of health care accessibility and utilization in the context of acute conditions such as AMI and lends impetus to access out-of-state health records to better understand health care facility access and utilization for NYS residents.

  14. Risk assessment of malaria in land border regions of China in the context of malaria elimination.

    PubMed

    Zhang, Qian; Sun, Junling; Zhang, Zike; Geng, Qibin; Lai, Shengjie; Hu, Wenbiao; Clements, Archie C A; Li, Zhongjie

    2016-11-08

    Cross-border malaria transmission poses a challenge for countries to achieve and maintain malaria elimination. Because of a dramatic increase of cross-border population movement between China and 14 neighbouring countries, the malaria epidemic risk in China's land border regions needs to be understood. In this study, individual case-based epidemiological data on malaria in the 136 counties of China with international land borders, from 2011 to 2014, were extracted from the National Infectious Disease Information System. The Plasmodium species, seasonality, spatiotemporal distribution and changing features of imported and indigenous cases were analysed using descriptive spatial and temporal methods. A total of 1948 malaria cases were reported, with 1406 (72.2%) imported cases and 542 (27.8%) indigenous cases. Plasmodium vivax is the predominant species, with 1536 malaria cases occurrence (78.9%), following by Plasmodium falciparum (361 cases, 18.5%), and the others (51 cases, 2.6%). The magnitude and geographic distribution of malaria in land border counties shrunk sharply during the elimination period. Imported malaria cases were with a peak of 546 cases in 2011, decreasing yearly in the following years. The number of counties with imported cases decreased from 28 counties in 2011 to 26 counties in 2014. Indigenous malaria cases presented a markedly decreasing trend, with 319 indigenous cases in 2011 reducing to only 33 indigenous cases in 2014. The number of counties with indigenous cases reduced from 26 counties in 2011 to 10 counties in 2014. However, several bordering counties of Yunnan province adjacent to Myanmar reported indigenous malaria cases in the four consecutive years from 2011 to 2014. The scale and extent of malaria occurrence in the international land border counties of China decreased dramatically during the elimination period. However, several high-risk counties, especially along the China-Myanmar border, still face a persistent risk of malaria introduction and transmission. The study emphasizes the importance and urgency of cross-border cooperation between neighbouring countries to jointly face malaria threats to elimination goals.

  15. 76 FR 49527 - Joint Motor Carrier Safety Advisory Committee and Medical Review Board Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-10

    ... Task 11-03, regarding the Agency's Cross Border Trucking Pilot Program, will meet. Copies of all MCSAC... Trucking Pilot Program Task The MCSAC Subcommittee will continue its work on Task 11-03 concerning the... a meeting of the Cross-Border Trucking Pilot Program subcommittee. All three days of the meeting...

  16. "Los Papeles No Trabajan": The Papers Don't Do the Work

    ERIC Educational Resources Information Center

    Hones, Donald; Cifuentes, Persida

    2012-01-01

    Schools across the United States serve children from families that have crossed the U.S. border without documents. Some of these children have crossed the border themselves. For teachers and other educators, the Supreme Court decision of "Plyler v. Doe" (1982) has set the precedent that all children in the United States are entitled to a…

  17. 77 FR 58782 - Closing of the Jamieson Line, NY Border Crossing

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-24

    ... border at a point just across from Jamieson Line and have to travel through an alternate port of entry to..., and the cost to the economy of lost revenue resulting from potential decreased Canadian travel. CBP... Line. If the crossing is closed, these travelers would need to travel to an alternate port, which could...

  18. Implementing the First Cross-Border Professional Development Online Course through International E-Mentoring: Reflections and Perspectives

    ERIC Educational Resources Information Center

    Jayatilleke, Buddhini Gayathri; Kulasekara, Geetha Udayanganie; Kumarasinha, Malinda Bandara; Gunawardena, Charlotte Nirmalani

    2017-01-01

    This research paper discusses the accomplishments, issues, and challenges experienced by Open University of Sri Lanka (OUSL) academics when offering the first cross-border professional development online course to train online tutors and mentors. The course was delivered exclusively online and facilitated by OUSL academics and e-mentors from the…

  19. Cross-Border Educational Collaboration between Taiwan and China: The Implications for Educational Governance

    ERIC Educational Resources Information Center

    Chan, Sheng-Ju

    2011-01-01

    Taiwan has undertaken a series of cross-border collaboration with China for the past two decades. This paper aims to investigate the Taiwanese approach and policies of educational collaboration with China in a globalized context, where international competitiveness has become a great concern for most countries. It also examines how the Taiwanese…

  20. "Countability Not Answerability?" Accountability in Hong Kong and Singapore Universities

    ERIC Educational Resources Information Center

    Currie, Jan; Vidovich, Lesley; Yang, Rui

    2008-01-01

    Singapore and Hong Kong are vying to be the principal educational hub for the Asia-Pacific region and have begun to compete with Australia, Britain, Canada and the USA in providing cross-border education. Although these four Anglo-American countries still dominate cross-border education, Singapore and Hong Kong hope to make inroads into this…

  1. Non-Formal Education as a Factor in Civilizational Development of Educational Space Subject in the Cross-Border Region

    ERIC Educational Resources Information Center

    Dugarova, Dulma T.; Starostina, Svetlana E.; Namsarayev, Sergey D.; Dagbaeva, Nina Zh.; Malanov, Innokentiy A.

    2016-01-01

    The research is aimed at determining the organizational and pedagogical conditions of nonformal education implementation as a factor in civilizational development of subjects, joint international projects performers, in the educational space of the cross-border region. New integration projects forming the need for effective models implementation…

  2. Analysis of longitudinal data from the Puget Sound Transportation Panel : task F : cross section and dynamic analysis of activity and travel patterns in PSTP

    DOT National Transportation Integrated Search

    1995-02-01

    The profiles contained in the appendix are all in the Portland, Maine district. They are listed below by border groups as used in the study, with the U.S. Customs port codes indicated. Maine Frontier Border Crossings: Calais - Calais, Ferry Point, ME...

  3. Border Crossings: Undocumented Migration between Mexico and the United States in Contemporary Young Adult Literature

    ERIC Educational Resources Information Center

    Cummins, Amy

    2013-01-01

    This study identifies patterns in 11 English language young adult novels from the past three decades (1981-2011) which depict undocumented migration between Mexico and the United States. The increase in YA novels on this topic demonstrates rising public concern. These books offer sympathetic identification with border crossing youth. Eight of the…

  4. Transmigrant Women in the US: Border Crossing Narratives, Identity, Spirituality, and Language & Literacy Practices

    ERIC Educational Resources Information Center

    Nidever-Jordan, Sherilynn

    2013-01-01

    The purpose of this study was to understand how transmigrant women living in the US encounter the border crossing and settlement experience, as well as how these experiences, gender, spirituality, and residence in the US have impacted their identity construction and reconstruction and their language and literacy practices. In my feminist narrative…

  5. Identity and Cross-Border Student Mobility: The Mainland China-Hong Kong Experience

    ERIC Educational Resources Information Center

    Xu, Cora Lingling

    2015-01-01

    This article is drawn from research in an ongoing multiple case study of the identity constructions of tertiary-level border-crossing students from mainland China to Hong Kong. It begins by outlining the contextual and conceptual background of the study, followed by the presentation and discussion of the three aspects of identity being…

  6. Cross-Border Higher Education in India: False Understandings and True Overestimates

    ERIC Educational Resources Information Center

    Stella, Antony; Gnanam, A.

    2005-01-01

    The on going debate about the (World Trade Organisation) General Agreement on Trade in Services (GATS) framework brings out conflicting views about cross-border education the world over. Between the enthusiastic views of trade promoters, at one end, and the sceptical reflections of academics with a traditional outlook, at the other, there are many…

  7. Crossing Borders within: Stanley Cavell and the Politics of Interpretation

    ERIC Educational Resources Information Center

    Saito, Naoko; Standish, Paul

    2010-01-01

    The matter of crossing borders in the creation of democratic communities arises in ways that are pressing, both within the nation-state and on a global scale. Tensions between tendencies toward nationalism and the cosmopolitan call for global understanding touch the heart of ideas of democracy as beginning at home--at political, psychological, and…

  8. Assessing regional public health preparedness: a new tool for considering cross-border issues.

    PubMed

    Jones, Maggie; O'Carroll, Patrick; Thompson, Jack; D'Ambrosio, Luann

    2008-01-01

    To provide regional, state, and local public health officials a conceptual framework and checklist for assessing regional public health emergency preparedness, specifically in regard to cross-border public health preparedness needs. The project had four phases that are as follows: defining the scope, conducting a literature review, soliciting expert opinion, and creating the assessment framework and checklist. A conceptual framework was developed to define the scope of the project on the basis of the kinds of resources likely to be shared across borders in a public health response (eg, data, supplies, staff), in support of the public health functions likely to be important in a health emergency (eg, epidemiology, laboratory). A literature review was then conducted to identify key articles and tools addressing regional preparedness. Key informant interviews (n = 23) were conducted with public health and emergency management professionals in the Pacific Northwest to identify a set of systems, agreements, and protocols that should be systematically considered in assessing regional public health preparedness. Using the literature review and themes from interviews, a checklist was developed. A checklist was developed for use by public health leaders, which recommends 24 specific agreements, protocols, systems, and management structures that should be considered to foster cross-border public health preparedness. Regional public health preparedness represents not only the sum of state-level preparedness of the states in a region but also the capacity of those states to collaborate across state and international borders during a public health emergency. This checklist provides a tool to systematically consider cross-border preparedness issues.

  9. Integrative health care in Israel and traditional arab herbal medicine: when health care interfaces with culture and politics.

    PubMed

    Keshet, Yael; Popper-Giveon, Ariela

    2013-09-01

    This article contributes to contemporary critical debate in medical anthropology concerning medical pluralism and integrative medicine by highlighting the issue of exclusion of traditional medicine (TM) and presenting attempts at border crossing. Although complementary medicine (CM) modalities are integrated into most Israeli mainstream health care organizations, local indigenous TM modalities are not. Ethnographic fieldwork focused on a group of Israeli dual-trained integrative physicians that has recently begun to integrate traditional herbal medicine preferred by the Arab minority, using it as a boundary object to bridge professional gaps between biomedicine, CM, and TM. This article highlights the relevance of political tensions, ethnicity, and medical inequality to the field of integrative health care. It shows that using herbal medicine as a boundary object can overcome barriers and provide opportunities for dialog and reciprocal learning. © 2013 by the American Anthropological Association.

  10. Environmental Resource Management in Borderlands: Evolution from Competing Interests to Common Aversions

    PubMed Central

    Buckley, Patrick Henry; Belec, John; Levy, Jason

    2015-01-01

    Great enthusiasm is attached to the emergence of cross-border regions (CBRs) as a new institutional arrangement for dealing with local cross-border environmental resource management and other issues that remain too distant from national capitals and/or too expensive to be addressed in the traditional topocratic manner requiring instead local adhocratic methods. This study briefly discusses the perceived value of CBRs and necessary and sufficient conditions for the successful and sustainable development of such places. Then, assuming that necessary conditions can be met, the study investigates an intriguing hypothesis concerning the catalyzing of sustainable consensus for cross-border resource management based on a game theoretical approach that employs the use of dilemma of common aversion rather than the more traditional dilemma of competing common interests. Using this lens to investigate a series of events on the Pacific northwestern Canadian-American border in a part of the Fraser Lowland, we look for evidence of the emergence of an active and sustainable CBR to address local trans-border resource management issues. Although our micro-level scale fails to conclusively demonstrate such evidence, it does demonstrate the value of using this approach and suggests a number of avenues for further research. PMID:26154660

  11. Cross-border policy effects on alcohol outcomes: drinking without thinking on the u.s.-Mexico border?

    PubMed

    Mills, Britain A; Caetano, Raul; Vaeth, Patrice

    2014-11-01

    Rates of alcohol-related outcomes are sensitive to policy differences in politically distinct, adjacent territories. Factors that shape these cross-border effects, particularly when the policy differences are longstanding, remain poorly understood. We compared the ability of 2 classes of variables with theoretical relevance to the U.S.-Mexico border context-bar attendance and alcohol-related social-cognitive variables-to explain elevated drinking on the U.S. side of the border relative to other areas of the United States. Data were collected from multistage cluster samples of adult Mexican Americans on and off the U.S.-Mexico border (current drinker N = 1,351). Structural equation models were used to test drinking context (frequency of bar attendance) and 6 different social-cognitive variables (including alcohol-related attitudes, norms, motives, and beliefs) as mediators of border effects on a composite drinking index. The border effect on drinking varied by age (with younger adults showing a stronger effect), consistent with previous findings and known risk factors in the region. Contrary to theoretical expectations, 6 different social-cognitive variables-despite relating strongly with drinking-were comparable in border and nonborder areas (within and across age) and played no role in elevated drinking on the border. Conversely, elevated drinking among border youth was mediated by bar attendance. This mediated moderation effect held after adjusting for potential sociodemographic and neighborhood-level confounders. Increased drinking among U.S.-Mexico border youth is explained by patterns of bar attendance, but not by more permissive alcohol-related social-cognitive variables in border areas: Border youth attend bars and drink more than their nonborder counterparts, despite having comparable alcohol-related beliefs, attitudes, norms, and motives for use. Alcohol's heightened availability and visibility on both sides of the border may create opportunities for border youth to drink that otherwise would not be considered. Copyright © 2014 by the Research Society on Alcoholism.

  12. Unauthorized border crossings and migrant deaths: Arizona, New Mexico, and El Paso, Texas, 2002-2003.

    PubMed

    Sapkota, Sanjeeb; Kohl, Harold W; Gilchrist, Julie; McAuliffe, Jay; Parks, Bruce; England, Bob; Flood, Tim; Sewell, C Mack; Perrotta, Dennis; Escobedo, Miguel; Stern, Corrine E; Zane, David; Nolte, Kurt B

    2006-07-01

    We examined the major causes of and risk factors for death among migrants who died while making unauthorized border crossings into the United States from Mexico. Decedents were included in the study if (1) their remains were found between January 1, 2002, and December 31, 2003, in any US county along the 650-mi (1040-km) section of the US-Mexican border from Yuma, Ariz, to El Paso, Tex; (2) their immigration status was unauthorized; and (3) they were believed to have died during transit from Mexico to the United States. Characteristics of the decedents and causes of and risk factors for their deaths were examined. Among the 409 decedents meeting our inclusion criteria, environmental heat exposure (n=250; 61.1%) was the leading cause of death, followed by vehicle crashes (n=33; 8.1%) and drownings (n=24; 5.9%). Male decedents (n= 298; 72.8%) outnumbered female decedents (n = 105; 25.6%) nearly 3 to 1. More than half of the decedents were known to be Mexican nationals (n=235; 57.5%) and were aged 20 to 39 years (n=213; 52.0%); the nationality of 148 (36.2%) decedents was undetermined. Deaths among migrants making unauthorized crossings of the US-Mexican border are due to causes that are largely preventable. Prevention strategies should target young Mexican men, and focus on preventing them from conceiving plans to cross the border, discouraging them from using dangerous routes as crossing points, and providing search-and-rescue teams to locate lost or injured migrant crossers.

  13. Unauthorized Border Crossings and Migrant Deaths: Arizona, New Mexico, and El Paso, Texas, 2002–2003

    PubMed Central

    Sapkota, Sanjeeb; Kohl, Harold W.; Gilchrist, Julie; McAuliffe, Jay; Parks, Bruce; England, Bob; Flood, Tim; Sewell, C. Mack; Perrotta, Dennis; Escobedo, Miguel; Stern, Corrine E.; Zane, David; Nolte, Kurt B.

    2006-01-01

    Objectives. We examined the major causes of and risk factors for death among migrants who died while making unauthorized border crossings into the United States from Mexico. Methods. Decedents were included in the study if (1) their remains were found between January 1, 2002, and December 31, 2003, in any US county along the 650-mi (1040-km) section of the US–Mexican border from Yuma, Ariz, to El Paso, Tex; (2) their immigration status was unauthorized; and (3) they were believed to have died during transit from Mexico to the United States. Characteristics of the decedents and causes of and risk factors for their deaths were examined. Results. Among the 409 decedents meeting our inclusion criteria, environmental heat exposure (n=250; 61.1%) was the leading cause of death, followed by vehicle crashes (n=33; 8.1%) and drownings (n=24; 5.9%). Male decedents (n= 298; 72.8%) outnumbered female decedents (n = 105; 25.6%) nearly 3 to 1. More than half of the decedents were known to be Mexican nationals (n=235; 57.5%) and were aged 20 to 39 years (n=213; 52.0%); the nationality of 148 (36.2%) decedents was undetermined. Conclusions. Deaths among migrants making unauthorized crossings of the US–Mexican border are due to causes that are largely preventable. Prevention strategies should target young Mexican men, and focus on preventing them from conceiving plans to cross the border, discouraging them from using dangerous routes as crossing points, and providing search-and-rescue teams to locate lost or injured migrant crossers. PMID:16735618

  14. Border-Crossing Model for the Diffusive Coarsening of Wet Foams

    NASA Astrophysics Data System (ADS)

    Durian, Douglas; Schimming, Cody

    For dry foams, the transport of gas from small high-pressure bubbles to large low-pressure bubbles is dominated by diffusion across the thin soap films separating neighboring bubbles. For wetter foams, the film areas become smaller as the Plateau borders and vertices inflate with liquid. So-called ``border-blocking'' models can explain some features of wet-foam coarsening based on the presumption that the inflated borders totally block the gas flux; however, this approximation dramatically fails in the wet/unjamming limit where the bubbles become close-packed spheres. Here, we account for the ever-present border-crossing flux by a new length scale defined by the average gradient of gas concentration inside the borders. We argue that it is proportional to the geometric average of film and border thicknesses, and we verify this scaling and the numerical prefactor by numerical solution of the diffusion equation. Then we show how the dA / dt =K0 (n - 6) von Neumann law is modified by the appearance of terms that depend on bubble size and shape as well as the concentration gradient length scale. Finally, we use the modified von Neumann law to compute the growth rate of the average bubble, which is not constant.

  15. Cross-border movement, economic development and malaria elimination in the Kingdom of Saudi Arabia.

    PubMed

    Al Zahrani, Mohammed H; Omar, Abdiasiis I; Abdoon, Abdelmohsin M O; Ibrahim, Ali Adam; Alhogail, Abdullah; Elmubarak, Mohamed; Elamin, Yousif Eldirdiry; AlHelal, Mohammed A; Alshahrani, Ali M; Abdelgader, Tarig M; Saeed, Ibrahim; El Gamri, Tageddin B; Alattas, Mohammed S; Dahlan, Abdu A; Assiri, Abdullah M; Maina, Joseph; Li, Xiao Hong; Snow, Robert W

    2018-06-26

    Malaria at international borders presents particular challenges with regards to elimination. International borders share common malaria ecologies, yet neighboring countries are often at different stages of the control-to-elimination pathway. Herein, we present a case study on malaria, and its control, at the border between Saudi Arabia and Yemen. Malaria program activity reports, case data, and ancillary information have been assembled from national health information systems, archives, and other related sources. Information was analyzed as a semi-quantitative time series, between 2000 and 2017, to provide a plausibility framework to understand the possible contributions of factors related to control activities, conflict, economic development, migration, and climate. The malaria recession in the Yemeni border regions of Saudi Arabia is a likely consequence of multiple, coincidental factors, including scaled elimination activities, cross-border vector control, periods of low rainfall, and economic development. The temporal alignment of many of these factors suggests that economic development may have changed the receptivity to the extent that it mitigated against surges in vulnerability posed by imported malaria from its endemic neighbor Yemen. In many border areas of the world, malaria is likely to be sustained through a complex congruence of factors, including poverty, conflict, and migration.

  16. Medical returns: seeking health care in Mexico.

    PubMed

    Horton, Sarah; Cole, Stephanie

    2011-06-01

    Despite the growing prevalence of transnational medical travel among immigrant groups in industrialized nations, relatively little scholarship has explored the diverse reasons immigrants return home for care. To date, most research suggests that cost, lack of insurance and convenience propel US Latinos to seek health care along the Mexican border. Yet medical returns are common even among Latinos who do have health insurance and even among those not residing close to the border. This suggests that the distinct culture of medicine as practiced in the border clinics Latinos visit may be as important a factor in influencing medical returns as convenience and cost. Drawing upon qualitative interviews, this article presents an emic account of Latinos' perceptions of the features of medical practice in Mexico that make medical returns attractive. Between November 15, 2009 and January 15, 2010, we conducted qualitative interviews with 15 Mexican immigrants and nine Mexican Americans who sought care at Border Hospital, a private clinic in Tijuana. Sixteen were uninsured and eight had insurance. Yet of the 16 uninsured, six had purposefully dropped their insurance to make this clinic their permanent "medical home." Moreover, those who substituted receiving care at Border Hospital for their US health insurance plan did so not only because of cost, but also because of what they perceived as the distinctive style of medical practice at Border Hospital. Interviewees mentioned the rapidity of services, personal attention, effective medications, and emphasis on clinical discretion as features distinguishing "Mexican medical practice," opposing these features to the frequent referrals and tests, impersonal doctor-patient relationships, uniform treatment protocols and reliance on surgeries they experienced in the US health care system. While interviewees portrayed these features as characterizing a uniform "Mexican medical culture," we suggest that they are best described as unique to the private clinics and hospitals returning migrants visit. In short, we suggest that the perceived contrast in cultures of medicine derives from the difference in organization of health care services on each side of the border. Copyright © 2011 Elsevier Ltd. All rights reserved.

  17. Crossing Borders in Educational Innovation: Framing Foreign Examples in Discussing Comprehensive Education in the Netherlands, 1969-1979

    ERIC Educational Resources Information Center

    Greveling, Linda; Amsing, Hilda T. A.; Dekker, Jeroen J. H.

    2014-01-01

    In the Netherlands, crossing borders to study comprehensive schools was an important strategy in the 1970s, a decisive period for the start and the end of the innovation. According to policy-borrowing theory, actors that engage in debating educational issues are framing foreign examples of comprehensive schooling to convince their audiences.…

  18. Crossing Cultural Borders into Science Teaching: Early Life Experiences, Racial and Ethnic Identities, and Beliefs about Diversity

    ERIC Educational Resources Information Center

    Brand, Brenda R.; Glasson, George E.

    2004-01-01

    The purpose of this ethnographic study was to explore the development of belief systems as related to racial and ethnic identities of preservice teachers as they crossed cultural borders into science teaching. Data were collected throughout a yearlong teacher preparation program to learn how early life experiences and racial and ethnic identities…

  19. Regulating the New Borderlands: An Event History Analysis of State Cross-Border Distance Higher Education Policy Adoption

    ERIC Educational Resources Information Center

    Milner, Patricia E.

    2013-01-01

    Cross-border state distance higher education policy is a complex web of complicated and often contradictory regulations stretching across 50 states and 14 US territories. This study examined the applicability of strategic choice theory to state higher education policy innovation in the context of the adoption of polices that regulate the distance…

  20. Regional Centre of Expertise (RCE) Rhine-Meuse: A Cross-Border Network

    ERIC Educational Resources Information Center

    Rikers, Jos H. A. N.; Hermans, Jos H. C. L. M.

    2008-01-01

    Purpose: The purpose of this paper is to introduce the case of the cross-border RCE Rhine-Meuse established as the first Regional Centre of Expertise (RCE) on Education for Sustainable Development in Europe. RCE Rhine-Meuse is an initiative of two institutions of higher education in the South of The Netherlands, but reaching out to the German and…

  1. Threats to cross-border wildlife linkages in the Sky Islands Wildlands Network

    Treesearch

    Kim Vacariu

    2005-01-01

    One of the greatest challenges facing conservationists in the Sky Islands region is finding a realistic means to maintain historic travel routes for wide-ranging species crossing the United States-Mexico border. This challenge is made difficult due to the ongoing efforts by the Federal government to install additional security infrastructure to stem the flood of...

  2. Translation of the UNESCO/OECD Guidelines for Quality Provision in Cross-Border Higher Education into Local Policy Contexts: A Comparative Study of Finland and Russia

    ERIC Educational Resources Information Center

    Kallo, Johanna; Semchenko, Anzhelika

    2016-01-01

    This article analyses the localisation of the United Nations Educational Scientific and Cultural Organisation (UNESCO)/Organisation for Economic Co-operation and Development (OECD) "Guidelines for Quality Provision in Cross-Border Higher Education" (2005) at the national and university levels in Finland and Russia. The article engages…

  3. The Public Good, the Market, and Academic Capitalism: U.S. Cross-Border Higher Education in Panama

    ERIC Educational Resources Information Center

    Montoto, Lisette

    2013-01-01

    In recent years, U.S. colleges and universities have begun to extend their international presence through different models of cross-border higher education. This research explores three models of U.S. higher education in Panama City, Panama: a branch campus, a franchise model and merger/acquisition models. Using a qualitative approach, this study…

  4. Language Planning at a Cross-Border University in Swaziland: The Case of Teaching and Learning, Research and Institutional Administration

    ERIC Educational Resources Information Center

    Kamwendo, Gregory Hankoni; Dlamini, Nosisi Percis

    2016-01-01

    The paper discusses language planning at a cross-border university (a Zimbabwean university) that offers academic programmes to the Kingdom of Swaziland in the Southern African region. The paper is situated within the micro-level language planning framework, and discusses language decisions that govern three areas of university business, namely:…

  5. The Influence and Implications of Chinese Culture in the Decision to Undertake Cross-Border Higher Education

    ERIC Educational Resources Information Center

    Bodycott, Peter; Lai, Ada

    2012-01-01

    Little is known about how a family in the Peoples Republic of China (PRC) makes decisions on cross-border study. International marketers and managers in higher education turn to research based on Chinese student preferences. However, such research ignores cultural traditions steeped in Confucian ideals of family and the subsequent roles and…

  6. Cross-border reprogenetic services.

    PubMed

    Couture, V; Drouin, R; Tan, S-L; Moutquin, J-M; Bouffard, C

    2015-01-01

    The purpose of this review is to synthesize the current knowledge on the international movement of patients and biopsied embryo cells for pre-implantation genetic diagnosis and its different applications. Thus far, few attempts have been made to identify the specific nature of this phenomenon called 'cross-border reprogenetic services'. There is scattered evidence, both empirical and speculative, suggesting that these services raise major issues in terms of service provision, risks for patients and the children-to-come, the legal liabilities of physicians, as well as social justice. To compile this evidence, this review uses the narrative overview protocol combined with thematic analysis. Five major themes have emerged from the literature at the conjunction of cross-border treatments and reprogenetics: 'scope', 'scale', 'motivations', 'concerns', and 'governance'. Similar themes have already been observed in the case of other medical tourism activities, but this review highlights their singularity with reprogenetic services. It emphasizes the diagnostic and autologous feature of reprogenetics, the constant risk of misdiagnosis, the restriction on certain tests for medically controversial conditions, and the uncertain accessibility of genetic counseling in cross-border settings. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  7. Importing the Poor: Welfare Magnetism and Cross-Border Welfare Migration

    ERIC Educational Resources Information Center

    Journal of Human Resources, 2005

    2005-01-01

    A study of the welfare programs in two counties bordering different states along with comparative welfare expenditure in interior counties tests the theory that Aid for Families with Dependent Children (AFDC) recipients migrate to counties which have a higher per capita welfare budget. Research shows that border counties with a $100 differential…

  8. INTRA-URBAN GRADIENTS OF FINE PARTICULATE MATTER (PM2.5) IN THE EL PASO CHILDREN'S HEALTH STUDY

    EPA Science Inventory

    El Paso, Texas, a metropolitan area with over 500,000 residents, is located directly across the US/Mexico border from Ciudad Juarez with over 1 million residents. An estimated 18 million vehicles annually cross the international border between these two large cities. The border...

  9. The social and environmental context of cross-border drug use in Mexico: findings from a mixed methods study of young injection drug users living in San Diego, CA.

    PubMed

    Wagner, Karla D; Moynihan, Matthew J; Strathdee, Steffanie A; Cuevas-Mota, Jazmine; Clark, Maureen; Zúñiga, María Luisa; Volkmann, Tyson A; Teshale, Eyasu; Garfein, Richard S

    2012-01-01

    The authors report the results of qualitative (n = 19) and quantitative (n = 545) interviews with young injection drug users (IDUs) in San Diego, California about their experiences using drugs in Tijuana, Mexico, and associated risks for HIV infection. Young IDUs who have ever traveled to Mexico (n = 365) used a variety of injection (54%) and noninjection (30%) drugs there and appear to be heavier users than those who have never traveled to Mexico. Sociocultural themes influencing drug use in Mexico included interactions among the purpose of travel, drug preference, and route of administration; familiarity with the border region; evolving relationships with the United States and Mexican drug markets; and the experience of crossing the U.S.-Mexico border. Interventions for IDUs in border regions need to be sensitive to the ethnicity, familiarity with the border region, and life history of participants, as well as differences in national policies that could influence drug use and risk for HIV on both sides of the border.

  10. The Social and Environmental Context of Cross-border Drug Use in Mexico: Findings from a Mixed Methods Study of Young IDUs Living in San Diego, CA

    PubMed Central

    Wagner, Karla D.; Moynihan, Matthew J.; Strathdee, Steffanie A.; Cuevas-Mota, Jazmine; Clark, Maureen; Zúñiga, María Luisa; Volkmann, Tyson A.; Teshale, Eyasu; Garfein, Richard S.

    2012-01-01

    We report the results of qualitative (n=19) and quantitative (n=545) interviews with young injection drug users (IDUs) in San Diego, California, USA about their experiences using drugs in Tijuana, Mexico, and associated risks for HIV infection. Young IDUs who have ever traveled to Mexico (n=365) used a variety of injection (54%) and non-injection (30%) drugs there, and appear to be heavier users than those who have never traveled to Mexico. Sociocultural themes influencing drug use in Mexico included: interactions amongst the purpose of travel, drug preference, and route of administration; familiarity with the border region; evolving relationships with the US and Mexican drug markets; and the experience of crossing the US/Mexico border. Interventions for IDUs in border regions need to be sensitive to the ethnicity, familiarity with the border region, and life history of participants, as well as differences in national policies that could influence drug use and risk for HIV on both sides of the border. PMID:23216441

  11. Cross-border gas-line projects face daunting challenges

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Khene, D.E.

    1997-12-15

    Pricing, costs, financing, and politics are chief among the issues that can impede construction of major, cross-border gas-pipeline projects trying to connect plentiful reserves with unsatisfied market demand. Additionally, strained relationships among parties involved in both supply and delivery can further slow or even halt progress on a project. In the cases of the Transmed (Algeria across Tunisia to Italy) and the Maghreb-Europe (Algeria across Morocco to Spain), the close working relationships of all parties involved helped resolve many issues and were key in the projects` eventual completion. Here is an update on these two important pipelines in addition tomore » a synthesis of Sonatrach`s views on some of the major issues raised by the development of cross-border gas-transmission projects.« less

  12. Spectrum of critical illness in undocumented border crossers. The Arizona-Mexico border experience.

    PubMed

    Wong, Candy; Hsu, Wendy; Carr, Gordon E

    2015-03-01

    Approximately 150-250 migrants die each year while attempting to cross the border from Mexico to the Southwest United States. Many border crossers survive the journey, but some develop life-threatening medical complications. Such complications have been subject to little formal analysis. We sought to determine the causes of critical illness in this population and to analyze the hospital course and outcomes of these patients. We retrospectively identified border crossers admitted to the intensive care units (ICUs) of two major teaching hospitals in southern Arizona. We recorded admitting diagnoses, severity of illness, length of stay, resource use, discharge diagnoses, and mortality. Our investigation identified 55 admissions to adult ICUs between January 1, 2010 and December 31, 2012. The median age of patients was 27 years. The median hospital length of stay was 7 days, with a median ICU length of stay of 3 days. The median temperature on arrival to the emergency department was 36.8°C. The most common admission diagnoses included trauma (40), rhabdomyolysis (27), acute liver injury (25), dehydration (24), acute kidney injury (19), and encephalopathy (17). Thirteen patients presented with respiratory failure, six patients with severe sepsis, and two with septic shock. A total of 19 patients required ventilator support during their hospital stay, and 30 required at least one surgical intervention. One patient required renal replacement therapy. The median Acute Physiology and Chronic Health Evaluation II score was 6. All but one patient survived to discharge from the hospital. Border crossers are a unique population of young individuals exposed to high temperatures and extreme conditions. Our review of border crosser admissions showed that most patients demonstrated signs of dehydration and leukocytosis, despite a normal median temperature. The median ICU stay was short, despite a high number of patients requiring ventilator support and surgical intervention. Only one death occurred in this cohort.

  13. Importing the Poor: Welfare Magnetism and Cross-Border Welfare Migration

    PubMed Central

    McKinnish, Terra

    2011-01-01

    I test for welfare-induced migration by comparing AFDC participation in border counties to interior counties in the same state. If migration costs are lower for border county residents, border counties on the high-benefit side of a state border should have higher welfare participation relative to the state’s interior counties. Border counties on the low-benefit side should have lower welfare participation relative to the state’s interior counties. The results obtained using county-level data from 1970–90 indicate that having a neighbor with benefits that are $100 lower increases AFDC expenditures in border counties by 4.0–6.8 percent relative to interior counties. PMID:21949446

  14. Natural Gas Imports and Exports. Third Quarter Report 1999

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    none

    1999-10-01

    The second quarter 1997 Quarterly Report of Natural Gas Imports and Exports featured a Quarterly Focus report on cross-border natural gas trade between the United States and Mexico. This Quarterly Focus article is a follow-up to the 1997 report. This report revisits and updates the status of some of the pipeline projects discussed in 1997, and examines a number of other planned cross-border pipeline facilities which were proposed subsequent to our 1997 report. A few of the existing and proposed pipelines are bidirectional and thus have the capability of serving either Mexico, or the United States, depending on market conditionsmore » and gas supply availability. These new projects, if completed, would greatly enhance the pipeline infrastructure on the U.S.-Mexico border and would increase gas pipeline throughput capacity for cross-border trade by more than 1 billion cubic feet (Bcf) per day. The Quarterly Focus is comprised of five sections. Section I includes the introduction as well as a brief historic overview of U.S./Mexican natural gas trade; a discussion of Mexico's energy regulatory structure; and a review of trade agreements and a 1992 legislative change which allows for her cross-border gas trade in North America. Section II looks at initiatives that have been taken by the Mexican Government since 1995to open its energy markets to greater competition and privatization. Section III reviews Mexican gas demand forecasts and looks at future opportunities for U.S. gas producers to supplement Mexico's indigenous supplies in order to meet the anticipated rapid growth in demand. Section IV examines the U.S.-Mexico natural gas trade in recent years. It also looks specifically at monthly import and export volumes and prices and identifies short-term trends in this trade. Finally, Section V reviews the existing and planned cross-border gas pipeline infrastructure. The section also specifically describes six planned pipelines intended to expand this pipeline network and their planned in-service dates.« less

  15. Assessing and improving cross-border chemical incident preparedness and response across Europe.

    PubMed

    Stewart-Evans, James; Hall, Lisbeth; Czerczak, Slawomir; Manley, Kevin; Dobney, Alec; Hoffer, Sally; Pałaszewska-Tkacz, Anna; Jankowska, Agnieszka

    2014-11-01

    Good practices in emergency preparedness and response for chemical incidents include practices specific to the different functions of exposure assessment (e.g., within the monitoring function, the use of mobile monitoring equipment; within the modelling function, the use of rapid dispersion models with integrated mapping software) and generic practices to engage incident response stakeholders to maximise exposure assessment capabilities (e.g., sharing protocols and pre-prepared information and multi-agency training and exercising). Such practices can optimise cross-border collaboration. A wide range of practices have been implemented across MSs during chemical incident response, particularly during incidents that have cross-border and trans-boundary impacts. This paper proposes a self-assessment methodology to enable MSs, or organisations within MSs, to examine exposure assessment capabilities and communication pathways between exposure assessors and public health risk assessors. Where gaps exist, this methodology provides links to good practices that could improve response, communication and collaboration across local, regional and national borders. A fragmented approach to emergency preparedness for chemical incidents is a major obstacle to improving cross-border exposure assessment. There is no one existing body or structure responsible for all aspects of chemical incident preparedness and response in the European Union. Due to the range of different organisations and networks involved in chemical incident response, emergency preparedness needs to be drawn together. A number of recommendations are proposed, including the use of networks of experts which link public health risk assessors with experts in exposure assessment, in order to coordinate and improve chemical incident emergency preparedness. The EU's recent Decision on serious cross-border threats to health aims to facilitate MSs' compliance with the International Health Regulations, which require reporting and communication regarding significant chemical incidents. This provides a potential route to build on in order to improve chemical incident preparedness and response across Europe. Copyright © 2014 Elsevier Ltd. All rights reserved.

  16. Radiation Detection at Borders for Homeland Security

    NASA Astrophysics Data System (ADS)

    Kouzes, Richard

    2004-05-01

    Countries around the world are deploying radiation detection instrumentation to interdict the illegal shipment of radioactive material crossing international borders at land, rail, air, and sea ports of entry. These efforts include deployments in the US and a number of European and Asian countries by governments and international agencies. Items of concern include radiation dispersal devices (RDD), nuclear warheads, and special nuclear material (SNM). Radiation portal monitors (RPMs) are used as the main screening tool for vehicles and cargo at borders, supplemented by handheld detectors, personal radiation detectors, and x-ray imaging systems. Some cargo contains naturally occurring radioactive material (NORM) that triggers "nuisance" alarms in RPMs at these border crossings. Individuals treated with medical radiopharmaceuticals also produce nuisance alarms and can produce cross-talk between adjacent lanes of a multi-lane deployment. The operational impact of nuisance alarms can be significant at border crossings. Methods have been developed for reducing this impact without negatively affecting the requirements for interdiction of radioactive materials of interest. Plastic scintillator material is commonly used in RPMs for the detection of gamma rays from radioactive material, primarily due to the efficiency per unit cost compared to other detection materials. The resolution and lack of full-energy peaks in the plastic scintillator material prohibits detailed spectroscopy. However, the limited spectroscopic information from plastic scintillator can be exploited to provide some discrimination. Energy-based algorithms used in RPMs can effectively exploit the crude energy information available from a plastic scintillator to distinguish some NORM. Whenever NORM cargo limits the level of the alarm threshold, energy-based algorithms produce significantly better detection probabilities for small SNM sources than gross-count algorithms. This presentation discusses experience with RPMs for interdiction of radioactive materials at borders.

  17. Obtaining health care in another European Union Member State: how easy is it to find relevant information?

    PubMed

    Santoro, Alessio; Silenzi, Andrea; Ricciardi, Walter; McKee, Martin

    2015-02-01

    The European Union Directive on cross-border health care places an obligation on member states (MSs) to establish one or more national contact points (NCPs). We evaluated whether MSs were meeting their legal obligations. Two researchers created a set of criteria, drawn from the Directive, to evaluate the information that 18 MSs provide on their NCP websites. Some 15 of the 18 MSs evaluated provided >75% of the information sought. This report shows examples of best practices that could be used to encourage other MSs to improve the quality and quantity of information provided. © The Author 2014. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

  18. A Binational Overview of Reproductive Health Outcomes Among US Hispanic and Mexican Women in the Border Region

    PubMed Central

    Mojarro, Octavio; Sutton, Paul D.; Ventura, Stephanie J.

    2013-01-01

    Introduction The US–Mexico border region has 15 million residents and 300,000 births annually. Reproductive health concerns have been identified on both sides of the border, but comparable information about reproductive health is not available. The objective of this study was to compare reproductive health indicators among populations in this region. Methods We used 2009 US Hispanic and Mexican birth certificate data to compare births inside the border region, elsewhere within the border states, and in the United States and Mexico overall. We examined trends in total fertility and birth rates using birth data from 2000 through 2009 and intercensal population estimates. Results Among women in the border region, US women had more lifetime births than Mexican women in 2009 (2.69 births vs 2.15 births) and throughout the decade. Birth rates in the group aged 15 to 19 years were high in both the US (73.8/1,000) and Mexican (86.7/1,000) border regions. Late or no prenatal care was nearly twice as prevalent in the border regions as in the nonborder regions of border states. Low birth weight and preterm and early-term birth were more prevalent in the US border than in the Mexican border region; US border rates were higher and Mexican rates were lower than their corresponding nonborder and national rates. We found some variations within border states. Conclusion These findings constitute the first population-based information on the reproductive health of the entire Hispanic US–Mexico border population. Evidence of disparities warrants exploration at state and local levels. Teen pregnancy and inadequate prenatal care are shared problems in US–Mexico border communities and suggest an area for binational cooperation. PMID:23948338

  19. A binational overview of reproductive health outcomes among US Hispanic and Mexican women in the border region.

    PubMed

    McDonald, Jill A; Mojarro, Octavio; Sutton, Paul D; Ventura, Stephanie J

    2013-08-15

    The US-Mexico border region has 15 million residents and 300,000 births annually. Reproductive health concerns have been identified on both sides of the border, but comparable information about reproductive health is not available. The objective of this study was to compare reproductive health indicators among populations in this region. We used 2009 US Hispanic and Mexican birth certificate data to compare births inside the border region, elsewhere within the border states, and in the United States and Mexico overall. We examined trends in total fertility and birth rates using birth data from 2000 through 2009 and intercensal population estimates. Among women in the border region, US women had more lifetime births than Mexican women in 2009 (2.69 births vs 2.15 births) and throughout the decade. Birth rates in the group aged 15 to 19 years were high in both the US (73.8/1,000) and Mexican (86.7/1,000) border regions. Late or no prenatal care was nearly twice as prevalent in the border regions as in the nonborder regions of border states. Low birth weight and preterm and early-term birth were more prevalent in the US border than in the Mexican border region; US border rates were higher and Mexican rates were lower than their corresponding nonborder and national rates. We found some variations within border states. These findings constitute the first population-based information on the reproductive health of the entire Hispanic US-Mexico border population. Evidence of disparities warrants exploration at state and local levels. Teen pregnancy and inadequate prenatal care are shared problems in US-Mexico border communities and suggest an area for binational cooperation.

  20. Performance measures and reporting for international border crossings.

    DOT National Transportation Integrated Search

    2016-04-01

    There are several international borders shared among the ENTERPRISE Pooled Fund Study members (Washington State Department of Transportation, Minnesota Department of Transportation, Michigan Department of Transportation, Ministry of Transportation On...

  1. 77 FR 1550 - Environmental Impact Statement: Erie County, NY

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-10

    ... structure and to expand the border crossing plaza for Federal inspection agencies with reconstruction... the border can be accomplished without a combined bridge and plaza improvements project and addressed...

  2. Technological and cross-border mixture value chain of science and engineering of multi-integrative mechatronics-integronics-adaptronics

    NASA Astrophysics Data System (ADS)

    Gheorghe, Gh. Ion; Popan, Gheorghe

    2013-10-01

    This scientific paper presents in national premiere and in original concept of the author, the scientific national and the author's original concept, the technological and cross-border mixture value chain of science and engineering of multi-integrative Mechatronics-Integronics-Adaptronics, as high-tech vector support development, for viability and sustainability of a new intelligent and competitive labour market.

  3. New Era, New Policy: Cross-Border Education and Sino-Foreign Cooperation in Running Schools in the Eyes of a Fence-Sitter

    ERIC Educational Resources Information Center

    Minxuan, Zhang

    2009-01-01

    Since World War II, the internationalization of education has experienced a change from a period of political influence to a service trade structure. As the Third International Forum on the Educational Service Trade began, more and more governments accepted the concept of cross-border education. At a time when both opportunities and challenges lay…

  4. The Labor Market Outcomes of Two Forms of Cross-Border Higher Education Degree Programs between Malaysia and Japan

    ERIC Educational Resources Information Center

    Koda, Yoshiko; Yuki, Takako

    2013-01-01

    This paper examines the labor market outcomes of two different forms of cross-border higher education degree programs (i.e., study abroad vs. twinning) between Malaysia and Japan. Based on a new graduate survey, it examines whether there are differences in the labor market outcomes between the two programs and what other factors have significant…

  5. How Are School Systems Adapting to Increasing Numbers of Immigrant Students? PISA in Focus. No. 11

    ERIC Educational Resources Information Center

    OECD Publishing (NJ1), 2011

    2011-01-01

    Whether in flight from conflict, with the hope of building a better life, or to seize a social or economic opportunity, people have been crossing borders for as long as there have been borders to cross. Modern means of transportation and communication, the globalisation of the labour market, and the ageing of populations in OECD (Organisation for…

  6. Educational Strategies of Highly Educated Chinese Women Married to Japanese Men: A Preliminary Study on Child Raising in Japan

    ERIC Educational Resources Information Center

    Shikita, Keiko

    2014-01-01

    The past two decades have witnessed a dramatic increase in cross-border marriage in Southeast and East Asia largely as a result of increased population mobility as people move for work, study, lifestyle or even marital reasons. Japan is no exception with a substantial increase in the number of cross-border or "international marriages"…

  7. Global Connections to Global Partnerships: Navigating the Changing Landscape of Internationalism and Cross-Border Higher Education

    ERIC Educational Resources Information Center

    Olcott, Don, Jr.

    2009-01-01

    The purpose of this article is to provide continuing higher education leaders with a comprehensive overview of the major considerations for doing business in the global market. Included is an analysis of the driving forces in global higher education and current trends in cross-border programs and a brief review of activities that may be part of a…

  8. United States-Mexico cross-border health insurance initiatives: Salud Migrante and Medicare in Mexico.

    PubMed

    Vargas Bustamante, Arturo; Laugesen, Miriam; Caban, Mabel; Rosenau, Pauline

    2012-01-01

    While U.S. health care reform will most likely reduce the overall number of uninsured Mexican-Americans, it does not address challenges related to health care coverage for undocumented Mexican immigrants, who will remain uninsured under the measures of the reform; documented low-income Mexican immigrants who have not met the five-year waiting period required for Medicaid benefits; or the growing number of retired U.S. citizens living in Mexico, who lack easy access to Medicare-supported services. This article reviews two promising binational initiatives that could help address these challenges-Salud Migrante and Medicare in Mexico; discusses their prospective applications within the context of U.S. health care reform; and identifies potential challenges to their implementation (legal, political, and regulatory), as well as the possible benefits, including coverage of uninsured Mexican immigrants, and their integration into the U.S. health care system (through Salud Migrante), and access to lower-cost Medicare-supported health care for U.S. retirees in Mexico (Medicare in Mexico).

  9. United States-Mexico cross-border health insurance initiatives: Salud Migrante and Medicare in Mexico

    PubMed Central

    Bustamante, Arturo Vargas; Laugesen, Miriam; Caban, Mabel; Rosenau, Pauline

    2014-01-01

    While U.S. health care reform will most likely reduce the overall number of uninsured Mexican-Americans, it does not address challenges related to health care coverage for undocumented Mexican immigrants, who will remain uninsured under the measures of the reform; documented low-income Mexican immigrants who have not met the five-year waiting period required for Medicaid benefits; or the growing number of retired U.S. citizens living in Mexico, who lack easy access to Medicare-supported services. This article reviews two promising binational initiatives that could help address these challenges—Salud Migrante and Medicare in Mexico; discusses their prospective applications within the context of U.S. health care reform; and identifies potential challenges to their implementation (legal, political, and regulatory), as well as the possible benefits, including coverage of uninsured Mexican immigrants, and their integration into the U.S. health care system (through Salud Migrante), and access to lower-cost Medicare-supported health care for U.S. retirees in Mexico (Medicare in Mexico). PMID:22427168

  10. Exploring the association of homicides in northern Mexico and healthcare access for US residents

    PubMed Central

    Geissler, Kimberley; Becker, Charles; Stearns, Sally; Thirumurthy, Harsha; Holmes, George M.

    2016-01-01

    Background Many legal residents in the United States (US)-Mexico border region cross from the US into Mexico for medical treatment and pharmaceuticals. We analyzed whether recent increases in homicides in Mexico are associated with reduced healthcare access for US border residents. Methods We used data on healthcare access, legal entries to the US from Mexico, and Mexican homicide rates (2002–2010). Poisson regression models estimated associations between homicide rates and total legal US entries. Multivariate difference-in-difference linear probability models evaluated associations between Mexican homicide rates and self-reported measures of healthcare access for US residents. Results Increased homicide rates were associated with decreased legal entries to the US from Mexico. Contrary to expectations, homicides did not have significant associations with healthcare access measures for legal residents in US border counties. Conclusions Despite a decrease in border crossings, increased violence in Mexico did not appear to negatively affect access for US border residents. PMID:24917240

  11. Cross-Border Transitions: Navigating Conflict and Political Change through Community Education Practices in Myanmar and the Thai Border

    ERIC Educational Resources Information Center

    Maber, Elizabeth J. T.

    2016-01-01

    Political oscillations in Myanmar and Thailand, between militarisation and democratic reform, have prompted a rapid renegotiation of the alignments, goals and priorities of non-state education providers, both international and community-based, along the two countries' border. This paper explores the responses to shifts in political environment…

  12. Infectious Disease Border Issues Conference: Meeting Synopsis

    DTIC Science & Technology

    2012-04-03

    methicillin - resistant Staphylococcus aureus (MRSA). Operation MECACAR 1998 was highlighted as a successful example of cross-border coordination...training courses, no joint public health investigation teams) and illegal animal transportation across borders were identified as some of the existing...Work (2007), including fostering global partnerships; strengthening public health security in travel and transport ; improving the WHO global alert

  13. Evaluation of Exposures to Diesel Particulate Matter Utilizing Ambient Air Monitoring and Urinary Biomarkers Among Pedestrian Commuters who Cross the U.S.-Mexico Border at San Ysidro, CA

    NASA Astrophysics Data System (ADS)

    Galaviz, Vanessa Eileen

    Background: Walk-in-line pedestrians crossing the U.S.-Mexico border northbound at the San Ysidro, CA Port of Entry ("Border Commuters") may be at an increased risk of experiencing elevated traffic-related air pollution, including diesel exhaust (DE). DE exposure has been associated with numerous adverse health effects, particularly cardiovascular and respiratory problems, including as lung cancer. Pedestrian crossers wait in line for extended periods and stand within 10 feet of highly concentrated traffic, particularly to diesel buses. Understanding the magnitude of traffic-related exposures is important for this vulnerable population. It was hypothesized that subjects who reside in Tijuana, Baja California, Mexico and cross the border as a pedestrian will experience higher exposure to traffic-related pollutants than those who live and work in South San Diego, CA, USA and do not cross the border. Methods: Ninety-one participants were enrolled for this study; 80% were "Border Commuters" and 20% were "Non-Border Commuters". "Non-Border Commuters" served as the comparison group and were defined as residents who lived in or near and worked or went to school in San Ysidro, CA but did not cross the border. Questionnaires, time activity diaries, and urine samples were collected from all participants. Of the "Border Commuters", 56 personal 24-hour PM2.5 and 1-nitropyrene (1-NP) - a marker for diesel exhaust - samples were collected. There were 22 at-home indoor and 14 at-home outdoor 1-NP samples collected. Additionally, area samples collected at the border included 35 days of 1-NP, black carbon (BC), carbon monoxide (CO), fine particulate matter (PM2.5) and ultrafine particulate matter (UFP). Of the "Non-Border Commuters", 15 personal 24-hour PM2.5 and 1-NP samples were collected. Additonally, 3 at-home indoor and outdoor 24-hour 1-NP samples were collected. Results: Personal exposure to PM2.5 was nearly 2-fold higher among "Border Commuters" compared to "Non-Border Commuters" (39 +/- 30 μg/m3 vs 21 +/- 11 μg/m3), while personal exposure to 1-NP was more than 8-fold higher among the "Border Commuters"(1.7 +/- 2.6 vs 0.22 +/- 0.21 pg/m3, p<0.01, Mann-Whitney). Two metabolites of 1-NP were readily detected in urine samples, the most abundant of which was 8-hydroxy-1-nitropyrene (8-OHNP). "Border Commuters" had greater than a 2-fold higher concentration of 8-OHNP (0.071 +/- 0.066 vs 0.032 +/- 0.021 pg/mL, p=0.05, Mann-Whitney) and a 3-fold higher concentration of 8-OHNAAP (0.063 +/- 0.11 vs 0.021 +/- 0.013 pg/mL, p=0.11, Mann-Whitney) as compared to "Non-Border Commuters". Home indoor concentrations of 1-NP were 30-60% of home outdoor concentrations with "Border Commuters" having higher concentrations both indoors (0.64 +/- 0.81 vs 0.078 +/- 0.075 pg/m3, p=0.04, Mann-Whitney) and outdoors (1.0 +/- 0.93 vs 0.27 +/- 0.24 pg/m3, p=0.11, Mann-Whitney) compared to "Non-Border Commuters". Border concentrations of 1-NP weighted by the time spent at the border, total travel given season, and season were all predictors of personal exposure to 1-NP among "Border Commuters". However, when placed in a multivariate linear regression model total travel given season was the only predictor variable to remain significant. Season was the only predictor for personal exposure to PM2.5 among "Border Commuters". Total travel was also a significant predictor for 8-OHNP among "Border Commuters." Median values (IQR) of daily averages for fixed-site measurements made at the border were as follows: 40,000 (24,000-52,000) UFP/cm3, 5 (3-6) ppm CO, 1.3 (0.5-2.6) pg/m3 1-NP, 4 (3-11) μg/m3 BC, 41 (23-57) μg/m3 real-time PM2.5, and 15 (13-22) μg/m3 gravimetric PM2.5. Wind speed was a predictor of gravimetric PM2.5 at the border explaining 22% of the variance. Relative humidity and vehicle delay were both predictors of UFP measured at the border, explaining 13% and 21% of the variance, respectively. However, when modeled together none remain significant. There were no predictors for 1-NP measurements at the border. Conclusions: This is the first quantitative study characterizing traffic-related exposure to a vulnerable population, indicating that this vulnerable population is indeed at high risk for exposure. "Border Commuters" experience higher exposure to 1-NP and PM2.5 as compared to "Non-Border Commuters", as determined by both personal and at-home measurements. In addition, traffic-related air pollution exposure among "Border Commuters" within 10 feet of highly concentrated traffic is of great public health concern as concentrations at the border are similar to near-roadway studies that link exposure to adverse health effects. Interventions to reduce border wait times would significantly reduce traffic pollutant exposures in this vulnerable population. However, further work needs to be done to understand the spatial heterogeneity of at-home exposures between the two study groups.

  14. Is tuberculosis crossing borders at the Eastern boundary of the European Union?

    PubMed Central

    van der Werf, Marieke J.; Hollo, Vahur; Noori, Teymur

    2013-01-01

    Background: The Eastern border of the European Union (EU) consists of 10 countries after the expansion of the EU in 2004 and 2007. These 10 countries border to the East to countries with high tuberculosis (TB) notification rates. We analyzed the notification data of Europe to quantify the impact of cross-border TB at the Eastern border of the EU. Methods: We used TB surveillance data of 2010 submitted by 53 European Region countries to the European Centre for Disease Prevention and Control and the World Health Organization Regional Office for Europe. Notified TB cases were stratified by origin of the case (national/foreign). We calculated the contribution of foreign to overall TB notification. Results: In the 10 EU countries located at the EU Eastern border, 618 notified TB cases (1.7% of all notified TB cases) were of foreign origin. Of those 618 TB cases, 173 (28.0%) were from countries bordering the EU to the East. More specifically, 90 (52.0%) were from Russia, 33 (19.1%) from Belarus, 33 (19.1%) from Ukraine, 13 (7.5%) from Moldova and 4 (2.3%) from Turkey. Conclusions: Currently, migrants contribute little to TB notifications in the 10 EU countries at the Eastern border of the EU, but changes in migration patterns may result in an increasing contribution. Therefore, EU countries at the Eastern border of the EU should strive to provide prompt diagnostic services and adequate treatment of migrants. PMID:23813718

  15. Border-crossing model for the diffusive coarsening of two-dimensional and quasi-two-dimensional wet foams

    NASA Astrophysics Data System (ADS)

    Schimming, C. D.; Durian, D. J.

    2017-09-01

    For dry foams, the transport of gas from small high-pressure bubbles to large low-pressure bubbles is dominated by diffusion across the thin soap films separating neighboring bubbles. For wetter foams, the film areas become smaller as the Plateau borders and vertices inflate with liquid. So-called "border-blocking" models can explain some features of wet-foam coarsening based on the presumption that the inflated borders totally block the gas flux; however, this approximation dramatically fails in the wet or unjamming limit where the bubbles become close-packed spheres and coarsening proceeds even though there are no films. Here, we account for the ever-present border-crossing flux by a new length scale defined by the average gradient of gas concentration inside the borders. We compute that it is proportional to the geometric average of film and border thicknesses, and we verify this scaling by numerical solution of the diffusion equation. We similarly consider transport across inflated vertices and surface Plateau borders in quasi-two-dimensional foams. And we show how the d A /d t =K0(n -6 ) von Neumann law is modified by the appearance of terms that depend on bubble size and shape as well as the concentration gradient length scales. Finally, we use the modified von Neumann law to compute the growth rate of the average bubble area, which is not constant.

  16. SARS related preventive and risk behaviours practised by Hong Kong-mainland China cross border travellers during the outbreak of the SARS epidemic in Hong Kong

    PubMed Central

    Lau, J.; Yang, X.; Tsui, H; Pang, E.

    2004-01-01

    Objectives: To investigate patterns of behaviours and attitudes related to SARS prevention in the Hong Kong cross border traveller population. Settings: A survey was carried out at the Hong Kong-China cross border checkpoint in the middle of the epidemic. Participants: A total of 839 Hong Kong adult residents returning to Hong Kong from mainland China were surveyed. Main outcome measures: Practice of preventive measures and relevant behaviours and attitudes. Results: Around 40% of the respondents were using masks all or most of the time in public places or washing their hands frequently (>10 times per day) and about one third avoided visiting crowded places in mainland China. Such figures were however lower than those practised by the general public in Hong Kong. SARS related perceptions, such as perceived risk of transmission and efficacy, etc, were associated with mask use and not visiting crowded places, but not with hand washing, which was associated with duration of stay. Gender differences were also observed. Around 70% of the travellers would have delayed medical consultation for influenza-like illness in China; 12.7% would not wear masks during such episodes of illness. Furthermore, about 30% of the respondents used to wear masks in Hong Kong but not in mainland China. Conclusions: The findings have implications on cross border prevention of SARS. It seems that those travelling during the SARS epidemic were a "self selected" group, and they were using less preventive measures. Special attention and intervention need to be provided to travellers to prevent a second wave cross border transmission of the disease. PMID:15547057

  17. International Border Electronic Clearance -- IBEX : evaluation report

    DOT National Transportation Integrated Search

    1998-07-01

    The International Border Electronic Crossing (IBEX) system implemented in this operational test was intended to demonstrate the integration of electronic information systems and technologies aimed at facilitating the safe, efficient movement of goods...

  18. Attitudes towards cross-border reproductive care among infertile Japanese patients.

    PubMed

    Hibino, Yuri; Shimazono, Yosuke; Kambayashi, Yasuhiro; Hitomi, Yoshiaki; Nakamura, Hiroyuki

    2013-11-01

    The attitudes towards cross-border reproductive care (CBRC) held by infertile Japanese patients have not been explored. The objective of the present study was to examine interest levels, preferred destinations, motivations, and sources of information related to CBRC. Our findings provide a general outline of CBRC and the future of reproduction and assisted reproductive technology (ART) in Japan. The study used a cross-sectional design. Data were collected from 2,007 infertile Japanese patients from 65 accredited ART clinics in Japan (response rate, 27.4 %) via anonymous questionnaires. Most of the infertile Japanese patients who responded denied using CBRC. However, by group, 171 (8.5 %) patients in non-donor in vitro fertilization, 150 (7.5 %) in egg donation, 145 (7.2 %) in pre-implantation genetic diagnosis, and 129 (6.4 %) in surrogacy said that, depending on the situation, they might travel abroad in the future. Older respondents were more likely to express an intention to travel overseas for egg donation in the future. The most popular destination for CBRC was the United States. Popular reasons for interest in CBRC among those considering or planning using this approach to third-party reproduction were that egg donation or surrogacy was unavailable or that obtaining ethical approval takes too long in Japan, whereas these processes are legal and affordable overseas. However, high cost was the most common reason for hesitancy regarding CBRC. Among the participants who were considering or planning to travel abroad for this purpose, TV, medical agencies, print media, and message boards on websites were popular sources of information, whereas doctors, friends, and patient self-help groups were not. Although CBRC among infertile Japanese patients is not at present common, the demand for and use of this approach may increase in the future in the context of the increasingly aging population. Lack of regulation and unavailability of third-party reproduction is a major cause of CBRC among Japanese patients. Health care provider faces an urgent need for giving useful information for patients regarding CBRC.

  19. Comparison of the Partner Institutions' Perceptions of the Cross-Border Higher Education Program and the Impact on Program Implementation: Case Studies of Two Sino-U.S. Business Management Programs

    ERIC Educational Resources Information Center

    Jie, Yiyun

    2011-01-01

    This study examined discrepancies and similarities between the partner institutions' perceptions of the motivations, expected outcomes, and desired strategies achieving such outcomes in their cross-border higher educational programs from a game theory perspective, in the context of Mainland China (hereafter referred to as China). By comparing the…

  20. Medical sociology as a heuristic instrument for medical tourism and cross-border healthcare

    PubMed Central

    Mainil, Tomas

    2015-01-01

    In this commentary, we establish a relationship between medical sociology and the study of medical tourism and cross-border healthcare by introducing Ronald Andersen’s behavioral model of healthcare use, and linking this model to the recent empirical study of Kovacs et al. on patients travelling to Hungary for orthopedic treatment. Finally, we plead for more measurement in the field of patient mobility. PMID:25844386

  1. NATO, the Subjective Alliance: The Debate Over the Future

    DTIC Science & Technology

    1988-04-01

    consistency and conceptual neatness become the currency for intra-alliance bargaining in a manner which may exacerbate disagreement and transform difference...Republic. The West Germans of today are also comfortable realists who recog- nize the limits of cross -border brotherhood and the risks of too much of it...liberalization of the East, economic cooperation, and relaxation of border- crossing restrictions. Krell describes the breadth as well as the substance of

  2. The ties that bind : bi-national trade and its implications of the U.S. and Canada using bi-national freight movement network via border crossings : final report.

    DOT National Transportation Integrated Search

    2016-12-01

    The objectives of this research are to understand the economic importance of border bridges on the U.S.-Canada economies, especially involving the various US states proximate to the Provinces of Ontario, and to simulate various the U.S.-Canada border...

  3. Literacies Crossing Borders: Transfronterizo Literacy Practices of Students in a Dual Language Program on the USA-Mexico Border

    ERIC Educational Resources Information Center

    de la Piedra, Maria Teresa; Araujo, Blanca E.

    2012-01-01

    Research on transnational literacies has generally focused on youth who live in one country and communicate using digital literacies across national boundaries. Our work contributes to this literature by providing a view of transnational literacies that are unique to the USA-Mexico border region. The students in this ethnographic study navigate…

  4. 75 FR 73156 - Bureau of Western Hemisphere Affairs; Executive Order 11423, as Amended; Notice of Receipt of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-29

    ... San Ysidro Land Port of Entry on the U.S.- Mexico Border at San Diego, CA and Tijuana, Baja CA, Mexico... renovation and expansion of the San Ysidro border crossing facility on the U.S.-Mexico border at San Diego, California and Tijuana, Baja California, Mexico. The General Services Administration (GSA) filed this...

  5. Border Malaria Associated with Multidrug Resistance on Thailand-Myanmar and Thailand-Cambodia Borders: Transmission Dynamic, Vulnerability, and Surveillance

    PubMed Central

    Bhumiratana, Adisak; Intarapuk, Apiradee; Sorosjinda-Nunthawarasilp, Prapa; Maneekan, Pannamas; Koyadun, Surachart

    2013-01-01

    This systematic review elaborates the concepts and impacts of border malaria, particularly on the emergence and spread of Plasmodium falciparum and Plasmodium vivax multidrug resistance (MDR) malaria on Thailand-Myanmar and Thailand-Cambodia borders. Border malaria encompasses any complex epidemiological settings of forest-related and forest fringe-related malaria, both regularly occurring in certain transmission areas and manifesting a trend of increased incidence in transmission prone areas along these borders, as the result of interconnections of human settlements and movement activities, cross-border population migrations, ecological changes, vector population dynamics, and multidrug resistance. For regional and global perspectives, this review analyzes and synthesizes the rationales pertaining to transmission dynamics and the vulnerabilities of border malaria that constrain surveillance and control of the world's most MDR falciparum and vivax malaria on these chaotic borders. PMID:23865048

  6. International Issues: Cross-border mobility of junior neurologists within and to the European Union.

    PubMed

    Macerollo, Antonella; Varga, Edina T; Struhal, Walter; Györfi, Orsolya; Kobeleva, Xenia; Sellner, Johann

    2014-09-23

    To assess the general interest in and motivation for cross-border mobility among residents and junior neurologists from member states of the European Union and neighboring countries. Questionnaire-based paper survey among 118 participants of a neurology course. Ninety-seven (82%) participants returned the survey. Most of them had at one point considered relocating within or to the European Union for postgraduate education (87%) or employment (71%). Common motivations were superior prospects for clinical training (85%), resources at work and academic environment (both 80%), and remuneration (70%). Barely half of the surveyed intended to return to their home country. The attractiveness of Europe as a destination for migration was ranked over other continents. The most common reasons that reduce enthusiasm for relocation were the loss of family connection (55%) and uncertain future prospects (41%), whereas language barriers were less relevant (21%). There is keen interest of the upcoming generation of neurologists to relocate within and to the European Union. The motives include regional differences in training and career opportunities as well as economic welfare. Appropriate steps toward the harmonization of educational and career prospects are urgently required to ensure adequate provision of neurology service and patient care throughout Europe. © 2014 American Academy of Neurology.

  7. Comparative studies and healthcare policy: learning and mislearning across borders.

    PubMed

    Okma, Kieke G H; Marmor, Theodore R

    2013-10-01

    This article addresses the vocabulary of cross-national analysis and commentary about health care, health policy and health politics. We conclude there is a large gap between promise and performance in comparative policy commentary and point to major sources of confusion, such as the lack of generally agreed vocabulary, vague language and the use of faddish and misleading terms and aspirational labels (illustrated by a selection of widely used expressions in comparative reports). We next examine the basic purposes of international policy comparison, distinguish three useful and two misleading approaches and frame defensible ground rules for comparative work.

  8. Developing a composite index of spatial accessibility across different health care sectors: A German example.

    PubMed

    Siegel, Martin; Koller, Daniela; Vogt, Verena; Sundmacher, Leonie

    2016-02-01

    The evolving lack of ambulatory care providers especially in rural areas increasingly challenges the strict separation between ambulatory and inpatient care in Germany. Some consider allowing hospitals to treat ambulatory patients to tackle potential shortages of ambulatory care in underserved areas. In this paper, we develop an integrated index of spatial accessibility covering multiple dimensions of health care. This index may contribute to the empirical evidence concerning potential risks and benefits of integrating the currently separated health care sectors. Accessibility is measured separately for each type of care based on official data at the district level. Applying an Improved Gravity Model allows us to factor in potential cross-border utilization. We combine the accessibilities for each type of care into a univariate index by adapting the concept of regional multiple deprivation measurement to allow for a limited substitutability between health care sectors. The results suggest that better health care accessibility in urban areas persists when taking a holistic view. We believe that this new index may provide an empirical basis for an inter-sectoral capacity planning. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  9. Crossing Borders Virtual and Real: A Transnational Internet-Based Community of Spaghetti Western Fans Finally Meet Each Other Face to Face on the Wild Plains of Almeria, Spain

    ERIC Educational Resources Information Center

    Broughton, Lee

    2011-01-01

    Since the rise of the Internet, the act of border crossing has become a pursuit that must necessarily be conceptualized in both real and virtual terms. By using theories connected to virtual communities, new technologies, fan cultures and tourism, this paper seeks to show that the culturally productive activities of a transnational virtual…

  10. The implementation of the Directive on the Application of Patients' Rights in Cross-border Healthcare in the Netherlands.

    PubMed

    Bongers, L M H; Townend, D M R

    2014-03-01

    This article discusses the significance of the Directive 2011/24/EU on the application of patients' rights in cross-border healthcare for the protection of individual patients' rights in the Netherlands by describing how its provisions are implemented in Dutch health law. The responsible Dutch authorities take the view that most of the Directive's provisions and requirements are covered in existing Dutch law. Implementation of the Directive would only require adaptations to national legislation with regard to the establishment of a national contact point for cross-border healthcare and the recognition of medical prescriptions issued in another Member State. This article looks into the question of how far the Dutch law meets the requirements of the Directive in relation to the individual patients' rights addressed in this special issue of the European Journal of Health Law.

  11. Persistent disparities in the use of health care along the US-Mexico border: an ecological perspective.

    PubMed

    Bastida, Elena; Brown, H Shelton; Pagán, José A

    2008-11-01

    We examined disparities in health care use among US-Mexico border residents, with a focus on the unique binational environment of the region, to determine factors that may influence health care use in Mexico. Data were from 2 waves of a population-based study of 1048 Latino residents of selected Texas border counties. Logistic regression models examined predictors of health insurance coverage. Results from these models were used to examine regional patterns of health care use. Of the respondents younger than 65 years, 60% reported no health insurance coverage. The uninsured were 7 and 3 times more likely in waves 3 and 4, respectively, to use medical care in Mexico than were the insured. Preference for medical care in Mexico was an important predictor. For those who were chronically ill, old, poor, or burdened by the lengthy processing of their documents by immigration authorities, the United States provided the only source of health care. For some, Mexico may lessen the burden at the individual level, but it does not lessen the aggregate burden of providing highly priced care to the region's neediest. Health disparities will continue unless policies are enacted to expand health care accessibility in the region.

  12. Away from home: experiences of Mexican American families in pediatric palliative care.

    PubMed

    Contro, Nancy; Davies, Betty; Larson, Judith; Sourkes, Barbara

    2010-01-01

    In this study, the authors describe the experiences of Mexican American family members who immigrated to the United States and then experienced the death of a child. Participants described difficulties they encountered crossing the border, leaving the culture of their homeland, and then caring for a seriously ill child. Key themes that characterized their experience of being far from home included a backdrop of poverty, absence of traditional social support, and challenges caring for healthy siblings. Participants made comparisons between health care in Mexico and the United States and assessed the trade-off they made to come to the United States, discussing access to medical care and how they were able to relate to health care providers. Further, participants conveyed how rituals from their home country were important in maintaining connections with the child who died. Based on these themes, clinical implications and strategies that focus on understanding participants' experiences with past traumas, communication and literacy needs, and the challenges of living in poverty--especially with a critically ill child--are needed.

  13. German, Polish, and Czech School Cooperation in the Neisse-Nisa-Nysa EuroRegion

    ERIC Educational Resources Information Center

    Dubeck, Kirsti; Schulz, Dieter

    2004-01-01

    The Euroregions are a form of border and cross-border cooperation. The Euroregion Neisse (D)-Nisa (CZ)-Nysa (PL) is one of four Euroregions along the German-Polish border. It was established in 1991 by the Union of Polish Communities (ERN), The Union of German communities (ERN), and the Regional Community Union of the Cities and Communities of the…

  14. Infiltrating to Win: The Conduct of Border Denial Operations

    DTIC Science & Technology

    2016-04-04

    Infiltrating to Win: The Conduct of Border Denial Operations A Monograph by MAJ Craig A. Broyles United...YYYY) 12. REPORT TYPE 3. DATES COVERED (From - To) 04/04/2016 Monograph JUN 2015 - MAY 2016 4. TITLE AND SUBTITLE 5a. CONTRACT NUMBER Infiltrating ...for public release; Distribution is unlimited. 13. SUPPLEMENTARY NOTES 14. ABSTRACT Covert cross border infiltration plays a critical role in

  15. Crossing Borders and Building Bridges: A Video Ethnography of Special Education in Nuevo Progresso, Mexico

    ERIC Educational Resources Information Center

    Lowdermilk, John; Pecina, Julie; Fielding, Cheryl; Beccera, Lisa

    2016-01-01

    This paper presents an overview of a video ethnographic study of a special education school on the Texas/Mexico Border. The public school is located in Nuevo Progreso, which is a town in the Río Bravo Municipality in the state of Tamaulipas in Mexico. The town is located on the United States-Mexico border. The Progreso-Nuevo Progreso International…

  16. Occupational and Environmental Health Problems along the U.S.-Mexico Border.

    ERIC Educational Resources Information Center

    Abrams, Herbert K.

    1979-01-01

    Comments on the health of migrant farmworkers in the U.S. and the Border Industrialization ("twin plants") Program with a brief description of the unique U.S.-Mexico border region, emphasizing the status of air pollution, housing, nutrition, and health care. Available from Southwest Economy & Society, Box 4482, Albuquerque, New…

  17. Towards tuberculosis elimination: an action framework for low-incidence countries.

    PubMed

    Lönnroth, Knut; Migliori, Giovanni Battista; Abubakar, Ibrahim; D'Ambrosio, Lia; de Vries, Gerard; Diel, Roland; Douglas, Paul; Falzon, Dennis; Gaudreau, Marc-Andre; Goletti, Delia; González Ochoa, Edilberto R; LoBue, Philip; Matteelli, Alberto; Njoo, Howard; Solovic, Ivan; Story, Alistair; Tayeb, Tamara; van der Werf, Marieke J; Weil, Diana; Zellweger, Jean-Pierre; Abdel Aziz, Mohamed; Al Lawati, Mohamed R M; Aliberti, Stefano; Arrazola de Oñate, Wouter; Barreira, Draurio; Bhatia, Vineet; Blasi, Francesco; Bloom, Amy; Bruchfeld, Judith; Castelli, Francesco; Centis, Rosella; Chemtob, Daniel; Cirillo, Daniela M; Colorado, Alberto; Dadu, Andrei; Dahle, Ulf R; De Paoli, Laura; Dias, Hannah M; Duarte, Raquel; Fattorini, Lanfranco; Gaga, Mina; Getahun, Haileyesus; Glaziou, Philippe; Goguadze, Lasha; Del Granado, Mirtha; Haas, Walter; Järvinen, Asko; Kwon, Geun-Yong; Mosca, Davide; Nahid, Payam; Nishikiori, Nobuyuki; Noguer, Isabel; O'Donnell, Joan; Pace-Asciak, Analita; Pompa, Maria G; Popescu, Gilda G; Robalo Cordeiro, Carlos; Rønning, Karin; Ruhwald, Morten; Sculier, Jean-Paul; Simunović, Aleksandar; Smith-Palmer, Alison; Sotgiu, Giovanni; Sulis, Giorgia; Torres-Duque, Carlos A; Umeki, Kazunori; Uplekar, Mukund; van Weezenbeek, Catharina; Vasankari, Tuula; Vitillo, Robert J; Voniatis, Constantia; Wanlin, Maryse; Raviglione, Mario C

    2015-04-01

    This paper describes an action framework for countries with low tuberculosis (TB) incidence (<100 TB cases per million population) that are striving for TB elimination. The framework sets out priority interventions required for these countries to progress first towards "pre-elimination" (<10 cases per million) and eventually the elimination of TB as a public health problem (less than one case per million). TB epidemiology in most low-incidence countries is characterised by a low rate of transmission in the general population, occasional outbreaks, a majority of TB cases generated from progression of latent TB infection (LTBI) rather than local transmission, concentration to certain vulnerable and hard-to-reach risk groups, and challenges posed by cross-border migration. Common health system challenges are that political commitment, funding, clinical expertise and general awareness of TB diminishes as TB incidence falls. The framework presents a tailored response to these challenges, grouped into eight priority action areas: 1) ensure political commitment, funding and stewardship for planning and essential services; 2) address the most vulnerable and hard-to-reach groups; 3) address special needs of migrants and cross-border issues; 4) undertake screening for active TB and LTBI in TB contacts and selected high-risk groups, and provide appropriate treatment; 5) optimise the prevention and care of drug-resistant TB; 6) ensure continued surveillance, programme monitoring and evaluation and case-based data management; 7) invest in research and new tools; and 8) support global TB prevention, care and control. The overall approach needs to be multisectorial, focusing on equitable access to high-quality diagnosis and care, and on addressing the social determinants of TB. Because of increasing globalisation and population mobility, the response needs to have both national and global dimensions. The content of this work is ©the authors or their employers. Design and branding are ©ERS 2015.

  18. Healthcare Use and Mammography Among Latinas With and Without Health Insurance Near the US-Mexico Border.

    PubMed

    Lapeyrouse, Lisa M; Miranda, Patricia Y; Morera, Osvaldo F; Heyman, Josiah McC; Balcazar, Hector G

    2017-04-01

    Among Latinas, lacking health insurance and having lower levels of acculturation are associated with disparities in mammography screening. We seek to investigate whether differences in lifetime mammography exist between Latina border residents by health insurance status and health care site (i.e., U.S. only or a combination of U.S. and Mexican health care). Using data from the 2009 to 2010 Ecological Household Study on Latino Border Residents, mammography screening was examined among (n = 304) Latinas >40 years old. While more acculturated women were significantly (p < .05) more likely to report ever having a mammogram than less acculturated women, ever having a mammogram was not predicted by health care site or insurance status. Latinas who utilize multiple systems of care have lower levels of acculturation and health insurance, thus representing an especially vulnerable population for experiencing disparities in mammography screening.

  19. Patterns of HIV Prevalence and HIV Risk Behaviors among Injection Drug Users Prior to and 24 Months following Implementation of Cross-Border HIV Prevention Interventions in Northern Vietnam and Southern China

    ERIC Educational Resources Information Center

    Hammett, Theodore M.; Kling, Ryan; Johnston, Patrick; Liu, Wei; Ngu, Doan; Friedmann, Patricia; Binh, Kieu Thanh; Dong, Ha Viet; Van, Ly Kieu; Donghua, Meng; Chen, Yi; Des Jarlais, Don C.

    2006-01-01

    In 2002, we implemented a 4-year HIV prevention intervention for injection drug users (IDUs) in Lang Son Province, Vietnam, and Ning Ming County, Guangxi Province, China, a cross-border region seriously affected by inter-twined epidemics of heroin injection and HIV infection. The interventions involve peer education on HIV risk reduction and…

  20. Multi-Sensory Features for Personnel Detection at Border Crossings

    DTIC Science & Technology

    2011-07-08

    challenging problem. Video sensors consume high amounts of power and require a large volume for storage. Hence, it is preferable to use non- imaging sensors...temporal distribution of gait beats [5]. At border crossings, animals such as mules, horses, or donkeys are often known to carry loads. Animal hoof...field, passive ultrasonic, sonar, and both infrared and visi- ble video sensors. Each sensor suite is placed along the path with a spacing of 40 to

  1. Unimodal primary sensory cortices are directly connected by long-range horizontal projections in the rat sensory cortex.

    PubMed

    Stehberg, Jimmy; Dang, Phat T; Frostig, Ron D

    2014-01-01

    Research based on functional imaging and neuronal recordings in the barrel cortex subdivision of primary somatosensory cortex (SI) of the adult rat has revealed novel aspects of structure-function relationships in this cortex. Specifically, it has demonstrated that single whisker stimulation evokes subthreshold neuronal activity that spreads symmetrically within gray matter from the appropriate barrel area, crosses cytoarchitectural borders of SI and reaches deeply into other unimodal primary cortices such as primary auditory (AI) and primary visual (VI). It was further demonstrated that this spread is supported by a spatially matching underlying diffuse network of border-crossing, long-range projections that could also reach deeply into AI and VI. Here we seek to determine whether such a network of border-crossing, long-range projections is unique to barrel cortex or characterizes also other primary, unimodal sensory cortices and therefore could directly connect them. Using anterograde (BDA) and retrograde (CTb) tract-tracing techniques, we demonstrate that such diffuse horizontal networks directly and mutually connect VI, AI and SI. These findings suggest that diffuse, border-crossing axonal projections connecting directly primary cortices are an important organizational motif common to all major primary sensory cortices in the rat. Potential implications of these findings for topics including cortical structure-function relationships, multisensory integration, functional imaging, and cortical parcellation are discussed.

  2. Unimodal primary sensory cortices are directly connected by long-range horizontal projections in the rat sensory cortex

    PubMed Central

    Stehberg, Jimmy; Dang, Phat T.; Frostig, Ron D.

    2014-01-01

    Research based on functional imaging and neuronal recordings in the barrel cortex subdivision of primary somatosensory cortex (SI) of the adult rat has revealed novel aspects of structure-function relationships in this cortex. Specifically, it has demonstrated that single whisker stimulation evokes subthreshold neuronal activity that spreads symmetrically within gray matter from the appropriate barrel area, crosses cytoarchitectural borders of SI and reaches deeply into other unimodal primary cortices such as primary auditory (AI) and primary visual (VI). It was further demonstrated that this spread is supported by a spatially matching underlying diffuse network of border-crossing, long-range projections that could also reach deeply into AI and VI. Here we seek to determine whether such a network of border-crossing, long-range projections is unique to barrel cortex or characterizes also other primary, unimodal sensory cortices and therefore could directly connect them. Using anterograde (BDA) and retrograde (CTb) tract-tracing techniques, we demonstrate that such diffuse horizontal networks directly and mutually connect VI, AI and SI. These findings suggest that diffuse, border-crossing axonal projections connecting directly primary cortices are an important organizational motif common to all major primary sensory cortices in the rat. Potential implications of these findings for topics including cortical structure-function relationships, multisensory integration, functional imaging, and cortical parcellation are discussed. PMID:25309339

  3. Bi-national Social Networks and Assimilation: A Test of the Importance of Transnationalism

    PubMed Central

    Mouw, Ted; Chavez, Sergio; Edelblute, Heather; Verdery, Ashton

    2015-01-01

    While the concept of transnationalism has gained widespread popularity among scholars as a way to describe immigrants’ long-term maintenance of cross-border ties to their origin communities, critics have argued that the overall proportion of immigrants who engage in transnational behavior is low and that, as a result, transnationalism has little sustained effect on the process of immigrant adaptation and assimilation. In this paper, we argue that a key shortcoming in the current empirical debate on transnationalism is the lack of data on the social networks that connect migrants to each other and to non-migrants in communities of origin. To address this shortcoming, our analysis uses unique bi-national data on the social network connecting an immigrant sending community in Guanajuato, Mexico, to two destination areas in the United States. We test for the effect of respondents’ positions in cross-border networks on their migration intentions and attitudes towards the United States using data on the opinions of their peers, their participation in cross border and local communication networks, and their structural position in the network. The results indicate qualified empirical support for a network-based model of transnationalism; in the U.S. sample we find evidence of network clustering consistent with peer effects, while in the Mexican sample we find evidence of the importance of cross-border communication with friends. PMID:25750462

  4. Paediatric tuberculosis in Queensland, Australia: overrepresentation of cross-border and Indigenous children.

    PubMed

    Donnan, E J; Coulter, C; Simpson, G; Clark, J; Nourse, C

    2017-03-01

    Queensland, Australia. Understanding paediatric tuberculosis (TB) is important, as children with TB typically reflect recent community transmission. Children pose unique diagnostic challenges and are at risk of developing severe disseminated infection. To describe the epidemiology, presentation and outcomes of children with TB disease in Queensland. This is a retrospective case series of children diagnosed with TB aged 0-16 years notified in 2005-2014. Data collected in the Queensland Notifiable Conditions System were extracted and analysed. Of 127 children diagnosed with TB, 16 were Australian-born (including 12 Indigenous Queenslanders), 41 were overseas-born permanent and temporary residents and 70 were cross-border Papua New Guinea (PNG) children; 88 children had pulmonary disease (with/without other sites) and 39 had extra-pulmonary disease only, with lymph node TB the predominant extra-pulmonary site; 70.1% of children had laboratory confirmation; and 14 cross-border children had multidrug-resistant TB. Treatment outcomes among children residing in Australia were good (100% among Australian-born and 97.2% among permanent and temporary residents), but they were less favourable among PNG children diagnosed in the Torres Strait Protected Zone (76.6%). Queensland has unique challenges in TB control, with a high proportion of cross-border diagnoses and over-representation of Indigenous children. Vigilance is needed given the wide spectrum of clinical presentation, particularly in high-risk communities.

  5. Travelling home for treatment and EU patients' rights to care abroad: results of a survey among German students at Maastricht University.

    PubMed

    Glinos, Irene A; Doering, Nora; Maarse, Hans

    2012-04-01

    Empirical evidence on patient mobility in Europe is lacking despite widespread legal, policy and media attention which the phenomenon attracts. This paper presents quantitative data on the health care seeking behaviour of German students at Maastricht University in the Netherlands. A cross-sectional survey design was applied with a mixed-methods approach including open and closed questions. Questionnaire items were based on a theoretical model of patient mobility and input from focus group discussions with German students living in Maastricht. 235 valid surveys were completed, representing ca. 8% of the target population. Data collection took place in Oct-Dec 2010. Of respondents who received medical care over the last two years, 97% returned to Germany; of these, 76% travelled to their home city for medical treatment. 72% received care only in Germany, i.e. not even once in Maastricht. Distance partly influenced whether students travelled to Germany, returned home or stayed in Maastricht, and the type of care accessed. Key motivations were familiarity with home providers/system, and reimbursement issues. In the context of the new EU Directive on patients' rights, the findings call into question whether Europeans use entitlements to cross-border care and what the real potential of patient mobility is. The results demonstrate the existence and magnitude of return movements as a sub-group of patient mobility. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  6. Managing US-Mexico "border health": an organizational field approach.

    PubMed

    Collins-Dogrul, Julie

    2006-12-01

    During World War II Mexican and US health professionals and organizations constructed a transnational organizational field to manage the border's public health problems. Despite barriers to inter-organizational cooperation, including disparate administrative structures and North-South stratification, the field's transnational approach to health on the border has continued for 60 years. Using archival data to track changes in the number and types of organizations, this article argues that the field practitioners call "border health" reconfigured during the North American Free Trade Association (NAFTA) decade from an era of loosely organized professionals to a specialized bureaucracies era. This change brought new vitality to border health, with transnational ties increasing and diversifying, but has not weakened entrenched cross-border inequalities. The organizational history of the US-Mexico border health field demonstrates how macro-politics and inter-organizational stratification shape transnational public health problems.

  7. Measuring the Effectiveness of Border Security Between Ports of Entry

    DTIC Science & Technology

    2010-01-01

    missions. Th is report describes the results of a short study on such measures. It should be of interest to analysts and leaders responsible for...32 6.2 Identifying and Exploiting Opportunities to Estimate Attempted Illegal Crossings . . . . . . . 33 6.3 Translating Studies of...ected discussions with DHS component agencies engaged in border-security eff orts, review of prior studies of border security, and fi eld visits to

  8. The Economic Impact of the Homeland Security Advisory System: The Cost of Heightened Border Security

    DTIC Science & Technology

    2008-12-01

    the United States. Secondary economic impacts of the HSAS such as the airline industry , lost tourism , and retail business from cross-border...Ontario and its businesses. The study is aimed at the trucking, automotive, and tourism industries ; and how they are impacted by border delays. The...19 A. DETROIT-WINDSOR AND THE AUTOMOTIVE INDUSTRY ............19 B. THE AMBASSADOR BRIDGE SYSTEM .................................................21

  9. A partial ban on sales to reduce high-risk drinking South of the border: seven years later.

    PubMed

    Voas, Robert B; Romano, Eduardo; Kelley-Baker, Tara; Tippetts, A Scott

    2006-09-01

    On weekend evenings, thousands of youths (ages 20 and younger) and young adults (ages 21-25) residing in communities along the U.S. border cross into Mexico to patronize all-night bars where the drinking age is 18, rather than 21, and where the price of alcohol is considerably less than in the United States. On January 1, 1999, Juárez, Mexico, implemented a 2 AM (instead of 5 AM) bar-closing policy. The number of crossers and their blood alcohol concentration levels on return were reduced in the year following this policy change. The present study's objective was to determine the long-term (7-year) effect of the earlier-closing bar policy on cross-border drinking in Mexico. Analyzed data (1998 to August 2005) were from quarterly breath-test surveys at the El Paso (Texas)/Juárez (Mexico) border, bar observations in Juárez, and trauma data in El Paso. Bar surveys in Juárez show that the 2 AM closing policy, initiated 7 years ago, continues to be enforced, as has the reduction (89%) in youthful crossers returning after 3 AM. The number of underage youths returning earlier in the evening (before 3 AM), however, unchanged for 2 years after the policy change, has doubled recently. The early closing of bars in Juárez has a continuing positive impact on the reduction of the number of those returning after 3 AM. Although initially there appeared to be no displacement of the late returnees into the early hours (before 3 AM), the number of bar visitors crossing and returning earlier has been steadily increasing. Suggestions for reducing cross-border heavy episodic drinking are described.

  10. Language-in-Healthcare Policy, Interaction Patterns, and Unequal Care on the U.S.-Mexico Border

    ERIC Educational Resources Information Center

    Martinez, Glenn

    2008-01-01

    This paper examines the implementation of language-in-healthcare policy in a highly bilingual, medically stressed border region of south Texas. In its current form, federal language-in-healthcare policy unevenly impacts different geographic regions. Healthcare markets along the U.S.-Mexico border are particularly taxed by the recent language…

  11. Validation of a semiquantitative food frequency questionnaire to assess folate status. Results discriminate a high-risk group of women residing on the Mexico-US border.

    PubMed

    Bacardí-Gascón, Montserrat; Ley y de Góngora, Silvia; Castro-Vázquez, Brenda Yuniba; Jiménez-Cruz, Arturo

    2003-01-01

    The purpose of the study was to estimate dietary intake of folate in two groups of women from different economic backgrounds and to evaluate validity of the 5-day-weighed food registry (5-d-WFR) and Food Frequency Questionnaire (FFQ) using biological markers. A cross-sectional study was conducted in two samples of urban Mexican women: one represented the middle socioeconomic status (middle SES) and the other, low socioeconomic status (low SES). Middle SES included 34 women recruited from 1998 to 1999. Participants were between the ages of 18 and 32 years and were employed in the banking industry (middle SES) in the US-Mexican border city of Tijuana, Baja California. Low SES included 70 women between the ages of 18 and 35 years recruited during the year 2000. These women were receiving care at a primary health care center in Ensenada, Baja California Norte State, Mexico (low SES). Pearson correlations were calculated between folate intake among 5-day diet registry, FFQ, and biochemical indices. FFQ reproducibility was performed by Spearman correlation of each food item daily and of weekly intake. Average folate intake in middle SES from 5-d-WFR was 210 microg +/- 171. Fifty four percent of participants had intakes <200 microg/daily. Average folate intake from FFQ was 223 +/- 78 microg/day. Pearson correlation between log transformed and within individually adjusted 5-d-WFR folate intakes and serum folate was 0.40 (p=0.02). Mexican women of reproductive age living in the US-Mexican border State of Baja California are at very high risk of NTDs as a result of low folate intake and low serum folate and RBC folate concentrations.

  12. Yellow Fever Outbreak - Kongo Central Province, Democratic Republic of the Congo, August 2016.

    PubMed

    Otshudiema, John O; Ndakala, Nestor G; Mawanda, Elande-Taty K; Tshapenda, Gaston P; Kimfuta, Jacques M; Nsibu, Loupy-Régence N; Gueye, Abdou S; Dee, Jacob; Philen, Rossanne M; Giese, Coralie; Murrill, Christopher S; Arthur, Ray R; Kebela, Benoit I

    2017-03-31

    On April 23, 2016, the Democratic Republic of the Congo's (DRC's) Ministry of Health declared a yellow fever outbreak. As of May 24, 2016, approximately 90% of suspected yellow fever cases (n = 459) and deaths (45) were reported in a single province, Kongo Central Province, that borders Angola, where a large yellow fever outbreak had begun in December 2015. Two yellow fever mass vaccination campaigns were conducted in Kongo Central Province during May 25-June 7, 2016 and August 17-28, 2016. In June 2016, the DRC Ministry of Health requested assistance from CDC to control the outbreak. As of August 18, 2016, a total of 410 suspected yellow fever cases and 42 deaths were reported in Kongo Central Province. Thirty seven of the 393 specimens tested in the laboratory were confirmed as positive for yellow fever virus (local outbreak threshold is one laboratory-confirmed case of yellow fever). Although not well-documented for this outbreak, malaria, viral hepatitis, and typhoid fever are common differential diagnoses among suspected yellow fever cases in this region. Other possible diagnoses include Zika, West Nile, or dengue viruses; however, no laboratory-confirmed cases of these viruses were reported. Thirty five of the 37 cases of yellow fever were imported from Angola. Two-thirds of confirmed cases occurred in persons who crossed the DRC-Angola border at one market city on the DRC side, where ≤40,000 travelers cross the border each week on market day. Strategies to improve coordination between health surveillance and cross-border trade activities at land borders and to enhance laboratory and case-based surveillance and health border screening capacity are needed to prevent and control future yellow fever outbreaks.

  13. Persistent Disparities in the Use of Health Care Along the US–Mexico Border: An Ecological Perspective

    PubMed Central

    Brown, H. Shelton; Pagán, José A.

    2008-01-01

    Objectives. We examined disparities in health care use among US–Mexico border residents, with a focus on the unique binational environment of the region, to determine factors that may influence health care use in Mexico. Methods. Data were from 2 waves of a population-based study of 1048 Latino residents of selected Texas border counties. Logistic regression models examined predictors of health insurance coverage. Results from these models were used to examine regional patterns of health care use. Results. Of the respondents younger than 65 years, 60% reported no health insurance coverage. The uninsured were 7 and 3 times more likely in waves 3 and 4, respectively, to use medical care in Mexico than were the insured. Preference for medical care in Mexico was an important predictor. Conclusions. For those who were chronically ill, old, poor, or burdened by the lengthy processing of their documents by immigration authorities, the United States provided the only source of health care. For some, Mexico may lessen the burden at the individual level, but it does not lessen the aggregate burden of providing highly priced care to the region's neediest. Health disparities will continue unless policies are enacted to expand health care accessibility in the region. PMID:18799782

  14. Mariposa port of entry bottleneck study : facilitating efficient, secure and economical cross-border transportation movements.

    DOT National Transportation Integrated Search

    2008-10-01

    The Arizona-Sonora border has become increasingly important to both states economy : due to increased trade between the regions following the 1994 passage of the North American : Free Trade Agreement (NAFTA) and the establishment of maquiladora in...

  15. Intelligent transportation systems at international borders : a cross-cutting study : facilitating trade and enhancing transportation safety

    DOT National Transportation Integrated Search

    2001-04-01

    The International Border Clearance (IBC) program was initiated under the provisions of the Intermodal Surface Transportation Efficiency Act (ISTEA) of 1991. The program was originally conceived as a means to test the feasibility of utilizing Intellig...

  16. EPIC : expedited processing at international crossings : evaluation final report

    DOT National Transportation Integrated Search

    1998-09-01

    This executive summary presents an overview of the Expedited Processing at International Crossings (EPIC) Field Operational Test (FOT). The EPIC focus was on the commercial vehicle transport component of international border crossings at the Nogales,...

  17. Crossing cultural borders into science teaching: Early life experiences, racial and ethnic identities, and beliefs about diversity

    NASA Astrophysics Data System (ADS)

    Brand, Brenda R.; Glasson, George E.

    2004-02-01

    The purpose of this ethnographic study was to explore the development of belief systems as related to racial and ethnic identities of preservice teachers as they crossed cultural borders into science teaching. Data were collected throughout a yearlong teacher preparation program to learn how early life experiences and racial and ethnic identities of preservice teachers influenced both their beliefs about diversity in science classrooms and science teaching pedagogy. Case studies of three preservice teachers from diverse racial and ethnic background are presented: Asian American, African American, and Rural Appalachian. Using Bank's ethnicity typology, findings suggest that racial and ethnic identity, developed in early life experiences of preservice teachers, provided clarity on the rigidity of their beliefs about diversity and how they view science teaching. By learning about the border crossing experiences of preservice teachers in relation to their beliefs about diversity as related to racial and ethnic identities, the researchers hoped to provide insight on preparing preservice teachers for the challenges of working in diverse classrooms.

  18. Post-vaccinal distemper encephalitis in two Border Collie cross littermates.

    PubMed

    Fairley, R A; Knesl, O; Pesavento, P A; Elias, B C

    2015-03-01

    One 4.5-month-old male Border Collie cross presented with aggression and seizures in October 2006. A 16-month-old, female, spayed Border Collie cross presented with hypersalivation and a dropped jaw and rapidly became stuporous in September 2007. The dogs were littermates and developed acute neurological signs 5 and 27 days, respectively, after vaccination with different modified live vaccines containing canine distemper virus. Sections of brain in both dogs showed evidence of encephalitis mainly centred on the grey matter of brainstem nuclei, where there was extensive and intense parenchymal and perivascular infiltration of histiocytes and lymphocytes. Intra-nuclear and intra-cytoplasmic inclusions typical of distemper were plentiful and there was abundant labelling for canine distemper virus using immunohistochemistry. Post-vaccinal canine distemper. Post-vaccinal canine distemper has mainly been attributed to virulent vaccine virus, but it may also occur in dogs whose immunologic nature makes them susceptible to disease induced by a modified-live vaccine virus that is safe and protective for most dogs.

  19. Cross border semantic interoperability for clinical research: the EHR4CR semantic resources and services

    PubMed Central

    Daniel, Christel; Ouagne, David; Sadou, Eric; Forsberg, Kerstin; Gilchrist, Mark Mc; Zapletal, Eric; Paris, Nicolas; Hussain, Sajjad; Jaulent, Marie-Christine; MD, Dipka Kalra

    2016-01-01

    With the development of platforms enabling the use of routinely collected clinical data in the context of international clinical research, scalable solutions for cross border semantic interoperability need to be developed. Within the context of the IMI EHR4CR project, we first defined the requirements and evaluation criteria of the EHR4CR semantic interoperability platform and then developed the semantic resources and supportive services and tooling to assist hospital sites in standardizing their data for allowing the execution of the project use cases. The experience gained from the evaluation of the EHR4CR platform accessing to semantically equivalent data elements across 11 European participating EHR systems from 5 countries demonstrated how far the mediation model and mapping efforts met the expected requirements of the project. Developers of semantic interoperability platforms are beginning to address a core set of requirements in order to reach the goal of developing cross border semantic integration of data. PMID:27570649

  20. Ways of knowing: Howard Stein's border-crossing use of poetry to interrogate clinical medicine, medical education, and health care organizations.

    PubMed

    Shapiro, Johanna

    2016-09-01

    This article explores how medical anthropologist Howard Stein's poetry and his unique practice of sharing this poetry with the patients, physicians, and administrators who inspired it create ways of knowing that are at once revelatory and emancipatory. Stein's writing shows readers that poetry can be considered as a form of data and as a method of investigation into the processes of the human soul. Furthermore, it represents a kind of intervention that invites health professional readers toward connection, bridge building, and solidarity with their patients and with one another. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  1. Transplantation okay--psyche okay? Reflections on psychosomatics in the field of organ transplantation.

    PubMed

    Storkebaum, Sibylle

    2005-01-01

    Transplantation puts a large burden on patients' psyche, before and after the operation. Psychosomatic care implicates helping patients to take a firm decision in favour of a new organ, of a new life. Incorporation of the graft, efficient doctor-patient-relations, pregnancy and sexuality, everything is possible but crucial to many patients. Psychosomatic knowledge and specified consulting help them and their families and even the doctors and nurses to cope with overwhelming emotions, fear and a lifelong danger of losing the organ. Transplantation means crossing borders, going into unknown psychic regions. And the recent rapid development of living liver transplantation does not facilitate things.

  2. Cross-border mobility of health professionals: contesting patients' right to health.

    PubMed

    Plotnikova, Evgeniya Vadimovna

    2012-01-01

    Cross-border labour mobility in the health sector is portrayed as both an opportunity for health professionals immigrating to developed countries, and as a challenge for patients remaining in low-income countries with restricted access to health care provision. In policy debate, this problem is articulated as the opposition between, 'the right to freedom of movement' and 'the right to health'. The underlying layers of this dilemma expose competing institutional interests for source and destination countries, international organisations, private recruitment agencies, trade unions and professional organisations. To resolve some of these tensions, a 'soft law' regulation (ethical recruitment policy) was adopted in the UK in the early 2000s. This article argues that this ethical recruitment policy produces an ambivalent effect. The qualitative content analysis refers to documents produced by international organisations, government bodies, professional organisations and trade unions in the UK and source countries. We found that ethical recruitment on the one hand proposes a practical mechanism to the realisation of the right to health in source countries, through encouraging employers' behaviour in accordance with ethical principles in international recruitment. On the other hand, this policy protects the reputation of institutional stakeholders changing rhetoric around international recruitment rather than the practice. The findings of this study contribute to a broader discussion of the international norms diffusion and the ambivalent role of 'soft law' in their implementation. Copyright © 2011 Elsevier Ltd. All rights reserved.

  3. Planning and Managing Intermodal Transportation Systems: A Guide to ISTEA Requirements

    DOT National Transportation Integrated Search

    1995-02-01

    The profiles contained in the appendix are all in the St. Albans, Vermont district. They are listed below by border groups as used in the study, with the U.S. Customs port codes indicated. Montreal South Frontier Border Crossings: Derby Line, VT (102...

  4. Geo-Located Tweets. Enhancing Mobility Maps and Capturing Cross-Border Movement.

    PubMed

    Blanford, Justine I; Huang, Zhuojie; Savelyev, Alexander; MacEachren, Alan M

    2015-01-01

    Capturing human movement patterns across political borders is difficult and this difficulty highlights the need to investigate alternative data streams. With the advent of smart phones and the ability to attach accurate coordinates to Twitter messages, users leave a geographic digital footprint of their movement when posting tweets. In this study we analyzed 10 months of geo-located tweets for Kenya and were able to capture movement of people at different temporal (daily to periodic) and spatial (local, national to international) scales. We were also able to capture both long and short distances travelled, highlighting regional connections and cross-border movement between Kenya and the surrounding countries. The findings from this study has broad implications for studying movement patterns and mapping inter/intra-region movement dynamics.

  5. Geo-Located Tweets. Enhancing Mobility Maps and Capturing Cross-Border Movement

    PubMed Central

    Blanford, Justine I.; Huang, Zhuojie; Savelyev, Alexander; MacEachren, Alan M.

    2015-01-01

    Capturing human movement patterns across political borders is difficult and this difficulty highlights the need to investigate alternative data streams. With the advent of smart phones and the ability to attach accurate coordinates to Twitter messages, users leave a geographic digital footprint of their movement when posting tweets. In this study we analyzed 10 months of geo-located tweets for Kenya and were able to capture movement of people at different temporal (daily to periodic) and spatial (local, national to international) scales. We were also able to capture both long and short distances travelled, highlighting regional connections and cross-border movement between Kenya and the surrounding countries. The findings from this study has broad implications for studying movement patterns and mapping inter/intra-region movement dynamics. PMID:26086772

  6. On the intended and unintended consequences of enhanced U.S. Border and interior immigration enforcement: evidence from Mexican deportees.

    PubMed

    Amuedo-Dorantes, Catalina; Pozo, Susan

    2014-12-01

    Since about 2000, a number of federal and state policies have been implemented in the United States with the intention of stemming the flow of illegal immigration. In this article, we focus on two initiatives: (1) Operation Streamline, as an example of increased border enforcement by the federal government; and (2) state-level omnibus immigration laws, as an illustration of enhanced interior enforcement by state governments. We investigate whether these policies have reduced the intentions of deported Mexican immigrants to attempt a new unauthorized crossing. Although state-level omnibus immigration laws reduce the proportion of deportees intending to attempt a new crossing, increased border enforcement has proven to be far less effective. In addition, we ascertain the human costs associated with these policies. Our findings are mixed in this regard. Noteworthy is how the adoption of more stringent interior enforcement seems to result in a "herding" or "ganging-up" effect, whereby the incidence of verbal and physical abuse rises with the number of states enacting such measures. Additionally, our estimates suggest that deportees are more likely to respond that they have risked their lives to cross into the United States as a result of enhanced border enforcement.

  7. Grenzhandel am Hochrhein. Schweizer Franken - Potenzial oder Risiko für den deutschen Handel?

    NASA Astrophysics Data System (ADS)

    Emmerling, Sandra

    2017-09-01

    Retail shopping in Hochrhein on the tri-border region is affected by the shopping behaviour of the Swiss households. On the one hand the German retail in the German border towns was able to develop dynamically and tap the demand from regions beyond the border. A market-relevant example was used to investigate the question of whether these cross-border inflows should be considered an area of potential growth or risk for German retail. On the other hand, together with e-commerce the shopping tourism leads to a tilt in spatial structure in the Swiss border regions. The demand and strategy for sustainable city and regional development are discussed from the perspective of retail, city planning and market research.

  8. SELECTED AIR QUALITY TRENDS AND RECENT AIR POLLUTION INVESTIGATIONS IN THE U.S.-MEXICO BORDER REGION

    EPA Science Inventory

    The thirteen journal articles in this issue deal with air quality indicators due, in part, to population growth, cross-border traffic, and economic expansion since ratification of NAFTA; regions covered span from Tijuana, Baja California to Brownsville, Texas. This introductio...

  9. Globalisation and Higher Education: From Within-Border to Cross-Border

    ERIC Educational Resources Information Center

    Youssef, Leïla

    2014-01-01

    Globalisation, the shift to a knowledge economy, and changing demographics are increasingly challenging higher education systems. The move from elite through mass to universal education, coupled with the internationalisation of higher education, has profoundly influenced the system, especially in terms of academic mobility. It has created new…

  10. (Re)conceptualizing International Student Mobility: The Potential of Transnational Social Fields

    ERIC Educational Resources Information Center

    Gargano, Terra

    2009-01-01

    Although educational border crossings are not new, the creation of innovative theoretical constructs, such as transnational social fields, to examine the flow of students and social networks across national borders is a profound development. Within transnational social fields, a constant flow of ideas and practices is embedded within…

  11. Peer Facilitators as Border Crossers in Community Service Learning

    ERIC Educational Resources Information Center

    Chesler, Mark A.; Ford, Kristie A.; Galura, Joseph A.; Charbeneau, Jessica M.

    2006-01-01

    Community service learning offers students the opportunity to cross socially constructed and epistemological borders of power and privilege, allowing them to come into contact with groups of people who are different from themselves and to learn in different ways. Peer facilitators, undergraduate student instructional leaders who guide others…

  12. A study of decisive factors in cross-national acquisitions - An example of BenQ and Foxconn cooperation

    NASA Astrophysics Data System (ADS)

    Tu, Kai-Jan

    2012-09-01

    As a result of globalization, the number of multinational mergers and acquisitions across the globe has grown steadily over the years. In this article I have conducted research based on two key studies: the failure and success of two companies, BenQ and Foxconn, through the mergers and acquisitions. I gain the conclusion that effective cross-border culture communication is an absolute, decisive factor in building successful relationships among companies; enterprises must develop a "cross-border culture communication motivation function" from both the acquiring and the acquired parts of the partnership. It is only then, that enterprises can exert their market and financial synergy influence to the fullest extents.

  13. Depression, Self-Esteem, and Childhood Abuse Among Hispanic Men Residing in the U.S.-Mexico Border Region.

    PubMed

    Provencio-Vasquez, Elias; Mata, Holly J; Tomaka, Joe; De Santis, Joseph P

    Hispanics experience health disparities in mental health and HIV infection when compared to non-Hispanic Whites, which may be related to childhood abuse. The purpose of our cross-sectional study was to examine the relationship between childhood abuse and depressive symptoms in a sample of Hispanic men (N = 103) living in a metropolitan U.S.-Mexico border area. Secondarily, we examined the role of self-esteem in mediating this relationship, and the moderating role of sexual orientation. Gay/bisexual men (n = 53) were more likely to report childhood abuse than heterosexual (n = 50) counterparts (47.2% vs. 32%). Self-esteem mediated the relationship between childhood abuse and depression for men who have sex with men, but not heterosexual men. Nurses should increase knowledge of mental health disparities that impact Hispanic men to ensure that appropriate treatment can be provided to reduce the risk of co-occurring health risks to these men, including risk for HIV infection. Copyright © 2017 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.

  14. Health information exchange: national and international approaches.

    PubMed

    Vest, Joshua R

    2012-01-01

    Health information exchange (HIE), the process of electronically moving patient-level information between different organizations, is viewed as a solution to the fragmentation of data in health care. This review provides a description of the current state of HIE in seven nations, as well was three international HIE efforts, with a particular focus on the relation of exchange efforts to national health care systems, common challenges, and the implications of cross-border information sharing. National and international efforts highlighted in English language informatics journals, professional associations, and government reports are described. Fully functioning HIE is not yet a common phenomenon worldwide. However, multiple nations see the potential benefits of HIE and that has led to national and international efforts of varying scope, scale, and purview. National efforts continue to work to overcome the challenges of interoperability, record linking, insufficient infrastructures, governance, and interorganizational relationships, but have created architectural strategies, oversight agencies, and incentives to foster exchange. The three international HIE efforts reviewed represent very different approaches to the same problem of ensuring the availability of health information across borders. The potential of HIE to address many cost and quality issues will ensure HIE remains on many national agendas. In many instances, health care executives and leaders have opportunities to work within national programs to help shape local exchange governance and decide technology partners. Furthermore, HIE raises policy questions concerning the role of centralized planning, national identifiers, standards, and types of information exchanged, each of which are vital issues to individual health organizations and worthy of their attention.

  15. Assessment of U.S. Government and Coalition Efforts to Train, Equip, and Advise the Afghan Border Police

    DTIC Science & Technology

    2013-05-24

    abuse of materiel. In zones that were under-resourced, zone commanders do not have the resources to meet their operational needs. Funding for Canine ...Program – Coalition forces and German Police Training Teams worked with the Border Police to develop a canine program to search for explosives and...airports and major border crossings did not know if their canine teams would be available post-2014, which prevented planning for effective security

  16. Assessment of Primary Health Care in the Treatment of Tuberculosis in a Brazilian Locality of the International Triple Frontier.

    PubMed

    Silva-Sobrinho, Reinaldo Antonio; Wysocki, Anneliese Domingues; Scatena, Lúcia Marina; Pinto, Erika Simone Galvão; Beraldo, Aline Ale; Andrade, Rubia Laine Paula; Zilly, Adriana; Munhak da Silva, Rosane Meire; Gomes, Michela Prestes; Mayer, Paulo César Morales; Ruffino-Netto, Antonio; Villa, Tereza Cristina Scatena

    2017-01-01

    To evaluate the performance of Primary Health Care (PHC) in treatment of TB patients in a triple international border municipality. The present study was an evaluative survey of cross-sectional and quantitative approach conducted with 225 PHC healthcare professionals. Data was collected through a structured and validated instrument, which provided five indicators of "structure" and four indicators of "process" classified as unsatisfactory, regular or satisfactory. The "structure" component was unsatisfactory for the indicator of professionals involved in TB care and training, and regular for the indicator of connection between the units and other levels of care. The "process" component was regular for the indicators of TB information, directly observed treatment and reference and counter reference on TB, and unsatisfactory for external actions on TB control. The "structure" and "process" components points out some weaknesses in terms of management and organization of human resources. Low frequency of training and the turnover influenced the involvement of professionals. Elements of "structure" and "process" show the need for investing in the PHC team and improving the clinical management of cases.

  17. Detecting a trend change in cross-border epidemic transmission

    NASA Astrophysics Data System (ADS)

    Maeno, Yoshiharu

    2016-09-01

    A method for a system of Langevin equations is developed for detecting a trend change in cross-border epidemic transmission. The equations represent a standard epidemiological SIR compartment model and a meta-population network model. The method analyzes a time series of the number of new cases reported in multiple geographical regions. The method is applicable to investigating the efficacy of the implemented public health intervention in managing infectious travelers across borders. It is found that the change point of the probability of travel movements was one week after the WHO worldwide alert on the SARS outbreak in 2003. The alert was effective in managing infectious travelers. On the other hand, it is found that the probability of travel movements did not change at all for the flu pandemic in 2009. The pandemic did not affect potential travelers despite the WHO alert.

  18. 'Because the baby asks for it': a mixed-methods study on local perceptions toward nutrition during pregnancy among marginalised migrant women along the Myanmar-Thailand border.

    PubMed

    Hashmi, Ahmar H; Paw, Moo Kho; Nosten, Suphak; Darakamon, Mu Chae; Gilder, Mary Ellen; Charunwatthana, Prakaykaew; Carrara, Verena I; Wickramasinghe, Kremlin; Angkurawaranon, Chaisiri; Plugge, Emma; McGready, Rose

    2018-01-01

    Under- and over-nutrition during pregnancy are known risk factors for pregnancy complications and adverse pregnancy and infant outcomes. Understanding perceptions around nutrition in pregnancy can create culturally appropriate interventions for improved health outcomes. A mixed-methods study was performed to explore local perceptions and practices of diet and physical activity in pregnancy in a marginalised population along the Myanmar-Thailand border. From April to July 2017, a cross-sectional survey and focus group discussions were conducted with pregnant women reporting to antenatal care; in-depth interviews were conducted with senior midwives at participating organisations along the Myanmar-Thailand border. A total of 388 pregnant women were interviewed at two clinic sites along the Myanmar-Thailand border. A high proportion of women had limited knowledge of and poor dietary practices. Consuming a sweetened drink in the last 24 hours as well as being a non-teenage, multigravida woman was significantly associated with high body mass index (BMI) compared to normal BMI. Qualitative analysis combined focus group discussions (n = 66) and in-depth interviews (n = 4) summarising emergent themes: common foods eaten or avoided and rationale; benefits of nutrition; perceptions of overweight and weight gain during pregnancy; barriers to a healthy diet; and sources of diet information. There is limited awareness about healthy diets and lifestyle in these marginalised, migrant communities along the Myanmar-Thailand border. This study suggests that simple, culturally appropriate messaging should be provided to women and communities with low health literacy to generate awareness about healthy lifestyles and their effects on pregnancy outcomes as an important element of a broader strategy to address maternal nutrition in this population. However, more studies to determine the effectiveness of a broad range of interventions in low- and middle-income countries (LMIC) are needed, especially in marginalised migrant populations.

  19. Developing an Intercultural Competence Programme at an International Cross-Border University

    ERIC Educational Resources Information Center

    Hiller, Gundula Gwenn; Wozniak, Maja

    2009-01-01

    The European University Viadrina located on the German-Polish border, with a high number of international students, was founded to promote the "growing-together" of Europe. Despite those aims, it is becoming more evident that international institutions must develop special strategies to sensitize their members on an intercultural level…

  20. SPRINGTIME SPATIAL CONCENTRATION GRADIENTS OF NITROGEN DIOXIDE AND VOLATILE ORGANIC SPECIES IN THE EL PASO CHILDREN'S HEALTH STUDY

    EPA Science Inventory

    Each year, over 18 million vehicles cross the international border between El Paso, TX (USA) and Ciudad Juarez (Mexico). The border traffic congestion, as well as the more typical intra-urban and interstate traffic, provide an opportunity to investigate the health effects of PM ...

  1. Medical returns as class transformation: situating migrants' medical returns within a framework of transnationalism.

    PubMed

    Horton, Sarah B

    2013-01-01

    Because studies of migrants' 'medical returns' have been largely confined to the field of public health, such forms of return migration are rarely contextualized within the rich social scientific literature on transnational migration. Drawing on ethnographic interviews with Mexican migrants in an immigrant enclave in central California, I show that migrants' reasons for returning to their hometowns for care must be understood within the class disjunctures facilitated by migration. While migrants' Medicaid insurance confined them to public clinics and hospitals in the United States, their migrant dollars enabled them to visit private doctors and clinics in Mexico. Yet medical returns were not mere medical arbitrage, but also allowed migrants to access care that had previously been foreclosed to them as poor peasants in Mexico. Thus crossing the border enabled a dual class transformation, as Mexican migrants transitioned from Medicaid recipients to cash-paying patients, and from poor rural peasants to 'returning royalty.'

  2. European Patient Summary Guideline: Focus on Greece.

    PubMed

    Berler, Alexander; Tagaris, Anastassios; Chronaki, Catherine

    2016-01-01

    The European Patient Summary (PS) guideline specifies a minimal dataset of essential and important information for unplanned or emergency care initially defined in the epSOS project with aim to improve patients' safety and quality of Care. The eHealth Network of European Union (EU) Member State (MS) representatives established under Article 14 of the EU directive 2011/24 on patient rights to cross-border healthcare adopted PS guideline in November 2013 and since then the guideline has been part of MS strategic eHealth implementation plans, standardization efforts, and concrete regional, national, European and international projects. This paper reviews implementation efforts for the implementation of an operational patient summary service in Greece drawing on challenges and lessons learned for sustainable standards-based large scale eHealth deployment in Europe and abroad, as well as the reuse of best practices from international standards and integration profiles.

  3. Transmission of tuberculosis among people living in the border areas of Poland, the Czech Republic, and Slovakia.

    PubMed

    Kozińska, Monika; Zientek, Jerzy; Augustynowicz-Kopeć, Ewa; Zwolska, Zofia; Kozielski, Jerzy

    2016-01-01

    In 2007, Poland, the Czech Republic, and Slovakia joined the Schengen Agreement, abolishing restrictions on people crossing the borders. Currently, these areas are places of population movements for economic, family, and touristic reasons. This favors the transmission of infectious diseases, including tuberculosis, and requires enhanced control over the spread of the source of infection in the population of patients living in the border areas. The aim of this study was to investigate the genetic relatedness among Mycobacterium tuberculosis complex strains isolated from patients living in 3 border areas: Poland, the Czech Republic, and Slovakia. PATIENTS AND METHODS The study group consisted of 209 patients with tuberculosis diagnosed and treated between 2007 and 2011 in health care facilities in the Silesia Province in Poland (121 patients [58%]), Žilina in Slovakia (57 [27%]), and the Moravian-Silesian Region in the Czech Republic (31 [15%]). Genotyping of strains was performed using spoligotyping and IS6110-Mtb1-Mtb2 polymerase chain reaction. Among 209 strains, 23 molecular families (clusters) were identified. Seventeen clusters were identified as national. Six international clusters consisted of 30 strains isolated from patients of various nationalities. We identified 6 potential outbreaks of tuberculosis transmission between patients of different nationalities. The circumstances favorable to potential contacts of patients included mainly travelling to the neighboring countries, hospital stays, and addictions. However, there was no evidence of an epidemiological link between these patients, so it may be assumed that if they had come in contact with one another, it was accidental. We observed that the greater incidence of tuberculosis on the Polish territory did not affect the incidence in the Czech Republic or Slovakia over the analysis period.

  4. Attitudes toward self-sampling for cervical cancer screening among primary care attendees living on the US-Mexico border.

    PubMed

    Penaranda, Eribeth; Molokwu, Jennifer; Hernandez, Ingrid; Salaiz, Rebekah; Nguyen, Norma; Byrd, Theresa; Shokar, Navkiran

    2014-07-01

    Hispanic women living along the US border with Mexico have one of the highest cervical cancer mortality rates in the nation, owing in part to lower rates of screening. The barriers to screening in this population include lack of access to care and fear of and embarrassment about the pelvic examination. Screening for oncogenic or high-risk human papillomavirus during cervical cytology has been added to screening recommendations. A novel method for human papillomavirus testing is self-sampling, in which women collect their own cervicovaginal samples. There is lack of information about the acceptability of self-sampling as an alternative to cytology for cervical cancer screening in women living along the US-Mexico border. We conducted five focus groups with women between the ages of 30 and 65 who were primary care patients of clinics along the US-Mexico border. We used constructs from different health behavioral theories as a framework for the interview guide. A total of 21 women participated in the focus groups, 80% of whom were Hispanic; mean age was 53.4 (standard deviation 7.9). More than one-third (38%) of the participants had not undergone a Papanicolaou test in the last 3 years. Women identified the perceived benefits of self-sampling as ease, convenience, practicability, less embarrassment, and need for child care as compared with a Papanicolaou test. The main barrier to self-sampling was concern about not performing the test correctly. In this qualitative study, we found positive attitudes toward self-sampling among women living along the US border with Mexico. Further research is needed to evaluate interventions that address women's low levels of self-efficacy to perform the test and to evaluate the effectiveness of self-sampling in increasing cervical cancer screening rates.

  5. First Trimester Prenatal Care Initiation Among Hispanic Women Along the U.S.-Mexico Border.

    PubMed

    Selchau, Katherine; Babuca, Maricela; Bower, Kara; Castro, Yara; Coakley, Eugenie; Flores, Araceli; Garcia, Jonah O; Reyes, Maria Lourdes F; Rojas, Yvonne; Rubin, Jason; Samuels, Deanne; Shattuck, Laura

    2017-12-01

    Background First trimester prenatal care (FTPNC) is associated with improved birth outcomes. U.S.-Mexico border Hispanic women have lower FTPNC than non-border or non-Hispanic women. This study aimed to identify (1) what demographic, knowledge and care-seeking factors influence FTPNC among Hispanic women in border counties served by five Healthy Start sites, and (2) what FTPNC barriers may be unique to this target population. Healthy Starts work to eliminate disparities in perinatal health in areas with high poverty and poor birth outcomes. Methods 403 Hispanic women of reproductive age in border communities of California, Arizona, New Mexico and Texas were surveyed on knowledge and behaviors related to prenatal care (PNC) and basic demographic information. Chi square analyses and logistic regressions were used to identify important relationships. Results Chi square analyses revealed that primiparous women were significantly less likely to start FTPNC than multiparous women (χ 2 = 6.8372, p = 0.0089). Women with accurate knowledge about FTPNC were more likely to obtain FTPNC (χ 2  = 29.280, p < .001) and more likely to have seen a doctor within the past year (χ 2  = 5.550, p = .018). Logistic regression confirmed that multiparity was associated with FTPNC and also that living in Texas was negatively associated with FTPNC (R 2  = 0.066, F(9,340) = 2.662, p = .005). Among 27 women with non-FTPNC, barriers included late pregnancy recognition (n = 19) and no medical insurance (n = 5). Conclusions This study supports research that first time pregnancies have lower FTPNC, and demonstrated a strong association between delayed PNC and late pregnancy recognition. Strengthened investments in preconception planning could improve FTPNC in this population.

  6. Stakeholder identification of advanced technology opportunities at international ports of entry

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Parker, S.K.; Icerman, L.

    As part of the Advanced Technologies for International and Intermodal Ports of Entry (ATIPE) Project, a diverse group of stakeholders was engaged to help identify problems experienced at inland international border crossings, particularly those at the US-Mexican border. The fundamental issue at international ports of entry is reducing transit time through the required documentation and inspection processes. Examples of other issues or problems, typically manifested as time delays at border crossings, repeatedly mentioned by stakeholders include: (1) lack of document standardization; (2) failure to standardize inspection processes; (3) inadequate information and communications systems; (4) manual fee and tariff collection; (5)more » inconsistency of processes and procedures; and (6) suboptimal cooperation among governmental agencies. Most of these issues can be addressed to some extent by the development of advanced technologies with the objective of allowing ports of entry to become more efficient while being more effective. Three categories of technologies were unambiguously of high priority to port of entry stakeholders: (1) automated documentation; (2) systems integration; and (3) vehicle and cargo tracking. Together, these technologies represent many of the technical components necessary for pre-clearance of freight approaching international ports of entry. Integration of vehicle and cargo tracking systems with port of entry information and communications systems, as well as existing industry legacy systems, should further enable border crossings to be accomplished consistently with optimal processing times.« less

  7. [Mental health: an identification of new directions walking in Archie Cochrane footsteps].

    PubMed

    Tansella, Michele

    2006-10-01

    New borders and promising new directions in scientific fields are often difficult to identify and define. This paper attempts to it so in relation to recent developments and new research evidence in mental health, recognizing that this exercise may be biased by many factors, including: the author's own perspective, professional background and research training and the always present dialectic between the analysis of the past and the attraction of the future. A good starting point is the ground-breaking work by Sir Archibald Cochrane. He recommended to adopt a rigorous and continuous evaluation of clinical practice and protocols, promoting well designed clinical research and the use of scientific methods. This evidence-based approach should also be used in mental health. High quality research, continuous education and good clinical practice, incorporating the results of scientific experiments and observations, represent the approach that ensures an improvement in care provision and patient satisfaction. Currently, mental health care is still too "opinion oriented", due to the over emphasis placed on personal experience and traditional approaches by many psychiatrists. In this paper some of the most promising recent results in psychosocial research, psychopharmacological studies and genetics, as well as in neuroimaging studies, are briefly summarised. From a pragmatic point of view, it is possible to achieve a significant improvement in the quality of mental health care if the following procedure is followed: firstly, to start from solid evidence; secondly, to promote the wide implementation of evidence-based research into every day practice; thirdly, to ensure that administrators and policy makers incorporate the available scientific evidence in the planning and evaluating services and mental health systems of care. The integration between research, education and practice remains the hardest border to cross, yet the achievement of it holds the greatest promise for better mental health care in the future.

  8. Doctors Without Borders.

    PubMed

    Wass, Val; Southgate, Lesley

    2017-04-01

    The unprecedented demands of patient and population priorities created by globalization and escalating health and social inequities will not be met unless medical education changes. Educators have failed to move fast enough to create an education framework that meets current population needs. A new common set of professional values around global social accountability is necessary. Education borders must be broken down at three levels-societal-institutional, interpersonal, and individual.At a societal-institutional level, global health must be embraced as part of a philosophy of population needs, human rights, equity, and justice. A move from informative acquisition of knowledge and skills to formative learning where students socialize around values, develop leadership attributes, and become agents for change is needed. At an interpersonal level, radical changes in curriculum delivery, which move away from the well-defined borders of specialty rotations, are required. Students must develop an integrated understanding of the future of health care and the patient's journey through health care delivery, within the context of population needs. At an individual level, doctors need to understand the boundaries of the professional values they hold within themselves and develop a deeper understanding of their own internal prejudices and conflicts. Opening the borders between the sciences and humanities is essential. Fostering and mentoring that emphasize that resilience, leadership, flexibility, and the ability to cope with uncertainty are needed to tackle the complexities of current, as well as future, health care. Doctors need to understand the restraints within themselves to work effectively without borders.

  9. Foreign currency-related translation complexities in cross-border healthcare applications.

    PubMed

    Kumar, Anand; Rodrigues, Jean M

    2009-01-01

    International cross-border private hospital chains need to apply the standards for foreign currency translation in order to consolidate the balance sheet and income statements. This not only exposes such chains to exchange rate fluctuations in different ways, but also creates added requirements for enterprise-level IT systems especially when they produce parameters which are used to measure the financial and operational performance of the foreign subsidiary or the parent hospital. Such systems would need to come to terms with the complexities involved in such currency-related translations in order to provide the correct data for performance benchmarking.

  10. System of Earthquakes Alert (SEA) on the territory of Bulgaria developed as a result of DACEA project

    NASA Astrophysics Data System (ADS)

    Solakov, Dimcho; Dimitrova, Liliya; Simeonova, Stela; Aleksandrova, Irena; Stoyanov, Stoyan; Metodiev, Metodi

    2013-04-01

    The prevention of the natural disasters and the performing management of reactions to crisis are common problems for many countries. The Romania-Bulgaria border region is significantly affected by earthquakes occurred in both territories: on the one-hand, Vrancea seismic source, with intermediate-depth events and on the other hand, crustal seismicity recorded in the northern part of Bulgaria (Shabla, Dulovo, Gorna Orjahovitza). The general objective of DACEA (2010-2013) project is to develop an system of earthquake alert in order to prevent the natural disasters caused by earthquakes in the cross-border area, taking into account the nuclear power plants and other chemical plants located along the Danube on the territories of Romania and Bulgaria. An integrated warning system is designed and implemented in the cross-border area. A seismic detection network is put in operation in order to warn the bodies in charge with emergency situations management in case of seismic danger. The main purpose of this network is: • monitoring of the four seismogenic areas relevant for the cross-border area, in order to detect dangerous earthquakes • sending the seismic warning signals within several seconds to the local public authorities in the cross-border area On the territory of Bulgaria the seismic network belonging to SEA is consists of: • 8 seismic stations equipped with Basalt digitizer, accelerometer Epi-sensor and BB seismometer KS2000. • 8 seismic stations equipped with Basalt digitizer, accelerometer Epi-sensor, warning and visual monitoring equipment. The stations are spanned allover the North Bulgaria. The sites were thoroughly examined and the most important requirement was the low level of noise or vibrations. SEA centers were established both in Sofia (in National Institute of Geophysics, Geodesy and Geography - NIGGG) and Bucharest (in National Institute of Research and Development for Earth Physics). Both centers are equipped with servers for data analyses and storage. Specialized software for elaboration of scenarios of seismic hazard is designed and implemented. The reaction of buildings, roads, bridges, land etc. to earthquakes is graphically shown on the monitor. The high risk areas are highlighted in order for the emergency units to be prepared for intervention. This software is designed on the base of a comprehensive relational data base of historical and contemporary seismicity in the cross-border region. The output shake maps and scenarios are to be used by the emergency intervention units, local public authorities and for general public awareness.

  11. 78 FR 29201 - Notice of Availability of Finding of No Significant Impact for the Proposed Vantage Pipeline US...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-17

    ... maintenance at the borders of the United States, of facilities for the exportation or importation of liquid... installation of associated aboveground mainline block valves; and the use of access roads and pipe storage and... Permit authorizing the construction, connection, operation, and maintenance of the Cross Border Facility...

  12. The Border Crossed Us: Education, Hospitality Politics, and the Social Construction of the "Illegal Immigrant"

    ERIC Educational Resources Information Center

    Carlson, Dennis

    2009-01-01

    In this essay, Dennis Carlson explores some of the implications of Derrida's "hospitality politics" in helping articulate a progressive response to a rightist cultural politics in the United States of policing national, linguistic, and other borders. He applies the concept of hospitality politics to a critical analysis of the social construction…

  13. Cultural Identity in Teaching across Borders: Mainland Chinese Pre-Service Teachers in Hong Kong

    ERIC Educational Resources Information Center

    Gu, Mingyue Michelle

    2013-01-01

    This study explores transformations in the cultural identities of a group of pre-service teachers from mainland China during their educational experiences in Hong Kong, and how these transformations subsequently impact their professional identity. Individual and focus group interviews were conducted with 16 cross-border pre-service teachers from a…

  14. Blending Borders of Language and Culture: Schooling in La Villita

    ERIC Educational Resources Information Center

    Olmedo, Irma M.

    2009-01-01

    This article examines the efforts of a school in a Mexican community in Chicago to help children and parents capitalize on the language and culture of their 2 worlds. It builds on the concepts of border crossings and hybridity, metaphors used to describe the sociocultural and linguistic reality of people living transnationally. Some US communities…

  15. 19 CFR 10.17 - Valuation of exempted components.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... components when last purchased, f.o.b. United States port of exportation or point of border crossing as set out in the invoice and entry papers, or, if no purchase was made, the value of the components at the time of their shipment for exportation, f.o.b. United States port of exportation or point of border...

  16. Korean Social Studies Preservice Teachers' Cross-Cultural Learning and Global Perspective Development: Crossing Borders between Korea and the United States

    ERIC Educational Resources Information Center

    Choi, Yoonjung; Choi, Minsik

    2012-01-01

    This study investigated the influence of cross-cultural learning experiences on Korean preservice social studies teachers' global perspectives development. Social studies preservice teachers in a large woman's university in Korea participated in a cross-cultural learning course, which focused on critical understanding of globalization and global…

  17. Crossing the Border? Exploring the Cross-State Mobility of the Teacher Workforce

    ERIC Educational Resources Information Center

    Goldhaber, Dan; Grout, Cyrus; Holden, Kristian L.; Brown, Nate

    2015-01-01

    Due to data limitations, very little is known about patterns of cross-state teacher mobility. It is an important issue because barriers to cross-state mobility create labor market frictions that could lead both current and prospective teachers to opt out of the teaching profession. In this article, we match state-level administrative data sets…

  18. Ecole Maternelle (Preschool) in France: A Cross-Cultural Perspective

    ERIC Educational Resources Information Center

    Brougere, Gilles; Guenif-Souilamas, Nacira; Rayna, Sylvie

    2008-01-01

    This article looks at a cross-cultural analysis of interviews of (im/migrant and non-im/migrant) preschool teachers and parents, concerning im/migrant children enrolled in the French "ecole maternelle", in the context of the international Children Crossing Borders (CCB) research project. Interviews were conducted in France following a…

  19. Do Chinese International Students' Personalities Change during Cross-National Transitions?

    ERIC Educational Resources Information Center

    Wang, Kenneth T.; Tian, Lu; Fujiki, Mayo; Bordon, Jennifer J.

    2017-01-01

    Perfectionism is a multidimensional personality construct salient for international students; they are known to be likely high achievers in their home country and face several acculturative challenges after crossing national borders. This study examined whether perfectionist types changed during cross-national transitions in a sample of 227…

  20. The Structure of Borders in a Small World

    PubMed Central

    Thiemann, Christian; Theis, Fabian; Grady, Daniel; Brune, Rafael; Brockmann, Dirk

    2010-01-01

    Territorial subdivisions and geographic borders are essential for understanding phenomena in sociology, political science, history, and economics. They influence the interregional flow of information and cross-border trade and affect the diffusion of innovation and technology. However, it is unclear if existing administrative subdivisions that typically evolved decades ago still reflect the most plausible organizational structure of today. The complexity of modern human communication, the ease of long-distance movement, and increased interaction across political borders complicate the operational definition and assessment of geographic borders that optimally reflect the multi-scale nature of today's human connectivity patterns. What border structures emerge directly from the interplay of scales in human interactions is an open question. Based on a massive proxy dataset, we analyze a multi-scale human mobility network and compute effective geographic borders inherent to human mobility patterns in the United States. We propose two computational techniques for extracting these borders and for quantifying their strength. We find that effective borders only partially overlap with existing administrative borders, and show that some of the strongest mobility borders exist in unexpected regions. We show that the observed structures cannot be generated by gravity models for human traffic. Finally, we introduce the concept of link significance that clarifies the observed structure of effective borders. Our approach represents a novel type of quantitative, comparative analysis framework for spatially embedded multi-scale interaction networks in general and may yield important insight into a multitude of spatiotemporal phenomena generated by human activity. PMID:21124970

  1. The structure of borders in a small world.

    PubMed

    Thiemann, Christian; Theis, Fabian; Grady, Daniel; Brune, Rafael; Brockmann, Dirk

    2010-11-18

    Territorial subdivisions and geographic borders are essential for understanding phenomena in sociology, political science, history, and economics. They influence the interregional flow of information and cross-border trade and affect the diffusion of innovation and technology. However, it is unclear if existing administrative subdivisions that typically evolved decades ago still reflect the most plausible organizational structure of today. The complexity of modern human communication, the ease of long-distance movement, and increased interaction across political borders complicate the operational definition and assessment of geographic borders that optimally reflect the multi-scale nature of today's human connectivity patterns. What border structures emerge directly from the interplay of scales in human interactions is an open question. Based on a massive proxy dataset, we analyze a multi-scale human mobility network and compute effective geographic borders inherent to human mobility patterns in the United States. We propose two computational techniques for extracting these borders and for quantifying their strength. We find that effective borders only partially overlap with existing administrative borders, and show that some of the strongest mobility borders exist in unexpected regions. We show that the observed structures cannot be generated by gravity models for human traffic. Finally, we introduce the concept of link significance that clarifies the observed structure of effective borders. Our approach represents a novel type of quantitative, comparative analysis framework for spatially embedded multi-scale interaction networks in general and may yield important insight into a multitude of spatiotemporal phenomena generated by human activity.

  2. Imported Plasmodium falciparum and locally transmitted Plasmodium vivax: cross-border malaria transmission scenario in northwestern Thailand.

    PubMed

    Sriwichai, Patchara; Karl, Stephan; Samung, Yudthana; Kiattibutr, Kirakorn; Sirichaisinthop, Jeeraphat; Mueller, Ivo; Cui, Liwang; Sattabongkot, Jetsumon

    2017-06-21

    Cross-border malaria transmission is an important problem for national malaria control programmes. The epidemiology of cross-border malaria is further complicated in areas where Plasmodium falciparum and Plasmodium vivax are both endemic. By combining passive case detection data with entomological data, a transmission scenario on the northwestern Thai-Myanmar border where P. falciparum is likely driven by importation was described, whereas P. vivax is also locally transmitted. This study highlights the differences in the level of control required to eliminate P. falciparum and P. vivax from the same region. Malaria case data were collected from malaria clinics in Suan Oi village, Tak Province, Thailand between 2011 and 2014. Infections were diagnosed by light microscopy. Demographic data, including migrant status, were correlated with concomitantly collected entomology data from 1330 mosquito trap nights using logistic regression. Malaria infection in the captured mosquitoes was detected by ELISA. Recent migrants were almost four times more likely to be infected with P. falciparum compared with Thai patients (OR 3.84, p < 0.001) and cases were significantly associated with seasonal migration. However, P. falciparum infection was not associated with the Anopheles mosquito capture rates, suggesting predominantly imported infections. In contrast, recent migrants were equally likely to present with P. vivax as mid-term migrants. Both migrant groups were twice as likely to be infected with P. vivax in comparison to the resident Thai population (OR 1.96, p < 0.001 and OR 1.94, p < 0.001, respectively). Plasmodium vivax cases were strongly correlated with age and local capture rates of two major vector species Anopheles minimus and Anopheles maculatus (OR 1.23, p = 0.020 and OR 1.33, p = 0.046, respectively), suggesting that a high level of local transmission might be causing these infections. On the Thai-Myanmar border, P. falciparum infections occur mostly in the recent migrant population with a seasonality reflecting that of agricultural activity, rather than that of the local mosquito population. This suggests that P. falciparum was mostly imported. In contrast, P. vivax cases were significantly associated with mosquito capture rates and less with migrant status, indicating local transmission. This highlights the different timelines and requirements for P. falciparum and P. vivax elimination in the same region and underlines the importance of multinational, cross-border malaria control.

  3. International comparisons of waiting times in health care--limitations and prospects.

    PubMed

    Viberg, Nina; Forsberg, Birger C; Borowitz, Michael; Molin, Roger

    2013-09-01

    Long waiting times for health care is an important health policy issue in many countries, and many have introduced some form of national waiting time guarantees. International comparison of waiting times are critical for countries to improve policy and for patients to be able to make informed choices, especially in Europe, where patients have the right to seek care in other countries if there is undue delay. The objective of this study was to describe how countries measure waiting times and to assess whether waiting times can be compared internationally. Twenty-three OECD countries were included. Information was collected through scientific articles, official and unofficial documents and web pages. Fifteen of the 23 countries monitor and publish national waiting time statistics and have some form of waiting time guarantees. There are significant differences in how waiting times are measured: whether they measure the "ongoing" or "completed" waiting period what kind of care the patient is waiting for; the parameters used; and where in the patient journey the measurement begins. Current national waiting time statistics are of limited use for comparing health care availability among the various countries due to the differences in measurements and data collection. Different methodological issues must be taken into account when making such cross-country comparisons. Within the given context of national sovereignty of health systems it would be desirable if countries could collaborate in order to facilitate international comparisons. Such comparisons would be of benefit to all involved in the process of continuous improvement of health services. They would also benefit patients who seek cross-border alternatives for their care. Copyright © 2013 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

  4. A randomized controlled trial to evaluate the relative efficacy of adding voluntary counseling and testing (VCT) to information dissemination in reducing HIV-related risk behaviors among Hong Kong male cross-border truck drivers.

    PubMed

    Lau, Joseph T F; Tsui, Hi Yi; Cheng, Shannon; Pang, Margaret

    2010-01-01

    Mobile populations are vulnerable to contracting HIV. The present study aims to evaluate the relative efficacy of the voluntary counseling and testing plus information dissemination (VCT-ID) approach versus the information dissemination (ID) approach for promoting HIV preventive behaviors in a mobile population, cross-border truck drivers. A total of 301 adult male cross-border truck drivers who self-reported having had sex with female sex workers (FSW) or non-regular sex partners (NRPs) in mainland China in the last 12 months were recruited and randomized into the VCT-ID intervention group (Group I) or ID control group (Group C). Anonymous structured questionnaires, administered through a computer-assisted method, were used to collect data. At the follow-up survey (about 8-9 weeks since the baseline survey), Group I participants, as compared to Group C participants, were more likely to be consistent condom users when having sex with FSW (85.5% versus 68.5%, p<0.05) and with NRP (54.8% versus 36.4%, p<0.1), more knowledgeable about HIV, and were less likely to have contracted sexually transmitted diseases (STD) in the last two months. The VCT-ID approach is shown to be more efficacious than the ID approach in promoting safer sex and HIV-related knowledge among local cross-border truck drivers. Feasibility of providing voluntary counseling and testing (VCT) services at locations which are convenient to the target population is demonstrated. It also shows that VCT services can be used as a means of HIV prevention. The findings of this study resulted in up-scaled VCT services for the local target population.

  5. Health system factors influencing management of multidrug-resistant tuberculosis in four European Union countries - learning from country experiences.

    PubMed

    de Vries, Gerard; Tsolova, Svetla; Anderson, Laura F; Gebhard, Agnes C; Heldal, Einar; Hollo, Vahur; Cejudo, Laura Sánchez-Cambronero; Schmid, Daniela; Schreuder, Bert; Varleva, Tonka; van der Werf, Marieke J

    2017-04-19

    In the European Union and European Economic Area only 38% of multidrug-resistant tuberculosis patients notified in 2011 completed treatment successfully at 24 months' evaluation. Socio-economic factors and patient factors such as demographic characteristics, behaviour and attitudes are associated with treatment outcomes. Characteristics of healthcare systems also affect health outcomes. This study was conducted to identify and better understand the contribution of health system components to successful treatment of multidrug-resistant tuberculosis. We selected four European Union countries to provide for a broad range of geographical locations and levels of treatment success rates of the multidrug-resistant tuberculosis cohort in 2009. We conducted semi-structured interviews following a conceptual framework with representatives from policy and planning authorities, healthcare providers and civil society organisations. Responses were organised according to the six building blocks of the World Health Organization health systems framework. In the four included countries, Austria, Bulgaria, Spain, and the United Kingdom, the following healthcare system factors were perceived as key to achieving good treatment results for patients with multidrug-resistant tuberculosis: timely diagnosis of drug-resistant tuberculosis; financial systems that ensure access to a full course of treatment and support for multidrug-resistant tuberculosis patients; patient-centred approaches with strong intersectoral collaboration that address patients' emotional and social needs; motivated and dedicated healthcare workers with sufficient mandate and means to support patients; and cross-border management of multidrug-resistant tuberculosis to secure continuum of care between countries. We suggest that the following actions may improve the success of treatment for multidrug-resistant tuberculosis patients: deployment of rapid molecular diagnostic tests; development of context-specific treatment guidance and criteria for hospital admission and discharge in the European context; strengthening patient-centred approaches; development of collaborative mechanisms to ensure cross-border care, and development of long-term sustainable financing strategies.

  6. [Dental care for foreigners in Hungary].

    PubMed

    Balázs, Péter; Oesterle, August

    2008-10-01

    High quality elective dental care for foreign patients was not exceptional in Hungary before the collapse of the old regime in 1989. Nevertheless, it became business as usual only in the new era thanks to the open state borders and the international competitive market environment. Unfortunately, no scientific study concerning this phenomenon has been conducted so far, however its professional and economic significance has been indicated by day-to-day experience. Additionally, the term "dental tourism" also used in international scientific papers became a commonplace in Hungary with unfavourable connotations. The present survey was the first to study this phenomenon by scientific standards in the most involved areas, namely in the capital city Budapest and in three counties in the Western Hungarian Region. Data collecting was performed by a self-reported questionnaire sent via conventional mail to all members of the Dental Section of the Hungarian Medical Chamber practicing in those indicated regions. Respond rates were 20.65% in Budapest and 25.34% in Western Hungary. The sample obtained this way, clearly indicated dimensions of cross-border patient migration and its economic significance as well. In Western Hungary 80.81% of foreign patients came from the neighbouring Austria and two out of ten practices realized 40 to 100% of their income out of this business. In Budapest foreign patients' nationality was more diversified. The largest group arrived from the United Kingdom (9.93%). Nevertheless the economic impact of dental tourism in Budapest is not relevant and outbalanced by a considerable domestic demand on the local private market.

  7. Impact of cross-reference pricing on pharmaceutical prices: manufacturers' pricing strategies and price regulation.

    PubMed

    Stargardt, Tom; Schreyögg, Jonas

    2006-01-01

    Several EU countries are determining reimbursement prices of pharmaceuticals by cross-referencing prices of foreign countries. Our objective is to quantify the theoretical cross-border spill-over effects of cross-reference pricing schemes on pharmaceutical prices in the former EU-15 countries. An analytical model was developed estimating the impact of pharmaceutical price changes in Germany on pharmaceutical prices in other countries in the former EU-15 using cross-reference pricing. We differentiated between the direct impact (from referencing to Germany directly) and the indirect impact (from referencing to other countries that conduct their own cross-reference pricing schemes). The relationship between the direct and indirect impact of a price change depends mainly on the method applied to set reimbursement prices. When applying cross-reference pricing, the reimbursement price is either determined by the lowest of foreign prices (e.g. Portugal), the average of foreign prices (e.g. Ireland) or a weighted average of foreign prices (e.g. Italy). If the respective drug is marketed in all referenced countries and prices are regularly updated, a price reduction of 1.00 euro in Germany will reduce maximum reimbursement prices in the former EU-15 countries from 0.15 euros in Austria to 0.36 euros in Italy. On one side, the cross-border spill-over effects of price reductions are undoubtedly welcomed by decision makers and may be favourable to the healthcare system in general. On the other side, these cross-border spill-over effects also provide strong incentives for strategic product launches, launch delays and lobbying activities, and can affect the effectiveness of regulation. To avoid the negative effects of cross-reference pricing, a weighted index of prices from as many countries as possible should be used to determine reimbursement prices in order to reduce the direct and indirect impact of individual countries.

  8. Deterring Cross-Border Conflict in the Horn of Africa: A Case Study of Kenya-Uganda Border

    DTIC Science & Technology

    2008-06-01

    enabled them to poach elephants and introduced a new dimension in the competition for scarce resources, leading to the development of a superior social...SOCIAL- ECONOMIC AND POLITICAL IMPACT OF THE CONFLICTS...rivalries. These conflicts have caused extensive local crises, drawn heavily on military resources, and have had an adverse impact on economic

  9. Sin Fronteras Boy: Students Create Collaborative Websites to Explore the Border

    ERIC Educational Resources Information Center

    Cornell, Grace

    2012-01-01

    Around one table, four 4th-grade girls chat quietly as they write on their laptops: Ruby interviews Alejandra about her experience crossing the U.S.-Mexico border as a 6-year-old. Meanwhile, Cindy turns notes from an interview with her uncle into a narrative about his immigration experience. Next to them, four boys work on the "Sin Fronteras…

  10. Marriage Migration as a Multifaceted System: The Intersectionality of Intimate Partner Violence in Cross-Border Marriages.

    PubMed

    Chiu, Tuen Yi

    2016-08-18

    This article addresses the intersectional nature of intimate partner violence (IPV) against female marriage migrants in Mainland China-Hong Kong cross-border marriages. The author analyzes data from 15 battered female marriage migrants who share the same ethnicity as their husbands to illustrate how the immigration of female marriage migrants intricately intersects with gender, class, and culture to form a multifaceted system that traps battered marriage migrants in abusive marriages. It is proposed that marriage migration, as a distinct form of migration, involves certain intrinsic risk factors that make marriage migrants particularly vulnerable to IPV. © The Author(s) 2016.

  11. Asymmetrical Integration: Lessons from a Railway Empire.

    PubMed

    McDonald, Kate

    2015-01-01

    This article reexamines railway imperialism in Manchuria from the perspective of global network building. Through a case study of the Japanese-owned South Manchuria Railway Company (SMR), I trace how one railway empire used through traffic agreements to integrate Northeast Asian railways into a global network while at the same time installing itself as the necessary intermediary between European and Asian overland traffic. I argue that the SMR's pursuit of global reach and local dominance compels us to reconsider the traditional division of border-crossing railways into international and imperialist types, and instead to examine how border-crossing railways contributed to the uneven or "asymmetrical" integration of the global transportation infrastructure.

  12. Assessing a cross-border logistics policy using a performance measurement system framework: the case of Hong Kong and the Pearl River Delta region

    NASA Astrophysics Data System (ADS)

    Wong, David W. C.; Choy, K. L.; Chow, Harry K. H.; Lin, Canhong

    2014-06-01

    For the most rapidly growing economic entity in the world, China, a new logistics operation called the indirect cross-border supply chain model has recently emerged. The primary idea of this model is to reduce logistics costs by storing goods at a bonded warehouse with low storage cost in certain Chinese regions, such as the Pearl River Delta (PRD). This research proposes a performance measurement system (PMS) framework to assess the direct and indirect cross-border supply chain models. The PMS covers four categories including cost, time, quality and flexibility in the assessment of the performance of direct and indirect models. Furthermore, a survey was conducted to investigate the logistics performance of third party logistics (3PLs) at the PRD regions, including Guangzhou, Shenzhen and Hong Kong. The significance of the proposed PMS framework allows 3PLs accurately pinpoint the weakness and strengths of it current operations policy at four major performance measurement categories. Hence, this helps 3PLs further enhance the competitiveness and operations efficiency through better resources allocation at the area of warehousing and transportation.

  13. Crossing Borders: Evaluating a Work Integrated Learning Project Involving Australian and Vietnamese Students

    ERIC Educational Resources Information Center

    Welch, Bernadette; Vo-Tran, Huan; Pittayachawan, Siddhi; Reynolds, Sue

    2012-01-01

    The value of work integrated learning (WIL) is well-established in the education of information management (IM) professionals. Adding value to WIL through cross-cultural or cross-disciplinary experiences is considered in this article. Using online communication, simulation activities, and onsite work, students from RMIT Melbourne and RMIT Ho Chi…

  14. The brave new world of managed care.

    PubMed

    Korcok, M

    1995-07-01

    Canadian hospitals that think they can charge higher-than-normal rates to foreign visitors are learning a lesson as US-style managed care moves north of the border. Dr. Robert MacMillan, president and medical director of Florida-based Insurance Claims Management Systems and past president of the Ontario Medical Association, says that south of the border US-style managed care has already hauled in the reins on wild expectations about high payments, and it is expected to do the same for Canadian hospitals that charge private insurers "as much as the traffic will bear." He says it is no longer uncommon for a large Toronto hospital to charge a foreign patient $3000 a day for care that can now be purchased in a US hospital for one-third that price.

  15. Research protocol: a realist synthesis of cross-border patient mobility from low-income and middle-income countries

    PubMed Central

    Durham, Jo; Blondell, Sarah J

    2014-01-01

    Introduction People are increasingly mobile for numerous reasons, including healthcare. Patient mobility has vast implications for individuals, communities and whole populations and yet, to date, research on patient mobility has been quite limited. Only a small body of evidence exists on patient mobility between low-income and middle-income countries, instead having focused primarily on cross-border movement between high-income and low-income countries. In this paper, we present a protocol for examining this under-studied phenomenon. Methods and analysis We propose to examine patient mobility between low-income and middle-income countries using a realist synthesis approach. Specifically, we aim to document why patients from low-income and middle-income countries cross international borders for healthcare, by identifying the mechanisms through which patients decide to cross-borders, and the contextual characteristics of domestic health markets that influence this choice. An underlying theory was established, based on the lead author's experience and a brief literature review, which will provide the basis to analyse search results in a subsequent paper. Search results will be obtained from databases (Ovid Medline, EMBASE, Scopus, EconLit, Web of Science) and the grey literature. An expert committee will be enlisted, prior to screening results, to review search results to ensure comprehensiveness. Based on this preliminary theory, we propose that, in some low-income and middle-income country markets, the interaction between demand-side and supply-side determinants results in market imperfections that, in turn, lead to patient movement across borders. Ethics and dissemination The study does not involve primary research and, therefore, does not require formal ethical approval; we do, however, follow the relevant standards of utility, usefulness, feasibility, propriety, accuracy and accountability. The standards of realist and meta-narrative evidence synthesis (RAMESES) will be adhered to in reporting the findings of the review. Once completed, the findings of the resulting manuscript will be published in a peer-reviewed journal. Trial registration number This protocol has been registered with PROSPERO, registration number CRD42014014391. PMID:25406157

  16. Assessment of Primary Health Care in the Treatment of Tuberculosis in a Brazilian Locality of the International Triple Frontier

    PubMed Central

    Silva-Sobrinho, Reinaldo Antonio; Wysocki, Anneliese Domingues; Scatena, Lúcia Marina; Pinto, Erika Simone Galvão; Beraldo, Aline Ale; Andrade, Rubia Laine Paula; Zilly, Adriana; Munhak da Silva, Rosane Meire; Gomes, Michela Prestes; Mayer, Paulo César Morales; Ruffino-Netto, Antonio; Villa, Tereza Cristina Scatena

    2017-01-01

    Objective: To evaluate the performance of Primary Health Care (PHC) in treatment of TB patients in a triple international border municipality. Methods: The present study was an evaluative survey of cross-sectional and quantitative approach conducted with 225 PHC healthcare professionals. Data was collected through a structured and validated instrument, which provided five indicators of "structure" and four indicators of "process" classified as unsatisfactory, regular or satisfactory. Results: The "structure" component was unsatisfactory for the indicator of professionals involved in TB care and training, and regular for the indicator of connection between the units and other levels of care. The "process" component was regular for the indicators of TB information, directly observed treatment and reference and counter reference on TB, and unsatisfactory for external actions on TB control. Conclusion: The "structure" and "process" components points out some weaknesses in terms of management and organization of human resources. Low frequency of training and the turnover influenced the involvement of professionals. Elements of "structure" and "process" show the need for investing in the PHC team and improving the clinical management of cases. PMID:29204229

  17. Frequency of canine nt230(del4) MDR1 mutation in prone pure breeds, their crosses and mongrels in Israel - insights from a worldwide comparative perspective.

    PubMed

    Dekel, Yaron; Machluf, Yossy; Stoler, Aviad; Aderet, Arava; Baumel, Daniel; Kellerman, Efrat; Plotsky, Yoram; Noked Partouche, Oshrat; Elhalal, Gal; Ben-Shlomo, Izhar; Bercovich, Dani

    2017-11-13

    Sensitivity to macrocyclic lactones, which are commonly used in veterinary clinics, was first found in Rough Collies, and was attributed in 2001 to a 4 bp deletion in the MDR1 gene. The list of affected breeds currently includes 13 breeds. Researchers from different countries and continents examined the allelic frequencies of the nt230(del4) MDR1 mutation, emphasizing the clinical importance of this test not only to mutation-prone dogs, but also to their crosses and mongrels, since treatment of a deletion carrier with these compounds may lead to its death. In this study, the allelic frequencies of nt230(del4) MDR1 mutation in affected breeds, their crosses, unrelated pure breeds and mongrels are reported for the state of Israel (n = 1416 dogs). The Israeli data were compared with reports from the US, Europe, UK, Australia and Japan. The allelic frequencies of nt230(del4) MDR1 mutation in Israel for Australian, Swiss and German Shepherds (31%, 17% and 2.4%, respectively) are similar to the corresponding frequencies worldwide, much higher for Border Collies (4.8%), twice lower for Rough Collies (28%, compared to 55% or more elsewhere), and ~1% for mongrels. The frequencies for crosses of Australian Shepherd and Border Collies in Israel are 4 and 1.6 times lower, respectively, compared to the frequencies for the respective pure breeds. This work, that for the first time presents the frequency of nt230(del4) MDR1 mutation in Israel, along with a worldwide survey, has implications for clinicians, owners and breeders of sheepdogs and their crosses and supports the need for extra care in treatment and in future breeding. Of note, the relative proportion of affected breeds, in the overall tested dogs, might be higher than their actual proportion in Israel due to directed samples collection by veterinarians for clinical purposes, as these are mainly limited to certain affected breeds or dogs that resemble them.

  18. Caring in an Unjust World: Negotiating Borders and Barriers in Schools.

    ERIC Educational Resources Information Center

    Eaker-Rich, Deborah, Ed.; Van Galen, Jane, Ed.

    Authors of this collection address the difficulties and complexities of apprehending the reality of "others" when the caregivers or those receiving care or both are from historically marginalized groups. Caring across social barriers as demonstrated in caring relationships in schools is explored in: (1) "Caring and the Open Moment…

  19. Cross border waters: Fragile treasures for the 21st Century; Ninth U.S./Mexico Border States Conference on Recreation, Parks, and Wildlife; 1998, June 3-6

    Treesearch

    G. J. Gottfried; C. B. Edminster; Madelyn C. Dillon

    1998-01-01

    This conference brought together scientists and resource managers from government, universities, and private organizations in the United States and Mexico. In a continuing international forum, participants exchanged information on existing or potential cooperative projects, agency functions and programs, and issues were concerning natural and cultural resource...

  20. Beyond Sister City Agreements: Exploring the Challenges of Full International Interoperability

    DTIC Science & Technology

    2016-03-01

    are often interconnected by more than simple proximity. They are connected through social networks, economy, culture, and shared natural resources...southern U.S. borders to determine how various regions address their cross-border agreements. Research indicated that unique challenges—such as liability...They are connected through social networks, economy, culture, and shared natural resources. Despite this interdependent relationship, and in spite

  1. Trends of cross-border mobility of physicians and nurses between Portugal and Spain

    PubMed Central

    2013-01-01

    Context Health workforce cross-border mobility has an impact not only on individual health workers, but also on how health services are organized, planned, and delivered. This paper presents the results of a study of current mobility trends of health professionals along the borders between Portugal and Spain. The objective was to describe the profile of mobile physicians and nurses; to elicit the opinions of employers on mobility factors; to describe incentive policies to retain or attract health professionals; and to collect and analyse employers’ opinions on the impact of this mobility on their health services. Methods Phone interviews of key informants were used to collect relevant data. The interviews were conducted during December 2010 and January 2011 in health organizations along the border of the two countries. In Portugal and Spain, four and 13 organizations were selected, respectively. Interviews were obtained in all the Portuguese organizations and in four of the Spanish organizations. Results Findings suggest that cross-border mobility between the two countries has decreased. From Spain to Portugal, mobility trends are mainly of physicians who seek professional development in the form of specialization, the availability of positions, better salaries, and the perceived good living conditions. The mobility of nurses lasted until 2008, when reforms improved working conditions in Spain and contributed to reversing the flow. Since then, there has been an increase of Portuguese nurses going to Spain seeking better working conditions or simply a job. Portuguese nurses as well as Spanish physicians are well considered in terms of professionalism and qualifications by their Spanish and Portuguese hosts, respectively. Conclusions There is a deficit of valid data on the health workforce in general. The present study allowed further exploration of the reality of the mobility trends between Portugal and Spain. At present, the mobility trends are mainly of Spanish physicians to Portugal and Portuguese nurses to Spain. There is a consensus on both sides of the border that the benefits of migratory flows are much greater than the limited problems (for example, language and salary differences) that they may bring. PMID:23902587

  2. High school biology evolution learning experiences in a rural context: a case of and for cultural border crossing

    NASA Astrophysics Data System (ADS)

    Borgerding, Lisa A.

    2017-03-01

    Although the concept of "rural" is difficult to define, rural science education provides the possibility for learning centered upon a strong connection to the local community. Rural American adolescents tend to be more religious than their urban counterparts and less accepting of evolution than their non-rural peers. Because the status and perception of evolutionary theory may be very different within the students' lifeworlds and the subcultures of the science classroom and science itself, a cultural border crossing metaphor can be applied to evolution teaching and learning. This study examines how a teacher may serve as a cultural border crossing tour guide for students at a rural high school as they explore the concept of biological evolution in their high school biology class. Data collection entailed two formal teacher interviews, field note observations of two biology class periods each day for 16 days during the Evolution unit, individual interviews with 14 students, student evolution acceptance surveys, student evolution content tests, and classroom artifacts. The major findings center upon three themes regarding how this teacher and these students had largely positive evolution learning experiences even as some students continued to reject evolution. First, the teacher strategically positioned himself in two ways: using his unique "local" trusted position in the community and school and taking a position in which he did not personally represent science by instead consistently teaching evolution "according to scientists." Second, his instruction honored local "rural" funds of knowledge with respect to local knowledge of nature and by treating students' religious knowledge as a form of local expertise about one set of answers to questions also addressed by evolution. Third, the teacher served as a border crossing "tour guide" by helping students identify how the culture of science and the culture of their lifeworlds may differ with respect to evolutionary theory. Students negotiated the cultural borders for learning evolution in several ways, and different types of border crossings are described. The students respected the teacher's apparent neutrality, sensitivity toward multiple positions, explicit attention to religion/evolution, and transparency of purposes for teaching evolution. These findings add to the current literature on rural science education by highlighting local funds of knowledge for evolution learning and how rural teachers may help students navigate seemingly hazardous scientific topics. The study's findings also add to the current evolution education literature by examining how students' religious perspectives may be respected as a form of expertise about questions of origins by allowing students to examine similarities and differences between scientific and religious approaches to questions of biological origins and change.

  3. Risk behaviours for HIV infection among traveling Mexican migrants: The Mexico-US border as a contextual risk factor

    PubMed Central

    Zhang, Xiao; Martinez-Donate, Ana P.; Simon, Norma-Jean E.; Hovell, Melbourne F.; Rangel, Maria Gudelia; Magis-Rodriguez, Carlos; Sipan, Carol L.

    2016-01-01

    The Mexico-US border region is a transit point in the trajectory of Mexican migrants traveling to and from the U.S. and a final destination for domestic migrants from other regions in Mexico. This region also represents a high-risk environment that may increase risk for HIV among migrants and the communities they connect. We conducted a cross-sectional, population-based survey, in Tijuana, Mexico, and compared Mexican migrants with a recent stay on the Mexico-US border region (Border, n=553) with migrants arriving at the border from Mexican sending communities (Northbound, n=1077). After controlling for demographics and migration history, border migrants were more likely to perceive their risk for HIV infection as high in this region and regard this area as a liberal place for sexual behaviours compared to Northbound migrants reporting on their perceptions of the sending communities (p<0.05). Male border migrants were more likely to engage in sex, and have unprotected sex, with female sex workers during their recent stay on the border compared to other contexts (rate ratio= 3.0 and 6.6, respectively, p<0.05). Binational and intensified interventions targeting Mexican migrants should be deployed in the Mexican border region to address migration related HIV transmission in Mexico and the U.S. PMID:26878494

  4. Risk behaviours for HIV infection among travelling Mexican migrants: The Mexico-US border as a contextual risk factor.

    PubMed

    Zhang, Xiao; Martinez-Donate, Ana P; Simon, Norma-Jean E; Hovell, Melbourne F; Rangel, Maria Gudelia; Magis-Rodriguez, Carlos; Sipan, Carol L

    2017-01-01

    The Mexico-US border region is a transit point in the trajectory of Mexican migrants travelling to and from the USA and a final destination for domestic migrants from other regions in Mexico. This region also represents a high-risk environment that may increase risk for HIV among migrants and the communities they connect. We conducted a cross-sectional, population-based survey, in Tijuana, Mexico, and compared Mexican migrants with a recent stay on the Mexico-US border region (Border, n = 553) with migrants arriving at the border from Mexican sending communities (Northbound, n = 1077). After controlling for demographics and migration history, border migrants were more likely to perceive their risk for HIV infection as high in this region and regard this area as a liberal place for sexual behaviours compared to Northbound migrants reporting on their perceptions of the sending communities (p < .05). Male border migrants were more likely to engage in sex, and have unprotected sex, with female sex workers during their recent stay on the border compared to other contexts (rate ratio = 3.0 and 6.6, respectively, p < .05). Binational and intensified interventions targeting Mexican migrants should be deployed in the Mexican border region to address migration related HIV transmission in Mexico and the USA.

  5. Foodborne disease control: a transnational challenge.

    PubMed

    Käferstein, F K; Motarjemi, Y; Bettcher, D W

    1997-01-01

    In the globalized political economy of the late 20th century, increasing social, political, and economic interdependence is occurring as a result of the rapid movement of people, images, values, and financial transactions across national borders. Another consequence of the increase in transnational trade, travel, and migration is the greater risk of cross-border transmission of infectious diseases. As the world becomes more interconnected, diseases spread more rapidly and effectively. With more than one million people crossing international borders every day, and with the globalization of food production, manufacturing, and marketing, the risk of infectious disease transmission is greater. Economic globalization has also increased the need for governmental budget austerity, and consequent national preparedness has been eroded. The emergence of new infectious diseases, as well as the reemergence of old ones, thus represents a crucial transnational policy issue. These problems cannot be resolved by national governments alone; they require international cooperation. This article analyzes the role of foodborne disease surveillance programs, nationally and internationally, in the control of foodborne diseases.

  6. Foodborne disease control: a transnational challenge.

    PubMed Central

    Käferstein, F. K.; Motarjemi, Y.; Bettcher, D. W.

    1997-01-01

    In the globalized political economy of the late 20th century, increasing social, political, and economic interdependence is occurring as a result of the rapid movement of people, images, values, and financial transactions across national borders. Another consequence of the increase in transnational trade, travel, and migration is the greater risk of cross-border transmission of infectious diseases. As the world becomes more interconnected, diseases spread more rapidly and effectively. With more than one million people crossing international borders every day, and with the globalization of food production, manufacturing, and marketing, the risk of infectious disease transmission is greater. Economic globalization has also increased the need for governmental budget austerity, and consequent national preparedness has been eroded. The emergence of new infectious diseases, as well as the reemergence of old ones, thus represents a crucial transnational policy issue. These problems cannot be resolved by national governments alone; they require international cooperation. This article analyzes the role of foodborne disease surveillance programs, nationally and internationally, in the control of foodborne diseases. PMID:9368787

  7. Estimates of Commercial Motor Vehicles Using the Southwest Border Crossings

    DOT National Transportation Integrated Search

    2000-09-20

    The United States has experienced almost a five-fold increase in commercial motor vehicle traffic to and from Mexico during the past sixteen years. There were more than 4< million commercial motor vehicle (CMV) crossings from Mexico into the United S...

  8. Prospects for comparing European hospitals in terms of quality and safety: lessons from a comparative study in five countries

    PubMed Central

    Burnett, Susan; Renz, Anna; Wiig, Siri; Fernandes, Alexandra; Weggelaar, Anne Marie; Calltorp, Johan; Anderson, Janet E.; Robert, Glenn; Vincent, Charles; Fulop, Naomi

    2013-01-01

    Purpose Being able to compare hospitals in terms of quality and safety between countries is important for a number of reasons. For example, the 2011 European Union directive on patients' rights to cross-border health care places a requirement on all member states to provide patients with comparable information on health-care quality, so that they can make an informed choice. Here, we report on the feasibility of using common process and outcome indicators to compare hospitals for quality and safety in five countries (England, Portugal, The Netherlands, Sweden and Norway). Main Challenges Identified The cross-country comparison identified the following seven challenges with respect to comparing the quality of hospitals across Europe: different indicators are collected in each country; different definitions of the same indicators are used; different mandatory versus voluntary data collection requirements are in place; different types of organizations oversee data collection; different levels of aggregation of data exist (country, region and hospital); different levels of public access to data exist; and finally, hospital accreditation and licensing systems differ in each country. Conclusion Our findings indicate that if patients and policymakers are to compare the quality and safety of hospitals across Europe, then further work is urgently needed to agree the way forward. Until then, patients will not be able to make informed choices about where they receive their health care in different countries, and some governments will remain in the dark about the quality and safety of care available to their citizens as compared to that available in neighbouring countries. PMID:23292003

  9. Transformational leadership, transnational culture and political competence in globalizing health care services: a case study of Jordan's King Hussein Cancer Center.

    PubMed

    Moe, Jeffrey L; Pappas, Gregory; Murray, Andrew

    2007-11-16

    Following the demise of Jordan's King Hussein bin Talal to cancer in 1999, the country's Al-Amal Center was transformed from a poorly perceived and ineffectual cancer care institution into a Western-style comprehensive cancer center. Renamed King Hussein Cancer Center (KHCC), it achieved improved levels of quality, expanded cancer care services and achieved Joint Commission International accreditation under new leadership over a three-year period (2002-2005). An exploratory case research method was used to explain the rapid change to international standards. Sources including personal interviews, document review and on-site observations were combined to conduct a robust examination of KHCC's rapid changes. The changes which occurred at the KHCC during its formation and leading up to its Joint Commission International (JCI) accreditation can be understood within the conceptual frame of the transformational leadership model. Interviewees and other sources for the case study suggest the use of inspirational motivation, idealized influence, individualized consideration and intellectual stimulation, four factors in the transformational leadership model, had significant impact upon the attitudes and motivation of staff within KHCC. Changes in the institution were achieved through increased motivation and positive attitudes toward the use of JCI continuous improvement processes as well as increased professional training. The case study suggests the role of culture and political sensitivity needs re-definition and expansion within the transformational leadership model to adequately explain leadership in the context of globalizing health care services, specifically when governments are involved in the change initiative. The KHCC case underscores the utility of the transformational leadership model in an international health care context. To understand leadership in globalizing health care services, KHCC suggests culture is broader than organizational or societal culture to include an informal global network of medical professionals and Western technologies which facilitate global interaction. Additionally, political competencies among leaders may be particularly relevant in globalizing health care services where the goal is achieving international standards of care. Western communication technologies facilitate cross-border interaction, but social and political capital possessed by the leaders may be necessary for transactions across national borders to occur thus gaining access to specialized information and global thought leaders in a medical sub-specialty such as oncology.

  10. Transformational leadership, transnational culture and political competence in globalizing health care services: a case study of Jordan's King Hussein Cancer Center

    PubMed Central

    Moe, Jeffrey L; Pappas, Gregory; Murray, Andrew

    2007-01-01

    Background Following the demise of Jordan's King Hussein bin Talal to cancer in 1999, the country's Al-Amal Center was transformed from a poorly perceived and ineffectual cancer care institution into a Western-style comprehensive cancer center. Renamed King Hussein Cancer Center (KHCC), it achieved improved levels of quality, expanded cancer care services and achieved Joint Commission International accreditation under new leadership over a three-year period (2002–2005). Methods An exploratory case research method was used to explain the rapid change to international standards. Sources including personal interviews, document review and on-site observations were combined to conduct a robust examination of KHCC's rapid changes. Results The changes which occurred at the KHCC during its formation and leading up to its Joint Commission International (JCI) accreditation can be understood within the conceptual frame of the transformational leadership model. Interviewees and other sources for the case study suggest the use of inspirational motivation, idealized influence, individualized consideration and intellectual stimulation, four factors in the transformational leadership model, had significant impact upon the attitudes and motivation of staff within KHCC. Changes in the institution were achieved through increased motivation and positive attitudes toward the use of JCI continuous improvement processes as well as increased professional training. The case study suggests the role of culture and political sensitivity needs re-definition and expansion within the transformational leadership model to adequately explain leadership in the context of globalizing health care services, specifically when governments are involved in the change initiative. Conclusion The KHCC case underscores the utility of the transformational leadership model in an international health care context. To understand leadership in globalizing health care services, KHCC suggests culture is broader than organizational or societal culture to include an informal global network of medical professionals and Western technologies which facilitate global interaction. Additionally, political competencies among leaders may be particularly relevant in globalizing health care services where the goal is achieving international standards of care. Western communication technologies facilitate cross-border interaction, but social and political capital possessed by the leaders may be necessary for transactions across national borders to occur thus gaining access to specialized information and global thought leaders in a medical sub-specialty such as oncology. PMID:18021412

  11. Overview Of Cal-Mex 2010: US-Mexico Collaborative Project On Air Quality And Climate Change In The California-Mexico Border Region

    NASA Astrophysics Data System (ADS)

    Molina, L. T.; Cal-Mex Science Team

    2010-12-01

    The composition of the atmosphere over the US-Mexico border region is affected by cross-border transport of emissions in both directions. Air quality issues in the California-Mexico (Cal-Mex) border are associated with air masses originating in the portion of the border region adjacent to California, which includes two of the sister city pairs (Tijuana-San Diego and Mexicali-Calexico) that have the most severe air pollution problems, posing a serious health threat to their inhabitants as well as affecting ecosystem viability and regional climate for large downwind distances. During May-June 2010, an intensive field study was undertaken by US-Mexico collaborative teams to characterize the major sources of primary and secondary particulate matter and precursor gases in the California-Mexico (Cal-Mex) border region, their transport and transformation, and the impact of these emissions on regional air quality and climate. The ground-based measurements included a central fixed site located in Tijuana that housed state-of-the-science instruments to measure gases, aerosols, radiation and meteorological parameters; a mobile eddy covariance laboratory that measured surface-atmosphere exchange fluxes of carbon dioxide, nitrogen oxides, and particle number; several mobile units for criteria pollutants and meteorological parameters; and measurements of fine particles and trace gases at the border crossing areas. Preliminary results from the field study will be presented. Cal-Mex Science Team includes: Molina Center for Energy and the Environment, Texas A & M University, Scripps Institution of Oceanography/University of California at San Diego, Virginia Tech, San Diego State University, National University of Mexico, National Institute of Ecology/Mexican Ministry of the Environment, University of the State of Morelos, LT Consulting Group, University of Baja California (Mexicali, Tijuana, Ensenada, Valle de Las Palmas campuses), Secretary of the Environment of Baja California, Tijuana Technological University, and University of Ciudad Juarez.

  12. [Health on the borders: access to and demands on the Brazilian National Health System by foreigners and non-resident Brazilians in cities along the border with MERCOSUR countries from the perspective of municipal health secretaries].

    PubMed

    Giovanella, Ligia; Guimarães, Luisa; Nogueira, Vera Maria Ribeiro; Lobato, Lenaura de Vasconcelos Costa; Damacena, Giseli Nogueira

    2007-01-01

    In the context of forming common markets, border areas require special attention, since they anticipate the effects of integration processes. Along borders, different political, monetary, security, and social systems coexist; the intensification of flows resulting from integration raises challenges for the health systems, requiring specific policies focused on guaranteeing the right to health. This article presents the results of a study on the conditions for access to (and demands for) health services in the MERCOSUR border cities. A survey was performed with municipal health secretaries in the 69 Brazilian cities in the States of Rio Grande do Sul, Santa Catarina, Paraná, and Mato Grosso do Sul that border on the other MERCOSUR countries. The study attempted to identify the services demanded by the border population, mechanisms used for access, flows between services and systems, response strategies, and local agreements. Initiatives for cooperation between Brazilian and foreign local administrators were identified in nearly half of the municipalities and can orient the formulation of guidelines for border situations, allowing improvement in comprehensive access to health care.

  13. Network communities within and across borders

    PubMed Central

    Cerina, Federica; Chessa, Alessandro; Pammolli, Fabio; Riccaboni, Massimo

    2014-01-01

    We investigate the impact of borders on the topology of spatially embedded networks. Indeed territorial subdivisions and geographical borders significantly hamper the geographical span of networks thus playing a key role in the formation of network communities. This is especially important in scientific and technological policy-making, highlighting the interplay between pressure for the internationalization to lead towards a global innovation system and the administrative borders imposed by the national and regional institutions. In this study we introduce an outreach index to quantify the impact of borders on the community structure and apply it to the case of the European and US patent co-inventors networks. We find that (a) the US connectivity decays as a power of distance, whereas we observe a faster exponential decay for Europe; (b) European network communities essentially correspond to nations and contiguous regions while US communities span multiple states across the whole country without any characteristic geographic scale. We confirm our findings by means of a set of simulations aimed at exploring the relationship between different patterns of cross-border community structures and the outreach index. PMID:24686380

  14. Network communities within and across borders.

    PubMed

    Cerina, Federica; Chessa, Alessandro; Pammolli, Fabio; Riccaboni, Massimo

    2014-04-01

    We investigate the impact of borders on the topology of spatially embedded networks. Indeed territorial subdivisions and geographical borders significantly hamper the geographical span of networks thus playing a key role in the formation of network communities. This is especially important in scientific and technological policy-making, highlighting the interplay between pressure for the internationalization to lead towards a global innovation system and the administrative borders imposed by the national and regional institutions. In this study we introduce an outreach index to quantify the impact of borders on the community structure and apply it to the case of the European and US patent co-inventors networks. We find that (a) the US connectivity decays as a power of distance, whereas we observe a faster exponential decay for Europe; (b) European network communities essentially correspond to nations and contiguous regions while US communities span multiple states across the whole country without any characteristic geographic scale. We confirm our findings by means of a set of simulations aimed at exploring the relationship between different patterns of cross-border community structures and the outreach index.

  15. Traffic-related air pollution in the community of San Ysidro, CA, in relation to northbound vehicle wait times at the US-Mexico border Port of Entry

    NASA Astrophysics Data System (ADS)

    Quintana, Penelope J. E.; Dumbauld, Jill J.; Garnica, Lynelle; Chowdhury, M. Zohir; Velascosoltero, José; Mota-Raigoza, Arturo; Flores, David; Rodríguez, Edgar; Panagon, Nicolas; Gamble, Jamison; Irby, Travis; Tran, Cuong; Elder, John; Galaviz, Vanessa E.; Hoffman, Lisa; Zavala, Miguel; Molina, Luisa T.

    2014-05-01

    The San Diego/Tijuana US-Mexico border crossing at the San Ysidro Port of Entry (POE) is the world's busiest international land border crossing (GSA, 2013). San Ysidro, California, is the US community immediately adjacent to the border crossing. More than 90% of San Ysidro residents are Hispanic, and the average household income is less than 60% of the San Diego regional average. This study investigated the San Ysidro POE as a source of traffic-related air pollutants in San Ysidro, especially in relation to wind direction and northbound vehicle wait times. The pollutants ultrafine particulate matter (UFP), black carbon (BC), and particulate matter <2.5 μm in diameter (PM2.5) were periodically sampled through the course of 2010 at four rooftop locations: one commercial establishment near the POE, two elementary schools in San Ysidro, and a coastal estuary reference site. Weather data from two nearby sites and northbound border wait times were also collected. Results indicate consistently higher daytime BC and UFP concentrations at the measurement sites near the POE. Pollution concentrations were higher during low wind speeds or when wind was blowing from the POE towards San Ysidro. In February, March and November measurements, black carbon pollution appeared to be significantly positively associated with the POE northbound wait times when the wind direction was blowing from the POE towards San Ysidro or during low wind speeds, but not when the wind direction was from the west/northwest towards the POE. This pilot study is the first to investigate the potential effect of the POE, especially the long northbound traffic delays, on the nearby community of San Ysidro. Disparities in traffic exposures are an environmental justice issue and this should be taken into account during planning and operation of POEs.

  16. Mapping cross-border collaboration and communication in cardiovascular research from 1992 to 2012

    PubMed Central

    Gal, Diane; Glänzel, Wolfgang; Sipido, Karin R.

    2017-01-01

    Aims The growing burden of cardiovascular disease requires growth in research and innovation. We examine world-wide participation and citation impact across the cardiovascular research landscape from 1992 to 2012; we investigate cross-fertilization between countries and examine whether cross-border collaboration affects impact. Methods and Results State-of-the-art bibliometric methods and indicators are used to identify cardiovascular publications from the Web of Science, and to map trends over time in output, citation impact, and collaboration. The publication output in cardiovascular research has grown steadily from 1992 to 2012 with increased participation worldwide. China has the highest growth as relative share. The USA share initially predominated yet has reduced steadily. Over time, the EU-27 supra-national region has increased its participation above the USA, though on average it has not had greater citation impact than the USA. However, a number of European countries, as well as Australia and Canada, have improved their absolute and relative citation impact above that of the USA by 2006–2012. Europe is a hub of cross-fertilization with strengthening collaborations and strong citation links; the UK, Germany, and France remain central in this network. The USA has the highest number of strong citation links with other countries. All countries, but especially smaller, highly collaborative countries, have higher citation impact for their internationally collaborative research when compared with their domestic publications. Conclusion Participation in cardiovascular research is growing but growth and impact show wide variability between countries. Cross-border collaboration is increasing, in particular within the EU, and is associated with greater citation impact. PMID:27997881

  17. Effect of acculturation and access to care on colorectal cancer screening in low-income Latinos.

    PubMed

    Savas, Lara S; Vernon, Sally W; Atkinson, John S; Fernández, Maria E

    2015-06-01

    Latinos have lower colorectal cancer screening (CRCS) and survival rates compared to other race/ethnic groups. This cross-sectional study examines relationships between acculturation, access to and utilization of healthcare services, and CRCS in low-income Latinos. Bilingual data collectors conducted structured interviews with 544 Latino men and women (>50 years) residing in the Texas-Mexico border area. Using a hierarchical logistic regression model, we examined the relationship between lifetime history of any CRCS test and indicators of acculturation, healthcare utilization and access to care, adjusting for socio-demographic characteristics. Survey results revealed a 34% prevalence of CRCS. Participants reporting a provider recommendation for screening, regular check-ups, higher acculturation level, and health insurance had significantly increased odds of CRCS. Findings indicate CRCS intervention research in Latinos should focus on (1) increasing physicians' recommendations for screening, (2) promoting regular check-ups, (3) and increasing CRC prevention efforts on less acculturated and uninsured groups.

  18. Is It More Important to Address the Issue of Patient Mobility or to Guarantee Universal Health Coverage in Europe?: Comment on "Regional Incentives and Patient Cross-Border Mobility: Evidence From the Italian Experience".

    PubMed

    Legido-Quigley, Helena

    2015-09-02

    This paper discusses whether European institutions should devote so much attention and funding to cross-border healthcare or they should instead prioritise guaranteeing universal health coverage (UHC), "addressing inequalities" and tackling the effects of austerity measures. The paper argues through providing the evidence in both areas of research, that the priority at European level from a public health and social justice perspective should be to guarantee UHC for all the population living in Europe and prioritise protective action for those who are most in need. © 2016 by Kerman University of Medical Sciences.

  19. Borders, Corridors, and Economics: The Keys to Stopping Cross Border Violence

    DTIC Science & Technology

    2013-04-22

    control in the United States. The Tijuana Cartel, Federation Cartel, Gulf Cartel, Juarez Cartel, Sinaloa Cartel, Knights Templar Cartel, and Los Zetas...defeated rule of law and legitimate commerce migrated toward security. The lack of rule of law transmitted violence across Peru and was perpetuated by...million people live in poverty in Mexico. Deeply impoverished and unemployed people in Mexico have three options for survival: migration , tenuous and

  20. Perceptions of self-drive tourists along the Alaska-Canada border toward the increased security requirements of the western hemisphere travel initiative

    Treesearch

    Nicholas Palso

    2009-01-01

    This study explores the attitudes and feelings of self-drive tourists who cross the Alaska-Canada border about the increased security requirements of the Western Hemisphere Travel Initiative (WHTI), and how such attitudes and feelings may impact the tourism industry in this region. Results of a 2007 survey suggest that implementation of passport requirements will have...

  1. Crossing the Border from Science Student to Science Teacher: Preservice Teachers' Views and Experiences Learning to Teach Inquiry

    NASA Astrophysics Data System (ADS)

    Kang, Emily J. S.; Bianchini, Julie A.; Kelly, Gregory J.

    2013-04-01

    Preservice science teachers face numerous challenges in understanding and teaching science as inquiry. Over the course of their teacher education program, they are expected to move from veteran science students with little experience learning their discipline through inquiry instruction to beginning science teachers adept at implementing inquiry in their own classrooms. In this study, we used Aikenhead's (Sci Educ 81: 217-238, 1997, Science Educ 85:180-188, 2001) notion of border crossing to describe this transition preservice teachers must make from science student to science teacher. We examined what one cohort of eight preservice secondary science teachers said, did, and wrote as they both conducted a two-part inquiry investigation and designed an inquiry lesson plan. We conducted two types of qualitative analyses. One, we drew from Costa (Sci Educ 79: 313-333, 1995) to group our preservice teacher participants into one of four types of potential science teachers. Two, we identified successes and struggles in preservice teachers' attempts to negotiate the cultural border between veteran student and beginning teacher. In our implications, we argue that preservice teachers could benefit from explicit opportunities to navigate the border between learning and teaching science; such opportunities could deepen their conceptions of inquiry beyond those exclusively fashioned as either student or teacher.

  2. Healthcare access among circular and undocumented Mexican migrants: results from a pilot survey on the Mexico-US border

    PubMed Central

    Martinez-Donate, Ana P.; Zhang, Xiao; Rangel, M. Gudelia; Hovell, Melbourne; Simon, Norma-Jean; Amuedo-Dorantes, Catalina; Sipan, Carol; Guendelman, Sylvia

    2014-01-01

    Background Temporary and unauthorized migrants may face unique obstacles to access health care services in the U.S. Objective This study estimated levels of health care access among Mexican migrants returning to Mexico from the U.S. and factors associated with access to health care, with emphasis on the role of modifiable, enabling factors. Methods We conducted a pilot probability health care survey of migrants in the border city of Tijuana, Mexico (N=186). Results Approximately 42% of migrants reported having used health care services in the U.S. during the past year. Only 38% had a usual source of care and approximately 11% went without needed medical care in the U.S. About 71% of migrants did not have health insurance in the U.S. Lack of health insurance and transportation limitations were significantly related to various access indicators. Conclusion These results have implications for future policies and programs aimed to address modifiable health care access barriers faced by these vulnerable and underserved segments of the Mexican migrant population. PMID:25364381

  3. CO-OCCURRENCE OF ALCOHOL, DRUG USE, DSM-5 ALCOHOL USE DISORDER AND SYMPTOMS OF DRUG USE DISORDER ON BOTH SIDES OF THE U.S.-MEXICO BORDER

    PubMed Central

    Borges, Guilherme; Zemore, Sarah; Orozco, Ricardo; Cherpitel, Cheryl J.; Ye, Yu; Bond, Jason; Maxwell, Jane Carlisle; Wallisch, Lynn

    2015-01-01

    Background The U.S.-Mexico border displays elevated rates of hazardous alcohol and drug use. Whether the co-occurrence of alcohol and drug use and disorders is also high in the border area is unknown. Methods Data are from the U.S.-Mexico Study on Alcohol and Related Conditions, a cross-sectional survey of randomly selected respondents interviewed from 2011–2013. Participants included 1,690 Mexican Americans from Texas (572 in an off-border city and 1,118 from 3 border cities) and 1,293 Mexicans from Nuevo Leon and Tamaulipas (415 in an off-border city and 878 from 3 Mexican cities bordering Texas) who reported drinking in the last 12 months. Participants were interviewed regarding the prevalence of and risk factors for: a) co-occurring hazardous alcohol use (5+/4+ at least monthly) and drug use (medical and illicit), and b) co-occurring presence of a DSM-5 alcohol use disorder (AUD) and 2 symptoms (hazardous use and quit/control) of drug use disorders (DUD symptoms). Results Co-occurring hazardous alcohol and drug use was more common in the U.S. border cities (14.7%) than off-border (7.2%), but similar for Mexican border (1.2%) and off-border (1.4%) cities. Co-occurrence of AUD and DUD symptoms was likewise more common at the U.S. border (6.8%) than off-border (3.3%), as well as at the Mexican border (1.3%), compared to off-border (0.6%), but not statistically significant for Mexico. In models adjusting for demographics, mobility factors and exposure to the U.S. culture, border residence in both countries related to a nearly two-fold increase in prevalence ratios (PR) of co-occurring AUD and DUD symptoms (PR=1.97, 95%CI=1.36–2.85). Conclusions Increased rates of co-occurring alcohol and drug use disorders suggest an added negative impact on already difficult conditions of the border population. PMID:25833029

  4. [Violence and mental health issues among Mexican adolescents that have considered or attempted cross-border migration].

    PubMed

    Chavez-Ayala, Ruben; Orozco-Núñez, Emanuel; Sánchez-Estrada, Marcela; Hernández-Girón, Carlos

    2017-07-13

    The aim of this study was to estimate the role of victimization by violence among Mexican adolescents that have considered or attempted migrating to the United States, including mental health variables (emotional self-esteem, self-esteem in school, depression, suicidal ideation, and attempted suicide) as mediators of the effects. The study used a cross-sectional design with a stratified cluster sample of 13,198 adolescents from the 2nd Mexican National Survey on Exclusion, Intolerance, and Violence in public schools in 2009. The analysis used the regression models proposed by Baron & Kenny. Prevalence of having considered or attempted cross-border migration was 23.1%. Mean age was 16.36 years. Female adolescents constituted 54.9% of the sample, and 56% were lower-income. Mental health variables that acted as partial mediators were suicidal ideation (35.9%), depression (19.2%), attempted suicide (17.7%), emotional self-esteem (6.2%), and self-esteem in school (3.4%) for moderate family violence, and emotional self-esteem (17.5%) for social rejection in school and suicidal ideation (8.1%) for physical harm in school. Female adolescents showed greater impact from mediators than men in considering or having attempted cross-border migration. The study discusses the importance of incorporating the prevention of violence in the social contexts studied here and incorporating mental health in dealing with violence in adolescents and in public health programs in transit areas for illegal migrants.

  5. The impact of work-life balance on intention to stay in academia: Results from a national survey of pharmacy faculty.

    PubMed

    Lindfelt, Tristan; Ip, Eric J; Gomez, Alejandra; Barnett, Mitchell J

    2018-04-01

    Border-Crossing theory suggests work-life balance and career satisfaction are inter-related and disappointment in work-life balance may predict changes in one's career path. Application of this theory to health profession faculty is plausible but has not been fully explored. The purpose of this study is to examine factors related to reported career change intention among United States pharmacy school faculty and to determine if Border-Crossing theory fits these observations. Results from a national web-based survey administered via Qualtrics ® to American Association of Colleges of Pharmacy (AACP) members were utilized. Bivariate analyses were conducted to compare differences among faculty stating an intention to stay or leave academia. A logistic multivariate model was used to determine if work-life balance remains significant when controlling for other variables and if survey results support the Border-Crossing theory. Nearly all (seven hundred of 811 responders, or 86.3%) stated a desire to stay in academia. Faculty with higher work-life balance were more likely to report an intent to remain in academia. Male, older, full-professor and non-pharmacy practice faculty (social or administrative science, pharmacology, medicinal chemistry and others) were more likely to state an intention to remain in academia relative to their counterparts. Lower stress, as measured by the validated Perceived Stress Scale (PSS) scores, was seen among faculty stating a desire to remain in academia. Work-life balance remained significantly inversely related to career change intention after controlling for all other factors. A significant factor related to pharmacy faculty's stated intention to remain in academia was work-life balance. Other factors such as gender, age, rank, stress level and department may also play a role. These results support the application of the Border-Crossing theory in health profession faculty and may provide pharmacy school administrators and stakeholders with insight to foster faculty retention and decrease faculty turnover. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. [U.S.-Mexico cross-border cooperation in research on diabetes mellitus type 2].

    PubMed

    Canela-Soler, Jaume; Frontini, María; Cerqueira, Maria Teresa; Ruiz-Holguín, Rosalba; Díaz-Apodaca, Beatriz A

    2010-09-01

    To describe and analyze, utilizing a case study approach, the U.S.- Mexico Border Diabetes Prevention and Control Project, a health research cooperation initiative incorporating the participation of federal, state, and local institutions of both countries. A model of equal representation, participation, consensus, and shared leadership was used, with the participation of more than 130 institutions. A sample of 4 020 people over 18 years of age was obtained by a random, multistage, stratified, clustered design. A questionnaire about diabetes mellitus type 2 (DM2) and health was applied. The statistical analysis took into account the design effect. The prevalence of diagnosed DM2 was 14.9% (95% confidence interval [95% CI]: 12.5-17.6) and the prevalence of diagnosed DM2 adjusted by age was 19.5% (95% CI: 16.8-22.6) on the Mexican side of the border and 16.1% (IC95%: 13.5-19.2) on the U.S. border side. There were differences between the DM2 prevalence and risk factors along the border. The U.S.-Mexico Border Diabetes Prevention and Control Project allowed the border zone between the two countries to be considered, for the first time ever, as a unit for epidemiological research. A shared understanding among all participating institutions and entities of sociopolitical structures and procedures is required for effective border health cooperation initiatives.

  7. The impact of Ontario’s extended drinking hours on cross-border cities of Windsor and Detroit

    PubMed Central

    Vingilis, E.; McLeod, A.I.; Seeley, J.; Mann, R.; Voas, R.; Compton, C.

    2008-01-01

    Purpose This study evaluated the cross-border safety impact of extended drinking hours from 1:00 to 2:00 a.m., in licensed establishments in Ontario, Canada. Methods This study examined patterns in total and alcohol-related casualties in: (1) Windsor, Ontario, Canada compared to Detroit, Michigan, US with a 2:00 a.m. closing time, and (2) Ontario compared to Michigan for overall trends. The criterion outcome indicators were: (1) monthly motor vehicle casualties (major injuries and fatalities) for the city-regions of Windsor and Detroit and (2) Ontario and Michigan monthly motor vehicle fatalities occurring between 11:00 p.m. and 3:00 a.m. for 4 years pre- and 3 years post-policy change. In order to examine cross-border drinking consequences, data were disaggregated to assess trends of motor vehicle injury collisions involving vehicles with US licence plates and with US drivers aged 16–20 in the Windsor region; similarly trends were assessed for motor vehicle injury collisions involving vehicles with Ontario licence plates in the Detroit region. Results The Windsor region total motor vehicle casualty data showed a non-significant pre–post increase, while the Detroit region showed a statistically significant decrease for total motor vehicle casualties. In the Windsor region, a significant increase was found for alcohol-related motor vehicle casualties after the drinking hours were extended. However, the Detroit region showed a statistically significant decrease in alcohol-related motor vehicle casualties concomitant with Ontario’s drinking hour extension. No similar trends were found for the province of Ontario and the state of Michigan as a whole. Moreover, a significant decrease was found for injury collisions involving vehicles with Ontario licence plates in the Detroit region but no similar pattern was found for injury collisions involving vehicles with US licence plates and with 16–20-year-old US drivers in the Windsor region. Discussion These data seem to support a cross-border impact of the Ontario extended drinking policy. A significant increase in alcohol-related motor vehicle casualties was found in the Windsor region and concomitantly, significant decreases in total and alcohol-related motor vehicle casualties were found in the Detroit region after the extended drinking hours amendment. The Ontario government’s belief that the extended drinking hour policy would “reduce the number of patrons who cross the border when Ontario’s bars and restaurants close” may have been realized. PMID:16169506

  8. Seismic Hazard and risk assessment for Romania -Bulgaria cross-border region

    NASA Astrophysics Data System (ADS)

    Simeonova, Stela; Solakov, Dimcho; Alexandrova, Irena; Vaseva, Elena; Trifonova, Petya; Raykova, Plamena

    2016-04-01

    Among the many kinds of natural and man-made disasters, earthquakes dominate with regard to their social and economical impact on the urban environment. Global seismic hazard and vulnerability to earthquakes are steadily increasing as urbanization and development occupy more areas that are prone to effects of strong earthquakes. The assessment of the seismic hazard and risk is particularly important, because it provides valuable information for seismic safety and disaster mitigation, and it supports decision making for the benefit of society. Romania and Bulgaria, situated in the Balkan Region as a part of the Alpine-Himalayan seismic belt, are characterized by high seismicity, and are exposed to a high seismic risk. Over the centuries, both countries have experienced strong earthquakes. The cross-border region encompassing the northern Bulgaria and southern Romania is a territory prone to effects of strong earthquakes. The area is significantly affected by earthquakes occurred in both countries, on the one hand the events generated by the Vrancea intermediate-depth seismic source in Romania, and on the other hand by the crustal seismicity originated in the seismic sources: Shabla (SHB), Dulovo, Gorna Orjahovitza (GO) in Bulgaria. The Vrancea seismogenic zone of Romania is a very peculiar seismic source, often described as unique in the world, and it represents a major concern for most of the northern part of Bulgaria as well. In the present study the seismic hazard for Romania-Bulgaria cross-border region on the basis of integrated basic geo-datasets is assessed. The hazard results are obtained by applying two alternative approaches - probabilistic and deterministic. The MSK64 intensity (MSK64 scale is practically equal to the new EMS98) is used as output parameter for the hazard maps. We prefer to use here the macroseismic intensity instead of PGA, because it is directly related to the degree of damages and, moreover, the epicentral intensity is the original parameter in the historical earthquake catalogues. A particular advantage of using intensities is that the very irregular pattern of the attenuation field of the Vrancea intermediate depth earthquakes can be estimated from detailed macroseismic observations that are available (in both countries) for the study region. Additionally, de-aggregation of the seismic hazard for a recurrence period of 475 years (probability of exceedance of 10% in 50 years) for intensity was performed for 9 cities (administrative centers) situated in northern Bulgaria. Finally, applying SELENA software earthquake risk for Bulgarian part of the cross-boarder region is analyzed. The results presented for the Romania-Bulgaria cross border region are part of the work carried out in the DACEA Project (2010-2013) that was implemented in the framework of the Romania - Bulgaria Cross Border Cooperation Programme (2007-2013).

  9. National Strategy for the Southwest Border: Having the Desired Effect?

    DTIC Science & Technology

    2011-03-18

    marijuana and, increasingly in recent years, synthetics ”9 entering the United States. As Figure 1 illustrates, they operate throughout the Southwest...significant cross-border, drug smuggling tunnel and netted about 30 tons of marijuana seized at two warehouses in the United States and Mexico.”40 Once the...illegal drugs. The increased seizures of heroin, methamphetamine, and marijuana were 30.8 percent, 24 percent, and 16.9 percent respectively.45 This

  10. Transect studies on pine forests along parallel 52° north, 12-32° east and along a pollution gradient in Poland: general assumptions

    Treesearch

    Alicja Breymeyer

    1998-01-01

    The responses of pine forest to changing climate and environmental chemistry were studied along two transects following the pollution and continentality gradients in Poland. One axis begins on the western border of Poland, crosses the country along the 52nd parallel, and ends on the eastern border of Poland in the area of Bialowieza National Park, Biosphere Reserve....

  11. Crossing Our Red Lines About Partner Engagement in Mexico

    DTIC Science & Technology

    2013-03-01

    aware that notwithstanding any other provision of law , no person shall be subject to any penalty for failing to comply with a collection of...the United States is willing to provide the military or law enforcement forces required to adequately control the international border or the...war on drugs. Americans demand that Mexico do a better job of imposing the rule of law within its own borders. Both positions divert attention away

  12. When the Border Educates: Malín Alegria's "Sofi Mendoza's Guide to Getting Lost in Mexico" (2007)

    ERIC Educational Resources Information Center

    Ibarraran-Bigalondo, Amaia

    2016-01-01

    The border between the United States and Mexico, since it was first conceived in 1848, has marked the lives of those who live on both of its sides, as well as of those who want to cross it. It has also become the source of a vast array of theoretical and artistic work. Chicano writers have written about it, and so have theorists dealt with its…

  13. Cross-Border Higher Education, Who Profits?

    ERIC Educational Resources Information Center

    Martin, Graeme; Peim, Nick

    2011-01-01

    Emphasis on "the knowledge economy", the commodification of public services, the massification of HE and decreases in public funding of education are the context for new forms of educational provision. Some nations have led the demand for and provision of cross-national educational services. The largest exporters of Higher Education have…

  14. Organizational Legitimacy of International Research Collaborations: Crossing Boundaries in the Middle East

    ERIC Educational Resources Information Center

    Oleksiyenko, Anatoly

    2013-01-01

    Cross-border academic collaborations in conflict zones are vulnerable to escalated turbulence, liability concerns and flagging support. Multi-level stakeholder engagement at home and abroad is essential for securing the political and financial sustainability of such collaborations. This study examines the multilayered stakeholder arrangements…

  15. Staffing for Success

    ERIC Educational Resources Information Center

    Perozzi, Brett; Seifert, Tricia; Al-Sharif, Mary Ann Bodine

    2016-01-01

    This chapter explores institutional capacity building in cross-border student affairs and services. The focus is on human capital and its importance to international higher education within local contexts.

  16. Surrogacy and the ECtHR: Reflections on Paradiso and Campanelli v Italy.

    PubMed

    Iliadou, Marianna

    2018-02-21

    This case note analyses the recent judgment of the European Court of Human Rights in Paradiso and Campanelli v Italy and examines its implications for cross-border surrogacy in Europe. It is argued that this judgment is highly significant, because it sets new standards in terms of the concept of family life under Article 8 of the European Convention on Human Rights. This judgment, it is argued, only appears to bring a halt to the (seemingly) backdoor legitimacy of commercial surrogacy established by the findings of the Second Section and previous judgments of the Court. Finally, this case note critiques the Grand Chamber's findings and examines its likely impact on the problem of cross-border surrogacy.

  17. Reproductive tourism and the quest for global gender justice.

    PubMed

    Donchin, Anne

    2010-09-01

    Reproductive tourism is a manifestation of a larger, more inclusive trend toward globalization of capitalist cultural and material economies. This paper discusses the development of cross-border assisted reproduction within the globalized economy, transnational and local structural processes that influence the trade, social relations intersecting it, and implications for the healthcare systems affected. I focus on prevailing gender structures embedded in the cross-border trade and their intersection with other social and economic structures that reflect and impact globalization. I apply a social connection model of responsibility for unjust outcomes and consider strategies to counter structural injustices embedded in this industry. The concluding section discusses policy reforms and proposals for collaborative action to preclude further injustices and extend full human rights to all.

  18. Mapping cross-border collaboration and communication in cardiovascular research from 1992 to 2012.

    PubMed

    Gal, Diane; Glänzel, Wolfgang; Sipido, Karin R

    2017-04-21

    The growing burden of cardiovascular disease requires growth in research and innovation. We examine world-wide participation and citation impact across the cardiovascular research landscape from 1992 to 2012; we investigate cross-fertilization between countries and examine whether cross-border collaboration affects impact. State-of-the-art bibliometric methods and indicators are used to identify cardiovascular publications from the Web of Science, and to map trends over time in output, citation impact, and collaboration. The publication output in cardiovascular research has grown steadily from 1992 to 2012 with increased participation worldwide. China has the highest growth as relative share. The USA share initially predominated yet has reduced steadily. Over time, the EU-27 supra-national region has increased its participation above the USA, though on average it has not had greater citation impact than the USA. However, a number of European countries, as well as Australia and Canada, have improved their absolute and relative citation impact above that of the USA by 2006-2012. Europe is a hub of cross-fertilization with strengthening collaborations and strong citation links; the UK, Germany, and France remain central in this network. The USA has the highest number of strong citation links with other countries. All countries, but especially smaller, highly collaborative countries, have higher citation impact for their internationally collaborative research when compared with their domestic publications. Participation in cardiovascular research is growing but growth and impact show wide variability between countries. Cross-border collaboration is increasing, in particular within the EU, and is associated with greater citation impact. © The Author 2016. Published by Oxford University Press on behalf of the European Society of Cardiology.

  19. Decision Making About Method of Delivery on the U.S.–Mexico Border

    PubMed Central

    DESISTO, CARLA L.; McDONALD, JILL A.; ROCHAT, ROGER; DIAZ-APODACA, BEATRIZ A.; DECLERCQ, EUGENE

    2015-01-01

    We explored how low-risk, nulliparous pregnant women and their doctors in two contiguous U.S.–Mexico border communities communicate about methods of delivery and how they perceive that the delivery method decision is made. We recruited 18 women through obstetricians in El Paso, Texas (n = 10), and prenatal care providers in Ciudad Juárez, Mexico (n = 8). We observed prenatal care visits, interviewed women prenatally and postpartum, and interviewed the El Paso obstetricians. Qualitative analysis demonstrated that birthing decisions are complex and involve multiple influences, including women's level of knowledge about birth, doctor–patient communication, and women's participation in decision making. PMID:25364879

  20. Redressing the limitations of the Affordable Care Act for Mexican immigrants through bi-national health insurance: a willingness to pay study in Los Angeles.

    PubMed

    González Block, Miguel Angel; Vargas Bustamante, Arturo; de la Sierra, Luz Angélica; Martínez Cardoso, Aresha

    2014-04-01

    The 12.4 million Mexican migrants in the United States (US) face considerable barriers to access health care, with 45% of them being uninsured. The Affordable Care Act (ACA) does not address lack of insurance for some immigrants, and the excluded groups are a large proportion of the Mexican-American community. To redress this, innovative forms of health insurance coverage have to be explored. This study analyses factors associated with willingness to pay for cross-border, bi-national health insurance (BHI) among Mexican immigrants in the US. Surveys were administered to 1,335 Mexican migrants in the Mexican Consulate of Los Angeles to assess their health status, healthcare utilization, and willingness to purchase BHI. Logistic regression was used to identify predictors of willingness to pay for BHI. Having a job, not having health insurance in the US, and relatives in Mexico attending public health services were significant predictors of willingness to pay for BHI. In addition, individuals identified quality as the most important factor when considering BHI. In spite of the interest for BHI among 54% of the sampled population, our study concludes that this type of coverage is unlikely to solve access to care challenges due to ACA eligibility among different Mexican immigrant populations.

  1. Health, migration and border management: analysis and capacity-building at Europe's borders.

    PubMed

    Hollings, Jennifer; Samuilova, Mariya; Petrova-Benedict, Roumyana

    2012-04-01

    Three key elements were analysed in Hungary, Poland and Slovakia as a basis for strengthening the capacity of staff and structures related to health, migration and border management: public health concerns linked to migration, health needs and rights of migrants and the occupational health of staff. This IOM project was implemented through an in-depth situation analysis as well as the development of training modules and public health guidelines. Findings indicate a paucity of existing data, gaps in the health care for migrants and few existing tools for border officials and health professionals. Sets of training modules were developed for each of these groups, including common modules on migration and the right to health and intercultural communication, as well as targeted health modules. The guidelines promote good practices in the context of border management and detention. The EU is working towards a common immigration policy and integrated border management; however, a harmonized approach to migration and health is still lacking. Further research and piloting of the developed materials is needed to fully establish an adaptable, common toolkit.

  2. Unaccompanied Children at the United States Border, a Human Rights Crisis that can be Addressed with Policy Change.

    PubMed

    Ataiants, Janna; Cohen, Chari; Riley, Amy Henderson; Tellez Lieberman, Jamile; Reidy, Mary Clare; Chilton, Mariana

    2017-04-08

    In recent years, unaccompanied minors have been journeying to the United States (U.S.)-Mexico border in great numbers in order to escape violence, poverty and exploitation in their home countries. Yet, unaccompanied children attempting to cross the United States border face treatment at the hands of government representatives which violates their inherent rights as children. The result is a human rights crisis that has severe health consequences for the children. Their rights as children are clearly delineated in various, international human rights documents which merit increased understanding of and recognition by the U.S. government. This paper calls for the improvement of policies and procedures for addressing the rights of unaccompanied immigrant children; it provides specific, rights-based recommendations which work together to safeguard the rights of the child at the U.S. southwestern border.

  3. In vitro sensitivity of Plasmodium falciparum to artesunate in Thailand.

    PubMed Central

    Wongsrichanalai, C.; Wimonwattrawatee, T.; Sookto, P.; Laoboonchai, A.; Heppner, D. G.; Kyle, D. E.; Wernsdorfer, W. H.

    1999-01-01

    Reported are the in vitro susceptibilities of Plasmodium falciparum to artesunate, mefloquine, quinine and chloroquine of 86 isolates and to dihydroartemisinin of 45 isolates collected from areas of high resistance to mefloquine within Thailand near the borders with Myanmar and Cambodia, and from southern Thailand where P. falciparum is generally still sensitive to mefloquine. All the isolates were highly sensitive to artesunate, but the geometric mean IC50S were higher in isolates from the Thai-Myanmar and Thai-Cambodian borders than in those from southern Thailand. The IC50S for mefloquine and artesunate were strongly correlated (Pearson r = 0.605; n = 86; P < 0.00001). As expected, the in vitro sensitivities to dihydroartemisinin and artesunate were similar and strongly correlated (at IC50, Pearson r = 0.695; n = 45; P < 0.00002). The correlation between the activity of mefloquine and artesunate requires further investigation in order to determine the potential for development of cross-resistance in nature. Our results suggest that combination with mefloquine is not the ideal way of protecting the usefulness of artemisinin and its derivatives. A search for more suitable partner drugs to these compounds and careful regulation of their use are necessary in the interest of ensuring their long therapeutic life span. PMID:10361756

  4. The Evolution of Animal Welfare and the 3Rs in Brazil, China, and India

    PubMed Central

    Bayne, Kathryn; Ramachandra, Gudde S; Rivera, Ekaterina A; Wang, Jianfei

    2015-01-01

    Increasingly, scientific collaborations and contracts cross country borders. The need for assurance that the quality of animal welfare and the caliber of animal research conducted are equivalent among research partners around the globe is of concern to the scientific and laboratory animal medicine communities, the general public, and other key stakeholders. Therefore, global harmonization of animal care and use standards and practices, with the welfare of the animals as a cornerstone, is essential. In the evolving global landscape of enhanced attention to animal welfare, a widely accepted path to achieving this goal is the successful integration of the 3Rs in animal care and use programs. Currently, awareness of the 3Rs, their implementation, and the resulting animal care and use standards and practices vary across countries. This variability has direct effects on the animals used in research and potentially the data generated and may also have secondary effects on the country's ability to be viewed as a global research partner. Here we review the status of implementation of the 3Rs worldwide and focus on 3 countries–Brazil, China and India–with increasing economic influence and an increasing footprint in the biomedical research enterprise. PMID:25836965

  5. North American Free Trade Agreement (NAFTA) Implementation: The Future of Commercial Trucking Across the Mexican Border

    DTIC Science & Technology

    2010-02-01

    project because only 29 Mexican carriers had participated thus far. In October 2008, an independent evaluation panel ( IEP ) appointed by the FMCSA...Evaluation Panel ( IEP ) Report to the U.S. Secretary of Transportation, U.S.- Mexico Cross-Border Trucking Demonstration Project, October 31, 2008. The...for destinations beyond the commercial zone. Moreover, the Independent Evaluation Panel’s ( IEP ) review of FMCSA data indicate that only 4% of the

  6. Automated Border Control Systems as Part of e-border Crossing Process

    DTIC Science & Technology

    2015-01-01

    which is led by Defence Research and Development Canada’s Centre for Security Science, in partnership with Public Safety Canada. The project was led...Canada, as represented by the Minister of National Defence, 2015 © Sa Majesté la Reine (en droit du Canada), telle que représentée par le ministre de...FAST US,EU (2013): AVATAR kiosks Examples: US, Canada: Deployed in Vancouver, Montreal, Toronto, and Chicago International Airports

  7. The Borderlands - A region of physical and cultural diversity: Chapter 2 in United States-Mexican Borderlands: Facing tomorrow's challenges through USGS science

    USGS Publications Warehouse

    Parcher, Jean W.; Papoulias, Diana M.; Woodward, Dennis G.; Durall, Roger A.

    2013-01-01

    The area surrounding the United States–Mexican border is very physically and culturally diverse and cannot be generalized by any single description. To assist in an accurate appraisal and understanding of this remarkable region, the Borderlands team has divided it into eight subareas based on the watershed subareas of the U.S. Geological Survey Border Environmental Health Initiative (http://borderhealth.cr.usgs.gov) (fig. 2–1), the boundaries of which are defined primarily by surface-water drainage basins. The drainage basins directly adjacent to or crossing the international boundary were automatically included in the defined border region, as were those basins that contain unconsolidated aquifers that extend to or cross the international boundary. Also, “protected areas” adjacent to included basins were selectively added to the defined border region. Though some geographic features are entirely within the Borderlands, many features—deserts, mountain ranges, rivers, etc.— extend beyond the region boundaries but are still influential to Borderlands environments (fig. 2–2). In some cases, the authors of the following chapters have made fine adjustments to the Borderlands boundaries, and they have described those alterations where necessary. By describing and studying these subareas individually and comparing them to one another, we can emphasize the physical and cultural diversity that makes the Borderlands such an important geographic area.

  8. [Micro and Macro Social Work Practice in the Context of Tuberculosis].

    PubMed

    Moya, Eva M; Chavez-Baray, Silvia M; Martínez, Omar

    2017-07-01

    The study of tuberculosis (TB) in the U.S.-Mexico border involves the consideration of three key components, which are complex and interrelated: the difficulty tracking and providing appropriate TB care due to the epidemiological and pathological characteristics of TB; the border itself is a geographical and epidemiological area that interweaves two nations, two cultures, two health systems and different laws; and the need for prevention and treatment approaches to TB that involve comprehensive clinical care and prevention while also taking into consideration stigma, social context and knowledge. This manuscript describes the work of ten studies conducted in Mexico and in the U.S.-Mexico border region from 2006 to 2013. It also provides an understanding of the social and public health implications of TB, the environment and communities, as well as the identification and application of advocacy and social mobilization practices. The work presented provides an understanding of different interventions related to adherence, stigma reduction, person-centered approaches, and effective micro and macro practices in social work.

  9. Interdisciplinary Collaboration: Two Heads Are Better than One

    ERIC Educational Resources Information Center

    Horn, Bradley; Stoller, Fredricka; Robinson, Marin S.

    2008-01-01

    To meet the ever-changing needs of students in the modern world, forward-thinking educators are crossing the traditional borders of their own disciplines to work with colleagues from other fields to develop novel approaches to teaching. Examples of cross-disciplinary efforts illustrate both the creativity of their participants and the promise and…

  10. Folk Opera: Stories Crossing Borders in Papua New Guinea

    ERIC Educational Resources Information Center

    Haseman, B.; Baldwin, A.; Linthwaite, H.

    2014-01-01

    The Life Drama project is a drama-based sexual health promotion project, developed by a cross-cultural research team in Papua New Guinea (PNG) over the past four years. Recognising the limitations of established theatre-in-education and theatre-for-development approaches when working across cultures, the research team explored ways of tapping into…

  11. 76 FR 61622 - Potential Closing of Morses Line Border Crossing

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-05

    ... travelers would need to travel to an alternate crossing which could cost them both time and money. CBP does... measured the distance and estimated time for each combination assuming they could not travel through Morses Line. By comparing the distance and travel time for the fastest route to those for the fastest route...

  12. Introducing the chronic disease self-management program in Switzerland and other German-speaking countries: findings of a cross-border adaptation using a multiple-methods approach.

    PubMed

    Haslbeck, Jörg; Zanoni, Sylvie; Hartung, Uwe; Klein, Margot; Gabriel, Edith; Eicher, Manuela; Schulz, Peter J

    2015-12-28

    Stanford's Chronic Disease Self-Management Program (CDSMP) stands out as having a large evidence-base and being broadly disseminated across various countries. To date, neither evidence nor practice exists of its systematic adaptation into a German-speaking context. The objective of this paper is to describe the systematic German adaptation and implementation process of the CDSMP (2010-2014), report the language-specific adaptation of Franco-Canadian CDSMP for the French-speaking part of Switzerland and report findings from the initial evaluation process. Multiple research methods were integrated to explore the perspective of workshop attendees, combining a longitudinal quantitative survey with self-report questionnaires, qualitative focus groups, and interviews. The evaluation process was conducted in for both the German and French adapted versions to gain insights into participants' experiences in the program and to evaluate its impact. Perceived self-efficacy was measured using the German version of the Self-Efficacy for Managing Chronic Disease 6-Item Scale (SES6G). Two hundred seventy eight people attending 35 workshops in Switzerland and Austria participated in the study. The study participants were receptive to the program content, peer-led approach and found principal methods useful, yet the structured approach did not address all their needs or expectations. Both short and long-term impact on self-efficacy were observed following the workshop participation (albeit with a minor decrease at 6-months). Participants reported positive impacts on aspects of coping and self-care, but limited effects on healthcare service utilization. Our findings suggest that the process for cross-border adaptation was effective, and that the CDSMP can successfully be implemented in diverse healthcare and community settings. The adapted CDSMP can be considered an asset for supporting self-management in both German-and French-speaking central European countries. It could have meaningful, wide-ranging implications for chronic illness care and primary prevention and potentially tertiary prevention of chronic disease. Further investigations are needed to tailor the program for better access to vulnerable and disadvantaged groups who might benefit the most, in terms of facilitating their health literacy in chronic illness.

  13. Health equity and migrants in the Greater Mekong Subregion

    PubMed Central

    McMichael, Celia; Healy, Judith

    2017-01-01

    ABSTRACT Background: Migrant health is receiving increasing international attention, reflecting recognition of the health inequities experienced among many migrant populations and the need for health systems to adapt to diverse migrant populations. In the Greater Mekong Subregion (GMS) there is increasing migration associated with uneven economic integration and growth, socio-economic vulnerabilities, and disparities between countries. There has been limited progress, however, in improving migrant access to health services in the Subregion. This paper examines the health needs, access barriers, and policy responses to cross-border migrants in five GMS countries. Methods: A review of published literature and research was conducted on migrant health and health service access in Cambodia, Lao People’s Democratic Republic, Myanmar, Thailand, and Viet Nam, as well as analysis of current migration trends and universal health coverage (UHC) indicators in the Subregion. The review included different migrant types: i.e. migrant workers, irregular migrants, victims of trafficking, refugees and asylum seekers, and casual cross-border migrants. Results: There is substantial diversity in the capacity of GMS health systems to address migrant populations. Thailand has sought to enhance migrant health coverage, including development of migrant health policies/programs, bilateral migrant worker agreements, and migrant health insurance schemes; Viet Nam provides health protection for emigrant workers. Overall, however, access to good quality health care remains weak for many citizens in GMS countries let alone migrants. Migrant workers – and irregular migrants in particular – face elevated health risks yet are not adequately covered and incur high out-of-pocket (OOP) payments for health services. Conclusions: UHC implies equity: UHC is only achieved when everyone has the opportunity to access and use good-quality health care. Efforts to achieve UHC in the GMS require deliberate policy decisions to include migrants. The emergence of the UHC agenda, and the focus on migrant health among policy makers and partners, present an opportunity to tackle barriers to health service access, extend coverage, and strengthen partnerships in order to improve migrant health. This is an opportune time for GMS countries to develop migrant-inclusive health systems. PMID:28452652

  14. Sources and transport of black carbon at the California-Mexico border

    NASA Astrophysics Data System (ADS)

    Shores, Christopher A.; Klapmeyer, Michael E.; Quadros, Marina E.; Marr, Linsey C.

    2013-05-01

    At international border areas that suffer from poor air quality, assessment of pollutant sources and transport across the border is important for designing effective air quality management strategies. As part of the Cal-Mex 2010 field campaign at the US-Mexico border in San Diego and Tijuana, we measured black carbon (BC) concentrations at three locations in Mexico and one in the United States. The measurements were intended to support the following objectives: to characterize the spatial and temporal variability in BC, to estimate the BC emission inventory, to identify potential source areas of BC emissions, and to assess the cross-border transport of BC. Concentrations at Parque Morelos, the campaign's supersite, averaged 2.2 μg m-3 and reached a maximum value of 55.9 μg m-3 (1-min average). Sharp, regularly occurring peaks around midnight were suggestive of clandestine industrial activity. BC concentrations were more than two times higher, on average, in Tijuana compared to San Diego. BC and carbon monoxide (CO) were strongly correlated at the three sites in Mexico. The ΔBC/ΔCO ratio of 5.6 ± 0.5 μg m-3 ppm-1 in Tijuana, or 4.7 ± 0.5 μg m-3 ppm-1 when adjusted for seasonal temperature effects to represent an annual average, was comparable to that in other urban areas. Tijuana's emissions of BC were estimated to be 230-890 metric tons per year, 6-23% of those estimated for San Diego. Large uncertainties in this estimate stem mainly from uncertainties in the CO emission inventory, and the lower end of the estimate is more likely to be accurate. Patterns in concentrations and winds suggest that BC in Tijuana was usually of local origin. Under typical summertime conditions such as those observed during the study, transport from Tijuana into the US was common, crossing the border in a northeasterly direction, sometimes as far east as Imperial County at the eastern edge of California.

  15. Informed consumer or unlucky visitor? A profile of German patients who received dental services abroad.

    PubMed

    Panteli, Dimitra; Augustin, Uta; Röttger, Julia; Struckmann, Verena; Verheyen, Frank; Wagner, Caroline; Busse, Reinhard

    2015-10-01

    A common characteristic of sending countries in cross-border dental care is that of high costs and/or high copayments for dental services. This study aims to provide an insight into the characteristics of German patients receiving planned and emergency (unplanned) dental care abroad and their satisfaction with received services. The Europabefragung is a postal survey carried out by Techniker Krankenkasse for patients who are treated in EU/EEA countries. This study uses data from the Europabefragung 2012. The survey was sent to 45 189 individuals; descriptive statistics for the subset of respondents who received emergency (unplanned) or planned dental treatment are presented. There were 18 339 responses to the questionnaire, out of which 17 543 were deemed valid; 1416 respondents had received emergency (unplanned) (78%) or planned (22%) dental care and were included in the analysis. There were clear differences between unplanned and planned treatments regarding country and type of treatment as well as satisfaction with different aspects of treatment and the need for follow-up care. Overall, satisfaction with treatment was high for both groups; individuals who had received planned treatment were more satisfied on all aspects of care and reported a need for follow-up care less frequently. While German patients who received both emergency (unplanned) and planned services abroad are mostly satisfied with their experience, some concerns arise with regard to continuity of care. Types of information provided to patients seeking care abroad and dissemination modalities should be carefully planned. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  16. 14 April 1895, Ljubljana earthquake - A new, cross-border study

    NASA Astrophysics Data System (ADS)

    Albini, Paola; Cecić, Ina; Hammerl, Christa

    2014-05-01

    Though it has been the object of both contemporary and modern investigations, the 14 April 1895, Ljubljana event (Mw ~6, according to the European catalogue SHEEC) is still not fully described in its effects. One manifest reason for this is that being the 1895 earthquake a cross-border event, it affected an area that today pertains to three different countries, Slovenia, Austria, and Italy, as well as accounted for in sources today scattered in different archives and libraries. In addition, the 1895 Ljubljana earthquake was a turning point for many aspects. Imperial Vienna sent help to rebuild the damaged city and its surroundings, and the architects brought modern ideas about urban planning, public hygiene and contemporary design. It was also the beginning of organised seismological observations in Slovenia - macroseismic, right after the earthquake, and instrumental, in 1896. The macroseismic data about this earthquake are plentiful and very well preserved. In this new, cross-border study we intend to re-evaluate the already known as well as the newly collected data sources. Specific attention is devoted to the archival documentation on damage, and to the far-field data, which were not comprehensively taken into account beforehand. As the earthquake was felt in a large part of central and Eastern Europe, a considerable effort is put into collecting and interpreting the coeval sources, written in many different languages.

  17. 3D geological modeling of the transboundary Berzdorf-Radomierzyce basin in Upper Lusatia (Germany/Poland)

    NASA Astrophysics Data System (ADS)

    Woloszyn, Iwona; Merkel, Broder; Stanek, Klaus

    2017-07-01

    The management of natural resources has to follow the principles of sustainable development. Therefore, before starting new mining activities, it should be checked, whether existing deposits have been completely exploited. In this study, a three-dimensional (3D) cross-border geologic model was created to generalize the existing data of the Neogene Berzdorf-Radomierzyce basin, located in Upper Lusatia on the Polish-German border south of the city of Görlitz-Zgorzelec. The model based on boreholes and cross sections of abandoned and planned lignite fields was extended to the Bernstadt and Neisse-Ręczyn Graben, an important tectonic structure at the southern rim of the basin. The partly detailed stratigraphy of Neogene sequences was combined to five stratigraphic units, considering the lithological variations and the main tectonic structures. The model was used to check the ability of a further utilization of the Bernstadt and Neisse-Ręczyn Graben, containing lignite deposits. Moreover, it will serve as a basis for the construction of a 3D cross-border groundwater model, to investigate the groundwater flow and transport in the Miocene and Quaternary aquifer systems. The large amount of data and compatibility with other software favored the application of the 3D geo-modeling software Paradigm GOCAD. The results demonstrate a very good fit between model and real geological boundaries. This is particularly evident by matching the modeled surfaces to the implemented geological cross sections. The created model can be used for planning of full-scale mining operations in the eastern part of the basin (Radomierzyce).

  18. Undocumentedness and public policy: the impact on communities, individuals, and families along the Arizona/Sonora border.

    PubMed

    McEwen, Marylyn Morris; Boyle, Joyceen S; Hilfinger Messias, DeAnne K

    2015-01-01

    The focus of this article is the health impact and implications of undocumentedness along the U.S.-Mexico border, particularly the Arizona/Sonora region. We describe the direct and indirect influences of immigration policies on the health of individuals, families, and communities. The Arizona border region maintains close social, cultural, and linguistic ties to Mexico, and the amplified efforts to secure the border have been dramatic on the region and on the people who live there. The 261-mile stretch across the Arizona-Sonora Desert is the most deadly corridor for immigrants crossing into the United States because they are at risk of being killed, kidnapped, and coerced into smuggling drugs or dying in the desert. Gang-related violence is pushing more Central Americans, including unaccompanied minors, to the United States. The impact on individual migrants and their families has been devastating. We examine the health implications of policy and applaud the actions of the Arizona Nurses Association and the American Academy of Nursing to address the health needs of border communities. Copyright © 2015 Elsevier Inc. All rights reserved.

  19. "In rape cases we can use this pill": a multimethods assessment of emergency contraception knowledge, access, and needs on the Thailand-Burma border.

    PubMed

    Hobstetter, Margaret; Sietstra, Cari; Walsh, Meredith; Leigh, Jennifer; Foster, Angel M

    2015-08-01

    To evaluate availability, service delivery, and barriers to access to emergency contraceptive pills (ECPs) along the Thailand-Burma border. From June 2010 to May 2011 we undertook a multimethods qualitative assessment among cross-border populations, migrants, and refugees. We conducted 46 key informant interviews with representatives from 25 organizations, 18 focus group discussions with migrant adults, migrant adolescents, and healthcare workers, and a service mapping exercise with 22 stakeholders. We found low use of ECPs among the target populations. Structural barriers and lack of evidence-based reproductive health protocols, education, and information restrict access to the limited family planning resources available in this region. Misinformation about ECPs was widespread among health workers and organizational policies were often non-evidence based. Potential policy and program interventions to improve access to ECPs along the Thailand-Burma border include integrating evidence-based practices into community efforts, expanding training opportunities for health workers, and improving communication and coordination among organizations serving populations on both sides of the border. Copyright © 2015. Published by Elsevier Ireland Ltd.

  20. Mobile surveillance units (MSU) for border protection of the enlarged economic union

    NASA Astrophysics Data System (ADS)

    Crandon, Christopher

    2004-12-01

    During the last 12 years the European Union (EU) has financed the new member applicant countries of Central and Eastern Europe in their preparation for joining the EU. Based on this enlargement of the EU, funding for Cross Border Protection has been made available from the overall infrastructure improvement budget. Border protection was required in areas where border conflicts had taken place and to limit Illegal Immigration (II) and smuggling. After 9/11/2001, defence against terrorist activities will no doubt be added to the requirement. This paper describes the approach taken in the design of the latest "containerised" police and para military Mobile Surveillance Units (MSUs). This approach may also be considered for Homeland Security initiatives. These MSU's utilise standard road vehicles, and off-road variants, converted to use high performance military thermal imagers, such as SiGMA. In future the current, in service, MSUs will require increased sensor integration and networking to cover land and coastal borders. The underlying key is affordability for the police and para-military markets whilst retaining the highest performance derived from the latest SFPA military standard thermal imagers.

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