Factors Influencing African Postgraduate International Students' Choice of South Africa as a Study Destination

ERIC Educational Resources Information Center

Mpinganjira, Mercy

2012-01-01

Many African countries are concerned with the targeting of international postgraduate students by developed countries for skilled migration. Increased provision of postgraduate studies within the continent would go a long way in dealing with the problem. Success will however depend on the ability of countries in the continent to attract…

International migration beyond gravity: A statistical model for use in population projections

PubMed Central

Cohen, Joel E.; Roig, Marta; Reuman, Daniel C.; GoGwilt, Cai

2008-01-01

International migration will play an increasing role in the demographic future of most nations if fertility continues to decline globally. We developed an algorithm to project future numbers of international migrants from any country or region to any other. The proposed generalized linear model (GLM) used geographic and demographic independent variables only (the population and area of origins and destinations of migrants, the distance between origin and destination, the calendar year, and indicator variables to quantify nonrandom characteristics of individual countries). The dependent variable, yearly numbers of migrants, was quantified by 43653 reports from 11 countries of migration from 228 origins and to 195 destinations during 1960–2004. The final GLM based on all data was selected by the Bayesian information criterion. The number of migrants per year from origin to destination was proportional to (population of origin)0.86(area of origin)−0.21(population of destination)0.36(distance)−0.97, multiplied by functions of year and country-specific indicator variables. The number of emigrants from an origin depended on both its population and its population density. For a variable initial year and a fixed terminal year 2004, the parameter estimates appeared stable. Multiple R2, the fraction of variation in log numbers of migrants accounted for by the starting model, improved gradually with recentness of the data: R2 = 0.57 for data from 1960 to 2004, R2 = 0.59 for 1985–2004, R2 = 0.61 for 1995–2004, and R2 = 0.64 for 2000–2004. The migration estimates generated by the model may be embedded in deterministic or stochastic population projections. PMID:18824693

The role of wages in the migration of health care professionals from developing countries

PubMed Central

Vujicic, Marko; Zurn, Pascal; Diallo, Khassoum; Adams, Orvill; Dal Poz, Mario R

2004-01-01

Several countries are increasingly relying on immigration as a means of coping with domestic shortages of health care professionals. This trend has led to concerns that in many of the source countries – especially within Africa – the outflow of health care professionals is adversely affecting the health care system. This paper examines the role of wages in the migration decision and discusses the likely effect of wage increases in source countries in slowing migration flows. This paper uses data on wage differentials in the health care sector between source country and receiving country (adjusted for purchasing power parity) to test the hypothesis that larger wage differentials lead to a larger supply of health care migrants. Differences in other important factors affecting migration are discussed and, where available, data are presented. There is little correlation between the supply of health care migrants and the size of the wage differential between source and destination country. In cases where data are available on other factors affecting migration, controlling for these factors does not affect the result. At current levels, wage differentials between source and destination country are so large that small increases in health care wages in source countries are unlikely to affect significantly the supply of health care migrants. The results suggest that non-wage instruments might be more effective in altering migration flows. PMID:15115549

The financial cost of doctors emigrating from sub-Saharan Africa: human capital analysis

PubMed Central

Kanters, Steve; Hagopian, Amy; Bansback, Nick; Nachega, Jean; Alberton, Mark; Au-Yeung, Christopher G; Mtambo, Andy; Bourgeault, Ivy L; Luboga, Samuel; Hogg, Robert S; Ford, Nathan

2011-01-01

Objective To estimate the lost investment of domestically educated doctors migrating from sub-Saharan African countries to Australia, Canada, the United Kingdom, and the United States. Design Human capital cost analysis using publicly accessible data. Settings Sub-Saharan African countries. Participants Nine sub-Saharan African countries with an HIV prevalence of 5% or greater or with more than one million people with HIV/AIDS and with at least one medical school (Ethiopia, Kenya, Malawi, Nigeria, South Africa, Tanzania, Uganda, Zambia, and Zimbabwe), and data available on the number of doctors practising in destination countries. Main outcome measures The financial cost of educating a doctor (through primary, secondary, and medical school), assuming that migration occurred after graduation, using current country specific interest rates for savings converted to US dollars; cost according to the number of source country doctors currently working in the destination countries; and savings to destination countries of receiving trained doctors. Results In the nine source countries the estimated government subsidised cost of a doctor’s education ranged from $21 000 (£13 000; €15 000) in Uganda to $58 700 in South Africa. The overall estimated loss of returns from investment for all doctors currently working in the destination countries was $2.17bn (95% confidence interval 2.13bn to 2.21bn), with costs for each country ranging from $2.16m (1.55m to 2.78m) for Malawi to $1.41bn (1.38bn to 1.44bn) for South Africa. The ratio of the estimated compounded lost investment over gross domestic product showed that Zimbabwe and South Africa had the largest losses. The benefit to destination countries of recruiting trained doctors was largest for the United Kingdom ($2.7bn) and United States ($846m). Conclusions Among sub-Saharan African countries most affected by HIV/AIDS, lost investment from the emigration of doctors is considerable. Destination countries should consider investing in measurable training for source countries and strengthening of their health systems. PMID:22117056

Diaspora engagement of African migrant health workers – examples from five destination countries

PubMed Central

Wojczewski, Silvia; Poppe, Annelien; Hoffmann, Kathryn; Peersman, Wim; Nkomazana, Oathokwa; Pentz, Stephen; Kutalek, Ruth

2015-01-01

Background Migrant health workers fill care gaps in their destination countries, but they also actively engage in improving living conditions for people of their countries of origin through expatriate professional networks. This paper aims to explore the professional links that migrant health workers from sub-Saharan African countries living in five African and European destinations (Botswana, South Africa, Belgium, Austria, and the United Kingdom) have to their countries of origin. Design Qualitative interviews were conducted with migrant doctors, nurses, and midwives from sub-Saharan Africa (N=66). A qualitative content analysis of the material was performed using the software ATLAS.ti. Results Almost all migrant health workers have professional ties with their countries of origin supporting health, education, and social structures. They work with non-governmental organizations, universities, or hospitals and travel back and forth between their destination country and country of origin. For a few respondents, professional engagement or even maintaining private contacts in their country of origin is difficult due to the political situation at home. Conclusions The results show that African migrant health workers are actively engaged in improving living conditions not only for their family members but also for the population in general in their countries of origin. Our respondents are mediators and active networkers in a globalized and transnationally connected world. The research suggests that the governments of these countries of origin could strategically use their migrant health workforce for improving education and population health in sub-Saharan Africa. Destination countries should be reminded of their need to comply with the WHO Global Code of Practice for the international recruitment of health professionals. PMID:26652910

The migration of nurses: trends and policies.

PubMed Central

Buchan, James; Sochalski, Julie

2004-01-01

This paper examines the policy context of the rise in the international mobility and migration of nurses. It describes the profile of the migration of nurses and the policy context governing the international recruitment of nurses to five countries: Australia, Ireland, Norway, the United Kingdom, and the United States. We also examine the policy challenges for workforce planning and the design of health systems infrastructure. Data are derived from registries of professional nurses, censuses, interviews with key informants, case studies in source and destination countries, focus groups, and empirical modelling to examine the patterns and implications of the movement of nurses across borders. The flow of nurses to these destination countries has risen, in some cases quite substantially. Recruitment from lower-middle income countries and low-income countries, as defined by The World Bank, dominate trends in nurse migration to the United Kingdom, Ireland, and the United States, while Norway and Australia, primarily register nurses from other high-income countries. Inadequate data systems in many countries prevent effective monitoring of these workforce flows. Policy options to manage nurse migration include: improving working conditions in both source and destination countries, instituting multilateral agreements to manage the flow more effectively, and developing compensation arrangements between source and destination countries. Recommendations for enhancements to workforce data systems are provided. PMID:15375448

The role of language in shaping international migration

PubMed Central

Adserà, Alícia; Pytliková, Mariola

2016-01-01

This paper examines the importance of language in international migration from multiple angles by studying the role of linguistic proximity, widely spoken languages, linguistic enclaves and language-based immigration policy requirements. To this aim we collect a unique dataset on immigration flows and stocks in 30 OECD destinations from all world countries over the period 1980–2010, and construct a set of linguistic proximity measures. Migration rates increase with linguistic proximity and with English at destination. Softer linguistic requirements for naturalization and larger linguistic communities at destination encourage more migrants to move. Linguistic proximity matters less when local linguistic network are larger. PMID:27330195

Emigration flows from North Africa to Europe.

PubMed

Kassar, Hassène; Marzouk, Diaa; Anwar, Wagida A; Lakhoua, Chérifa; Hemminki, Kari; Khyatti, Meriem

2014-08-01

The region of North Africa (NA) represents a striking locality regarding migration with several migration patterns, namely emigration in the form of labour export to Europe and North America and, to a lesser extent, to the Arab Gulf area. The latter has increased enormously in the last decade because of the political instability in most of the NA countries. The aim of the present chapter was to explore the patterns of migration stocks and flows in NA countries, based on several websites, systematic review of journals, comparable data available by the United Nations and by the International Organization of Migration. The NA region has become an area of transit migration and labour migration. Emigrant flows from NA countries towards Europe and North America are increasing this decade more than towards the Arab Gulf countries after being replaced by Asian labour. The recent increase in the proportion of women among the migrant population is remarkable. Remittances sent by African migrants have become an important source of external finance for countries of origin. Transient and irregular migration to Egypt originates at the borders with Sudan, Palestine and Libya with destination to the Euro Mediterranean countries. In Tunisia and Morocco, irregular migrants originate from Sub-Saharan Africa to the northern borders. The NA countries serve as departure rather than destination countries, and migration flows to the Euro-Mediterranean countries through legal or illegal routes. © The Author 2014. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Circulating East to East: Understanding the Push-Pull Factors of Chinese Students Studying in Korea

ERIC Educational Resources Information Center

Lee, Se Woong

2017-01-01

Every year, substantial numbers of students choose to study abroad, and China is one of the largest exporters of international students. Interestingly, instead of choosing English-speaking countries, increasingly more Chinese students are choosing nearby Asian countries as their destination to study abroad, particularly Korea. Despite this…

Canadian Educators Look for Ways to Recruit More Foreign Students

ERIC Educational Resources Information Center

Birchard, Karen

2006-01-01

Canadian educators are increasingly worried about their country's position as a destination of choice for international students, according the annual conference of the Canadian Bureau for International Education. The bureau added that Canada has dropped out of the top five preferred countries as a place to study. Over all, the number of…

The incidence of malaria in travellers to South-East Asia: is local malaria transmission a useful risk indicator?

PubMed Central

2010-01-01

Background The presence of ongoing local malaria transmission, identified though local surveillance and reported to regional WHO offices, by S-E Asian countries, forms the basis of national and international chemoprophylaxis recommendations in western countries. The study was designed to examine whether the strategy of using malaria transmission in a local population was an accurate estimate of the malaria threat faced by travellers and a correlate of malaria in returning travellers. Methods Malaria endemicity was described from distribution and intensity in the local populations of ten S-E Asian destination countries over the period 2003-2008 from regionally reported cases to WHO offices. Travel acquired malaria was collated from malaria surveillance reports from the USA and 12 European countries over the same period. The numbers of travellers visiting the destination countries was based on immigration and tourism statistics collected on entry of tourists to the destination countries. Results In the destination countries, mean malaria rates in endemic countries ranged between 0.01 in Korea to 4:1000 population per year in Lao PDR, with higher regional rates in a number of countries. Malaria cases imported into the 13 countries declined by 47% from 140 cases in 2003 to 66 in 2008. A total of 608 cases (27.3% Plasmodium falciparum (Pf)) were reported over the six years, the largest number acquired in Indonesia, Thailand and Korea. Four countries had an incidence > 1 case per 100,000 traveller visits; Burma (Myanmar), Indonesia, Cambodia and Laos (range 1 to 11.8-case per 100,000 visits). The remaining six countries rates were < 1 case per 100,000 visits. The number of visitors arriving from source countries increased by 60% from 8.5 Million to 13.6 million over the 6 years. Conclusion The intensity of malaria transmission particularly sub-national activity did not correlate with the risk of travellers acquiring malaria in the large numbers of arriving visitors. It is proposed to use a threshold incidence of > 1 case per 100,000 visits to consider targeted malaria prophylaxis recommendations to minimize use of chemoprophylaxis for low risk exposure during visits to S-E Asia. Policy needs to be adjusted regularly to reflect the changing risk. PMID:20920352

The Market Positioning and the Selection of Destination Countries for Music Students from Taiwan

ERIC Educational Resources Information Center

Wang, Li-Ping; Ho, Hsuan-fu

2014-01-01

Students now-a-days have to develop international skills to be successful in this global environment, and choosing a sound destination country is a crucial issue to the success of their overseas study. On the other hand, since international students may contribute a great deal to the host country's educational quality and its economy, countries…

Shifting subjects of health-care: placing "medical tourism" in the context of Malaysian domestic health-care reform.

PubMed

Ormond, Meghann

2011-01-01

"Medical tourism" has frequently been held to unsettle naturalised relationships between the state and its citizenry. Yet in casting "medical tourism" as either an outside "innovation" or "invasion," scholars have often ignored the role that the neoliberal retrenchment of social welfare structures has played in shaping the domestic health-care systems of the "developing" countries recognised as international medical travel destinations. While there is little doubt that "medical tourism" impacts destinations' health-care systems, it remains essential to contextualise them. This paper offers a reading of the emergence of "medical tourism" from within the context of ongoing health-care privatisation reform in one of today's most prominent destinations: Malaysia. It argues that "medical tourism" to Malaysia has been mobilised politically both to advance domestic health-care reform and to cast off the country's "underdeveloped" image not only among foreign patient-consumers but also among its own nationals, who are themselves increasingly envisioned by the Malaysian state as prospective health-care consumers.

The downward occupational mobility of internationally educated nurses to domestic workers.

PubMed

Salami, Bukola; Nelson, Sioban

2014-06-01

Despite the fact that there is unmet demand for nurses in health services around the world, some nurses migrate to destination countries to work as domestic workers. According to the literature, these nurses experience contradictions in class mobility and are at increased risk of exploitation and abuse. This article presents a critical discussion of the migration of nurses as domestic workers using the concept of 'global care chain'. Although several scholars have used the concept of global care chains to illustrate south to north migration of domestic workers and nurses, there is a paucity of literature on the migration of nurses to destination countries as domestic workers. The migration of nurses to destination countries as domestic workers involves the extraction of reproductive and skilled care labor without adequate compensatory mechanisms to such skilled nurses. Using the case of the Canadian Live-in Caregiver Program, the study illustrates how the global movement of internationally educated nurses as migrant domestic workers reinforces inequities that are structured along the power gradient of gender, class, race, nationality, and ethnicity, especially within an era of global nursing shortage. © 2013 John Wiley & Sons Ltd.

Factors affecting the attractiveness of medical tourism destination: an empirical study on India- review article.

PubMed

Sultana, Seyama; Haque, Ahasanul; Momen, Abdul; Yasmin, Farzana

2014-07-01

In this edge, medical tourism is not a new idea. Medical treatment is one of the essential demands of human beings and it requires high quality and intensive care. Beside western world, few developing countries are playing key roles as medical tourism destinations. India is one of the leading names among these countries. The purpose of the paper is to find the factors influencing the attractiveness of India as a health tourism destination. The study has found the major contributing factors and their relative importance in the attractiveness of the health tourism destination that is India from consumers' perspectives by conducting survey with an application of structural equation modelling approach. In Indian context, medical tourists consider service quality and cost mostly to select any medical destination. In addition they also give value to the destination competitiveness but tourist attitude is less important in comparison with other factors affecting their destination choice. Since the study has used structural equation modelling approach to test the hypothesis and figure out the relative importance of the factors, the fundamental indices such as Normed Chi square(less than 3), RMSEA (less than 0.08) and CFI (more than 0.90) values show the overall model fit of the proposed model. In order to transform a country such as India as an attractive and competitive medical tourist destination in this time of globalization, a step should be taken to control cost ensuring the quality of services.

Factors Affecting the Attractiveness of Medical Tourism Destination: An Empirical Study on India- Review Article

PubMed Central

SULTANA, Seyama; HAQUE, Ahasanul; MOMEN, Abdul; YASMIN, Farzana

2014-01-01

Abstract Background In this edge, medical tourism is not a new idea. Medical treatment is one of the essential demands of human beings and it requires high quality and intensive care. Beside western world, few developing countries are playing key roles as medical tourism destinations. India is one of the leading names among these countries. The purpose of the paper is to find the factors influencing the attractiveness of India as a health tourism destination. Methods The study has found the major contributing factors and their relative importance in the attractiveness of the health tourism destination that is India from consumers’ perspectives by conducting survey with an application of structural equation modelling approach. Results In Indian context, medical tourists consider service quality and cost mostly to select any medical destination. In addition they also give value to the destination competitiveness but tourist attitude is less important in comparison with other factors affecting their destination choice. Since the study has used structural equation modelling approach to test the hypothesis and figure out the relative importance of the factors, the fundamental indices such as Normed Chi square(less than 3), RMSEA (less than 0.08) and CFI (more than 0.90) values show the overall model fit of the proposed model. Conclusion In order to transform a country such as India as an attractive and competitive medical tourist destination in this time of globalization, a step should be taken to control cost ensuring the quality of services. PMID:25909055

Managing biodiversity for a competitive ecotourism industry in tropical developing countries: New opportunities in biological fields

NASA Astrophysics Data System (ADS)

Hakim, Luchman

2017-11-01

Managing biodiversity for sustainable and competitive ecotourism destinations requires a basic understanding of the principles of biology, which are poorly understood in tropical developing countries, including Indonesia. This paper describes the current status of tourism in Indonesia, identifies environment and biodiversity vulnerability in tourism destinations, and explores the challenges of the biological field in supporting ecotourism development. This review found that tourism, especially nature-based and ecotourism, has grown significantly in Indonesia, and the contribution of Indonesian biodiversity has been identified as significant. Threats to biodiversity, however, are found in nature-based tourism destinations. Issues related to pollution, exotic plant species invasion, habitat changes and degradation, habitat loss, and wildlife disturbance are widely reported, indicating the importance of such issues in destination management. Pollution is found in both terrestrial and aquatic ecosystems. Water pollution is an important issue among lakes and rivers. To date, there are few assessments of the impact of tourism activities on aquatic ecosystems, resulting in the management of aquatic ecosystems facing numerous difficulties. These studies identify the invasive plants found, which become a crucial problem in many nature-based tourism destinations, and which significantly contribute to a reduction in the existence of many flora-fauna in a wild habitat. Habitat changes and degradation are mostly influenced by tourism infrastructure development. Massive infrastructure development often leads to habitat loss, which is a crucial step in local biodiversity extinction. Increasing and uncontrolled visitor behaviors influence animal behavior changes, which is recognized as a dangerous phenomenon affecting animal survival in the future. An agenda for future integrative biological research is needed to improve resource management, to increase sustainability and the competitiveness of the tourism industry in Indonesia.

Flux and permanence of risk perceptions: Tourists' perception of the relative and absolute risk for various destinations.

PubMed

Wolff, Katharina; Larsen, Svein

2016-12-01

The present investigation is a cross-sectional, multi-national, quantitative, and quasi-experimental comparison of tourists' risk perceptions regarding different destinations throughout the past decade. Over 10,000 tourists to Norway from 89 different countries filled in a questionnaire rating the perceived risk for various destinations. Data were collected during 2004, 2010, 2011, 2012, 2013 and 2015 and allow for a comparison of perceived risk across time, place and nationality. Results show that while absolute risk judgments for different destinations fluctuate somewhat over the years, relative risk judgments remain constant. Findings also reveal a "home-is-safer-then-abroad-bias" with tourists consistently perceiving their home country among the safest destinations. The current investigation is rare because it looks at more than one destination at a time. Insights gained from the present findings diverge from what would have been concluded from employing case studies, that is, looking at one destination at a time. © 2016 The Authors. Scandinavian Journal of Psychology published by Scandinavian Psychological Associations and John Wiley & Sons Ltd.

Sexual Health Help-Seeking Behavior among Migrants from Sub-Saharan Africa and South East Asia living in High Income Countries: A Systematic Review.

PubMed

Rade, Donna Angelina; Crawford, Gemma; Lobo, Roanna; Gray, Corie; Brown, Graham

2018-06-22

The number of migrants has increased globally. This phenomenon has contributed to increasing health problems amongst migrants in high-income countries, including vulnerability for HIV acquisition and other sexual health issues. Adaptation processes in destination countries can present difficulties for migrants to seek help from and gain access to health services. This study examined migrants’ from sub-Saharan Africa (SSA) and South East Asia (SEA) sexual health help-seeking behavior in high-income countries with universal health coverage. The systematic review followed PRISMA guidelines and was registered with PROSPERO. Several databases were searched from 2000 to 2017. Of 2824 studies, 15 met the inclusion criteria. These consisted of 12 qualitative and three quantitative studies conducted in Australia, Spain, the United Kingdom, Belgium, Scotland, Ireland, and Sweden. Migrants experienced a range of difficulties accessing health services, specifically those related to sexual health, in high-income countries. Few studies described sources of sexual health help-seeking or facilitators to help-seeking. Barriers to access were numerous, including: stigma, direct and indirect costs, difficulty navigating health systems in destination countries and lack of cultural competency within health services. More culturally secure health services, increased health service literacy and policy support to mitigate costs, will improve health service access for migrants from SSA and SEA. Addressing the structural drivers for stigma and discrimination remains an ongoing and critical challenge.

The Influence of Birth Country on Selection of Conference Destination--Employing Natural Language Processing

ERIC Educational Resources Information Center

Davidovitch, Nitza; Eckhaus, Eyal

2018-01-01

This study deals with immigrant scientists integrated in academia in Israel. Studies on the subject indicate the contribution of immigrant scientists to research. The current study focuses on the influence of scientists' birth country on selecting destinations for academic conferences, as well as on the influence of one's native language on the…

Virtual Red Light Districts: Detecting Covert Networks and Sex Trafficking Circuits in the U.S.

ERIC Educational Resources Information Center

Ibanez, Michelle

2015-01-01

The United States is the second leading destination country for sex trafficking in the world. Increased effort to understand patterns of sex trafficking within the U.S. is imperative to combatting this issue. Covert networks are increasingly using information and communication technologies (ICTs) to extend their operations. Due to the increase in…

New World Orders: Continuities and Changes in Latin American Migration

PubMed Central

DURAND, JORGE; MASSEY, DOUGLAS S.

2010-01-01

Although migration from Mexico to the United States is more than a century old, until recently most other countries in Latin America did not send out significant numbers of migrants to foreign destinations. Over the past thirty years, however, emigration has emerged as an important demographic force throughout the region. This article outlines trends in the volume and composition of the migrant outflows emanating from various countries in Latin America, highlighting their diversity with respect to country of destination; multiplicity of destinations; legal auspices of entry; gender and class composition; racial, ethnic, and national origins; and the mode of insertion into the receiving society. The review underscores the broadening of international migration away from unidirectional flows toward the United States to new streams going to Europe, Canada, Australia, and Japan, as well as to other countries in Latin America itself. PMID:20814591

Cumulative advantages and social capabilities in scientific mobility in the Health Sciences: The Spanish case.

PubMed

Aceituno-Aceituno, Pedro; Melchor, Lorenzo; Danvila-Del-Valle, Joaquín; Bousoño-Calzón, Carlos

2017-01-01

The big problem in global public health, arising from the international migration of physicians from less-developed to more-developed countries, increases if this migration also affects scientists dedicated to health areas. This article analyzes critical variables in the processes of Spanish scientific mobility in Health Sciences to articulate effective management policies for the benefit of national public health services and the balance between local and global science. This study develops a survey to measure and analyze the following crucial variables: research career, training, funding, working with a world-class team, institutional prestige, wages, facilities/infrastructure, working conditions in the organization of the destination country, fringe benefits in the organization of the destination country and social responsibility in the organization of the departure country. A total of 811 researchers have participated in the survey, of which 293 were from the health sector: Spanish scientists abroad (114), scientists that have returned to Spain (32) and young researchers in Spain (147). The most crucial variables for Spanish scientists and young researchers in Spain in Health Sciences moving abroad are the cumulative advantages (research career, training, funding and institutional prestige) plus wages. On the other hand, the return of Spanish scientists in the Health Sciences is influenced by cumulative variables (working with a world-class team, research career and institutional prestige) and also by other variables related to social factors, such as working conditions and fringe benefits in the destination country. Permanent positions are rare for these groups and their decisions regarding mobility depend to a large extent on job opportunities. Spanish health organizations can influence researchers to return, since these decisions mainly depend on job opportunities. These organizations can complement the cumulative advantages offered by the wealthier countries with the intensification of social factors.

An Investigation of the Factors Determining Student Destination Choice for Higher Education in the United Arab Emirates

ERIC Educational Resources Information Center

Ahmad, Syed Zamberi; Hussain, Matloub

2017-01-01

Previous studies on the destination choices of international students have mainly focused on the mobility of students from non-English-speaking countries to English-speaking countries, with limited attention being paid to the investigation of the factors that determine the flow of international students in emerging education hubs in the Middle…

Human Resources for Health Challenges in Nigeria and Nurse Migration.

PubMed

Salami, Bukola; Dada, Foluke O; Adelakun, Folake E

2016-05-01

The emigration of sub-Saharan African health professionals to developed Western nations is an aspect of increasing global mobility. This article focuses on the human resources for health challenges in Nigeria and the emigration of nurses from Nigeria as the country faces mounting human resources for health challenges. Human resources for health issues in Nigeria contribute to poor population health in the country, alongside threats from terrorism, infectious disease outbreaks, and political corruption. Health inequities within Nigeria mirror the geographical disparities in human resources for health distribution and are worsened by the emigration of Nigerian nurses to developed countries such as the United States and the United Kingdom. Nigerian nurses are motivated to emigrate to work in healthier work environments, improve their economic prospects, and advance their careers. Like other migrant African nurses, they experience barriers to integration, including racism and discrimination, in receiving countries. We explore the factors and processes that shape this migration. Given the forces of globalization, source countries and destination countries must implement policies to more responsibly manage migration of nurses. This can be done by implementing measures to retain nurses, promote the return migration of expatriate nurses, and ensure the integration of migrant nurses upon arrival in destination countries. © The Author(s) 2016.

Travelling for teeth: characteristics and perspectives of dental care tourism in Hungary.

PubMed

Osterle, A; Balázs, P; Delgado, J

2009-04-25

Despite quite lively debates about dental care tourism, scientific studies into the size and the characteristics of the phenomenon remain widely lacking. The present study is the first to measure the phenomenon in one of the most prominent destination countries, Hungary, with a particular focus on the Western Hungarian region and the capital Budapest. A questionnaire has been sent to dentists in these regions. The response rate is 25.3% in Western Hungary and 20.7% in Budapest. According to the survey, patients from neighbouring countries dominate dental care tourism in the border regions of Western Hungary, while Budapest attracts more patients from countries further away. In terms of motivation, dentists regard relative price levels but also service considerations as being of major importance for patients coming to Hungary for dental care. The study confirms Hungary as a centre for dental care tourism, attracting patients from bordering countries but also patients travelling longer distances. Price levels have been a major factor making Hungary an international treatment destination. With price differences narrowing down, broader service quality is increasingly emphasised as a selling strategy.

What is known about the effects of medical tourism in destination and departure countries? A scoping review.

PubMed

Johnston, Rory; Crooks, Valorie A; Snyder, Jeremy; Kingsbury, Paul

2010-11-03

Medical tourism involves patients intentionally leaving their home country to access non-emergency health care services abroad. Growth in the popularity of this practice has resulted in a significant amount of attention being given to it from researchers, policy-makers, and the media. Yet, there has been little effort to systematically synthesize what is known about the effects of this phenomenon. This article presents the findings of a scoping review examining what is known about the effects of medical tourism in destination and departure countries. Drawing on academic articles, grey literature, and media sources extracted from18 databases, we follow a widely used scoping review protocol to synthesize what is known about the effects of medical tourism in destination and departure countries. The review design has three main stages: (1) identifying the question and relevant literature; (2) selecting the literature; and (3) charting, collating, and summarizing the data. The large majority of the 203 sources accepted into the review offer a perspective of medical tourism from the Global North, focusing on the flow of patients from high income nations to lower and middle income countries. This greatly shapes any discussion of the effects of medical tourism on destination and departure countries. Five interrelated themes that characterize existing discussion of the effects of this practice were extracted from the reviewed sources. These themes frame medical tourism as a: (1) user of public resources; (2) solution to health system problems; (3) revenue generating industry; (4) standard of care; and (5) source of inequity. It is observed that what is currently known about the effects of medical tourism is minimal, unreliable, geographically restricted and mostly based on speculation. Given its positive and negative effects on the health care systems of departure and destination countries, medical tourism is a highly significant and contested phenomenon. This is especially true given its potential to serve as a powerful force for the inequitable delivery of health care services globally. It is recommended that empirical evidence and other data associated with medical tourism be subjected to clear and coherent definitions, including reports focused on the flows of medical tourists and surgery success rates. Additional primary research on the effects of medical tourism is needed if the industry is to develop in a manner that is beneficial to citizens of both departure and destination countries.

Not Merely a Matter of Academics: Student Experiences of a South African University as Study-Abroad Destination

ERIC Educational Resources Information Center

Paola, R. J.; Lemmer, E. M.

2013-01-01

Study abroad programmes attract considerable numbers of American college students; however, very few select an African country as their study-abroad destination. This article explores the experiences of American undergraduates who made the uncommon choice of a South African university as destination for a mid-length immersion type programme. The…

An analysis of seismic risk from a tourism point of view.

PubMed

Mäntyniemi, Päivi

2012-07-01

Global awareness of natural calamities increased after the destructive Indian Ocean tsunami of December 2004, largely because many foreigners lost their lives, especially in Thailand. This paper explores how best to communicate the seismic risk posed by different travel destinations to crisis management personnel in tourists' home countries. The analysis of seismic risk should be straightforward enough for non-specialists, yet powerful enough to identify the travel destinations that are most at risk. The output for each location is a point in 3D space composed of the natural and built-up environment and local tourism. The tourism-specific factors can be tailored according to the tourists' nationality. The necessary information can be collected from various directories and statistics, much of it available over the Internet. The output helps to illustrate the overall seismic risk conditions of different travel destinations, allows for comparison across destinations, and identifies the places that are most at risk. © 2012 The Author(s). Journal compilation © Overseas Development Institute, 2012.

Medical tourism's impacts on health worker migration in the Caribbean: five examples and their implications for global justice.

PubMed

Snyder, Jeremy; Crooks, Valorie A; Johnston, Rory; Adams, Krystyna; Whitmore, Rebecca

2015-01-01

Medical tourism is a practice where individuals cross international borders in order to access medical care. This practice can impact the global distribution of health workers by potentially reducing the emigration of health workers from destination countries for medical tourists and affecting the internal distribution of these workers. Little has been said, however, about the impacts of medical tourism on the immigration of health workers to medical tourism destinations. We discuss five patterns of medical tourism-driven health worker migration to medical tourism destinations: 1) long-term international migration; 2) long-term diasporic migration; 3) long-term migration and 'black sheep'; 4) short-term migration via time share; and 5) short-term migration via patient-provider dyad. These patterns of health worker migration have repercussions for global justice that include potential negative impacts on the following: 1) health worker training; 2) health worker distributions; 3) local provision of care; and 4) local economies. In order to address these potential negative impacts, policy makers in destination countries should work to ensure that changes in health worker training and licensure aimed at promoting the medical tourism sector are also supportive of the health needs of the domestic population. Policy makers in both source and destination countries should be aware of the effects of medical tourism on health worker flows both into and out of medical tourism destinations and work to ensure that the potential harms of these worker flows to both groups are mitigated.

Medical tourism's impacts on health worker migration in the Caribbean: five examples and their implications for global justice

PubMed Central

Snyder, Jeremy; Crooks, Valorie A.; Johnston, Rory; Adams, Krystyna; Whitmore, Rebecca

2015-01-01

Medical tourism is a practice where individuals cross international borders in order to access medical care. This practice can impact the global distribution of health workers by potentially reducing the emigration of health workers from destination countries for medical tourists and affecting the internal distribution of these workers. Little has been said, however, about the impacts of medical tourism on the immigration of health workers to medical tourism destinations. We discuss five patterns of medical tourism-driven health worker migration to medical tourism destinations: 1) long-term international migration; 2) long-term diasporic migration; 3) long-term migration and ‘black sheep’; 4) short-term migration via time share; and 5) short-term migration via patient-provider dyad. These patterns of health worker migration have repercussions for global justice that include potential negative impacts on the following: 1) health worker training; 2) health worker distributions; 3) local provision of care; and 4) local economies. In order to address these potential negative impacts, policy makers in destination countries should work to ensure that changes in health worker training and licensure aimed at promoting the medical tourism sector are also supportive of the health needs of the domestic population. Policy makers in both source and destination countries should be aware of the effects of medical tourism on health worker flows both into and out of medical tourism destinations and work to ensure that the potential harms of these worker flows to both groups are mitigated. PMID:25865122

PubMed Central

Tessier, D.; Gervais, F.

1994-01-01

HIV and AIDS infection has reached epidemic proportions; however, advances in treatment have made it possible for an increasing number of infected individuals to travel. These patients should be given travel advice before they leave. Mainly for political reasons, they should be advised to avoid certain countries. For other destinations, more detailed information might be required. PMID:8199526

Europe Challenges U.S. for Foreign Students

ERIC Educational Resources Information Center

Labi, Aisha

2007-01-01

Although the United States remains the world's preferred destination for students looking to earn degrees abroad, it is ceding ground to its rivals in Western Europe. Britain has long been the United States' main competitor for international students, but Continental countries like the Netherlands, France, and Germany are increasingly popular…

What is known about the effects of medical tourism in destination and departure countries? A scoping review

PubMed Central

2010-01-01

Background Medical tourism involves patients intentionally leaving their home country to access non-emergency health care services abroad. Growth in the popularity of this practice has resulted in a significant amount of attention being given to it from researchers, policy-makers, and the media. Yet, there has been little effort to systematically synthesize what is known about the effects of this phenomenon. This article presents the findings of a scoping review examining what is known about the effects of medical tourism in destination and departure countries. Methods Drawing on academic articles, grey literature, and media sources extracted from18 databases, we follow a widely used scoping review protocol to synthesize what is known about the effects of medical tourism in destination and departure countries. The review design has three main stages: (1) identifying the question and relevant literature; (2) selecting the literature; and (3) charting, collating, and summarizing the data. Results The large majority of the 203 sources accepted into the review offer a perspective of medical tourism from the Global North, focusing on the flow of patients from high income nations to lower and middle income countries. This greatly shapes any discussion of the effects of medical tourism on destination and departure countries. Five interrelated themes that characterize existing discussion of the effects of this practice were extracted from the reviewed sources. These themes frame medical tourism as a: (1) user of public resources; (2) solution to health system problems; (3) revenue generating industry; (4) standard of care; and (5) source of inequity. It is observed that what is currently known about the effects of medical tourism is minimal, unreliable, geographically restricted and mostly based on speculation. Conclusions Given its positive and negative effects on the health care systems of departure and destination countries, medical tourism is a highly significant and contested phenomenon. This is especially true given its potential to serve as a powerful force for the inequitable delivery of health care services globally. It is recommended that empirical evidence and other data associated with medical tourism be subjected to clear and coherent definitions, including reports focused on the flows of medical tourists and surgery success rates. Additional primary research on the effects of medical tourism is needed if the industry is to develop in a manner that is beneficial to citizens of both departure and destination countries. PMID:21047433

To What Extent Is Long-term Care Representative of Elderly Care? A Case Study of Elderly Care Financing in Lombardy, Italy

PubMed Central

Brenna, Elenka; Gitto, Lara

2017-01-01

The ageing of European population has been rapidly increasing during the last decades, and the problem of elderly care financing has become an issue for policy-makers. Long-term care (LTC) financing is considered a suitable proxy of the resources committed to elderly care by each government, but the preciseness of this approximation depends on the extent to which LTC is representative of elderly care within each country. Since there is a broad heterogeneity in LTC funding, organization and setting among European States, it is difficult to find a common parameter representing the public resources destined to the elderly care. We address these topics employing as a case study an Italian region, Lombardy, which in terms of population, dimension, healthcare organization and economic development could be compared to other European countries. The method we suggest, which consists basically in a careful estimate of all the public resources employed in the provision of services exclusively destined to the elderly, could be applied, with the due differences, to other European countries or regions. PMID:28812846

Cumulative advantages and social capabilities in scientific mobility in the Health Sciences: The Spanish case

PubMed Central

Melchor, Lorenzo; Danvila-del-Valle, Joaquín; Bousoño-Calzón, Carlos

2017-01-01

Background The big problem in global public health, arising from the international migration of physicians from less-developed to more-developed countries, increases if this migration also affects scientists dedicated to health areas. This article analyzes critical variables in the processes of Spanish scientific mobility in Health Sciences to articulate effective management policies for the benefit of national public health services and the balance between local and global science. Methods This study develops a survey to measure and analyze the following crucial variables: research career, training, funding, working with a world-class team, institutional prestige, wages, facilities/infrastructure, working conditions in the organization of the destination country, fringe benefits in the organization of the destination country and social responsibility in the organization of the departure country. A total of 811 researchers have participated in the survey, of which 293 were from the health sector: Spanish scientists abroad (114), scientists that have returned to Spain (32) and young researchers in Spain (147). Results The most crucial variables for Spanish scientists and young researchers in Spain in Health Sciences moving abroad are the cumulative advantages (research career, training, funding and institutional prestige) plus wages. On the other hand, the return of Spanish scientists in the Health Sciences is influenced by cumulative variables (working with a world-class team, research career and institutional prestige) and also by other variables related to social factors, such as working conditions and fringe benefits in the destination country. Permanent positions are rare for these groups and their decisions regarding mobility depend to a large extent on job opportunities. Conclusions Spanish health organizations can influence researchers to return, since these decisions mainly depend on job opportunities. These organizations can complement the cumulative advantages offered by the wealthier countries with the intensification of social factors. PMID:28296901

"I won't be staying here for long": a qualitative study on the retention of migrant nurses in Ireland

PubMed Central

2009-01-01

Background Although international nurse recruitment campaigns have succeeded in attracting large numbers of migrant nurses to countries such as Ireland, where domestic supply has not kept pace with demand, the long-term success of such initiatives from a workforce planning perspective will depend on the extent to which these nurses can be retained in destination countries. Methods This paper draws on qualitative, in-depth interviews undertaken with 21 migrant nurses in Ireland, focusing specifically on their future migration intentions. Results Our findings indicate that more than half of the respondents are considering migration onwards, for the most part because the destination country has failed to provide them with sufficient stability, particularly in terms of citizenship and family reunification. In considering onward migration, factors outside the health system were of most concern to those interviewed. Conclusion This demonstrates the need for destination countries to take a broader and more long-term approach to international nurse recruitment, rather than regarding it as an inexpensive way to fill gaps within the health care system. PMID:19660106

Using kernel density estimation to understand the influence of neighbourhood destinations on BMI

PubMed Central

King, Tania L; Bentley, Rebecca J; Thornton, Lukar E; Kavanagh, Anne M

2016-01-01

Objectives Little is known about how the distribution of destinations in the local neighbourhood is related to body mass index (BMI). Kernel density estimation (KDE) is a spatial analysis technique that accounts for the location of features relative to each other. Using KDE, this study investigated whether individuals living near destinations (shops and service facilities) that are more intensely distributed rather than dispersed, have lower BMIs. Study design and setting A cross-sectional study of 2349 residents of 50 urban areas in metropolitan Melbourne, Australia. Methods Destinations were geocoded, and kernel density estimates of destination intensity were created using kernels of 400, 800 and 1200 m. Using multilevel linear regression, the association between destination intensity (classified in quintiles Q1(least)–Q5(most)) and BMI was estimated in models that adjusted for the following confounders: age, sex, country of birth, education, dominant household occupation, household type, disability/injury and area disadvantage. Separate models included a physical activity variable. Results For kernels of 800 and 1200 m, there was an inverse relationship between BMI and more intensely distributed destinations (compared to areas with least destination intensity). Effects were significant at 1200 m: Q4, β −0.86, 95% CI −1.58 to −0.13, p=0.022; Q5, β −1.03 95% CI −1.65 to −0.41, p=0.001. Inclusion of physical activity in the models attenuated effects, although effects remained marginally significant for Q5 at 1200 m: β −0.77 95% CI −1.52, −0.02, p=0.045. Conclusions This study conducted within urban Melbourne, Australia, found that participants living in areas of greater destination intensity within 1200 m of home had lower BMIs. Effects were partly explained by physical activity. The results suggest that increasing the intensity of destination distribution could reduce BMI levels by encouraging higher levels of physical activity. PMID:26883235

Contemporary migration patterns in the prevalence of Helicobacter pylori infection: A systematic review.

PubMed

Morais, Samantha; Costa, Ana Rute; Ferro, Ana; Lunet, Nuno; Peleteiro, Bárbara

2017-06-01

A rapid growth in the number of international migrants over the past years has occurred with most traveling to more affluent settings. As Helicobacter pylori infects over half of the adult population and its prevalence is higher in developing countries, understanding the prevalence of infection in migrants can provide insight into future trends in the burden and management of infection. We aimed to describe the prevalence of H. pylori among migrants through a systematic literature review. We searched PubMed ® from inception to September 2015 to identify studies reporting the prevalence of H. pylori in international migrants according to country of birth for first-generation, and country of birth and parents' nationality for successive generations. Comparable data from origin and destination populations were obtained from the same studies or, when not present, from a previous systematic review on H. pylori worldwide. A total of 28 eligible studies were identified with data for 29 origin and 12 destination countries. Two studies that evaluated refugees presented prevalences of infection higher than both the origin and destination countries. Otherwise, the prevalences among migrants were generally similar or below that of the origin and higher than the destination. Second- or more generation had lower prevalences compared to first-generation migrants. Our study findings are consistent with what would be expected based on the prevalence of H. pylori worldwide. The results of this review show that migrants are particularly at risk of infection and help to identify gaps in the knowledge of migrants' prevalence of infection globally. © 2017 John Wiley & Sons Ltd.

Travel health attitudes among Turkish business travellers to African countries.

PubMed

Selcuk, Engin Burak; Kayabas, Uner; Binbasioglu, Hulisi; Otlu, Baris; Bayindir, Yasar; Bozdogan, Bulent; Karatas, Mehmet

The number of international travellers is increasing worldwide. Although health risks related to international travel are important and generally well-understood, the perception of these risks was unclear among Turkish travellers. We aimed to evaluate the attitudes and health risk awareness of Turkish travellers travelling to African countries. A survey was performed of Turkish travellers bound for Africa from Istanbul International Ataturk Airport in July 2013. A total of 124 travellers were enrolled in the study. Among them, 62.9% had information about their destination but only 11.3% had looked for information on health problems related to travel and their destination. Of all travellers, 53.2% had at least one vaccination before travelling. The most commonly administered vaccine was for typhoid. Among the travellers, 69.3% and 80.6% had "no idea" about yellow fever vaccination and malaria prophylaxis, respectively. A positive correlation was found between a higher level of travellers' education and receiving the recommended vaccination for the destination. Our study revealed significant gaps in the vaccination and chemoprophylaxis uptake of Turkish travellers departing to Africa. An awareness and training program should be developed for travellers, as well as public health workers, to address health risks related to travel. Copyright © 2016 Elsevier Ltd. All rights reserved.

7 CFR 981.474 - Other reports.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... classification (domestic and export by countries of destination); and on ABC Form 25-2 all commitments (almonds...-contract. If the destination of any export is unknown to the handler, such handler shall have the broker...

K-means cluster analysis of tourist destination in special region of Yogyakarta using spatial approach and social network analysis (a case study: post of @explorejogja instagram account in 2016)

NASA Astrophysics Data System (ADS)

Iswandhani, N.; Muhajir, M.

2018-03-01

This research was conducted in Department of Statistics Islamic University of Indonesia. The data used are primary data obtained by post @explorejogja instagram account from January until December 2016. In the @explorejogja instagram account found many tourist destinations that can be visited by tourists both in the country and abroad, Therefore it is necessary to form a cluster of existing tourist destinations based on the number of likes from user instagram assumed as the most popular. The purpose of this research is to know the most popular distribution of tourist spot, the cluster formation of tourist destinations, and central popularity of tourist destinations based on @explorejogja instagram account in 2016. Statistical analysis used is descriptive statistics, k-means clustering, and social network analysis. The results of this research were obtained the top 10 most popular destinations in Yogyakarta, map of html-based tourist destination distribution consisting of 121 tourist destination points, formed 3 clusters each consisting of cluster 1 with 52 destinations, cluster 2 with 9 destinations and cluster 3 with 60 destinations, and Central popularity of tourist destinations in the special region of Yogyakarta by district.

22 CFR 129.6 - Requirement for license/approval.

Code of Federal Regulations, 2012 CFR

2012-04-01

... are arranged wholly within and destined exclusively for the North Atlantic Treaty Organization, any member country of that Organization, Australia, Japan, New Zealand, or South Korea, except in the case of...) Brokering activities that are arranged wholly within and destined exclusively for the North Atlantic Treaty...

76 FR 70337 - Exports and Reexports to the Principality of Liechtenstein

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-14

..., possession, dependency or department of a country included on the Country Chart, the EAR accords your destination the same licensing treatment as the country of which it is a territory, possession, dependency or...

Students on Move: Understanding Decision-Making Process and Destination Choice of Indian Students

ERIC Educational Resources Information Center

Wadhwa, Rashim

2016-01-01

In recent years, the overall context of global mobility has significantly changed, so has the strategies to attract international students. What we observe now is the changes in strategies and the emergence of new host countries and increased opportunities for studying abroad. In an intense competitive environment of global higher education…

Passing through - reasons why migrant doctors in Ireland plan to stay, return home or migrate onwards to new destination countries.

PubMed

Brugha, Ruairí; McAleese, Sara; Dicker, Pat; Tyrrell, Ella; Thomas, Steve; Normand, Charles; Humphries, Niamh

2016-06-30

International recruitment is a common strategy used by high-income countries to meet their medical workforce needs. Ireland, despite training sufficient doctors to meet its internal demand, continues to be heavily dependent on foreign-trained doctors, many of whom may migrate onwards to new destination countries. A cross-sectional study was conducted to measure and analyse the factors associated with the migratory intentions of foreign doctors in Ireland. A total of 366 non-European nationals registered as medical doctors in Ireland completed an online survey assessing their reasons for migrating to Ireland, their experiences whilst working and living in Ireland, and their future plans. Factors associated with future plans - whether to remain in Ireland, return home or migrate to a new destination country - were tested by bivariate and multivariate analyses, including discriminant analysis. Of the 345 foreign doctors who responded to the question regarding their future plans, 16 % of whom were Irish-trained, 30 % planned to remain in Ireland, 23 % planned to return home and 47 % to migrate onwards. Country of origin, personal and professional reasons for migrating, experiences of training and supervision, opportunities for career progression, type of employment contract, citizenship status, and satisfaction with life in Ireland were all factors statistically significantly associated with the three migratory outcomes. Reported plans may not result in enacted emigration. However, the findings support a growing body of evidence highlighting dissatisfaction with current career opportunities, contributing to the emigration of Irish doctors and onward migration of foreign doctors. Implementation of the WHO Global Code, which requires member states to train and retain their own health workforce, could also help reduce onward migration of foreign doctors to new destination countries. Ireland has initiated the provision of tailored postgraduate training to doctors from Pakistan, enabling these doctors to return home with improved skills of benefit to the source country.

31 CFR 545.404 - Transshipment or transit through the United States prohibited.

Code of Federal Regulations, 2010 CFR

2010-07-01

... (AFGHANISTAN) SANCTIONS REGULATIONS Interpretations § 545.404 Transshipment or transit through the United... intended or destined for the Taliban or the territory of Afghanistan controlled by the Taliban. (b) The... Afghanistan controlled by the Taliban which are intended or destined for third countries. (c) Goods, software...

Measuring Geographic Migration Patterns Using Matrículas Consulares.

PubMed

Caballero, Maria Esther; Cadena, Brian C; Kovak, Brian K

2018-05-14

In this article, we show how to use administrative data from the Matrícula Consular de Alta Seguridad (MCAS) identification card program to measure the joint distribution of sending and receiving locations for migrants from Mexico to the United States. Whereas other data sources cover only a small fraction of source or destination locations or include only very coarse geographic information, the MCAS data provide complete geographic coverage of both countries, detailed information on migrants' sources and destinations, and a very large sample size. We first confirm the quality and representativeness of the MCAS data by comparing them with well-known household surveys in Mexico and the United States, finding strong agreement on the migrant location distributions available across data sets. We then document substantial differences in the mix of destinations for migrants from different places within the same source state, demonstrating the importance of detailed substate geographical information. We conclude with an example of how these detailed data can be used to study the effects of destination-specific conditions on migration patterns. We find that an Arizona law reducing employment opportunities for unauthorized migrants decreased emigration from and increased return migration to Mexican source regions with strong initial ties to Arizona.

Factors Influencing International Students' Choice of an Education Destination--A Correspondence Analysis

ERIC Educational Resources Information Center

Shanka, Tekle; Quintal, Vanessa; Taylor, Ruth

2005-01-01

A correspondence analysis technique was employed to elicit information from international students pertaining to their choice of study destination. A survey of international students at a major Australian university revealed that the proximity of the city to the students' home countries, in addition to safety, the educational quality/variety, etc.…

Poultry litter and the environment: Physiochemical properties of litter and soil during successive flock rotations and after remote site deposition

USDA-ARS?s Scientific Manuscript database

The U.S. broiler meat market has grown over the past 16 years and destinations for U.S. broiler meat exports expanded to over 150 countries. This market opportunity has spurred a corresponding increase in industrialized poultry production, which due to the confined space in which high numbers of an...

Healthy and unhealthy migrant effect on the mortality of immigrants from wealthy countries residing in Spain.

PubMed

Regidor, Enrique; Astasio, Paloma; Ortega, Paloma; Martínez, David; Calle, M Elisa; de la Fuente, Luis

2011-04-01

This study attempts to identify the possible existence of a healthy migrant effect and an unhealthy migrant effect on the mortality of immigrants from wealthy countries who move to Spain. Immigrants aged 35-64 years from France, Germany, Great Britain and 16 other wealthy OECD countries who resided in Spain were compared with respect to: (1) mortality from cancer, cardiovascular disease, and all other diseases and (2) employment status, duration of residence, and educational level, in two geographic areas: the "preferred destination area"-the Mediterranean coast, Balearic Islands and Canary Islands-and the rest of Spain. In general, cancer mortality was lower and mortality from cardiovascular disease was higher in immigrants who resided in the preferred destination area than in their countries of origin and than in immigrants who resided in the rest of Spain. Immigrants in the preferred destination area had a higher percentage of retired persons, longer time of residence and a lower percentage of persons with university education. The largest differences between the two areas in cardiovascular and all-disease mortality and in the frequency of the aforementioned sociodemographic characteristics were observed in British immigrants and those from the 16 OECD countries. Possible explanations for these findings are suggested which are compatible with the presence of an unhealthy and/or healthy immigrant bias in the two areas.

31 CFR 560.526 - Commodities trading and related transactions.

Code of Federal Regulations, 2011 CFR

2011-07-01

... with the United States person is a person in Iran or the Government of Iran, and (2) It was impossible... the Government of Iran. (b) Trading in commodities destined for Iran or the Government of Iran. With... by United States persons in commodities of U.S. or third-country origin destined for Iran or the...

22 CFR 123.9 - Country of ultimate destination and approval of reexports or retransfers.

Code of Federal Regulations, 2012 CFR

2012-04-01

... destination on an application for an export license, or on a Shipper's Export Declaration where an exemption... the export license, or on the Shipper's Export Declaration in cases where an exemption is claimed... the invoice whenever defense articles on the U.S. Munitions List are to be exported: These commodities...

The causes of international labor migrations--a demand-determined approach.

PubMed

Straubhaar, T

1986-01-01

The author first studies the reasons why people migrate using a neoclassical approach concerning income differentials. He tests this approach empirically and demonstrates its limits. A demand-determination approach based on human capital theory is then outlined to overcome these limits and to take into account restrictive immigration controls. Migration from Italy, Spain, Greece, Portugal, and Turkey to the European Community destination countries is examined. It is concluded that "the demand for immigrants in the destination country is the decisive condition for the phenomenon of international labor migration, and the supply of migration-willing workers is only a necessary condition." excerpt

21 CFR 1312.31 - Schedule I: Application for prior written approval.

Code of Federal Regulations, 2014 CFR

2014-04-01

... other authorization, issued by a competent authority of the country of origin (or other documentary... country of destination (or other documentary evidence deemed adequate by the Administrator), indicating... or other legitimate uses within such country. (e) Verification by an American consular officer of the...

21 CFR 1312.31 - Schedule I: Application for prior written approval.

Code of Federal Regulations, 2010 CFR

2010-04-01

... other authorization, issued by a competent authority of the country of origin (or other documentary... country of destination (or other documentary evidence deemed adequate by the Administrator), indicating... or other legitimate uses within such country. (e) Verification by an American consular officer of the...

21 CFR 1312.31 - Schedule I: Application for prior written approval.

Code of Federal Regulations, 2012 CFR

2012-04-01

... other authorization, issued by a competent authority of the country of origin (or other documentary... country of destination (or other documentary evidence deemed adequate by the Administrator), indicating... or other legitimate uses within such country. (e) Verification by an American consular officer of the...

21 CFR 1312.31 - Schedule I: Application for prior written approval.

Code of Federal Regulations, 2011 CFR

2011-04-01

... other authorization, issued by a competent authority of the country of origin (or other documentary... country of destination (or other documentary evidence deemed adequate by the Administrator), indicating... or other legitimate uses within such country. (e) Verification by an American consular officer of the...

21 CFR 1312.31 - Schedule I: Application for prior written approval.

Code of Federal Regulations, 2013 CFR

2013-04-01

... other authorization, issued by a competent authority of the country of origin (or other documentary... country of destination (or other documentary evidence deemed adequate by the Administrator), indicating... or other legitimate uses within such country. (e) Verification by an American consular officer of the...

Challenges to implementation of the WHO Global Code of Practice on International Recruitment of Health Personnel: the case of Sudan.

PubMed

Abuagla, Ayat; Badr, Elsheikh

2016-06-30

The WHO Global Code of Practice on the International Recruitment of Health Personnel (hereafter the WHO Code) was adopted by the World Health Assembly in 2010 as a voluntary instrument to address challenges of health worker migration worldwide. To ascertain its relevance and effectiveness, the implementation of the WHO Code needs to be assessed based on country experience; hence, this case study on Sudan. This qualitative study depended mainly on documentary sources in addition to key informant interviews. Experiences of the authors has informed the analysis. Migration of Sudanese health workers represents a major health system challenge. Over half of Sudanese physicians practice abroad and new trends are showing involvement of other professions and increased feminization. Traditional destinations include Gulf States, especially Saudi Arabia and Libya, as well as the United Kingdom and the Republic of Ireland. Low salaries, poor work environment, and a lack of adequate professional development are the leading push factors. Massive emigration of skilled health workers has jeopardized coverage and quality of healthcare and health professional education. Poor evidence, lack of a national policy, and active recruitment in addition to labour market problems were barriers for effective migration management in Sudan. Response of destination countries in relation to cooperative arrangements with Sudan as a source country has always been suboptimal, demonstrating less attention to solidarity and ethical dimensions. The WHO Code boosted Sudan's efforts to address health worker migration and health workforce development in general. Improving migration evidence, fostering a national dialogue, and promoting bilateral agreements in addition to catalysing health worker retention strategies are some of the benefits accrued. There are, however, limitations in publicity of the WHO Code and its incorporation into national laws and regulatory frameworks for ethical recruitment. The outlook is bleak for Sudan unless the country designs and implements a robust national policy for migration management and unless prospects for source-destination country collaboration improve within a more sound version of the WHO Code. The WHO Code catalysed some vital steps in managing migration and strengthening the national health workforce in Sudan. Nevertheless, the country has not utilized the full potential of this instrument. Revisions of the WHO Code would benefit much from lessons of its application in the context of developing countries such as Sudan.

15 CFR 740.14 - Baggage (BAG).

Code of Federal Regulations, 2010 CFR

2010-01-01

... to Country Groups D:1, D:2, D:3, D:4, or E:1. (See Supplement No. 1 of this part). (e) Special... or reexport encryption commodities and software to any destination not in Country Group E:1 of... United States as defined by 8 U.S.C. 1101(a)(20) (except a national of a country listed in Country Group...

International Migration and Human Development in Destination Countries: A Cross-National Analysis of Less-Developed Countries, 1970-2005

ERIC Educational Resources Information Center

Sanderson, Matthew

2010-01-01

Contemporary levels of international migration in less-developed countries are raising new and important questions regarding the consequences of immigration for human welfare and well-being. However, there is little systematic cross-national evidence of how international migration affects human development levels in migrant-receiving countries in…

Self-Employment of Immigrants: A Cross-National Study of 17 Western Societies

ERIC Educational Resources Information Center

Tubergen, Frank van

2005-01-01

This study examines the role of immigrants' country of origin, country of destination and combinations thereof (settings or communities) in the likelihood of immigrants being self-employed. I pooled census data from three classic immigrant countries (Australia, Canada and the United States) and labor-force surveys from 14 countries in the European…

78 FR 69755 - International Product and Price Changes

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-21

... provides reliable, high-speed service to over 185 countries with a money-back, date- certain delivery... Price Group Price groups 1-14 will have shaped-based pricing and will be require separate containers (i... decrease the minimum weight for a direct country container from 3 pounds to 2 pounds. Destination Countries...

[Medical tourism and its implications for patients and hospital services throughout the world].

PubMed

Hansen, Kristine Sorgenfri

2017-05-15

This article provides a snapshot of global medical tourism and its positive and negative implications for healthcare around the world presented through selected examples. Medical tourism is an old phenomenon which has seen a rapid increase due to global technological advances thus enabling people to receive treatment anywhere in the world, often combined with a tropical vacation. Treatments are of a non-acute, voluntary nature and are driven largely by high prices and long waiting lists at the home countries and low prices and high service quality at the destination country.

Country Image and Ideal Destination Choice in Study Abroad: Evidence from the Republic of Korea

ERIC Educational Resources Information Center

Ghazarian, Peter Gregory; Keller, Daniel Ryan

2016-01-01

In a time of growing competition for tertiary education, international students represent an important resource. However, more work is required to detail the factors that influence destination choice in study abroad. Drawing from a representative sample (n = 620) of the adult population over 19 in the Republic of Korea, the present study examined…

International recruitment of health workers: British lessons for Europe? Emerging concerns and future research recommendations.

PubMed

Lozano, Mariona; Meardi, Guglielmo; Martín-Artiles, Antonio

2015-01-01

Immigration as a solution to staff and skill shortages in the health system is increasingly on the agenda in the European Union. This article highlights the related social and policy dilemmas by comparing a new destination country with an old destination country: Spain and the United Kingdom. After describing the challenges met by the United Kingdom, we ask how well-prepared Spain is to face the same issues. In particular, attention is paid to the occupational mobility of health workers after entry and to how immigration as a staffing solution poses new political and social challenges. Through a review of background information regarding the immigration of health workers in the two countries and the preliminary analysis of 15 exploratory interviews, we aim to identify the primary trends and key concerns for future analysis. Although our interviews only allow us to draw tentative conclusions, they do highlight emerging issues to be explored in the near future. Our conclusions show that many of the problems traditionally encountered in the United Kingdom are now emerging in Spain, suggesting scope for further collaboration among government, employers, and other stakeholders across the European Union. © The Author(s) 2015 Reprints and permissions:]br]sagepub.co.uk/journalsPermissions.nav.

The role of internationally educated nurses in a quality, safe workforce.

PubMed

D Sherwood, Gwen; Shaffer, Franklin A

2014-01-01

Migration and globalization of the nursing workforce affect source countries and destination countries. Policies and regulations governing the movement of nurses from one country to another safeguard the public by ensuring educational comparability and competence. The global movement of nurses and other health care workers calls for quality and safety competencies that meet standards such as those defined by the Institute of Medicine. This article examines nurse migration and employment of internationally educated nurses (IENs) in the context of supporting and maintaining safe, quality patient care environments. Migration to the United States is featured as an exemplar to consider the following key factors: the impact of nurse migration on the nursing workforce; issues in determining educational comparability of nursing programs between countries; quality and safety concerns in transitioning IENs into the workforce; and strategies for helping IENs transition as safe, qualified members of the nursing workforce in the destination country. Copyright © 2014 Elsevier Inc. All rights reserved.

Theories of international labor migration: an overview.

PubMed

Stahl, C W

1995-01-01

"Emigration pressures are primarily the result of increasing inequalities between countries which, in turn, are the result of factors internal to less developed countries and their relations with developed countries. Both micro (neoclassical) and macrostructural theories of migration are reviewed. It is argued that the neoclassical theory of migration is often unjustly criticized and is sufficiently robust to incorporate those structural considerations which are at the core of macrostructural theories. Moreover, the neoclassical theory, with slight modification, can incorporate the ¿new economics of migration.' The major empirical problem confronting models of international labor migration is that migration flows are constrained by immigration policy. This policy, in turn, is influenced by various special interest groups. The direction and form of migration flows is conditioned by contemporary and historical relationships between source and destination countries." excerpt

African Female Physicians and Nurses in the Global Care Chain: Qualitative Explorations from Five Destination Countries.

PubMed

Wojczewski, Silvia; Pentz, Stephen; Blacklock, Claire; Hoffmann, Kathryn; Peersman, Wim; Nkomazana, Oathokwa; Kutalek, Ruth

2015-01-01

Migration of health professionals is an important policy issue for both source and destination countries around the world. The majority of migrant care workers in industrialized countries today are women. However, the dimension of mobility of highly skilled females from countries of the global south has been almost entirely neglected for many years. This paper explores the experiences of high-skilled female African migrant health-workers (MHW) utilising the framework of Global Care Chain (GCC) research. In the frame of the EU-project HURAPRIM (Human Resources for Primary Health Care in Africa), the research team conducted 88 semi-structured interviews with female and male African MHWs in five countries (Botswana, South Africa, Belgium, Austria, UK) from July 2011 until April 2012. For this paper we analysed the 34 interviews with female physicians and nurses using the qualitative framework analysis approach and the software atlas.ti. In terms of the effect of the migration on their career, almost all of the respondents experienced short-term, long-term or permanent inability to work as health-care professionals; few however also reported a positive career development post-migration. Discrimination based on a foreign nationality, race or gender was reported by many of our respondents, physicians and nurses alike, whether they worked in an African or a European country. Our study shows that in addition to the phenomenon of deskilling often reported in GCC research, many female MHW are unable to work according to their qualifications due to the fact that their diplomas are not recognized in the country of destination. Policy strategies are needed regarding integration of migrants in the labour market and working against discrimination based on race and gender.

African Female Physicians and Nurses in the Global Care Chain: Qualitative Explorations from Five Destination Countries

PubMed Central

Wojczewski, Silvia; Pentz, Stephen; Blacklock, Claire; Hoffmann, Kathryn; Peersman, Wim; Nkomazana, Oathokwa; Kutalek, Ruth

2015-01-01

Migration of health professionals is an important policy issue for both source and destination countries around the world. The majority of migrant care workers in industrialized countries today are women. However, the dimension of mobility of highly skilled females from countries of the global south has been almost entirely neglected for many years. This paper explores the experiences of high-skilled female African migrant health-workers (MHW) utilising the framework of Global Care Chain (GCC) research. In the frame of the EU-project HURAPRIM (Human Resources for Primary Health Care in Africa), the research team conducted 88 semi-structured interviews with female and male African MHWs in five countries (Botswana, South Africa, Belgium, Austria, UK) from July 2011 until April 2012. For this paper we analysed the 34 interviews with female physicians and nurses using the qualitative framework analysis approach and the software atlas.ti. In terms of the effect of the migration on their career, almost all of the respondents experienced short-term, long-term or permanent inability to work as health-care professionals; few however also reported a positive career development post-migration. Discrimination based on a foreign nationality, race or gender was reported by many of our respondents, physicians and nurses alike, whether they worked in an African or a European country. Our study shows that in addition to the phenomenon of deskilling often reported in GCC research, many female MHW are unable to work according to their qualifications due to the fact that their diplomas are not recognized in the country of destination. Policy strategies are needed regarding integration of migrants in the labour market and working against discrimination based on race and gender. PMID:26068218

15 CFR 732.3 - Steps regarding the ten general prohibitions.

Code of Federal Regulations, 2012 CFR

2012-01-01

... Country Chart does not apply to Cuba, Iran, North Korea, and Syria. For those countries you should review... destination for any item is Cuba, Iran, Iraq, North Korea, Rwanda, or Syria you must consider the requirements...

The Impact of Social Capital and Social Networks on Tourism Technology Adoption for Destination Marketing and Promotion: A Case of Convention and Visitors Bureaus

ERIC Educational Resources Information Center

Lee, Byeong Cheol

2011-01-01

Tourism is a growing and significant component of the world economy and competition for tourism revenues is intense. For countries or regions seeking community development through tourism, communication strategies are an essential element of success. The Internet plays an increasingly large role in how we communicate in the 21st century and with…

Europe as Unlikely Immigrant Destination: Location Choice for Internationally Mobile Students in India

ERIC Educational Resources Information Center

Hercog, Metka; van de Laar, Mindel

2016-01-01

This paper examines how country-specific factors in receiving countries influence a highly skilled migrant's choice between several possible locations. While continental European countries recognize that attracting migrants is a key component of their economic strategies, it is unclear to what extent these immigration policies result in European…

19 CFR 10.175 - Imported directly defined.

Code of Federal Regulations, 2011 CFR

2011-04-01

... country while en route to the U.S., and the invoice, bills of lading, and other shipping documents show the U.S. as the final destination; or (c) If shipped from the beneficiary developing country to the... amended (19 U.S.C. 2467(2)), through the territory of a former beneficiary developing country whose...

19 CFR 10.175 - Imported directly defined.

Code of Federal Regulations, 2013 CFR

2013-04-01

... country while en route to the U.S., and the invoice, bills of lading, and other shipping documents show the U.S. as the final destination; or (c) If shipped from the beneficiary developing country to the... amended (19 U.S.C. 2467(2)), through the territory of a former beneficiary developing country whose...

19 CFR 10.175 - Imported directly defined.

Code of Federal Regulations, 2014 CFR

2014-04-01

... country while en route to the U.S., and the invoice, bills of lading, and other shipping documents show the U.S. as the final destination; or (c) If shipped from the beneficiary developing country to the... amended (19 U.S.C. 2467(2)), through the territory of a former beneficiary developing country whose...

19 CFR 10.175 - Imported directly defined.

Code of Federal Regulations, 2012 CFR

2012-04-01

... country while en route to the U.S., and the invoice, bills of lading, and other shipping documents show the U.S. as the final destination; or (c) If shipped from the beneficiary developing country to the... amended (19 U.S.C. 2467(2)), through the territory of a former beneficiary developing country whose...

47 CFR 63.18 - Contents of applications for international common carriers.

Code of Federal Regulations, 2012 CFR

2012-10-01

... country (i.e., the destination foreign country) is a Member of the World Trade Organization; or (2) The... power on the foreign end of the route and will not enter into such agreements in the future. (o) A...

Homonegativity among first and second generation migrants in Europe: the interplay of time trends, origin, destination and religion.

PubMed

Van der Bracht, Koen; Van de Putte, Bart

2014-11-01

Previous studies reported declining disapproval of homosexuality in Europe but have simultaneously identified the decelerating effect of religiosity and the higher disapproval of homosexuality among migrants. In this paper, we address disapproval of homosexuality among first- and second-generation migrants in Europe by assessing (1) period and cohort changes, (2) origin and destination country influences and (3) the role of religiosity. We develop a specific cross-classified multilevel design enabling us to simultaneously examine these influences. We test hypotheses using a subsample of the European Social Survey (ESS), containing 19,878 first and second generation migrants. The analyses lead to three important conclusions. Firstly, disapproval of homosexuality is declining both over time and across cohorts. Secondly, migrants conform to levels of disapproval of homosexuality among natives in the destination country, and this explains the decline among migrants over time. Thirdly, religion has a multi-faceted influence on levels of disapproval of homosexuality among migrants. Copyright © 2014 Elsevier Inc. All rights reserved.

7 CFR 35.6 - Shipment.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 2 2010-01-01 2010-01-01 false Shipment. 35.6 Section 35.6 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... country regardless of the number of consignees, receivers, or ports of destination in that country. [41 FR...

Investitionen aus den BRIC-Staaten. Grund zur Sorge für Unternehmen, Beschäftigte und Kommunen?

NASA Astrophysics Data System (ADS)

Franz, Martin; Henn, Sebastian

2017-04-01

Investments from BRIC countries - Brazil, Russia, India and China - are playing an increasingly important role in Germany. However, both the public and the potentially affected labour force often adopt sceptical, and sometimes even hostile attitudes towards investors from these countries. This article shows that apart from a few exceptions investors from the BRIC countries are generally better than their reputation precedes. An important conclusion drawn in this paper is that investors should not be received with stereotypes. Rather, it is necessary to perform deeper investigations into their strategies and the specific investment goals in each case. This is all the more necessary to ensure that investments from BRIC countries do not conflict with the domestic firms' interests or of their personnel. In fact, they can assist to increase the competitiveness of German firms, and as such not only prove beneficial for the workforce but also for Germany as a business destination.

Inbound medical tourism to Barbados: a qualitative examination of local lawyers' prospective legal and regulatory concerns.

PubMed

Crooks, Valorie A; Cohen, I Glenn; Adams, Krystyna; Whitmore, Rebecca; Morgan, Jeffrey

2015-07-28

Enabled by globalizing processes such as trade liberalization, medical tourism is a practice that involves patients' intentional travel to privately obtain medical care in another country. Empirical legal research on this issue is limited and seldom based on the perspectives of destination countries receiving medical tourists. We consulted with diverse lawyers from across Barbados to explore their views on the prospective legal and regulatory implications of the developing medical tourism industry in the country. We held a focus group in February 2014 in Barbados with lawyers from across the country. Nine lawyers with diverse legal backgrounds participated. Focus group moderators summarized the study objective and engaged participants in identifying the local implications of medical tourism and the anticipated legal and regulatory concerns. The focus group was transcribed verbatim and analyzed thematically. Five dominant legal and regulatory themes were identified through analysis: (1) liability; (2) immigration law; (3) physician licensing; (4) corporate ownership; and (5) reputational protection. Two predominant legal and ethical concerns associated with medical tourism in Barbados were raised by participants and are reflected in the literature: the ability of medical tourists to recover medical malpractice for adverse events; and the effects of medical tourism on access to health care in the destination country. However, the participants also identified several topics that have received much less attention in the legal and ethical literature. Overall this analysis reveals that lawyers, at least in Barbados, have an important role to play in the medical tourism sector beyond litigation - particularly in transactional and gatekeeper capacities. It remains to be seen whether these findings are specific to the ecology of Barbados or can be extrapolated to the legal climate of other medical tourism destination countries.

15 CFR 742.2 - Proliferation of chemical and biological weapons.

Code of Federal Regulations, 2012 CFR

2012-01-01

... Country Chart (Supplement No. 1 to part 738 of the EAR) is indicated in the appropriate ECCN, a license is... ECCN, a license is required to all destinations except countries in Country Group A:3 (see Supplement... in ECCN 1C350 (precursor and intermediate chemicals used in the production of chemical warfare agents...

Medical Tourist's Perception in Selecting their Destination: A Global Perspective.

PubMed

Sarwar, Abdullah Am; Manaf, Noorhazilah A; Omar, Azura

2012-01-01

The need for better healthcare has grown significantly in recent years. In addition, the rising healthcare costs in the U.S. and in many European countries have forced many patients to seek medical treatment abroad, which has created the demand for medical tourism. With little yet known as to the perception of a medical tourist's destination selection, this study aims to explore medical tourist's perception in selecting their destination while going for medical treatment. Realizing the current need to examine closely the perception of medical tourists, this study had conducted a secondary study to collect data for assessing and identification of the key factors on patient's perception and destination selection criteria. The result confirms the existence of a very strong relationship between cost, service quality, treatment types and availability and marketing impact on the perception of the medical tourists' in selecting their medical tourism destination. This study offers support for the proposed conceptual model and an empirical basis for comparison in future research.

Medical Tourist’s Perception in Selecting their Destination: A Global Perspective

PubMed Central

Sarwar, Abdullah AM; Manaf, Noorhazilah A; Omar, Azura

2012-01-01

Background: The need for better healthcare has grown significantly in recent years. In addition, the rising healthcare costs in the U.S. and in many European countries have forced many patients to seek medical treatment abroad, which has created the demand for medical tourism. With little yet known as to the perception of a medical tourist’s destination selection, this study aims to explore medical tourist’s perception in selecting their destination while going for medical treatment. Methods: Realizing the current need to examine closely the perception of medical tourists, this study had conducted a secondary study to collect data for assessing and identification of the key factors on patient’s perception and destination selection criteria. Results: The result confirms the existence of a very strong relationship between cost, service quality, treatment types and availability and marketing impact on the perception of the medical tourists’ in selecting their medical tourism destination. Conclusion: This study offers support for the proposed conceptual model and an empirical basis for comparison in future research. PMID:23113218

What is the prevalence of and associations with forced labour experiences among male migrants from Dolakha, Nepal? Findings from a cross-sectional study of returnee migrants

PubMed Central

Mak, Joelle; Abramsky, Tanya; Sijapati, Bandita; Kiss, Ligia; Zimmerman, Cathy

2017-01-01

Objectives Growing numbers of people are migrating outside their country for work, and many experience precarious conditions, which have been linked to poor physical and mental health. While international dialogue on human trafficking, forced labour and slavery increases, prevalence data of such experiences remain limited. Methods Men from Dolakha, Nepal, who had ever migrated outside of Nepal for work were interviewed on their experiences, from predeparture to return (n=194). Forced labour was assessed among those who returned within the past 10 years (n=140) using the International Labour Organization's forced labour dimensions: (1) unfree recruitment; (2) work and life under duress; and (3) impossibility to leave employer. Forced labour is positive if any one of the dimensions is positive. Results Participants had worked in India (34%), Malaysia (34%) and the Gulf Cooperation Council countries (29%), working in factories (29%), as labourers/porters (15%) or in skilled employment (12%). Among more recent returnees (n=140), 44% experienced unfree recruitment, 71% work and life under duress and 14% impossibility to leave employer. Overall, 73% experienced forced labour during their most recent labour migration. Forced labour was more prevalent among those who had taken loans for their migration (PR 1.23) and slightly less prevalent among those who had migrated more than once (PR 0.87); however the proportion of those who experienced forced labour was still high (67%). Age, destination and duration of stay were associated with only certain dimensions of forced labour. Conclusion Forced labour experiences were common during recruitment and at destination. Migrant workers need better advice on assessing agencies and brokers, and on accessing services at destinations. As labour migration from Nepal is not likely to reduce in the near future, interventions and policies at both source and destinations need to better address the challenges migrants face so they can achieve safer outcomes. PMID:28801409

Making Canada a destination for medical tourists: why Canadian provinces should not try to become "Mayo Clinics of the North".

PubMed

Turner, Leigh

2012-05-01

When Canadian researchers examine the subject of medical tourism, they typically focus on ethical, social, public health and health policy issues related to Canadians seeking health services in other countries. They emphasize study of Canada as a departure point for medical tourists rather than as a potential destination for international patients. Several influential voices have recently argued that provincial healthcare systems in Canada should market health services to international patients. Proponents of marketing Canada as a destination for medical tourists argue that attracting international patients will generate revenue for provincial healthcare systems. Responding to such proposals, I argue that there are at least seven reasons why provincial health systems in Canada should not dedicate institutional, financial and health human resources to promoting themselves as destinations for medical tourists.

Making Canada a Destination for Medical Tourists: Why Canadian Provinces Should Not Try to Become “Mayo Clinics of the North”

PubMed Central

Turner, Leigh

2012-01-01

When Canadian researchers examine the subject of medical tourism, they typically focus on ethical, social, public health and health policy issues related to Canadians seeking health services in other countries. They emphasize study of Canada as a departure point for medical tourists rather than as a potential destination for international patients. Several influential voices have recently argued that provincial healthcare systems in Canada should market health services to international patients. Proponents of marketing Canada as a destination for medical tourists argue that attracting international patients will generate revenue for provincial healthcare systems. Responding to such proposals, I argue that there are at least seven reasons why provincial health systems in Canada should not dedicate institutional, financial and health human resources to promoting themselves as destinations for medical tourists. PMID:23634159

Characterizing International Travel Behavior from Geotagged Photos: A Case Study of Flickr

PubMed Central

Yuan, Yihong; Medel, Monica

2016-01-01

Recent advances in multimedia and mobile technologies have facilitated large volumes of travel photos to be created and shared online. Although previous studies have utilized geotagged photos to model travel patterns at individual locations, there is limited research on how these datasets can model international travel behavior and inter-country travel flows—a crucial indicator to quantify the interactions between countries in tourism economics. Realizing the necessity to investigate the potential of geotagged photos in tourism geography, this research investigates international travel patterns from two perspectives: 1) We apply a series of indicators (radius of gyration (ROG), number of countries visited, and entropy) to measure the descriptive characteristics of international travel in different countries; 2) By constructing a gravity model of trade, we investigate how distance decay influences the magnitude of international travel flow between geographic entities, and whether (or how much) the popularity of a given destination (defined as the percentage of tourist income in national gross domestic product (GDP)) affects travel choices in different countries. The results provide valuable input to various commercial applications such as individual travel planning and destination suggestions. PMID:27159195

Characterizing International Travel Behavior from Geotagged Photos: A Case Study of Flickr.

PubMed

Yuan, Yihong; Medel, Monica

2016-01-01

Recent advances in multimedia and mobile technologies have facilitated large volumes of travel photos to be created and shared online. Although previous studies have utilized geotagged photos to model travel patterns at individual locations, there is limited research on how these datasets can model international travel behavior and inter-country travel flows-a crucial indicator to quantify the interactions between countries in tourism economics. Realizing the necessity to investigate the potential of geotagged photos in tourism geography, this research investigates international travel patterns from two perspectives: 1) We apply a series of indicators (radius of gyration (ROG), number of countries visited, and entropy) to measure the descriptive characteristics of international travel in different countries; 2) By constructing a gravity model of trade, we investigate how distance decay influences the magnitude of international travel flow between geographic entities, and whether (or how much) the popularity of a given destination (defined as the percentage of tourist income in national gross domestic product (GDP)) affects travel choices in different countries. The results provide valuable input to various commercial applications such as individual travel planning and destination suggestions.

[International migration in the Americas: intraregional migration grows].

PubMed

Zlotnik, H

1992-01-01

The principal destinations for intraregional migrants in South America in recent decades have been Argentina, Brazil, and Venezuela, while in North America the U.S. has exerted a growing attraction since 1965. Intraregional migration in Latin America has been irregular and difficult to quantify, and reliable statistics on migratory flows are nonexistent. Census data indicate that most migration to Argentina and Brazil occurred before 1960, while most migration to Venezuela occurred during the 1970s. Between 1960 and 1980, the proportion of migrants from other Latin American countries showed a tendency to increase, despite decreases in the overall level of immigration. The effect of the economic crisis of the 1980s on immigration from Latin American countries will become more apparent as census data for the 1990s become available. Selectivity according to country of origin is an important characteristic of intraregional migration in South America. The U.S. has, however, been the principal destination of Latin American migrants for the past three decades. Between 1965 and 1991 the U.S. granted resident status to more than 7.4 million persons of Latin American and Caribbean origin, and they constituted 47% of immigrants during those years. The great majority of the Latin American immigrants in the U.S. are Mexican. The 3.5 million Mexicans admitted to the U.S. as immigrants between 1965 and 1991 accounted for 22% of all immigrants during this period.

To What Extent Is Long-term Care Representative of Elderly Care? A Case Study of Elderly Care Financing in Lombardy, Italy.

PubMed

Brenna, Elenka; Gitto, Lara

2017-02-25

The ageing of European population has been rapidly increasing during the last decades, and the problem of elderly care financing has become an issue for policy-makers. Long-term care (LTC) financing is considered a suitable proxy of the resources committed to elderly care by each government, but the preciseness of this approximation depends on the extent to which LTC is representative of elderly care within each country. Since there is a broad heterogeneity in LTC funding, organization and setting among European States, it is difficult to find a common parameter representing the public resources destined to the elderly care. We address these topics employing as a case study an Italian region, Lombardy, which in terms of population, dimension, healthcare organization and economic development could be compared to other European countries. The method we suggest, which consists basically in a careful estimate of all the public resources employed in the provision of services exclusively destined to the elderly, could be applied, with the due differences, to other European countries or regions. © 2017 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Chronic disease mortality associated with infectious agents: A comparative cohort study of migrants from the Former Soviet Union in Israel and Germany

PubMed Central

Ott, Jördis J; Paltiel, Ari M; Winkler, Volker; Becher, Heiko

2008-01-01

Background Prevalence of infectious diseases in migrant populations has been addressed in numerous studies. However, information is sparse on their mortality due to chronic diseases that are aetiologically associated with an infectious agent. This study investigates mortality related to infectious diseases with a specific focus on cancers of possibly infectious origin in voluntary migrants from the Former Soviet Union residing in Israel and in Germany. Methods Both groups of migrants arrived from the Former Soviet Union in their destination countries between 1990 and 2001. Population-based data on migrants in Israel were obtained from the Israel Central Bureau of Statistics. Data for migrants in Germany were obtained from a representative sample of all migrants from the Former Soviet Union in Germany. Cause of death information was available until 2003 for the Israeli cohort and until 2005 for the German cohort. Standardized mortality ratios were calculated relative to the destination country for selected causes of death for which infectious agents may be causally involved. Multivariate Poisson regression was applied to assess differences in mortality by length of residence in the host country. Results Both in Israel and in Germany these migrants have lower overall mortality than the population in their destination countries. However, they have significantly elevated mortality from viral hepatitis and from stomach and liver cancer when compared to the destination populations. Regression analysis shows that in Israel stomach cancer mortality is significantly higher among migrants at shorter durations of residence when compared to durations of more than nine years. Conclusion Higher mortality from cancers associated with infection and from viral hepatitis among migrants from the Former Soviet Union might result from higher prevalence of infections which were acquired in earlier years of life. The results highlight new challenges posed by diseases of infectious origin in migrants and call attention to the link between communicable and non-communicable diseases. PMID:18400085

Accounting for the Early Labour Market Destinations of 19/20-Year-Olds in England and Wales and Japan

ERIC Educational Resources Information Center

Furlong, Andy; Inui, Akio; Nishimura, Takayuki; Kojima, Yoshikazu

2012-01-01

In most advanced countries, young people are now expected to remain in education until the age of 18 and, in a context of poor opportunities for those who leave at an early stage, there are concerns about those who are being left behind. In this paper we use comparable survey data to focus on the destinations of young people in two contrasting…

The Impact of Origin and Host Country Schooling on the Economic Performance of Immigrants

ERIC Educational Resources Information Center

Kanas, Agnieszka; van Tubergen, Frank

2009-01-01

This study examines the economic returns to schooling acquired in the country of origin and the country of destination. It uses large-scale survey data on Turkish, Moroccan, Surinamese and Antillean immigrants in the Netherlands, which contain direct measures of pre- and post migration schooling. It is studied whether the returns to origin-country…

Pre-exposure rabies vaccination among US international travelers: findings from the global TravEpiNet consortium.

PubMed

Dolan, Samantha B; Jentes, Emily S; Sotir, Mark J; Han, Pauline; Blanton, Jesse D; Rao, Sowmya R; LaRocque, Regina C; Ryan, Edward T; Abraham, George M; Alvarez, Salvador; Ansdell, Vernon; Yates, Johnnie A; Atkins, Elisha H; Cahill, John; Birich, Holly K; Vitek, Dagmar; Connor, Bradley A; Dismukes, Roberta; Kozarsky, Phyllis; Dosunmu, Rone; Goad, Jeffrey A; Hagmann, Stefan; Hale, DeVon; Hynes, Noreen A; Jacquerioz, Frederique; McLellan, Susan; Knouse, Mark; Lee, Jennifer; LaRocque, Regina C; Ryan, Edward T; Oladele, Alawode; Demeke, Hanna; Pasinski, Roger; Wheeler, Amy E; Rao, Sowmya R; Rosen, Jessica; Schwartz, Brian S; Stauffer, William; Walker, Patricia; Vinetz, Joseph

2014-02-01

People who travel to areas with high rabies endemicity and have animal contact are at increased risk for rabies exposure. We examined characteristics of international travelers queried regarding rabies vaccination during pretravel consultations at Global TravEpiNet (GTEN) practices during 2009-2010. We performed bivariate and multivariable analyses of data collected from 18 GTEN clinics. Travel destinations were classified by strength level of rabies vaccination recommendation. Of 13,235 travelers, 226 (2%) reported previous rabies vaccination, and 406 (3%) received rabies vaccine at the consultation. Common travel purposes for these 406 travelers were leisure (26%), research/education (17%), and nonmedical service work (14%). Excluding the 226 who were previously vaccinated, 8070 (62%) of 13,009 travelers intended to visit one or more countries with a strong recommendation for rabies vaccination; 1675 (21%) of these 8070 intended to travel for 1 month or more. Among these 1675 travelers, 145 (9%) were vaccinated, 498 (30%) declined vaccination, 832 (50%) had itineraries that clinicians determined did not indicate vaccination, and 200 (12%) remained unvaccinated for other reasons. In both bivariate and multivariate analyses, travelers with trip durations >6 months versus 1-3 months (adjusted odds ratio [OR]=4.9 [95% confidence interval [CI] 2.1, 11.4]) and those traveling for "research/education" or to "provide medical care" (adjusted OR=5.1 [95% CI 1.9, 13.7] and 9.5 [95% CI 2.2, 40.8], respectively), compared with leisure travelers, were more likely to receive rabies vaccination. Few travelers at GTEN clinics received rabies vaccine, although many planned trips 1 month long or more to a strong-recommendation country. Clinicians often determined that vaccine was not indicated, and travelers often declined vaccine when it was offered. The decision to vaccinate should take into account the strength of the vaccine recommendation at the destination country, duration of stay, availability of postexposure prophylaxis, potential for exposure to animals, and likelihood of recurrent travel to high-risk destinations.

Characteristics of Travellers from Bosnia and Herzegovina to Africa

PubMed Central

Obradovic, Zarema; Obradovic, Amina

2013-01-01

Conflict of interest: none declared. Introduction Travellers from Bosnia and Herzegovina (B&H) travel to different world countries. The awareness of people is changing every day and nowadays travellers seek advices related to their travel and destination more often than before. In the previous years, travellers came to Travel Clinics almost only to get the vaccines which were obligatory for entry into a country. In B&H travel clinics are a part of public health institutes. The largest Travel Clinic which provides service for the highest number of travellers is in the Public Health Institute of Sarajevo Canton, in the city of Sarajevo, which is the capital of B&H. In the last years we have seen an increasing interest for travel to Africa because the highest number of travellers travel to African countries. Objective To show the characteristics of persons travelling to Africa, the reasons of their travel, the destination countries and the types of vaccines applied. Materials and methods We used protocol books of the Travel Clinic in Public Health Institute of Sarajevo Canton and the data from individual forms of travellers. Results Persons travelling to Africa make 55% of all travellers that are advised and vaccinated in the Travel Clinic in Public Health Institute of Sarajevo Canton. There are significantly more men than women among people travelling to Africa. The highest number of travellers is in the category of working population which means age group of 20-50 years. The most visited countries are Kenya, Ethiopia, Somalia and Ghana. Travellers received the following vaccines: yellow fever, VHA, VHB, meningitis, tetanus. All travellers were given the advice on how to dress, feed and protect against malaria. PMID:24082834

7 CFR 17.2 - Definition of terms.

Code of Federal Regulations, 2013 CFR

2013-01-01

.... United States. The 50 States, the District of Columbia, and Puerto Rico. ... date shown on the ocean bill of lading. Destination country The foreign country to which the commodity... required to repay the funds to CCC. For example, this part refers to CCC “financing” both the ocean freight...

7 CFR 17.2 - Definition of terms.

Code of Federal Regulations, 2014 CFR

2014-01-01

.... United States. The 50 States, the District of Columbia, and Puerto Rico. ... date shown on the ocean bill of lading. Destination country The foreign country to which the commodity... required to repay the funds to CCC. For example, this part refers to CCC “financing” both the ocean freight...

7 CFR 17.2 - Definition of terms.

Code of Federal Regulations, 2011 CFR

2011-01-01

.... United States. The 50 States, the District of Columbia, and Puerto Rico. ... date shown on the ocean bill of lading. Destination country The foreign country to which the commodity... required to repay the funds to CCC. For example, this part refers to CCC “financing” both the ocean freight...

7 CFR 17.2 - Definition of terms.

Code of Federal Regulations, 2012 CFR

2012-01-01

.... United States. The 50 States, the District of Columbia, and Puerto Rico. ... date shown on the ocean bill of lading. Destination country The foreign country to which the commodity... required to repay the funds to CCC. For example, this part refers to CCC “financing” both the ocean freight...

7 CFR 20.4 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-01-01

... for seed which have been treated in such a manner that their use is limited to seed for planting purposes or on which a certificate has been issued by a recognized seed testing laboratory setting forth variety, germination and purity. (d) Country of destination. (1) Any country outside the United States or...

7 CFR 20.4 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... for seed which have been treated in such a manner that their use is limited to seed for planting purposes or on which a certificate has been issued by a recognized seed testing laboratory setting forth variety, germination and purity. (d) Country of destination. (1) Any country outside the United States or...

Software Development Offshoring Competitiveness: A Case Study of ASEAN Countries

ERIC Educational Resources Information Center

Bui, Minh Q.

2011-01-01

With the success of offshoring within the American software industry, corporate executives are moving their software developments overseas. The member countries of the Association of Southeast Asian Nations (ASEAN) have become a preferred destination. However, there is a lack of published studies on the region's software competitiveness in…

The allure of new immigrant destinations and the Great Recession in the United States.

PubMed

Ellis, Mark; Wright, Richard; Townley, Matthew

2014-01-01

In the 1990s, the immigrant population in the United States dispersed to non-traditional settlement locations (what have become known as "new immigrant destinations"). This paper examines whether the allure of new destinations persisted in the 2000s with a particular focus on the internal migration of the foreign born during the recent deep recessionary period and its aftermath. Three specific questions motivate the analysis. First, are immigrants, much like the US-born population, becoming less migratory within the country over time? Second, is immigrant dispersal from traditional gateways via internal migration continuing despite considerable economic contraction in many new destination metropolitan areas? Third, is immigration from aboard a substitute for what appears to be declining immigrant internal migration to new destinations? The findings reveal a close correlation between the declining internal migration propensity of the US-born and immigrants in the last two decades. We also observe parallels between the geographies of migration of native- and foreign-born populations with both groups moving to similar metropolitan areas in the 1990s. This redistributive association, however, weakened in the subsequent decade as new destination metropolitan areas lost their appeal for both groups, especially immigrants. There is no evidence to suggest that immigration from abroad is substituting for the decline in immigrant redistribution through internal migration to new destinations. Across destination types the relationship between immigration from abroad and the internal migration of the foreign born remained the same before, during, and after the Great Recession.

International travellers from New Jersey: piloting a travel health module in the 2011 Behavioral Risk Factor Surveillance System survey†

PubMed Central

Stoney, Rhett J.; Kozarsky, Phyllis; Bostick, Roberd M.; Sotir, Mark J.

2016-01-01

Background In 2011, the Centers for Disease Control and Prevention and the New Jersey Department of Health used the New Jersey Behavioral Risk Factor Survey (NJBRFS), a state component of the national Behavioral Risk Factor Surveillance System (BRFSS) to pilot a travel health module designed to collect population-based data on New Jersey residents travelling internationally. Our objective was to use this population-based travel health information to serve as a baseline to evaluate trends in US international travellers. Methods A representative sample of New Jersey residents was identified through a random-digit-dialing method and administered the travel health module, which asked five questions: travel outside of USA during the previous year; destination; purpose; if a healthcare provider was visited before travel and any travel-related illness. Additional health variables from the larger NJBRFS were considered and included in bivariate analyses and multiple logistic regression; weights were assigned to variables to account for survey design complexity. Results Of 4029 participants, 841 (21%) travelled internationally. Top destinations included Mexico (10%), Canada (9%), Dominican Republic (6%), Bahamas (5%) and Italy (5%). Variables positively associated with travel included foreign birth, ≥$75 000 annual household income, college education and no children living in the household. One hundred fifty (18%) of 821 travellers with known destinations went to high-risk countries; 40% were visiting friends and relatives and only 30% sought pre-travel healthcare. Forty-eight (6%) of 837 responding travellers reported travel-related illness; 44% visited high-risk countries. Conclusions Approximately one in five NJBRFS respondents travelled internationally during the previous year, a sizeable proportion to high-risk destinations. Few reported becoming ill as a result of travel but almost one-half of those ill had travelled to high-risk destinations. Population-based surveillance data on travellers can help document trends in destinations, traveller type and disease prevalence and evaluate the effectiveness of disease prevention programmmes. PMID:26782130

22 CFR 126.1 - Prohibited exports and sales to certain countries.

Code of Federal Regulations, 2011 CFR

2011-04-01

... imports of defense articles and defense services, destined for or originating in certain countries. This... security and foreign policy of the United States. Information regarding certain other embargoes appears..., except § 123.17 of this subchapter, do not apply with respect to articles originating in or for export to...

22 CFR 123.9 - Country of ultimate destination and approval of reexports or retransfers.

Code of Federal Regulations, 2014 CFR

2014-04-01

... subchapter as Missile Technology Control Regime (MTCR) items; and (3) The person reexporting the defense... ARMS REGULATIONS LICENSES FOR THE EXPORT AND TEMPORARY IMPORT OF DEFENSE ARTICLES § 123.9 Country of... written approval of the Directorate of Defense Trade Controls must be obtained before reselling...

AIDS and sex tourism.

PubMed

Herold, E S; Van Kerkwijk, C

1992-01-01

Tourists traveling internationally lower their inhibitions and take greater risks than they would typically in their home cultures. Loneliness, boredom, and a sense of freedom contribute to this behavioral change. Some tourists travel internationally in search of sexual gratification. This motivation may be actively conscious or subconscious to the traveler. Billed as romantic with great natural beauty, Thailand, the Philippines, Brazil, the Dominican Republic, and Kenya are popular destinations of tourists seeking sex. The Netherlands and countries in eastern Europe are also popular. With most initial cases of HIV infection in Europe having histories of international travel, mass tourism is a major factor in the international transmission of AIDS. While abroad, tourists have sex with casual partners, sex workers, and/or other tourists. Far from all tourists, however, carry and consistently use condoms with these partners. One study found female and non white travelers to be less likely than Whites and males to carry condoms. The risk of HIV infection increases in circumstances where condoms are not readily available in the host country and/or are of poor quality. Regarding actual condom use, a study found only 34% of sex tourists from Switzerland to consistently use condoms while abroad. 28% of men in an STD clinic in Melbourne, Australia, reported consistent condom use in sexual relations while traveling in Asia; STDs were identified in 73% of men examined. The few studies of tourists suggest that a significant proportion engage in risky behavior while traveling. HIV prevalence is rapidly increasing in countries known as destinations for sex tourism. High infection rates are especially evident among teenage sex workers in Thailand. Simply documenting the prevalence of risky behavior among sex tourists will not suffice. More research is needed on travelers and AIDS with particular attention upon the motivating factors supporting persistent high-risk behavior.

Alzheimer's disease and vascular dementia in developing countries: prevalence, management, and risk factors

PubMed Central

Kalaria, Raj N; Maestre, Gladys E; Arizaga, Raul; Friedland, Robert P; Galasko, Doug; Hall, Kathleen; Luchsinger, José A; Ogunniyi, Adesola; Perry, Elaine K; Potocnik, Felix; Prince, Martin; Stewart, Robert; Wimo, Anders; Zhang, Zhen-Xin; Antuono, Piero

2010-01-01

Despite mortality due to communicable diseases, poverty, and human conflicts, dementia incidence is destined to increase in the developing world in tandem with the ageing population. Current data from developing countries suggest that age-adjusted dementia prevalence estimates in 65 year olds are high (≥5%) in certain Asian and Latin American countries, but consistently low (1–3%) in India and sub-Saharan Africa; Alzheimer's disease accounts for 60% whereas vascular dementia accounts for ∼30% of the prevalence. Early-onset familial forms of dementia with single-gene defects occur in Latin America, Asia, and Africa. Illiteracy remains a risk factor for dementia. The APOE ε4 allele does not influence dementia progression in sub-Saharan Africans. Vascular factors, such as hypertension and type 2 diabetes, are likely to increase the burden of dementia. Use of traditional diets and medicinal plant extracts might aid prevention and treatment. Dementia costs in developing countries are estimated to be US$73 billion yearly, but care demands social protection, which seems scarce in these regions. PMID:18667359

Country perspective on medical tourism: the Malaysian experience.

PubMed

Abd Manaf, Noor Hazilah; Hussin, Husnayati; Jahn Kassim, Puteri Nemie; Alavi, Rokiah; Dahari, Zainurin

2015-01-01

The study seeks to explore the perception of international patients on Malaysia as a medical tourism destination country, as well as overall patient satisfaction, perceived value and future intention for repeat treatment and services. Self-administered questionnaire was the main method of data collection. The survey covered major private hospitals in medical tourists' states in the country, namely, Penang, Melaka, Selangor and Kuala Lumpur. Convenience sampling was used due to the condition of patients as respondents. Indonesian patients formed the largest majority of international patients in the country. Five dimensions of medical tourism in Malaysia was identified, namely, hospital and staff, country factor, combining tourism and health services, cost saving and insurance and unavailability of treatment. Of these, hospital and staff was found to be the most important factor for the patients. Perception of value, overall satisfaction and intention for future treatment was also found to be high. This indicates that Malaysia is on the right footing in this burgeoning industry. Findings from the study will enable policy-makers to better position Malaysia as a medical tourist destination country. Medical tourism is a recent phenomenon and very little empirical research has been carried out at the patient level. This study is one of the first few studies which seek to explore medical tourism from the perspective of the patients themselves.

Road accidents and tourism: the case of the Balearic Islands (Spain).

PubMed

Rosselló, Jaume; Saenz-de-Miera, Oscar

2011-05-01

The increase in the number of tourists for many destinations and their increased mobility within host countries or regions has implied a rise in tourism-associated externalities, with vehicle crashes as the most common cause of injury for tourists. Within the transport literature, the number and variation in the amount of accidents has been related to a large set of determining variables, including weather conditions, socio-economic characteristics, exposure, physical characteristics of the road and a variety of dummies that try to capture effects such as safety laws and seasonal variations. However, the presence of tourism has been neglected. Using the case study of the Balearic Islands, the present study estimates the role of tourism in determining the number of accidents in a daily context, using the set of variables suggested by the literature and incorporating a daily measure for the stock of tourists at a host destination. Results show how tourism can be associated with a significant amount of the accidents that take place in the Balearics. Copyright © 2010 Elsevier Ltd. All rights reserved.

Transboundary movements of hazardous wastes: the case of toxic waste dumping in Africa.

PubMed

Anyinam, C A

1991-01-01

Developed and developing countries are in the throes of environmental crisis. The planet earth is increasingly being literally choked by the waste by-products of development. Of major concern, especially to industrialized countries, is the problem of what to do with the millions of tons of waste materials produced each year. Owing to mounting pressure from environmental groups, the "not-in-mu-backyard" movement, the close monitoring of the activities of waste management agents, an increasing paucity of repositories for waste, and the high cost of waste treatment, the search for dumping sites for waste disposal has, in recent years, extended beyond regional and national boundaries. The 1980s have seen several attempts to export hazardous wastes to third world countries. Africa, for example, is gradually becoming the prime hunting ground for waste disposal companies. This article seeks to examine, in the context of the African continent, the sources and destinations of this form of relocation-diffusion of pollution, factors that have contributed to international trade in hazardous wastes between developed and developing countries, the potential problems such exports would bring to African countries, and measures being taken to abolish this form of international trade.

22 CFR 129.6 - Requirement for license/approval.

Code of Federal Regulations, 2013 CFR

2013-04-01

... are arranged wholly within and destined exclusively for the North Atlantic Treaty Organization, any member country of that Organization, Australia, Israel, Japan, New Zealand, or the Republic of Korea...

Study of the influence of socio-economic factors in the international expansion of Spanish franchisors to Latin American countries.

PubMed

Ramírez-Hurtado, José M; Berbel-Pineda, Juan M; Palacios-Florencio, Beatriz

2018-01-01

The saturation of the domestic market is one of the factors which drive firms to expand their business to other markets. Franchising is one of the formats adopted by companies when establishing their internationalization strategy. Spain is a country where franchising is strongly consolidated. This degree of maturity means that many chains seek other countries in which to operate. This work's specific aims are, on the one hand, to offer a general view of the current situation of Spanish franchisors in Latin American countries and, on the other hand, to analyze which the socio-economic or external factors are that determine the presence of Spanish franchisors in this market. Canonical-correlation analysis is used to do so. The results show that Spanish franchisors focus on the market's potential and size, and the per capita income, while they do not take into account its unemployment level, the country risk or the competitiveness there. This work shows that there is a series of socio-economic factors which influence the final choice of the destination country. However, this decision is not solely based on this country's socio-economic aspects, but also on the structure of the franchising firm itself and on its export experience in other markets. This study therefore complements other research and helps franchisors in their difficult decision of choosing the destination for their internationalization.

[Demographic characteristics, malaria chemoprophylaxis and vaccination in 6,783 international travelers attended in a specialized unit].

PubMed

Jaén-Sánchez, N; Suárez-Hormiga, L; Carranza-Rodríguez, C; Hernández-Cabrera, M; Pisos-Álamo, E; García-Reina, L; Pérez-Arellano, J L

2016-10-01

The objective of this paper was to determine the demographic characteristics and the evolution of international travelers treated at the Unit of Infectious and Tropical Medicine in order to improve precautions prior to travel and, thus reduce the occurrence of these diseases. A retrospective study of all international travelers served in UEIMT (Las Palmas de Gran Canaria) during the period 1998-2013 was performed. The following variables were collected using a standardized protocol were analyzed: age, gender, date of consultation, type of traveler, countries of destination and preventive measures undertaken (malaria chemoprophylaxis and vaccines). A total of 6,783 international travelers of which 52% were women were analyzed. The average age was 36 years (SD 13). The most frequent destination continent was Africa (39%) followed by Asia (36%) and Latin America (23%). The most common country of destination was India 13% (882), followed by Senegal 7.5% (509) and Thailand 6.3% (429). The most frequently recommended vaccines were typhoid fever (82.9%) and hepatitis A (66.9%). As for malaria prophylaxis, the indicated drugs were atovaquone-proguanil (56.5%), mefloquine (36.7%), in regard to travelers returning to visit relatives and friends with a 26.81% were children (0-9 years).. The overall profile of the traveler is a young man who chooses holiday destination Africa followed by Asia and Latin America. Over 50% of travelers received vaccination against typhoid and hepatitis A. The most commonly used malaria chemoprophylaxis was atovaquone / proguanil followed by mefloquine.

An Investigation of Factors Determining the Study Abroad Destination Choice: A Case Study of Taiwan

ERIC Educational Resources Information Center

Lee, Cheng-Fei

2014-01-01

Previous studies on the field of education abroad have mainly focused on the factors influencing the mobility of international students from developing to developed countries and very few have been conducted to investigate the factors influencing the flow of international students to the Asia Pacific region. As a piece of country-specific…

15 CFR 748.14 - Import Certificate for firearms destined for Organization of American States member countries.

Code of Federal Regulations, 2012 CFR

2012-01-01

... Certificate. An Import Certificate or equivalent official document can only be used to support one BIS Form... period of one year or less. Although licenses generally are valid for two years, your ability to ship may..., overall length, number of shots, the manufacturer's name, the country of manufacture, and the serial...

15 CFR 748.14 - Import Certificate for firearms destined for Organization of American States member countries.

Code of Federal Regulations, 2013 CFR

2013-01-01

... Certificate. An Import Certificate or equivalent official document can only be used to support one BIS Form... period of one year or less. Although licenses generally are valid for two years, your ability to ship may..., overall length, number of shots, the manufacturer's name, the country of manufacture, and the serial...

15 CFR 748.14 - Import Certificate for firearms destined for Organization of American States member countries.

Code of Federal Regulations, 2014 CFR

2014-01-01

... Certificate. An Import Certificate or equivalent official document can only be used to support one BIS Form... period of one year or less. Although licenses generally are valid for two years, your ability to ship may..., overall length, number of shots, the manufacturer's name, the country of manufacture, and the serial...

15 CFR 748.14 - Import Certificate for firearms destined for Organization of American States member countries.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Certificate. An Import Certificate or equivalent official document can only be used to support one BIS Form... period of one year or less. Although licenses generally are valid for two years, your ability to ship may..., overall length, number of shots, the manufacturer's name, the country of manufacture, and the serial...

15 CFR 748.14 - Import Certificate for firearms destined for Organization of American States member countries.

Code of Federal Regulations, 2011 CFR

2011-01-01

... Certificate. An Import Certificate or equivalent official document can only be used to support one BIS Form... period of one year or less. Although licenses generally are valid for two years, your ability to ship may..., overall length, number of shots, the manufacturer's name, the country of manufacture, and the serial...

What is the prevalence of and associations with forced labour experiences among male migrants from Dolakha, Nepal? Findings from a cross-sectional study of returnee migrants.

PubMed

Mak, Joelle; Abramsky, Tanya; Sijapati, Bandita; Kiss, Ligia; Zimmerman, Cathy

2017-08-11

Growing numbers of people are migrating outside their country for work, and many experience precarious conditions, which have been linked to poor physical and mental health. While international dialogue on human trafficking, forced labour and slavery increases, prevalence data of such experiences remain limited. Men from Dolakha, Nepal, who had ever migrated outside of Nepal for work were interviewed on their experiences, from predeparture to return (n=194). Forced labour was assessed among those who returned within the past 10 years (n=140) using the International Labour Organization's forced labour dimensions: (1) unfree recruitment ; (2) work and life under duress ; and (3) impossibility to leave employer . Forced labour is positive if any one of the dimensions is positive. Participants had worked in India (34%), Malaysia (34%) and the Gulf Cooperation Council countries (29%), working in factories (29%), as labourers/porters (15%) or in skilled employment (12%). Among more recent returnees (n=140), 44% experienced unfree recruitment , 71% work and life under duress and 14% impossibility to leave employer . Overall, 73% experienced forced labour during their most recent labour migration.Forced labour was more prevalent among those who had taken loans for their migration (PR 1.23) and slightly less prevalent among those who had migrated more than once (PR 0.87); however the proportion of those who experienced forced labour was still high (67%). Age, destination and duration of stay were associated with only certain dimensions of forced labour. Forced labour experiences were common during recruitment and at destination. Migrant workers need better advice on assessing agencies and brokers, and on accessing services at destinations. As labour migration from Nepal is not likely to reduce in the near future, interventions and policies at both source and destinations need to better address the challenges migrants face so they can achieve safer outcomes. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Determinants of the Egyptian labour migration.

PubMed

Kandil, M; Metwally, M

1992-03-01

The objective is to summarize the pattern of Egyptian migration to Arab oil-producing countries (AOPC), to review some factors that are important determinants of labor movement based on theory, and to empirically model the migration rate to AOPC and to Saudi Arabia. Factors are differentiated as to their relative importance. Push factors are the low wages, high inflation rate, and high population density in Egypt; pull factors are higher wages. It is predicted that an increase in income from destination countries has a significant positive impact on the migration rate. An increase in population density stimulates migration. An increase in inflation acts to increase out-migration with a 2-year lag, which accommodates departure preparation. Egypt's experience with labor migration is described for the pre-oil boom, and the post-oil boom. Several estimates of labor migration are given. Government policy toward migration is positive. Theory postulates migration to be determined by differences in the availability of labor, labor rewards between destination and origin, and the cost of migration. In the empirical model, push factors are population density, the current inflation rate, and the ratio of income/capita in AOPC to Egypt. The results indicate that the ratio of income/capita had a strong pull impact and population density had a strong push impact. The inflation rate has a positive impact with a lag estimated at 2 years. Prior to the Camp David Accord, there was a significant decrease in the number of Egyptian migrants due to political tension. The findings support the classical theory of factor mobility. The consequences of migration on the Egyptian economy have been adverse. Future models should disaggregate data because chronic shortages exist in some parts of the labor market. Manpower needs assessment would be helpful for policy makers.

22 CFR 129.6 - Requirement for license/approval.

Code of Federal Regulations, 2011 CFR

2011-04-01

... are arranged wholly within and destined exclusively for the North Atlantic Treaty Organization, any member country of that Organization, Australia, Japan, New Zealand, or South Korea, except in the case of...

22 CFR 129.6 - Requirement for license/approval.

Code of Federal Regulations, 2010 CFR

2010-04-01

... are arranged wholly within and destined exclusively for the North Atlantic Treaty Organization, any member country of that Organization, Australia, Japan, New Zealand, or South Korea, except in the case of...

Empirical and model study on Travel-entering China

NASA Astrophysics Data System (ADS)

Han, Xue-Fang; Chen, Qi-Juan; Chang, Hui; He, Da-Ren

2006-03-01

We have done an empirical investigation on the travel-entering China from abroad to 31 regions of Chinese Mainland in recent ten years, including the development of the traveler's number, the traveler's number distribution for the traveler's home regions, the traveler's number distribution for the traveler's destination regions in Chinese mainland, and so on. We also suggest a dynamic model for simulating the competition between the 31 regions in the traveling market by considering two main influence factors, the attracting factor of the travel destinations and the distance between the destination and the home regions of the travelers. The simulation results show a good agreement with the empirical data. We expect the model could suggest some advice and thoughts to the travel-entering management departments in China and may be also for other countries.

22 CFR 129.5 - Exemption from requirement for approval.

Code of Federal Regulations, 2014 CFR

2014-04-01

... wholly within and destined exclusively for the North Atlantic Treaty Organization, any member country of that organization, Australia, Israel, Japan, New Zealand, or the Republic of Korea, except in the case...

The carbon footprint of global tourism

NASA Astrophysics Data System (ADS)

Lenzen, Manfred; Sun, Ya-Yen; Faturay, Futu; Ting, Yuan-Peng; Geschke, Arne; Malik, Arunima

2018-06-01

Tourism contributes significantly to global gross domestic product, and is forecast to grow at an annual 4%, thus outpacing many other economic sectors. However, global carbon emissions related to tourism are currently not well quantified. Here, we quantify tourism-related global carbon flows between 160 countries, and their carbon footprints under origin and destination accounting perspectives. We find that, between 2009 and 2013, tourism's global carbon footprint has increased from 3.9 to 4.5 GtCO2e, four times more than previously estimated, accounting for about 8% of global greenhouse gas emissions. Transport, shopping and food are significant contributors. The majority of this footprint is exerted by and in high-income countries. The rapid increase in tourism demand is effectively outstripping the decarbonization of tourism-related technology. We project that, due to its high carbon intensity and continuing growth, tourism will constitute a growing part of the world's greenhouse gas emissions.

International travellers from New Jersey: piloting a travel health module in the 2011 Behavioral Risk Factor Surveillance System survey.

PubMed

Stoney, Rhett J; Kozarsky, Phyllis; Bostick, Roberd M; Sotir, Mark J

2016-01-01

In 2011, the Centers for Disease Control and Prevention and the New Jersey Department of Health used the New Jersey Behavioral Risk Factor Survey (NJBRFS), a state component of the national Behavioral Risk Factor Surveillance System (BRFSS) to pilot a travel health module designed to collect population-based data on New Jersey residents travelling internationally. Our objective was to use this population-based travel health information to serve as a baseline to evaluate trends in US international travellers. A representative sample of New Jersey residents was identified through a random-digit-dialing method and administered the travel health module, which asked five questions: travel outside of USA during the previous year; destination; purpose; if a healthcare provider was visited before travel and any travel-related illness. Additional health variables from the larger NJBRFS were considered and included in bivariate analyses and multiple logistic regression; weights were assigned to variables to account for survey design complexity. Of 4029 participants, 841 (21%) travelled internationally. Top destinations included Mexico (10%), Canada (9%), Dominican Republic (6%), Bahamas (5%) and Italy (5%). Variables positively associated with travel included foreign birth, ≥$75 000 annual household income, college education and no children living in the household. One hundred fifty (18%) of 821 travellers with known destinations went to high-risk countries; 40% were visiting friends and relatives and only 30% sought pre-travel healthcare. Forty-eight (6%) of 837 responding travellers reported travel-related illness; 44% visited high-risk countries. Approximately one in five NJBRFS respondents travelled internationally during the previous year, a sizeable proportion to high-risk destinations. Few reported becoming ill as a result of travel but almost one-half of those ill had travelled to high-risk destinations. Population-based surveillance data on travellers can help document trends in destinations, traveller type and disease prevalence and evaluate the effectiveness of disease prevention programmmes. Published by Oxford University Press International Society of Travel Medicine 2016. This work is written by US Government employees and is in the public domain in the US.

Climate Variability and Inter-Provincial Migration in South America, 1970-2011

PubMed Central

Thiede, Brian; Gray, Clark; Mueller, Valerie

2016-01-01

We examine the effect of climate variability on human migration in South America. Our analyses draw on over 21 million observations of adults aged 15-40 from 25 censuses conducted in eight South American countries. Addressing limitations associated with methodological diversity among prior studies, we apply a common analytic approach and uniform definitions of migration and climate across all countries. We estimate the effects of climate variability on migration overall and also investigate heterogeneity across sex, age, and socioeconomic groups, across countries, and across historical climate conditions. We also disaggregate migration by the rural/urban status of destination. We find that exposure to monthly temperature shocks has the most consistent effects on migration relative to monthly rainfall shocks and gradual changes in climate over multi-year periods. We also find evidence of heterogeneity across demographic groups and countries. Analyses that disaggregate migration by the rural/urban status of destination suggest that much of the climate-related inter-province migration is directed toward urban areas. Overall, our results underscore the complexity of environment-migration linkages and challenge simplistic narratives that envision a linear and monolithic migratory response to changing climates. PMID:28413264

Part of a global workforce: migration of British-trained pharmacists.

PubMed

Hassell, Karen; Nichols, Liza; Noyce, Peter

2008-04-01

Many countries, including the UK, have identified a shortage of pharmacists, partly due to emigration. This study was undertaken to examine the extent and nature of migration taking place among British-qualified pharmacists. Mixed methods, including secondary analysis of quantitative data, qualitative research and a large self-completion survey of all British-registered pharmacists with an overseas address. Almost 11% of British-registered pharmacists reside overseas. Nearly three-quarters are British-trained and most are UK nationals. The US, Canada and Australia are the main destinations. The majority work as pharmacists in health services, but sizeable proportions are either retired, not working for other reasons or work in industry. Those who emigrate include those returning home, moving for career opportunities, for lifestyle reasons or as a 'spouse trailer'. For many the move abroad is a permanent one. Great Britain is both a source and destination country for migrating pharmacists. Emigration currently exceeds immigration. Pharmacists are not migrating to developing countries, so the profession may want to consider ways of contributing to the health care systems in developing countries which are the source of some of the immigrant pharmacists to Great Britain.

Climate Variability and Inter-Provincial Migration in South America, 1970-2011.

PubMed

Thiede, Brian; Gray, Clark; Mueller, Valerie

2016-11-01

We examine the effect of climate variability on human migration in South America. Our analyses draw on over 21 million observations of adults aged 15-40 from 25 censuses conducted in eight South American countries. Addressing limitations associated with methodological diversity among prior studies, we apply a common analytic approach and uniform definitions of migration and climate across all countries. We estimate the effects of climate variability on migration overall and also investigate heterogeneity across sex, age, and socioeconomic groups, across countries, and across historical climate conditions. We also disaggregate migration by the rural/urban status of destination. We find that exposure to monthly temperature shocks has the most consistent effects on migration relative to monthly rainfall shocks and gradual changes in climate over multi-year periods. We also find evidence of heterogeneity across demographic groups and countries. Analyses that disaggregate migration by the rural/urban status of destination suggest that much of the climate-related inter-province migration is directed toward urban areas. Overall, our results underscore the complexity of environment-migration linkages and challenge simplistic narratives that envision a linear and monolithic migratory response to changing climates.

Street furniture concept in Pasar Buah and Bukit Gundaling Based on place identity

NASA Astrophysics Data System (ADS)

Ginting, Nurlisa; Vinky Rahman, N.; Delianur Nasution, Achmad; Nawawiy Loebis, M.; Sinaga, Fitri A.

2018-03-01

Tourism is one of the largest sources of the foreign exchange for a country, that encourage many developers to develop it. Karo District located in the province of North Sumatera, Indonesia, which has many tourist destinations with natural and cultural resources, including Pasar Buah and Bukit Gundaling. To develop Tourism, one of way is with increasing place identity in tourist destinations. Unfortunately, place identity in Pasar Buah and Bukit Gundaling are still lacking, so it needs improvement, one of that is the Street furniture in Pasar Buah and Bukit Gundaling. This study aims to design the concept of the Street furniture planning in Pasar Buah and Bukit Gundaling. The method used is a qualitative method, that is design street furniture using five groups elements of street furniture: decorative element, service furniture, trade furniture, signaling furniture, and advertisement furniture. The result of this study is the concept of the design street furniture of Pasar Buah and Bukit Gundaling, which can use to improve place identity in tourism of Karo District.

Pre-Exposure Rabies Vaccination among US International Travelers: Findings from the Global TravEpiNet Consortium

PubMed Central

Dolan, Samantha B.; Sotir, Mark J.; Han, Pauline; Blanton, Jesse D.; Rao, Sowmya R.; LaRocque, Regina C.; Ryan, Edward T.

2014-01-01

Abstract Background: People who travel to areas with high rabies endemicity and have animal contact are at increased risk for rabies exposure. We examined characteristics of international travelers queried regarding rabies vaccination during pretravel consultations at Global TravEpiNet (GTEN) practices during 2009–2010. Material and Methods: We performed bivariate and multivariable analyses of data collected from 18 GTEN clinics. Travel destinations were classified by strength level of rabies vaccination recommendation. Results: Of 13,235 travelers, 226 (2%) reported previous rabies vaccination, and 406 (3%) received rabies vaccine at the consultation. Common travel purposes for these 406 travelers were leisure (26%), research/education (17%), and nonmedical service work (14%). Excluding the 226 who were previously vaccinated, 8070 (62%) of 13,009 travelers intended to visit one or more countries with a strong recommendation for rabies vaccination; 1675 (21%) of these 8070 intended to travel for 1 month or more. Among these 1675 travelers, 145 (9%) were vaccinated, 498 (30%) declined vaccination, 832 (50%) had itineraries that clinicians determined did not indicate vaccination, and 200 (12%) remained unvaccinated for other reasons. In both bivariate and multivariate analyses, travelers with trip durations >6 months versus 1–3 months (adjusted odds ratio [OR]=4.9 [95% confidence interval [CI] 2.1, 11.4]) and those traveling for “research/education” or to “provide medical care” (adjusted OR=5.1 [95% CI 1.9, 13.7] and 9.5 [95% CI 2.2, 40.8], respectively), compared with leisure travelers, were more likely to receive rabies vaccination. Conclusions: Few travelers at GTEN clinics received rabies vaccine, although many planned trips 1 month long or more to a strong-recommendation country. Clinicians often determined that vaccine was not indicated, and travelers often declined vaccine when it was offered. The decision to vaccinate should take into account the strength of the vaccine recommendation at the destination country, duration of stay, availability of postexposure prophylaxis, potential for exposure to animals, and likelihood of recurrent travel to high-risk destinations. PMID:24359420

Internationally recruited nurses from India and the Philippines in the United Kingdom: the decision to emigrate

PubMed Central

Alonso-Garbayo, Álvaro; Maben, Jill

2009-01-01

Background The United Kingdom has recruited nurses from countries with a reported surplus in their nursing workforce, such as India and the Philippines. However, little is known about the decision to emigrate made by nurses from these countries. One theory suggests that individuals weigh the benefits and costs of migration: the push and pull factors. This paper challenges the restricted economic focus of this predominant theory and compares the diverse motivations of nurses from different countries as well as those of nurses with previous migratory experience and first-time migrants. Methods This research was undertaken in a National Health Service acute trust in London by means of a qualitative interpretative approach. Data were collected through face-to-face longitudinal and cross-sectional interviews with internationally recruited nurses from India (n = 6) and the Philippines (n = 15); and analysis of their narratives was used to generate data about their expectations and experiences. Data were analysed by means of a framework approach that allowed for intra-case and cross-case analysis. Results From an individual perspective, nurses in this study reported economic reasons as the main trigger for migration in the first instance. Yet this doesn't entirely explain the decision to move from previous migratory destinations (e.g. Saudi Arabia) where economic needs are already fulfilled. In these cases migration is influenced by professional and social aspirations that highlight the influence of the cultural environment – specifically some religious and gender-related issues. Family support and support from migratory networks in the country of origin and destination were also important elements conducive to and supportive of migration. Nurses from India report coming to the United Kingdom to stay, while Filipina nurses come as temporary migrants sending remittances to support their families in the Philippines. Conclusion This study shows the diverse motivations of nurses from different countries and with different migratory backgrounds and provides evidence that factors other than economic factors influence nurses' decision to emigrate. This information can help developing countries increase retention of this essential and often scarce resource and can also help the United Kingdom's National Health Service to improve the experience of internationally recruited nurses and therefore increase their retention in the United Kingdom. PMID:19393080

Sub-Saharan Africa: beyond the health worker migration crisis?

PubMed

Connell, John; Zurn, Pascal; Stilwell, Barbara; Awases, Magda; Braichet, Jean-Marc

2007-05-01

Migration of skilled health workers from sub-Saharan African countries has significantly increased in this century, with most countries becoming sources of migrants. Despite the growing problem of health worker migration for the effective functioning of health care systems there is a remarkable paucity and incompleteness of data. Hence, it is difficult to determine the real extent of migration from, and within, Africa, and thus develop effective forecasting or remedial policies. This global overview and the most comprehensive data indicate that the key destinations remain the USA and the UK, and that major sources are South Africa and Nigeria, but in both contexts there is now greater diversity. Migrants move primarily for economic reasons, and increasingly choose health careers because they offer migration prospects. Migration has been at considerable economic cost, it has depleted workforces, diminished the effectiveness of health care delivery and reduced the morale of the remaining workforce. Countries have sought to implement national policies to manage migration, mitigate its harmful impacts and strengthen African health care systems. Recipient countries have been reluctant to establish effective ethical codes of recruitment practice, or other forms of compensation or technology transfer, hence migration is likely to increase further in the future, diminishing the possibility of achieving the United Nations millennium development goals and exacerbating existing inequalities in access to adequate health care.

Migration of health workers in the Pacific Islands: a bottleneck to health development.

PubMed

Yamamoto, T S; Sunguya, B F; Shiao, L W; Amiya, R M; Saw, Y M; Jimba, M

2012-07-01

Human resources for health (HRH) are a crucial component of a well-functioning health system. Problems in the global HRH supply and distribution are an obstacle to achieving the health-related Millennium Development Goals and other health outcomes. The Pacific Island region, covering 20,000 to 30,000 islands in the South Pacific Ocean, is suffering a serious HRH crisis. Yet updated evidence and data are not available for the 22 Pacific Island Countries and Territories. The objective of this study was thus to explore the current HRH situation in the Pacific Island region, focusing particularly on the issue of health workforce migration. HRH trends and gaps differ by country, with some showing increases in HRH density over the past 20 years whereas others have made negligible progress. Currently, three Pacific Island countries are facing critical HRH shortages, a worsening of the situation from 2006, when HRH issues were first brought to widespread global attention. In this region, skilled personnel migration is a major issue contributing to the limited availability of HRH. Political commitment from source and destination countries to strengthen HRH would be a key factor toward increasing efforts to train new health personnel and to implement effective retention strategies.

[Migrant vaccinations in Poland].

PubMed

Sakowski, Piotr

2012-01-01

After the European Union accession in 2004, Poland has been perceived by foreigners as an attractive destination of their migration, and also as a popular transit country for people going further to the Western Europe countries. The Nofer Institute of Occupational Medicine is involved in the implementation of the international project PROMOVAX (Promote Vaccinations among Migrant Populations in Europe). The objective of the project is to promote immunizations among migrant populations in Europe. This article presents the up-to-date legal regulations that are effective in Poland, taking into account their relevance to the issue of vaccinations in migrant population. The analysis of the Polish legislation concerning this problem shows that there are no specific regulations addressed to migrant population staying in our country. This issue seems to be popular in the European Union, where immunization of migrants is given high priority. From the point of view of health care professionals it is important to be aware of the fact that EU open borders favor the increased flow of people between countries. The scale of migration from outside the EU to its member states also contributes to the increase in potential contacts between health care workers and migrants working in Poland.

3 CFR 9011 - Proclamation 9011 of August 30, 2013. National Wilderness Month, 2013

Code of Federal Regulations, 2014 CFR

2014-01-01

... natural habitats for diverse wildlife; as destinations for family camping trips; and as venues for hiking.... Our iconic wilderness areas draw tourists from across the country and around the world, bolstering...

7 CFR 1488.10 - Evidence of entry into country of destination.

Code of Federal Regulations, 2014 CFR

2014-01-01

... COMMODITIES Financing of Export Sales of Agricultural Commodities From Private Stocks Under CCC Export Credit... CCC, become due and payable and liquidated damages shall be payable in accordance with § 1488.11. The...

7 CFR 1488.10 - Evidence of entry into country of destination.

Code of Federal Regulations, 2012 CFR

2012-01-01

... COMMODITIES Financing of Export Sales of Agricultural Commodities From Private Stocks Under CCC Export Credit... CCC, become due and payable and liquidated damages shall be payable in accordance with § 1488.11. The...

7 CFR 1488.10 - Evidence of entry into country of destination.

Code of Federal Regulations, 2013 CFR

2013-01-01

... COMMODITIES Financing of Export Sales of Agricultural Commodities From Private Stocks Under CCC Export Credit... CCC, become due and payable and liquidated damages shall be payable in accordance with § 1488.11. The...

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

Using routine diagnostic data as a method of surveillance of arboviral infection in travellers: a comparative analysis with a focus on dengue.

PubMed

Cleton, Natalie; Reusken, Chantal; Murk, Jean-Luc; de Jong, Menno; Reimerink, Johan; van der Eijk, Annemiek; Koopmans, Marion

2014-01-01

In a large part of the developing world, limited infectious disease surveillance is performed. In laboratory information management systems data on diagnostic requests is available and may be amenable to trend analyses. We explored this potential, using DENV diagnostic requests as a model. Test results and anonymised information provided by clinicians were received for 8942 patients from diagnostic centres in the Netherlands from January 2000 to May 2011. The data were evaluated for completeness of a predefined minimal dataset and trends in DENV positive results by travel destination. Population travel data were obtained from a commercial registry, and dengue case notification data by country from WHO DengueNet. Vaccination history was rarely reported (0.4%); travel destination was completed for 42% of requests; trends in diagnostic requests and IgM positive tests for this subset correlated to the WHO DENV notifications for the three main travel destinations, with some discrepancies. Additionally, this approach may provide information on disease outbreaks with other pathogens causing diseases clinically similar to DENV. PCR data proved to be insufficient for trend monitoring by country. This approach is not straightforward, but shows potential for use as a source of additional information for surveillance of disease. Copyright © 2013 Elsevier Ltd. All rights reserved.

Migrants' decision-process shaping work destination choice: the case of long-term care work in the United Kingdom and Norway.

PubMed

Christensen, Karen; Hussein, Shereen; Ismail, Mohamed

2017-09-01

Escalating demands for formal long-term care (LTC) result in the reliance on migrant workers in many developed countries. Within Europe, this is currently framed by progressive European immigration policies favouring inter-European mobility. Using the UK and Norway as case studies, this article has two main aims: (1) to document changes in the contribution of European Union (EU) migrants to the LTC sectors in Western Europe, and (2) to gain further understanding of migrants' decision-processes relating to destination and work choices. The UK and Norway provide examples of two European countries with different immigration histories, welfare regimes, labour market characteristics and cultural values, offering a rich comparison platform. The analysis utilizes national workforce datasets and data obtained from migrants working in the LTC sector in the UK and Norway ( n  = 248) and other stakeholders ( n  = 136). The analysis establishes a significant increase in the contribution of EU migrants (particularly from Eastern Europe) to the LTC sector in both the UK and Norway despite their different welfare regimes. The findings also highlight how migrant care workers develop rational decision-processes influenced by subjective perspectives of investments and returns within a context of wider structural migration barriers. The latter includes welfare and social care policies framing the conditions for migrants' individual actions.

Travel health prevention.

PubMed

Korzeniewski, Krzysztof

All around the world there has been a rapid growth in the number of international travels. According to the World Tourism Organisation the number of international tourist arrivals reached 1,235 billion in 2016 and continues to grow at a high rate. This has been much due to the development of air transport (including low-cost airlines), increasingly common economic migration, a growing number of travellers visiting friends and relatives, and an increase in medical tourism. With tropical destinations becoming increasingly popular among travellers, doctors have seen a rising number of patients who seek medical advice on health risks prevalent in hot countries and health prevention measures to be taken in tropical destinations, especially where sanitation is poor. The risk for developing a medical condition while staying abroad depends on a variety of factors, including the traveller's general health condition, health prevention measures taken before or during travel (vaccinations, antimalarial chemoprophylaxis, health precautions during air, road and sea travel, proper acclimatisation, prevention of heat injuries, protection against local flora and fauna, personal hygiene, water, food and feeding hygiene), as well as the prevalence of health risk factors in a given location. Health prevention is a precondition for safe travel and maintaining good physical health; in the era of a rapid growth in international tourism it has become of key importance for all travellers.

[Internal migration changes from 1980 to 1990].

PubMed

Corona Vazquez, R

1991-01-01

From 1930 to the 1970s, internal migration in Mexico consisted mostly of permanent movement from rural areas to cities, and especially to the 3 metropolitan areas of Mexico City, Monterrey, and Guadalajara. The migrations highlighted the developmental disparities between different regions. Their main consequence was the transformation of Mexico from a predominantly rural to a predominantly urban country. The regions expelling population were primarily densely populated and relatively unproductive areas in the center and south. Migrant destinations were the more developed and urban states. By 1980-90, there were a number of changes in migratory patterns that, along with participation of a greater number of household members in marginal economic activities, represented alternative survival strategies adopted by large population sectors in the face of declining living standards, natural disasters such as the earthquakes of 1985, and increasing ecological and safety problems in the large cities. Changes in migratory behavior during the 1980s included appearance and growing importance of new destinations, and the combination of permanent and temporary migration and of internal and international migration in the same localities, households, or even individuals. Greater distances were covered by migrants in the 1980s, and the relationship between socioeconomic status and migration became more varied. Another change was the decreased importance of migration to the 3 metropolitan areas. Metropolitan Mexico City even became a net expeller of population. At the same time, many medium-sized cities such as Orizaba, Matamoros, Juarez, and Tiajuana have become attractive destinations for migrants from surrounding areas and from Mexico City. The case of Baja California illustrates the combined occurrence of different types of migrations. Baja California in past decades had a high rate in-migration, but its growth has slowed. A greater diversity of origins and destinations is observed, along with a greater diversity of time frames.

7 CFR 782.16 - Designating end use on form FSA-751.

Code of Federal Regulations, 2011 CFR

2011-01-01

... applicable form FSA-751, Wheat Consumption and Resale Report, is “export,” the exporter must specify the final destination, by country, on form FSA-751. (b) If the end user utilizes the wheat for purposes...

7 CFR 1488.10 - Evidence of entry into country of destination.

Code of Federal Regulations, 2011 CFR

2011-01-01

... Under CCC Export Credit Sales Program (GSM-5) Documents Required After Financing § 1488.10 Evidence of... option of CCC, become due and payable and liquidated damages shall be payable in accordance with § 1488...

7 CFR 1488.10 - Evidence of entry into country of destination.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Under CCC Export Credit Sales Program (GSM-5) Documents Required After Financing § 1488.10 Evidence of... option of CCC, become due and payable and liquidated damages shall be payable in accordance with § 1488...

ILO - International Migration Programme.

PubMed

Boudraa, Miriam

2011-01-01

In a wide International Context characterised not only by the economical development but also by the social, cultural, political and individual development, we witness more and more to a exchange between the developed and the developing countries, which can be translated especially in the migration of the work force. In theory, all countries are either countries of origin either countries of transit or destination, and they are all responsible for the rights of migrant workers by promoting the rights, by monitoring and by preventing the abusive conditions. The process of migration of the workforce can be divided into three stages: the first coincides with the period prior to departure, the second is represented by the aftermath of the departure and the period of stay in the country of destination, the third stage corresponds to the return in the country of origin. The workers must be protected throughout this process by the international organizations that perform the catalytic role of communication and exchange between countries, for the only purpose of protecting the rights of immigrant and/or immigrants workers. The responsibility for the protection of workers is divided among the various players in the International Labour Organisation. Every country has to apply measures according to the international standards regarding workers' rights, standards that guide the various countries in the formulation and implementation of their policies and legislation. These standards are suggested by International Conventions, the ILO Conventions and other international instruments such as the human rights instrument. There has been a big step forward once the ILO Fundamental Conventions and Conventions on Migrant Workers where implemented and this implementation represented the use of the Guidelines "ILO Multilateral Framework on Labour Migration".

Study of the influence of socio-economic factors in the international expansion of Spanish franchisors to Latin American countries

PubMed Central

2018-01-01

The saturation of the domestic market is one of the factors which drive firms to expand their business to other markets. Franchising is one of the formats adopted by companies when establishing their internationalization strategy. Spain is a country where franchising is strongly consolidated. This degree of maturity means that many chains seek other countries in which to operate. This work’s specific aims are, on the one hand, to offer a general view of the current situation of Spanish franchisors in Latin American countries and, on the other hand, to analyze which the socio-economic or external factors are that determine the presence of Spanish franchisors in this market. Canonical-correlation analysis is used to do so. The results show that Spanish franchisors focus on the market’s potential and size, and the per capita income, while they do not take into account its unemployment level, the country risk or the competitiveness there. This work shows that there is a series of socio-economic factors which influence the final choice of the destination country. However, this decision is not solely based on this country’s socio-economic aspects, but also on the structure of the franchising firm itself and on its export experience in other markets. This study therefore complements other research and helps franchisors in their difficult decision of choosing the destination for their internationalization. PMID:29293596

Tracking rural-to-urban migration in China: Lessons from the 2005 inter-census population survey.

PubMed

Ebenstein, Avraham; Zhao, Yaohui

2015-01-01

We examined migration in China using the 2005 inter-census population survey, in which migrants were registered at both their place of original (hukou) residence and at their destination. We find evidence that the estimated number of internal migrants in China is extremely sensitive to the enumeration method. We estimate that the traditional destination-based survey method fails to account for more than a third of migrants found using comparable origin-based methods. The 'missing' migrants are disproportionately young, male, and holders of rural hukou. We find that origin-based methods are more effective at capturing migrants who travel short distances for short periods, whereas destination-based methods are more effective when entire households have migrated and no remaining family members are located at the hukou location. We conclude with a set of policy recommendations for the design of population surveys in countries with large migrant populations.

(Mis)Representation among U.S. Study Abroad Programs Traveling to the African Continent: A Critical Content Analysis of a Teach Abroad Program

ERIC Educational Resources Information Center

Onyenekwu, Ifeyinwa; Angeli, Julianne Marie; Pinto, Ransford; Douglas, Ty-Ron

2017-01-01

The Institute for International Education's Annual Open Doors Report (2014) indicates that less than 5% of study abroad college students travel to sub-Saharan African countries, with South Africa being the only African country to make the top 25 study abroad destinations for U.S. students, and it attracts only 1.8% of all collegians. Study abroad…

A European Sustainable Tourism Labels proposal using a composite indicator

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

Blancas, Francisco Javier, E-mail: fjblaper@upo.es; Lozano-Oyola, Macarena, E-mail: mlozoyo@upo.es; González, Mercedes, E-mail: m_gonzalez@uma.es

The tourism sector in Europe faces important challenges which it must deal with to promote its future development. In this context, the European Commission considers that two key issues must be addressed. On the one hand, a better base of socio-economic knowledge about tourism and its relationship with the environment is needed, and, on the other hand, it is necessary to improve the image of European areas as quality sustainable tourism destinations. In this paper we present analytical tools that cover these needs. Specifically, we define a system of sustainable tourism indicators and we obtain a composite indicator incorporating weightsmore » quantified using a panel of experts. Employing the values of this global indicator as a basis, we define a Sustainable Tourism Country-Brand Ranking which assesses the perception of each country-brand depending on its degree of sustainability, and a system of sustainable tourism labels which reward the management carried out. - Highlights: • We define a system of indicators to improve the knowledge about sustainable tourism. • We obtain composite indicators based on expert knowledge. • The Sustainable Tourism Country-Brand Ranking would improve the image of destinations. • We define a Sustainable Tourism Labels System to assess country-brands. • The conclusions of the empirical analysis can be extrapolated to other tourist areas.« less

Quantifying export flows of used electronics: advanced methods to resolve used goods within trade data.

PubMed

Duan, Huabo; Miller, T Reed; Gregory, Jeremy; Kirchain, Randolph

2014-03-18

There is limited convincing quantitative data on the export of used electronics from the United States (U.S.). Thus, we advance a methodology to quantify the export flows of whole units of used electronics from the U.S. using detailed export trade data, and demonstrate the methodology using laptops. Since used electronics are not explicitly identified in export trade data, we hypothesize that exports with a low unit value below a used-new threshold specific to a destination world region are used. The importance of using the most disaggregated trade data set available when resolving used and new goods is illustrated. Two detailed U.S. export trade data sets were combined to arrive at quantities and unit values for each port, mode of transport, month, trade partner country, and trade code. We add rigor to the determination of the used-new threshold by utilizing both the Neighborhood valley-emphasis method (NVEM) and published sales prices. This analysis found that 748 to 1199 thousand units of used laptops were exported from the U.S. in 2010, of which 78-81% are destined for non-OECD countries. Asia was found to be the largest destination of used laptop exports across all used-new threshold methods. Latin American and the Caribbean was the second largest recipient of these exports. North America and Europe also received used laptops from the U.S. Only a small fraction of used laptops was exported to Africa. However, these quantities are lower bound estimates because not all shipments of used laptops may be shipped using the proper laptop trade code. Still, this approach has the potential to give insight into the quantity and destinations of the exports if applied to all used electronics product types across a series of years.

United States Travelers' Concern about Zika Infection and Willingness to Receive a Hypothetical Zika Vaccine.

PubMed

Vielot, Nadja A; Stamm, Lola; Herrington, James; Squiers, Linda; Kelly, Bridget; McCormack, Lauren; Becker-Dreps, Sylvia

2018-06-01

The ongoing Zika pandemic has affected many countries that are common travel destinations. We assessed the willingness to receive a prophylactic Zika virus (ZIKV) vaccine, currently under development, among travelers to areas with reported autochthonous ZIKV transmission. We surveyed United States (U.S.) residents aged 18-44 years who had ever heard of ZIKV and planned to travel to Florida and/or Texas ( N = 420) or a U.S. territory or foreign country ( N = 415) in 2017, using a nationally representative internet panel. Travelers to Florida and/or Texas reported less concern about ZIKV infection than travelers to other destinations (27% versus 36%, P = 0.01). Female sex, Hispanic ethnicity, discussing ZIKV with medical professionals, ZIKV risk perception, and self-efficacy for ZIKV prevention predicted concern about ZIKV infection in both groups. Travelers to Florida and/or Texas (43%) and other destinations (44%) were equally willing to receive a ZIKV vaccine. Hispanic ethnicity, discussing ZIKV with medical professionals, and concern about ZIKV infection predicted vaccine willingness in both groups. Likelihood of using existing ZIKV prevention methods, confidence in the U.S. government to prevent ZIKV spread, self-efficacy for ZIKV prevention, and knowledge about ZIKV symptoms further predicted vaccine willingness in travelers to other destinations. In multivariable analyses, only concern about ZIKV infection was associated with vaccine willingness in both groups (prevalence ratio [95% confidence interval]: Florida and/or Texas: 1.34 [1.06, 1.69]; other: 1.82 [1.44, 2.29]). Targeted communications can educate travelers, particularly travelers who are pregnant or may become pregnant, about ZIKV risk to generate ZIKV vaccine demand.

Sex preferences and fertility in South Korea during the year of the Horse.

PubMed

Lee, Jungmin; Paik, Myungho

2006-05-01

Since antiquity, people in several East Asian countries, such as China, Japan, and South Korea, have believed that a person is destined to possess specific characteristics according to the sign of the zodiac under which he or she was born. South Koreans, in particular, have traditionally considered that the year of the Horse bears inauspicious implications for the birth of daughters. Using monthly longitudinal data at the region level in South Korea between 1970 and 2003, we found that in the year of the Horse, the sex ratio at birth significantly increased while fertility decreased.

Source and destination memory: two sides of the same coin?

PubMed

Lindner, Isabel; Drouin, Héloïse; Tanguay, Annick F N; Stamenova, Vessela; Davidson, Patrick S R

2015-01-01

Whereas source memory involves remembering from whom you have heard something, destination memory involves remembering to whom you have told something. Despite its practical relevance, destination memory has been studied little. Recently, two reports suggested that generally destination memory should be poorer than source memory, and that it should be particularly difficult for older people. We tested these predictions by having young and older participants read sentences to two examiners (destination encoding) and listen to sentences read by two examiners (source encoding), under intentional (Experiment 1) or incidental encoding (Experiments 2 and 3). Only in Experiment 3 (in which cognitive demands during destination encoding were increased) was destination memory significantly poorer than source memory. In none of the experiments were older adults inferior to the young on destination or source memory. Destination- and source-memory scores were significantly correlated. Item memory was consistently superior for sentences that had been read out loud (during destination encoding) versus those that had been heard (during source encoding). Destination memory needs not always be poorer than source memory, appears not to be particularly impaired by normal ageing and may depend on similar processes to those supporting source memory.

Developing an informational tool for ethical engagement in medical tourism.

PubMed

Adams, Krystyna; Snyder, Jeremy; Crooks, Valorie A; Johnston, Rory

2017-08-25

Medical tourism, the practice of persons intentionally travelling across international boundaries to access medical care, has drawn increasing attention from researchers, particularly in relation to potential ethical concerns of this practice. Researchers have expressed concern for potential negative impacts to individual safety, public health within both countries of origin for medical tourists and destination countries, and global health equity. However, these ethical concerns are not discussed within the sources of information commonly provided to medical tourists, and as such, medical tourists may not be aware of these concerns when engaging in medical tourism. This paper describes the methodology utilized to develop an information sheet intended to be disseminated to Canadian medical tourists to encourage contemplation and further public discussion of the ethical concerns in medical tourism. The methodology for developing the information sheet drew on an iterative process to consider stakeholder feedback on the content and use of the information sheet as it might inform prospective medical tourists' decision making. This methodology includes a literature review as well as formative research with Canadian public health professionals and former medical tourists. The final information sheet underwent numerous revisions throughout the formative research process according to feedback from medical tourism stakeholders. These revisions focused primarily on making the information sheet concise with points that encourage individuals considering travelling for medical tourism to do further research regarding their safety both within the destination country, while travelling, and once returning to Canada, and the potential impacts of their trip on third parties. This methodology may be replicated for the development of information sheets intending to communicate ethical concerns of other practices to providers or consumers of a certain service.

The relationship between migration and development in the ESCAP region.

PubMed

Skeldon, R

1991-01-01

The relationship between migration and development in the ESCAP region including southeast and south Asian countries and the Pacific island of Fiji, Papua New Guinea, Vanuatu, Kiribati, Samoa, and the Solomon Islands is discussed in terms of mobility transition and origin and destination factors. The changing patterns of mobility in Asia are further delineated in the discussion of internal movements and international movement. Emigration in the smaller countries of the Pacific are treated separately. Future predictions are that the Asia Pacific region will experience continued fertility decline and stabilization of low rates over the next 20 years. The declines will result in slow labor force growth, and increased demand for labor in traditional core and neocore countries as defined and presented in table form by Friedman will be heightened. International movements are likely to increase in large urban areas within destination countries. Tokyo and Singapore are the principal cities in Asia. Tokyo by restrictive government policy has limited immigration, but future labor shortages of unskilled labor from southeast Asia and China are expected. Singapore is already dependent on foreign labor by 10%. Current labor shortages have led to the creation of a growth triangle between Singapore, Indonesia, and Malaysia. Other cities expected to emerge as primary cities in international regional complexes with spillover into the hinterlands include the Hong Kong, Guangzhou, and Macau triangle in the Pearl River delta, Taipei and Seoul, and possibly Kuala Lumpur. Internal migration is expected to increase in the capital cities of Bangkok, Manila,j and centers such as Shanghai, Beijing, and other large cities of southeast Asia. These cities will be linked through the flows of skilled international migrants, which began in the 1960s and is expected to become a future major flow. Recreational and resource niches will be left in much of the Pacific, the Himalayan Kingdoms, and mountainous regions of northern southeast Asia and western China. Flows will be regulated by national government policy. Difficult decisions will be made on the extent to which multinational corporations and banks are sanctioned or regulated, i.e., currently Hong Kong development is company directed within the law governing power, transport, housing, and land, while in Singapore development is government planned and directed.

Fecal-orally transmitted diseases among travelers are decreasing due to better hygienic standards at travel destination.

PubMed

Baaten, Gijs G; Sonder, Gerard J B; Van Der Loeff, Maarten F Schim; Coutinho, Roel A; Van Den Hoek, Anneke

2010-01-01

To evaluate whether changes in attack rates of fecal-orally transmitted diseases among travelers are related to changes in pretravel vaccination practices or better hygienic standards at travel destination. National surveillance data on all laboratory-confirmed cases of travel-related hepatitis A, shigellosis, and typhoid fever diagnosed in the Netherlands from 1995 to 2006 were matched with the number of Dutch travelers to developing countries to calculate region-specific annual attack rates. Trends in attack rates of non-vaccine-preventable shigellosis were compared with those of vaccine-preventable hepatitis A and typhoid fever. Trends were also compared with three markers for hygienic standards of the local population at travel destinations, drawn from the United Nations Development Programme database: the human development index, the sanitation index, and the water source index. Attack rates among Dutch travelers to developing regions declined for hepatitis A, shigellosis, and typhoid fever. Region-specific trends in attack rates of shigellosis resembled trends of hepatitis A and typhoid fever. Declining attack rates of the three fecal-orally transmitted diseases correlated with improvements in socioeconomic, sanitary, and water supply conditions of the local population at travel destination. These findings suggest that improved hygienic standards at travel destination strongly contributed to the overall decline in attack rates of fecal-orally transmitted diseases among visiting travelers. © 2010 International Society of Travel Medicine.

15 CFR 738.4 - Determining whether a license is required.

Code of Federal Regulations, 2014 CFR

2014-01-01

... AT Column 1. Turning to the Country Chart, I locate my specific destination, India, and see that an “X” appears in the NS Column 2 cell for India, but not in the AT Column 1 cell. I understand that a...

15 CFR 738.4 - Determining whether a license is required.

Code of Federal Regulations, 2013 CFR

2013-01-01

... Country Chart, I locate my specific destination, India, and see that an “X” appears in the NS Column 2 cell for India, but not in the AT Column 1 cell. I understand that a license is required, unless my...

15 CFR 738.4 - Determining whether a license is required.

Code of Federal Regulations, 2011 CFR

2011-01-01

... Country Chart, I locate my specific destination, India, and see that an “X” appears in the NS Column 2 cell for India, but not in the AT Column 1 cell. I understand that a license is required, unless my...

15 CFR 738.4 - Determining whether a license is required.

Code of Federal Regulations, 2012 CFR

2012-01-01

... Country Chart, I locate my specific destination, India, and see that an “X” appears in the NS Column 2 cell for India, but not in the AT Column 1 cell. I understand that a license is required, unless my...

Visceral leishmaniasis in a child infected with the human immunodeficiency virus in a non-endemic region.

PubMed

Peeters, Ellen; Verhulst, Stijn; Wojciechowski, Marek; Vlieghe, Erika; Jorens, Philippe; Van Marck, Veerle; Ramet, Jose; De Dooy, Jozef

2011-12-01

We reported the case of a boy who fled from Chechnya to Belgium. He was diagnosed with a human immune deficiency virus (HIV)/Visceral leishmaniasis (VL) coinfection. In both countries, the prevalence of HIV-infected children is low and VL is not endemic. Migration of people results in confrontation with diseases that are not frequent in the countries of destination and becomes a challenge for pediatricians.

How to use sustainability indicators for tourism planning: the case of rural tourism in Andalusia (Spain).

PubMed

Blancas, F J; Lozano-Oyola, M; González, M; Guerrero, F M; Caballero, R

2011-12-15

This paper proposes an indicators system to analyse the sustainability of tourist activity at rural destinations in countries with a consolidated tourism sector. The proposed system aims at providing tourist managers and policy-makers with information to better understand the transition to sustainability at specific destinations and to encourage them to carry out corresponding policy and management responses. To illustrate how indicators can be quantified, we create a practical guideline on how to use the statistical information available. Likewise, we suggest a method for obtaining sustainability indexes by aggregation that reduces the subjectivity associated with the composite indicator. This procedure is based on the combination of principal component analysis and distance to a reference point. Together with the definition of sustainable tourism indicators, we explain how to use these systems and sustainability indexes to fulfil three practical uses in tourism sector planning: the comparison and characterisation of destinations, the definition of benchmarking practices, and the quantification of sustainable tourism objectives. Each practical use is illustrated using the case of rural zones in a consolidated destination such as Andalusia. Copyright © 2011 Elsevier B.V. All rights reserved.

Immigration policy and internationally educated nurses in the United States: A brief history

PubMed Central

Masselink, Leah E.; Jones, Cheryl B.

2015-01-01

Since the 1980s, U.S. policy makers have used immigration policy to influence the supply of nurses by allowing or restricting the entry of internationally educated nurses (IENs) into the U.S. workforce. The methods pursued have shifted over time from temporary visa categories in the 1980s and 1990s to permanent immigrant visas in the 2000s. The impact of policy measures adopted during nursing shortages has often been blunted by political and economic events, but the number and representation of IENs in the U.S. nursing workforce has increased substantially since the 1980s. Even as the United States seeks to increase domestic production of nurses, it remains a desirable destination for IENs and a target market for nurse-producing source countries. Hiring organizations and nurse leaders play a critical role in ensuring that the hiring and integration of IENs into U.S. health care organizations is constructive for nurses, source countries, and the U.S. health care system. PMID:24345614

Characterizing the International Migration Barriers with a Probabilistic Multilateral Migration Model

PubMed Central

Li, Xiaomeng; Xu, Hongzhong; Chen, Jiawei; Chen, Qinghua; Zhang, Jiang; Di, Zengru

2016-01-01

Human migration is responsible for forming modern civilization and has had an important influence on the development of various countries. There are many issues worth researching, and “the reason to move” is the most basic one. The concept of migration cost in the classical self-selection theory, which was introduced by Roy and Borjas, is useful. However, migration cost cannot address global migration because of the limitations of deterministic and bilateral choice. Following the idea of migration cost, this paper developed a new probabilistic multilateral migration model by introducing the Boltzmann factor from statistical physics. After characterizing the underlying mechanism or driving force of human mobility, we reveal some interesting facts that have provided a deeper understanding of international migration, such as the negative correlation between migration costs for emigrants and immigrants and a global classification with clear regional and economic characteristics, based on clustering of migration cost vectors. In addition, we deconstruct the migration barriers using regression analysis and find that the influencing factors are complicated but can be partly (12.5%) described by several macro indexes, such as the GDP growth of the destination country, the GNI per capita and the HDI of both the source and destination countries. PMID:27597319

Characterizing the International Migration Barriers with a Probabilistic Multilateral Migration Model

NASA Astrophysics Data System (ADS)

Li, Xiaomeng; Xu, Hongzhong; Chen, Jiawei; Chen, Qinghua; Zhang, Jiang; di, Zengru

2016-09-01

Human migration is responsible for forming modern civilization and has had an important influence on the development of various countries. There are many issues worth researching, and “the reason to move” is the most basic one. The concept of migration cost in the classical self-selection theory, which was introduced by Roy and Borjas, is useful. However, migration cost cannot address global migration because of the limitations of deterministic and bilateral choice. Following the idea of migration cost, this paper developed a new probabilistic multilateral migration model by introducing the Boltzmann factor from statistical physics. After characterizing the underlying mechanism or driving force of human mobility, we reveal some interesting facts that have provided a deeper understanding of international migration, such as the negative correlation between migration costs for emigrants and immigrants and a global classification with clear regional and economic characteristics, based on clustering of migration cost vectors. In addition, we deconstruct the migration barriers using regression analysis and find that the influencing factors are complicated but can be partly (12.5%) described by several macro indexes, such as the GDP growth of the destination country, the GNI per capita and the HDI of both the source and destination countries.

Bioethics and transnational medical travel: India,"medical tourism," and the globalisation of healthcare.

PubMed

Runnels, Vivien; Turner, Leigh

2011-01-01

Health-related travel, also referred to as "medical tourism" is historically well-known. Its emerging contemporary form suggests the development of a form of globalised for-profit healthcare. Medical tourism to India, the focus of a recent conference in Canada, provides an example of the globalisation of healthcare. By positioning itself as a low-cost, high-tech, fast-access and high-quality healthcare destination country, India offers healthcare to medical travellers who are frustrated with waiting lists and the limited availability of some procedures in Canada. Although patients have the right to travel and seek care at international medical facilities, there are a number of dimensions of medical tourism that are disturbing. The diversion of public investments in healthcare to the private sector, in order to serve medical travellers, perversely transfers public resources to international patients at a time when the Indian public healthcare system fails to provide primary healthcare to its own citizens. Further, little is known about patient safety and quality care in transnational medical travel. Countries that are departure points as well as destination countries need to carefully explore the ethical, social, cultural, and economic consequences of the growing phenomenon of for-profit international medical travel.

Effect of Destined High-Pressure Torsion on the Structure and Mechanical Properties of Rare Earth-Based Metallic Glasses

NASA Astrophysics Data System (ADS)

Zhao, W.; Cheng, H.; Jiang, X.; Wu, M. L.; Li, G.

2018-03-01

Changes in the atomic structure and mechanical properties of rare earth-based metallic glasses caused by destined high-pressure torsion (HPT) were studied by X-ray diffraction synchrotron radiation and nanoindentation. Results showed that destined HPT improved nanohardness and wear resistance, which indicated the significant contributions of this technique. The diffraction patterns showed that the contents of pairs between solvent and solute atoms with a large negative mixing enthalpy increased, whereas those of pairs between solvent atoms and between solute atoms decreased after destined HPT. Thus, the process was improved by increasing the proportion of high-intensity pairs between solvent and solute atoms.

GeoSentinel Surveillance of Illness in Returned Travelers, 2007–2011

PubMed Central

Leder, Karin; Torresi, Joseph; Libman, Michael D.; Cramer, Jakob P.; Castelli, Francesco; Schlagenhauf, Patricia; Wilder-Smith, Annelies; Wilson, Mary E.; Keystone, Jay S.; Schwartz, Eli; Barnett, Elizabeth D.; von Sonnenburg, Frank; Brownstein, John S.; Cheng, Allen C.; Sotir, Mark J.; Esposito, Douglas H.; Freedman, David O.

2015-01-01

Background International travel continues to increase, particularly to Asia and Africa. Clinicians are increasingly likely to be consulted for advice before travel or by ill returned travelers. Objective To describe typical diseases in returned travelers according to region, travel reason, and patient demographic characteristics; describe the pattern of low-frequency travel-associated diseases; and refine key messages for care before and after travel. Design Descriptive, using GeoSentinel records. Setting 53 tropical or travel disease units in 24 countries. Patients 42 173 ill returned travelers seen between 2007 and 2011. Measurements Frequencies of demographic characteristics, regions visited, and illnesses reported. Results Asia (32.6%) and sub-Saharan Africa (26.7%) were the most common regions where illnesses were acquired. Three quarters of travel-related illness was due to gastrointestinal (34.0%), febrile (23.3%), and dermatologic (19.5%) diseases. Only 40.5% of all ill travelers reported pretravel medical visits. The relative frequency of many diseases varied with both travel destination and reason for travel, with travelers visiting friends and relatives in their country of origin having both a disproportionately high burden of serious febrile illness and very low rates of advice before travel (18.3%). Life-threatening diseases, such as Plasmodium falciparum malaria, melioidosis, and African trypanosomiasis, were reported. Limitations Sentinel surveillance data collected by specialist clinics do not reflect healthy returning travelers or those with mild or self-limited illness. Data cannot be used to infer quantitative risk for illness. Conclusion Many illnesses may have been preventable with appropriate advice, chemoprophylaxis, or vaccination. Clinicians can use these 5-year GeoSentinel data to help tailor more efficient pretravel preparation strategies and evaluate possible differential diagnoses of ill returned travelers according to destination and reason for travel. Primary Funding Source Centers for Disease Control and Prevention. PMID:23552375

A Statistical Analysis of Venezuelan Defense Spending.

DTIC Science & Technology

1985-03-01

destined for the world market via exports [Ref. 13]. Venezuelan petroleum had accounted for more than half the world’s exports in the immediate post ...Organizacion Politica Electoral Independiente (COPEI) party was elected president. His March 1969 inauguration marked the country’s first peaceful

78 FR 44562 - Application for Final Commitment for a Long-Term Loan or Financial Guarantee in Excess of $100...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-24

... long-haul air service between Norway/Sweden and destinations in Asia, United States and other countries... Air Shuttle ASA. Guarantor(s): N/A. Description of Items Being Exported: The items being exported are...

Preventing Pollution to Local Waters, Bay; Preserving Historic Natural Bridge in Virginia

EPA Pesticide Factsheets

In helping to preserve one of the oldest tourist destinations in the country – a spectacular natural land bridge in Virginia – EPA funding is protecting the surrounding land from development that would have impacted local waters and the Chesapeake Bay.

Discovering Preferential Patterns in Sectoral Trade Networks.

PubMed

Cingolani, Isabella; Piccardi, Carlo; Tajoli, Lucia

2015-01-01

We analyze the patterns of import/export bilateral relations, with the aim of assessing the relevance and shape of "preferentiality" in countries' trade decisions. Preferentiality here is defined as the tendency to concentrate trade on one or few partners. With this purpose, we adopt a systemic approach through the use of the tools of complex network analysis. In particular, we apply a pattern detection approach based on community and pseudocommunity analysis, in order to highlight the groups of countries within which most of members' trade occur. The method is applied to two intra-industry trade networks consisting of 221 countries, relative to the low-tech "Textiles and Textile Articles" and the high-tech "Electronics" sectors for the year 2006, to look at the structure of world trade before the start of the international financial crisis. It turns out that the two networks display some similarities and some differences in preferential trade patterns: they both include few significant communities that define narrow sets of countries trading with each other as preferential destinations markets or supply sources, and they are characterized by the presence of similar hierarchical structures, led by the largest economies. But there are also distinctive features due to the characteristics of the industries examined, in which the organization of production and the destination markets are different. Overall, the extent of preferentiality and partner selection at the sector level confirm the relevance of international trade costs still today, inducing countries to seek the highest efficiency in their trade patterns.

Understanding transit ridership demand for a multi-destination, multimodal transit network in an American metropolitan area : lessons for increasing choice ridership while maintaining transit dependent ridership.

DOT National Transportation Integrated Search

2012-01-01

This study examines the factors underlying transit demand in the multi-destination, integrated bus and rail transit network for Atlanta, Georgia. Atlanta provides an opportunity to explore the consequences of a multi-destination transit network for b...

Understanding transit ridership demand for a multi-destination, multimodal transit network in an American metropolitan area : lessons for increasing choice ridership while maintaining transit dependent ridership : [research brief].

DOT National Transportation Integrated Search

2012-01-01

Recent research indicates that multi-destination transit systems are far more effective in attracting passengers than central business district (CBD)-focused systems. However, the same research suggests that multi-destination systems appeal largely t...

How to optimize tourism destination supply: A case in Shanghai from perspective of supplier and demand side perception

NASA Astrophysics Data System (ADS)

Xue, Huaju; Fang, Chengjiang

2018-02-01

It is vital to assess the regional tourist supply capability by suppliers and demand groups. The supply side’s evaluation of the regional supply capacity determines the direction of the supply investment in future, the demand side’s evaluation indicates their satisfaction degree of the destination supply and also effects their revisit the tourism destination. Therefore, the assessment of the supply and demand sides is an important reference for the reform of destination supply side, which helps us find the shortage of the destination supply factors and optimize tourism destination supply promptly. This paper through investigating tourism supply and demand groups in Shanghai, used the survey data and constructed tourism supply optimization model, analyzed the current situation of tourism supply factors in Shanghai. Results showed that the environment of Shanghai should be improved first, including improving urban air and water quality, up-grading public sanitation and increasing urban green coverage. Other supply factors improved priority were information and marketing, we should improve the information consultation of scenic spots, increase the intensity of tourism promotion and provide more free travel publicity brochures.

Experience of overseas-trained health professionals in rural and remote areas of destination countries: a literature review.

PubMed

Dywili, Sophia; Bonner, Ann; Anderson, Judith; O' Brien, Louise

2012-08-01

This study aimed to review and synthesise existing literature that investigated the experience of overseas-trained health professionals (OTHPs) in rural and remote areas of destination countries. A systematic literature review was conducted using electronic databases and manual search of studies published from January 2004 to February 2011. Data were analysed from the final 17 original report articles that met the inclusion criteria. The reviewed research studies were conducted in Australia, Canada, New Zealand, the UK and the USA. Overseas-trained medical practitioners were the most frequently researched (n = 14); two studies involved nurses and one study included several health professionals. Three main themes emerged from the review and these were: (i) expectations; (ii) cultural diversity; and (iii) orientation and integration to rural and remote health work environment. The OTHPs were expected to possess the appropriate professional and cultural skills while they themselves expected recognition of their previous experiences and adequate organisational orientation and support. A welcoming and accepting community coupled with a relaxed rural lifestyle and the joy of continued patient care resulted in successful integration and contributed to increased staff retention rates. Recognition of expectations and cultural diversity by all parties and comprehensive orientation with sufficient organisational support are important elements in the integration of OTHPs and subsequent delivery of quality health care to people living in rural and remote areas. © 2012 The Authors. Australian Journal of Rural Health © National Rural Health Alliance Inc.

Quality of malaria information provided on Internet travel operator websites.

PubMed

Bazaz, Rohit; Green, Edward; Green, Steve T

2010-09-01

Over the past 20 years, there has been a steady growth in the number of reported cases of malaria in the UK. With increasing Internet flight sales over recent years, online travel operator websites may be the only place many travellers could conceivably receive pre-travel malaria prevention advice. 29 Travel operator websites which allow for online flight purchases to malarious areas from the UK, identified using a Google(®) web search and the website of the International Air Transport Association, were assessed for the existence, accuracy and accessibility of malaria prevention advice available through internal and external website links. Eight (28%) websites provided malaria prevention information on their own pages. Five (17%) websites contained country specific malaria information relevant to the requested destination, including variation of malaria risk within that country and accurate destination specific chemoprophylaxis advice. No malaria information was available, either on internal or external links, on 8 (28%) websites. On average, it took 2.4 additional mouse clicks to access malaria information during the online flight booking process. Six of the 29 websites (21%) allowed for access to information with only 1 click. Malaria prevention information on online travel operator websites is most often absent or inadequate. Even on websites where such information is of good quality, it can be difficult to access. The travel industry should introduce and enforce guidelines for the malaria information provided by online travel operators. Copyright © 2010 Elsevier Ltd. All rights reserved.

Migration and its influence on the knowledge and usage of birth control methods among Afghan women who stay behind.

PubMed

Roosen, I; Siegel, M

2018-05-01

The objective of this article is to investigate the link between migration and knowledge and use of birth control methods among female household members (of migrants) who stay behind in Afghanistan. Migrants can remit birth control information received in the destination country to non-migrants staying in the origin country, who may as a consequence adjust their health behaviour accordingly. The consequences of this interaction for knowledge and use are what we aim to test. Population-based secondary analysis of cross-sectional data. This study used cross-sectional data from the Afghan Mortality Survey (2010). Using ordinary least squares regression and propensity score matching, this research studies to what extent having a migrant in the household influences the knowledge and use of birth control among non-migrant Afghan women. Women who stay behind are defined in this research as those with a migrant household member who moved between 2005 and 2010. Results indicated that non-Pashtun women with a migrant household member showed greater knowledge of contraceptive methods using injectables, birth control pill and lactational amenorrhea method compared to those women without a migrant household member. Less knowledge of male sterilisation and emergency contraception is observed for all women (both Pashtun and non-Pashtun) with a migrant in their household on male sterilisation and emergency contraception compared to the women without a migrant in the household. In addition, we show that Pashtun women with a migrant in the household had lower levels of overall knowledge and were less likely to use birth control methods than women without a migrant household member. In Afghanistan, given the proximity, religious similarity and sociocultural customs mainly men migrate either to Pakistan or Iran. The findings suggest that migrants in different destination countries transfer different information (or fail to successfully transfer information) about birth control methods to members of their transnational networks, compounding disparities in knowledge and use of birth control methods among women staying in the origin country. Migrants have the potential to be health-related development agents, but the health information migrants receive while abroad and remit back to their home countries varies by destination country context. Copyright © 2018 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

The metrics and correlates of physician migration from Africa.

PubMed

Arah, Onyebuchi A

2007-05-17

Physician migration from poor to rich countries is considered an important contributor to the growing health workforce crisis in the developing world. This is particularly true for Africa. The perceived magnitude of such migration for each source country might, however, depend on the choice of metrics used in the analysis. This study examined the influence of choice of migration metrics on the rankings of African countries that suffered the most physician migration, and investigated the correlates of physician migration. Ranking and correlational analyses were conducted on African physician migration data adjusted for bilateral net flows, and supplemented with developmental, economic and health system data. The setting was the 53 African birth countries of African-born physicians working in nine wealthier destination countries. Three metrics of physician migration were used: total number of physician émigrés; emigration fraction defined as the proportion of the potential physician pool working in destination countries; and physician migration density defined as the number of physician émigrés per 1000 population of the African source country. Rankings based on any of the migration metrics differed substantially from those based on the other two metrics. Although the emigration fraction and physician migration density metrics gave proportionality to the migration crisis, only the latter was consistently associated with source countries' workforce capacity, health, health spending, economic and development characteristics. As such, higher physician migration density was seen among African countries with relatively higher health workforce capacity (0.401 < or = r < or = 0.694, p < or = 0.011), health status, health spending, and development. The perceived magnitude of physician migration is sensitive to the choice of metrics. Complementing the emigration fraction, the physician migration density is a metric which gives a different but proportionate picture of which African countries stand to lose relatively more of its physicians with unchecked migration. The nature of health policies geared at health-worker migration can be expected to depend on the choice of migration metrics.

True North

ERIC Educational Resources Information Center

Benson, Jo-Anne Mary

2007-01-01

For Americans wanting to explore beyond their frontiers, their neighbor to the north is an ideal destination. Much of Canada's population is concentrated near the shared border, mostly in Ontario and Quebec. While nature is an obvious draw, Canada's dynamic urban centers present their own sophisticated enticements, and the country's ten provinces…

7 CFR 1530.109 - Reporting.

Code of Federal Regulations, 2012 CFR

2012-01-01

... AGRICULTURE THE REFINED SUGAR RE-EXPORT PROGRAM, THE SUGAR CONTAINING PRODUCTS RE-EXPORT PROGRAM, AND THE... transaction; (2) The date of the entry, transfer (only a refiner shall report transfers to the Licensing... license number; (5) The country of origin (entry of raw sugar) or final destination (refined exports...

7 CFR 1530.109 - Reporting.

Code of Federal Regulations, 2013 CFR

2013-01-01

... AGRICULTURE THE REFINED SUGAR RE-EXPORT PROGRAM, THE SUGAR CONTAINING PRODUCTS RE-EXPORT PROGRAM, AND THE... transaction; (2) The date of the entry, transfer (only a refiner shall report transfers to the Licensing... license number; (5) The country of origin (entry of raw sugar) or final destination (refined exports...

7 CFR 1530.109 - Reporting.

Code of Federal Regulations, 2014 CFR

2014-01-01

... AGRICULTURE THE REFINED SUGAR RE-EXPORT PROGRAM, THE SUGAR CONTAINING PRODUCTS RE-EXPORT PROGRAM, AND THE... transaction; (2) The date of the entry, transfer (only a refiner shall report transfers to the Licensing... license number; (5) The country of origin (entry of raw sugar) or final destination (refined exports...

7 CFR 1530.109 - Reporting.

Code of Federal Regulations, 2011 CFR

2011-01-01

... AGRICULTURE THE REFINED SUGAR RE-EXPORT PROGRAM, THE SUGAR CONTAINING PRODUCTS RE-EXPORT PROGRAM, AND THE... transaction; (2) The date of the entry, transfer (only a refiner shall report transfers to the Licensing... license number; (5) The country of origin (entry of raw sugar) or final destination (refined exports...

7 CFR 1530.109 - Reporting.

Code of Federal Regulations, 2010 CFR

2010-01-01

... AGRICULTURE THE REFINED SUGAR RE-EXPORT PROGRAM, THE SUGAR CONTAINING PRODUCTS RE-EXPORT PROGRAM, AND THE... transaction; (2) The date of the entry, transfer (only a refiner shall report transfers to the Licensing... license number; (5) The country of origin (entry of raw sugar) or final destination (refined exports...

Organ trafficking and transplant tourism: a commentary on the global realities.

PubMed

Budiani-Saberi, D A; Delmonico, F L

2008-05-01

The extent of organ sales from commercial living donors (CLDs) or vendors has now become evident. At the Second Global Consultation on Human Transplantation of the World Health Organization's (WHO) in March 2007, it was estimated that organ trafficking accounts for 5-10% of the kidney transplants performed annually throughout the world. Patients with sufficient resources in need of organs may travel from one country to another to purchase a kidney (or liver) mainly from a poor person. Transplant centers in 'destination' countries have been well known to encourage the sale of organs to 'tourist' recipients from the 'client' countries.

Tweets and Facebook Posts, the Novelty Techniques in the Creation of Origin-Destination Models

NASA Astrophysics Data System (ADS)

Malema, H. K.; Musakwa, W.

2016-06-01

Social media and big data have emerged to be a useful source of information that can be used for planning purposes, particularly transportation planning and trip-distribution studies. Cities in developing countries such as South Africa often struggle with out-dated, unreliable and cumbersome techniques such as traffic counts and household surveys to conduct origin and destination studies. The emergence of ubiquitous crowd sourced data, big data, social media and geolocation based services has shown huge potential in providing useful information for origin and destination studies. Perhaps such information can be utilised to determine the origin and destination of commuters using the Gautrain, a high-speed railway in Gauteng province South Africa. To date little is known about the origins and destinations of Gautrain commuters. Accordingly, this study assesses the viability of using geolocation-based services namely Facebook and Twitter in mapping out the network movements of Gautrain commuters. Explorative Spatial Data Analysis (ESDA), Echo-social and ArcGis software were used to extract social media data, i.e. tweets and Facebook posts as well as to visualize the concentration of Gautrain commuters. The results demonstrate that big data and geolocation based services have the significant potential to predict movement network patterns of commuters and this information can thus, be used to inform and improve transportation planning. Nevertheless use of crowd sourced data and big data has privacy concerns that still need to be addressed.

Environment, migration and the European demographic deficit

NASA Astrophysics Data System (ADS)

Harper, Sarah

2012-03-01

Many countries in the more developed world, and some in the less developed, are facing new economic and social pressures associated with the ageing of their populations. Europe, in particular, is forecast to have a demographic deficit, which may be alleviated by in-migration to the region. However, several commentators have proposed that Europe will not be able to successfully compete with other regions, in particular Asia, in the coming years for the skills it will require. This letter explores these themes, arguing that climate change will increase the attractiveness of Europe as a destination of economic choice for future skilled workers, to the detriment of more environmentally challenged regions.

Choices of Destination for Transnational Higher Education: "Pull" Factors in an Asia Pacific Market

ERIC Educational Resources Information Center

Ahmad, Syed Zamberi; Buchanan, Frederick Robert

2016-01-01

Traditional assumptions favouring native English language countries in transnational higher education (TNHE) overlook experiences of international students in new emerging Asian education hubs. Specifically, there has been limited research relating to international students' choice for studying in Malaysia. Drawing from the "push-pull"…

22 CFR 211.4 - Availability and shipment of commodities.

Code of Federal Regulations, 2011 CFR

2011-04-01

... Regulation 11. (b) Transfer of title and delivery. (1) Unless the approved Operational Plan or TA provides... destination point of entry, upon completion of delivery by the inland carrier (landlocked countries). Except... thereof have been clearly marked as not to be certified for billing. (Name of steamship co.) By...

India's growing participation in global clinical trials.

PubMed

Gupta, Yogendra K; Padhy, Biswa M

2011-06-01

Lower operational costs, recent regulatory reforms and several logistic advantages make India an attractive destination for conducting clinical trials. Efforts for maintaining stringent ethical standards and the launch of Pharmacovigilance Program of India are expected to maximize the potential of the country for clinical research. Copyright © 2011. Published by Elsevier Ltd.

Being Wholesaled: An Investigation of Chinese International Students' Higher Education Experiences

ERIC Educational Resources Information Center

Su, Mengwei; Harrison, Laura M.

2016-01-01

Using academic capitalism as a theoretical foundation, this phenomenological study examined the new study abroad experiences of Chinese college students in six popular English-speaking study destination countries--the U.S., the U.K., Australia, Canada, the Netherlands, and Singapore. Qualitative data collected from 20 interviews indicate some…

Degree Classification and Recent Graduates' Ability: Is There Any Signalling Effect?

ERIC Educational Resources Information Center

Di Pietro, Giorgio

2017-01-01

Research across several countries has shown that degree classification (i.e. the final grade awarded to students successfully completing university) is an important determinant of graduates' first destination outcome. Graduates leaving university with higher degree classifications have better employment opportunities and a higher likelihood of…

General Aviation Pilot and Aircraft Activity Survey.

DTIC Science & Technology

1985-09-01

Balloon 3. Rotorcraft piston 6. Turbojet 4. HOW 010 YOU OBTAIN THE AIRCRAFT FOR THIS FLIGHT’ iCheck only one) 1. Individual owner or partnership 4...you prefer that the destination airport in requirements? (Check all) your cross-country flight have the following facilities ? iCheck ail) Ve wll Ade

15 CFR Supplement No. 1 to Part 738 - Commerce Country Chart

Code of Federal Regulations, 2010 CFR

2010-01-01

... X X X X X Kiribati X X X X X X X X X X Korea, North See Sections 742.19 and 746.4 of the EAR to determine whether a license is required in order to export or reexport to this destination. Korea, South 3 4...

Skin disorders among travellers returning from tropical and non-tropical countries consulting a travel medicine clinic.

PubMed

Herbinger, K-H; Siess, C; Nothdurft, H D; von Sonnenburg, F; Löscher, T

2011-11-01

To evaluate the causes and risks for imported skin disorders among travellers. Data of 34,162 travellers returning from tropical and non-tropical countries and presenting at the outpatient travel medicine clinic of the University of Munich, Germany, between 1999 and 2009 were analyzed for this study. Of these, 12.2% were diagnosed with skin disorders. Main destinations visited were Asia (40%), Africa (27%) and Latin America (21%). Tourism in the form of adventure travel/backpacking (47%) and package holidays (23%) was the most common purpose of travel. The leading causes of skin disorders were arthropodal (23%), bacterial (22%), helminthic (11%), protozoan (6%), viral (6%), allergic (5%) and fungal (4%). The 10 most frequently diagnosed specific skin diseases associated with specific destinations were insect bites (17%, Southern Europe), cutaneous larva migrans (8%, Asia and Latin America), cutaneous leishmaniasis (2.4%, Mediterranean Region/Middle East), dengue fever (1.5%, Asia), rickettsioses (1.3%, Southern Africa), myiasis (0.8%, Central America), filarioses (0.7%, Africa), tick bites (0.6%, Central/Eastern Europe), schistosomiasis (0.6%, Africa) and tungiasis (0.6%, Africa). Travellers in sub-Saharan Africa had the highest relative risk of acquiring skin disorders. As more than 20% of all skin disorders among returned travellers were caused by arthropods and about 50% by infectious pathogens, pre-travel consultations should include specific prophylaxis and consider the most important risk factor for the travel destination. © 2011 Blackwell Publishing Ltd.

Destinations matter: The association between where older adults live and their travel behavior.

PubMed

Chudyk, Anna M; Winters, Meghan; Moniruzzaman, Md; Ashe, Maureen C; Gould, Joanie Sims; McKay, Heather

2015-03-01

The positive effect of physical activity in the prevention and treatment of many chronic diseases and age-related disabilities, such as mobility-disability, are widely accepted. Mobility is broadly defined as the ability of individuals to move themselves within community environments. These two concepts -physical activity and mobility - are closely linked and together contribute to older adults living healthy, independent lives. Neighborhood destinations may encourage mobility, as older adults typically leave their homes to travel to specific destinations. Thus, neighborhoods with a high prevalence of destinations may provide older adults an attractive opportunity to walk, instead of drive, and thereby obtain incidental physical activity. We know surprisingly little about the specific types of destinations older adults deem relevant and even less about destinations that support the mobility of older adults with low income. Accessible neighborhood destinations may be especially important to older adults with low income as they are more likely to walk as a primary travel mode. Conversely, this population may also be at increased risk of functional impairments that negatively affect their ability to walk. As a means to fill this information gap we aimed to better understand the mobility habits of older adults with low income. Thus, our specific objectives were to: (1) describe the types of destinations older adults with low income most commonly travel to in one week; and (2) determine the association between the prevalence of neighborhood destinations and the number of transportation walking trips these individuals make (average per day). We conducted a cross-sectional study of community-dwelling older adults with low income residing within Metro Vancouver, Canada. We assessed participant travel behavior (frequency, purpose, mode, destination) using seven-day travel diaries and measured the prevalence of neighborhood destinations using the Street Smart Walk Score. We also assessed participants' sociodemographic characteristics and mobility (physical function, car access, confidence walking). We used a negative binomial model to determine the association between Street Smart Walk Score and number of transportation walking trips (average per day). Our sample was comprised of 150 participants (median age 74 years; 51 men) from who we acquired at least one day of travel diary data (range = 1-7 days). Participants made three trips per day (2, 5; median P 25 , P 75 ) and travelled to six different destination types per week (5, 9; median P 25 , P 75 ). Destinations most relevant to older adults were grocery stores, malls, and restaurants/cafés. Each 10-point increase in Street Smart Walk Score was associated with a 20% increase in the number of transportation walking trips (average per day, incidence rate ratio = 1.20, 95% CI = 1.12, 1.29). Our findings provide preliminary evidence regarding destinations that may be most relevant to older adults. They also suggest that the prevalence of these neighborhood destinations may encourage walking. As we approach a new era of healthy city benchmarks, our findings guide policy makers and developers to retrofit and develop communities that support the mobility, health, and independence of older adults.

Destinations matter: The association between where older adults live and their travel behavior

PubMed Central

Chudyk, Anna M.; Winters, Meghan; Moniruzzaman, Md; Ashe, Maureen C.; Gould, Joanie Sims; McKay, Heather

2016-01-01

The positive effect of physical activity in the prevention and treatment of many chronic diseases and age-related disabilities, such as mobility-disability, are widely accepted. Mobility is broadly defined as the ability of individuals to move themselves within community environments. These two concepts –physical activity and mobility – are closely linked and together contribute to older adults living healthy, independent lives. Neighborhood destinations may encourage mobility, as older adults typically leave their homes to travel to specific destinations. Thus, neighborhoods with a high prevalence of destinations may provide older adults an attractive opportunity to walk, instead of drive, and thereby obtain incidental physical activity. We know surprisingly little about the specific types of destinations older adults deem relevant and even less about destinations that support the mobility of older adults with low income. Accessible neighborhood destinations may be especially important to older adults with low income as they are more likely to walk as a primary travel mode. Conversely, this population may also be at increased risk of functional impairments that negatively affect their ability to walk. As a means to fill this information gap we aimed to better understand the mobility habits of older adults with low income. Thus, our specific objectives were to: (1) describe the types of destinations older adults with low income most commonly travel to in one week; and (2) determine the association between the prevalence of neighborhood destinations and the number of transportation walking trips these individuals make (average per day). We conducted a cross-sectional study of community-dwelling older adults with low income residing within Metro Vancouver, Canada. We assessed participant travel behavior (frequency, purpose, mode, destination) using seven-day travel diaries and measured the prevalence of neighborhood destinations using the Street Smart Walk Score. We also assessed participants’ sociodemographic characteristics and mobility (physical function, car access, confidence walking). We used a negative binomial model to determine the association between Street Smart Walk Score and number of transportation walking trips (average per day). Our sample was comprised of 150 participants (median age 74 years; 51 men) from who we acquired at least one day of travel diary data (range = 1–7 days). Participants made three trips per day (2, 5; median P25, P75) and travelled to six different destination types per week (5, 9; median P25, P75). Destinations most relevant to older adults were grocery stores, malls, and restaurants/cafés. Each 10-point increase in Street Smart Walk Score was associated with a 20% increase in the number of transportation walking trips (average per day, incidence rate ratio = 1.20, 95% CI = 1.12, 1.29). Our findings provide preliminary evidence regarding destinations that may be most relevant to older adults. They also suggest that the prevalence of these neighborhood destinations may encourage walking. As we approach a new era of healthy city benchmarks, our findings guide policy makers and developers to retrofit and develop communities that support the mobility, health, and independence of older adults. PMID:27104147

Changes in the Built Environment and Changes in the Amount of Walking Over Time: Longitudinal Results From the Multi-Ethnic Study of Atherosclerosis

PubMed Central

Hirsch, Jana A.; Moore, Kari A.; Clarke, Philippa J.; Rodriguez, Daniel A.; Evenson, Kelly R.; Brines, Shannon J.; Zagorski, Melissa A.; Diez Roux, Ana V.

2014-01-01

Lack of longitudinal research hinders causal inference on the association between the built environment and walking. In the present study, we used data from 6,027 adults in the Multi-Ethnic Study of Atherosclerosis who were 45–84 years of age at baseline to investigate the association of neighborhood built environment with trends in the amount of walking between 2000 and 2012. Walking for transportation and walking for leisure were assessed at baseline and at 3 follow-up visits (median follow-up = 9.15 years). Time-varying built environment measures (measures of population density, land use, number of destinations, bus access, and street connectivity) were created using geographic information systems. We used linear mixed models to estimate the associations between baseline levels of and a change in each built environment feature and a change in the frequency of walking. After adjustment for potential confounders, we found that higher baseline levels of population density, area zoned for retail, social destinations, walking destinations, and street connectivity were associated with greater increases in walking for transportation over time. Higher baseline levels of land zoned for residential use and distance to buses were associated with less pronounced increases (or decreases) in walking for transportation over time. Increases in the number of social destinations, the number of walking destinations, and street connectivity over time were associated with greater increases in walking for transportation. Higher baseline levels of both land zoned for retail and walking destinations were associated with greater increases in leisure walking, but no changes in built environment features were associated with leisure walking. The creation of mixed-use, dense developments may encourage adults to incorporate walking for transportation into their everyday lives. PMID:25234431

Health professional mobility in the European Union: Exploring the equity and efficiency of free movement.

PubMed

Glinos, Irene A

2015-12-01

The WHO Global Code of Practice on the International Recruitment of Health Personnel is a landmark in the health workforce migration debate. Yet its principles apply only partly within the European Union (EU) where freedom of movement prevails. The purpose of this article is to explore whether free mobility of health professionals contributes to "equitably strengthen health systems" in the EU. The article proposes an analytical tool (matrix), which looks at the effects of health professional mobility in terms of efficiency and equity implications at three levels: for the EU, for destination countries and for source countries. The findings show that destinations as well as sources experience positive and negative effects, and that the effects of mobility are complex because they change, overlap and are hard to pin down. The analysis suggests that there is a risk that free health workforce mobility disproportionally benefits wealthier Member States at the expense of less advantaged EU Member States, and that mobility may feed disparities as flows redistribute resources from poorer to wealthier EU countries. The article argues that the principles put forward by the WHO Code appear to be as relevant within the EU as they are globally. Copyright © 2015. Published by Elsevier Ireland Ltd.

Complexity in built environment, health, and destination walking: a neighborhood-scale analysis.

PubMed

Carlson, Cynthia; Aytur, Semra; Gardner, Kevin; Rogers, Shannon

2012-04-01

This study investigates the relationships between the built environment, the physical attributes of the neighborhood, and the residents' perceptions of those attributes. It focuses on destination walking and self-reported health, and does so at the neighborhood scale. The built environment, in particular sidewalks, road connectivity, and proximity of local destinations, correlates with destination walking, and similarly destination walking correlates with physical health. It was found, however, that the built environment and health metrics may not be simply, directly correlated but rather may be correlated through a series of feedback loops that may regulate risk in different ways in different contexts. In particular, evidence for a feedback loop between physical health and destination walking is observed, as well as separate feedback loops between destination walking and objective metrics of the built environment, and destination walking and perception of the built environment. These feedback loops affect the ability to observe how the built environment correlates with residents' physical health. Previous studies have investigated pieces of these associations, but are potentially missing the more complex relationships present. This study proposes a conceptual model describing complex feedback relationships between destination walking and public health, with the built environment expected to increase or decrease the strength of the feedback loop. Evidence supporting these feedback relationships is presented.

Solar Power Satellite Thermal Control Approach

NASA Astrophysics Data System (ADS)

Sacchi, E.; Cassisa, G.; Gottero, M.

2004-12-01

The concept of generating solar power in space and transmitting it to earth or any other desired destination such as a planet, moon, or to charge a space vehicle via microwaves, stems from a wide variety of human needs and necessities. It is now a well-known fact that world population increases at a very rapid rate, nearly 80 millions or more per year, and the world-wide energy demand seems to double in the course of the present century. If technology has to advance at the present rate, in phase with high living standards, energy growth must not lag behind. These estimates are based on the population growth rate in the developing countries and the simultaneous increase in per capita energy consumption in these countries, coupled with economical boost. In most of the underdeveloped countries energy needs are of small scales, faraway from the power distribution line and can be very easily satisfied by harnessing solar energy. Furthermore, the Earth temperature has increased by 0.5° to 1° F during the past century. This rise in temperature is believed to have been caused by the use of oil, coal, and natural gas (fossil fuels) for transportation and energy production. Actually, fossil fuel combustion-based power plants are the dominant sources for energy demands. Therefore, increased power production will accelerate the production of greenhouse gases (predominantly CO2). To cope with their energy needs, countries could be engaged in the use of nuclear energy, which could accelerate the diffusion of nuclear arms as a bye- product.

Health problems of Nepalese migrants working in three Gulf countries.

PubMed

Joshi, Suresh; Simkhada, Padam; Prescott, Gordon J

2011-03-28

Nepal is one of the largest suppliers of labour to countries where there is a demand for cheap and low skilled workers. In the recent years the Gulf countries have collectively become the main destinations for international migration. This paper aims to explore the health problems and accidents experienced by a sample of Nepalese migrant in three Gulf countries. A cross-sectional survey was conducted among 408 Nepalese migrants who had at least one period of work experience of at least six months in any of three Gulf countries: Qatar, Saudi Arabia and United Arab Emirates (UAE). Face to face questionnaire interviews were conducted applying a convenience technique to select the study participants. Nepalese migrants in these Gulf countries were generally young men between 26-35 years of age. Unskilled construction jobs including labourer, scaffolder, plumber and carpenter were the most common jobs. Health problems were widespread and one quarter of study participants reported experiencing injuries or accidents at work within the last 12 months. The rates of health problems and accidents reported were very similar in the three countries. Only one third of the respondents were provided with insurance for health services by their employer. Lack of leave for illness, cost and fear of losing their job were the barriers to accessing health care services. The study found that construction and agricultural workers were more likely to experience accidents at their workplace and health problems than other workers. The findings suggest important messages for the migration policy makers in Nepal. There is a lack of adequate information for the migrants making them aware of their health risks and rights in relation to health services in the destination countries and we suggest that the government of Nepal should be responsible for providing this information. Employers should provide orientation on possible health risks and appropriate training for preventive measures and all necessary access to health care services to all their workers.

Health problems of Nepalese migrants working in three Gulf countries

PubMed Central

2011-01-01

Background Nepal is one of the largest suppliers of labour to countries where there is a demand for cheap and low skilled workers. In the recent years the Gulf countries have collectively become the main destinations for international migration. This paper aims to explore the health problems and accidents experienced by a sample of Nepalese migrant in three Gulf countries. Methods A cross-sectional survey was conducted among 408 Nepalese migrants who had at least one period of work experience of at least six months in any of three Gulf countries: Qatar, Saudi Arabia and United Arab Emirates (UAE). Face to face questionnaire interviews were conducted applying a convenience technique to select the study participants. Results Nepalese migrants in these Gulf countries were generally young men between 26-35 years of age. Unskilled construction jobs including labourer, scaffolder, plumber and carpenter were the most common jobs. Health problems were widespread and one quarter of study participants reported experiencing injuries or accidents at work within the last 12 months. The rates of health problems and accidents reported were very similar in the three countries. Only one third of the respondents were provided with insurance for health services by their employer. Lack of leave for illness, cost and fear of losing their job were the barriers to accessing health care services. The study found that construction and agricultural workers were more likely to experience accidents at their workplace and health problems than other workers. Conclusion The findings suggest important messages for the migration policy makers in Nepal. There is a lack of adequate information for the migrants making them aware of their health risks and rights in relation to health services in the destination countries and we suggest that the government of Nepal should be responsible for providing this information. Employers should provide orientation on possible health risks and appropriate training for preventive measures and all necessary access to health care services to all their workers. PMID:21443802

Code for ethical international recruitment practices: the CGFNS alliance case study.

PubMed

Shaffer, Franklin A; Bakhshi, Mukul; Dutka, Julia To; Phillips, Janice

2016-06-30

Projections indicate a global workforce shortage of approximately 4.3 million across the health professions. The need to ensure an adequate supply of health workers worldwide has created a context for the increased global migration of these professionals. The global trend in the migration of health professionals has given rise to the international recruitment industry to facilitate the passage of health workers from source to destination countries. This is particularly the case in the United States, where the majority of immigrant health professionals have come by way of the recruiting industry. This industry is largely unregulated in the United States as well as in many other countries, for which voluntary codes have been used as a means to increase transparency of the recruitment process, shape professional conduct, and mitigate harm to foreign-educated health workers. The CGFNS Alliance case study presented herein describes a multi-stakeholder effort in the United States to promote ethical recruitment practices. Such codes not only complement the WHO Global Code of Practice but are necessary to maximize the impact of these global standards on local settings. This case study offers both a historical perspective and a conceptual framework for examining the multiplicity of factors affecting the migration of human resources for health. The lessons learned provide critical insights into the factors pertaining to the relevancy and effectiveness of the WHO Code from the perspectives of both source and destination countries. This study provides a conceptual model for examining the usefulness of the WHO Code as well as how best to ensure its viability, sustainability, relevancy, and effectiveness in the global environment. This case study concludes with recommendations for evolving business models that need to be in place to strengthen the effectiveness of the WHO Code in the marketplace and to ensure its impact on the international recruitment industry in advancing ethical practices. These recommendations include using effective screening mechanisms to determine health professionals' readiness for migration as well as implementing certification processes to raise the practice standards for those directly involved in recruiting skilled workers and managing the migration flow.

Emergence of biopharmaceutical innovators in China, India, Brazil, and South Africa as global competitors and collaborators.

PubMed

Rezaie, Rahim; McGahan, Anita M; Frew, Sarah E; Daar, Abdallah S; Singer, Peter A

2012-06-06

Biopharmaceutical innovation has had a profound health and economic impact globally. Developed countries have traditionally been the source of most innovations as well as the destination for the resulting economic and health benefits. As a result, most prior research on this sector has focused on developed countries. This paper seeks to fill the gap in research on emerging markets by analyzing factors that influence innovative activity in the indigenous biopharmaceutical sectors of China, India, Brazil, and South Africa. Using qualitative research methodologies, this paper a) shows how biopharmaceutical innovation is taking place within the entrepreneurial sectors of these emerging markets, b) identifies common challenges that indigenous entrepreneurs face, c) highlights the key role played by the state, and d) reveals that the transition to innovation by companies in the emerging markets is characterized by increased global integration. It suggests that biopharmaceutical innovators in emerging markets are capitalizing on opportunities to participate in the drug development value chain and thus developing capabilities and relationships for competing globally both with and against established companies headquartered in developed countries.

Emergence of biopharmaceutical innovators in China, India, Brazil, and South Africa as global competitors and collaborators

PubMed Central

2012-01-01

Biopharmaceutical innovation has had a profound health and economic impact globally. Developed countries have traditionally been the source of most innovations as well as the destination for the resulting economic and health benefits. As a result, most prior research on this sector has focused on developed countries. This paper seeks to fill the gap in research on emerging markets by analyzing factors that influence innovative activity in the indigenous biopharmaceutical sectors of China, India, Brazil, and South Africa. Using qualitative research methodologies, this paper a) shows how biopharmaceutical innovation is taking place within the entrepreneurial sectors of these emerging markets, b) identifies common challenges that indigenous entrepreneurs face, c) highlights the key role played by the state, and d) reveals that the transition to innovation by companies in the emerging markets is characterized by increased global integration. It suggests that biopharmaceutical innovators in emerging markets are capitalizing on opportunities to participate in the drug development value chain and thus developing capabilities and relationships for competing globally both with and against established companies headquartered in developed countries. PMID:22672351

Canadian medical tourism companies that have exited the marketplace: Content analysis of websites used to market transnational medical travel

PubMed Central

2011-01-01

Background Medical tourism companies play an important role in promoting transnational medical travel for elective, out-of-pocket medical procedures. Though researchers are paying increasing attention to the global phenomenon of medical tourism, to date websites of medical tourism companies have received limited scrutiny. This article analyzes websites of Canadian medical tourism companies that advertised international healthcare but ultimately exited the marketplace. Using content analysis of company websites as an investigative tool, the article provides a detailed account of medical tourism companies that were based in Canada but no longer send clients to international health care facilities. Methods Internet searches, Google Alerts, searches on Google News Canada and ProQuest Newsstand, and searches of an Industry Canada database were used to locate medical tourism companies located in Canada. Once medical tourism companies were identified, the social science research method of content analysis was used to extract relevant information from company websites. Company websites were analyzed to determine: 1) where these businesses were based; 2) the destination countries and medical facilities that they promoted; 3) the health services they advertised; 4) core marketing messages; and 5) whether businesses marketed air travel, hotel accommodations, and holiday excursions in addition to medical procedures. Results In total, 25 medical tourism companies that were based in Canada are now defunct. Given that an estimated 18 medical tourism companies and 7 regional, cross-border medical travel facilitators now operate in Canada, it appears that approximately half of all identifiable medical tourism companies in Canada are no longer in business. 13 of the previously operational companies were based in Ontario, 7 were located in British Columbia, 4 were situated in Quebec, and 1 was based in Alberta. 14 companies marketed medical procedures within a single country, 9 businesses marketed health care at 2 or more destination nations, and 2 companies did not specify particular health care destinations. 22 companies operated as "generalist" businesses marketing many different types of medical procedures. 3 medical tourism companies marketed "specialist" services restricted to dental procedures or organ transplants. In general, medical tourism companies marketed health services on the basis of access to affordable, timely, and high-quality care. 16 businesses offered to make travel arrangements, 20 companies offered to book hotel reservations, and 17 medical tourism companies advertised holiday excursions. Conclusions This article provides a detailed empirical analysis of websites of medical tourism companies that were based in Canada but exited the marketplace and are now inoperative. The article identifies where these companies were located in Canada, what countries and health care facilities they selected as destination sites, the health services they advertised, how they marketed themselves in a competitive environment, and what travel-related services they promoted in addition to marketing health care. The paper reveals a fluid marketplace, with many medical tourism companies exiting this industry. In addition, by disclosing identities of companies, providing their websites, archiving these websites or print copies of websites for future studies, and analyzing content of medical tourism company websites, the article can serve as a useful resource for future studies. Citizens, health policy-makers, clinicians, and researchers can all benefit from increased insight into Canada's medical tourism industry. PMID:21995598

Canadian medical tourism companies that have exited the marketplace: Content analysis of websites used to market transnational medical travel.

PubMed

Turner, Leigh

2011-10-14

Medical tourism companies play an important role in promoting transnational medical travel for elective, out-of-pocket medical procedures. Though researchers are paying increasing attention to the global phenomenon of medical tourism, to date websites of medical tourism companies have received limited scrutiny. This article analyzes websites of Canadian medical tourism companies that advertised international healthcare but ultimately exited the marketplace. Using content analysis of company websites as an investigative tool, the article provides a detailed account of medical tourism companies that were based in Canada but no longer send clients to international health care facilities. Internet searches, Google Alerts, searches on Google News Canada and ProQuest Newsstand, and searches of an Industry Canada database were used to locate medical tourism companies located in Canada. Once medical tourism companies were identified, the social science research method of content analysis was used to extract relevant information from company websites. Company websites were analyzed to determine: 1) where these businesses were based; 2) the destination countries and medical facilities that they promoted; 3) the health services they advertised; 4) core marketing messages; and 5) whether businesses marketed air travel, hotel accommodations, and holiday excursions in addition to medical procedures. In total, 25 medical tourism companies that were based in Canada are now defunct. Given that an estimated 18 medical tourism companies and 7 regional, cross-border medical travel facilitators now operate in Canada, it appears that approximately half of all identifiable medical tourism companies in Canada are no longer in business. 13 of the previously operational companies were based in Ontario, 7 were located in British Columbia, 4 were situated in Quebec, and 1 was based in Alberta. 14 companies marketed medical procedures within a single country, 9 businesses marketed health care at 2 or more destination nations, and 2 companies did not specify particular health care destinations. 22 companies operated as "generalist" businesses marketing many different types of medical procedures. 3 medical tourism companies marketed "specialist" services restricted to dental procedures or organ transplants. In general, medical tourism companies marketed health services on the basis of access to affordable, timely, and high-quality care. 16 businesses offered to make travel arrangements, 20 companies offered to book hotel reservations, and 17 medical tourism companies advertised holiday excursions. This article provides a detailed empirical analysis of websites of medical tourism companies that were based in Canada but exited the marketplace and are now inoperative. The article identifies where these companies were located in Canada, what countries and health care facilities they selected as destination sites, the health services they advertised, how they marketed themselves in a competitive environment, and what travel-related services they promoted in addition to marketing health care. The paper reveals a fluid marketplace, with many medical tourism companies exiting this industry. In addition, by disclosing identities of companies, providing their websites, archiving these websites or print copies of websites for future studies, and analyzing content of medical tourism company websites, the article can serve as a useful resource for future studies. Citizens, health policy-makers, clinicians, and researchers can all benefit from increased insight into Canada's medical tourism industry.

Discovering Preferential Patterns in Sectoral Trade Networks

PubMed Central

Cingolani, Isabella; Piccardi, Carlo; Tajoli, Lucia

2015-01-01

We analyze the patterns of import/export bilateral relations, with the aim of assessing the relevance and shape of “preferentiality” in countries’ trade decisions. Preferentiality here is defined as the tendency to concentrate trade on one or few partners. With this purpose, we adopt a systemic approach through the use of the tools of complex network analysis. In particular, we apply a pattern detection approach based on community and pseudocommunity analysis, in order to highlight the groups of countries within which most of members’ trade occur. The method is applied to two intra-industry trade networks consisting of 221 countries, relative to the low-tech “Textiles and Textile Articles” and the high-tech “Electronics” sectors for the year 2006, to look at the structure of world trade before the start of the international financial crisis. It turns out that the two networks display some similarities and some differences in preferential trade patterns: they both include few significant communities that define narrow sets of countries trading with each other as preferential destinations markets or supply sources, and they are characterized by the presence of similar hierarchical structures, led by the largest economies. But there are also distinctive features due to the characteristics of the industries examined, in which the organization of production and the destination markets are different. Overall, the extent of preferentiality and partner selection at the sector level confirm the relevance of international trade costs still today, inducing countries to seek the highest efficiency in their trade patterns. PMID:26485163

Plastic Surgery Complications from Medical Tourism Treated in a U.S. Academic Medical Center.

PubMed

Ross, Kimberly M; Moscoso, Andrea V; Bayer, Lauren R; Rosselli-Risal, Liliana; Orgill, Dennis P

2018-04-01

Medical tourism is a growing, multi-billion dollar industry fueled by improvements in the global transportation infrastructure. The authors studied patients living in the United States who travel to other countries for plastic surgical procedures and returned to have their complications treated in the authors' center. A retrospective patient evaluation was performed. Patients who had presented to an urban tertiary academic hospital plastic surgery service with complications or complaints associated with plastic surgery performed in a developing country were studied. The authors collected demographic information, types of surgery performed, destinations, insurance coverage, and complications. Seventy-eight patients were identified over 7 years. Most commonly, complications were seen following abdominoplasty (n = 35), breast augmentation (n = 25), and foreign body injections (n = 15). Eighteen patients underwent multiple procedures in one operative setting. The most common destination country was the Dominican Republic (n = 59). Complications included surgical-site infections (n = 14), pain (n = 14), and wound healing complications (n = 12). Eighty-six percent of patients (n = 67) relied on their medical insurance to pay for their follow-up care or manage their complications, with the most common type of health insurance coverage being Massachusetts Medicaid (n = 48). Cosmetic surgery performed in developing countries can carry substantial risks of complications that can be challenging to patients, primary care providers, insurers, and plastic surgical teams not associated with the original surgery. These complications pose significant burdens on our public health systems.

Social Policy and Immigrant Joblessness in Britain, Germany and Sweden

ERIC Educational Resources Information Center

Kesler, Christel

2006-01-01

I examine patterns of joblessness among immigrant men and women from 33 countries of origin now living in Britain, Germany and Sweden. Access to welfare, access to the labor market, job segregation and institutional support for women's employment define distinct policy configurations in these three destinations. Findings show that gaps in…

15 CFR Supplement No. 2 to Part 734 - Guidelines for De Minimis Rules

Code of Federal Regulations, 2014 CFR

2014-01-01

... consistent with your business practice. (3) Foreign-made product value—(i) General. The value of the foreign... De Minimis Rules (a) Calculation of the value of controlled U.S.-origin content in foreign-made items... commodities, software, or technology that could be exported or reexported to the country of destination...

15 CFR Supplement No. 2 to Part 734 - Guidelines for De Minimis Rules

Code of Federal Regulations, 2012 CFR

2012-01-01

... consistent with your business practice. (3) Foreign-made product value—(i) General. The value of the foreign... De Minimis Rules (a) Calculation of the value of controlled U.S.-origin content in foreign-made items... commodities, software, or technology that could be exported or reexported to the country of destination...

15 CFR Supplement No. 2 to Part 734 - Guidelines for De Minimis Rules

Code of Federal Regulations, 2013 CFR

2013-01-01

... consistent with your business practice. (3) Foreign-made product value—(i) General. The value of the foreign... De Minimis Rules (a) Calculation of the value of controlled U.S.-origin content in foreign-made items... commodities, software, or technology that could be exported or reexported to the country of destination...

15 CFR Supplement No. 2 to Part 734 - Guidelines for De Minimis Rules

Code of Federal Regulations, 2011 CFR

2011-01-01

... consistent with your business practice. (3) Foreign-made product value—(i) General. The value of the foreign... De Minimis Rules (a) Calculation of the value of controlled U.S.-origin content in foreign-made items... commodities, software, or technology that could be exported or reexported to the country of destination...

Partnering for success : techniques for working with partners to plan for alternative transportation in National Park Service units

DOT National Transportation Integrated Search

2003-01-01

Americas national parks are among the most popular tourist destinations in the country, with more than 424 million visits in 2001 alone. But this very popularity, along with the fact that most visitors arrive by private passenger car, has led to a...

22 CFR 126.1 - Prohibited exports, imports, and sales to or from certain countries.

Code of Federal Regulations, 2013 CFR

2013-04-01

... other approvals for exports and imports of defense articles and defense services destined for or... in furtherance of world peace and the security and foreign policy of the United States. Information... a U.S. Government department or agency, do not apply with respect to defense articles or defense...

22 CFR 126.1 - Prohibited exports, imports, and sales to or from certain countries.

Code of Federal Regulations, 2014 CFR

2014-04-01

... other approvals for exports and imports of defense articles and defense services, destined for or... in furtherance of world peace and the security and foreign policy of the United States. Information... a U.S. Government department or agency, do not apply with respect to defense articles or defense...

75 FR 25763 - Addition to the List of Validated End-Users: Advanced Micro Devices China, Inc.

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-10

.... Additional Validated End-User in the PRC and Its Respective ``Eligible Items (By ECCN)'' and ``Eligible... to the ``development'' of products under ECCN 4A003). This authorization was made based on an... Country Validated end-user Eligible items (by ECCN) Eligible destination China (People's Republic of...

Modelling Adult Skills in OECD Countries

ERIC Educational Resources Information Center

Scandurra, Rosario; Calero, Jorge

2017-01-01

Research in the social sciences has focused extensively on the relationship between family background, educational attainment and social destination, on the one hand, and on the processes of skills creation and skills use, on the other. This paper brings these two branches of the literature together by examining the correlation between a range of…

22 CFR 129.7 - Prior approval (license).

Code of Federal Regulations, 2013 CFR

2013-04-01

... defense services (other than those that are arranged wholly within and destined exclusively for the North... Zealand, or the Republic of Korea (see §§ 129.6(b)(2) and 129.7(a)). (2) Brokering activities involving... under this subchapter, for or from any country not a member of the North Atlantic Treaty Organization...

Vocational Education Qualifications' Roles in Pathways to Work in Liberal Market Economies

ERIC Educational Resources Information Center

Wheelahan, Leesa; Moodie, Gavin

2017-01-01

The links between vocational qualifications and occupational destinations are weak in many Anglophone countries, even though the explicit purpose of vocational qualifications is to prepare individuals for occupations. Using Australia and Canada as case studies, this is explained at three levels of analysis: at the national level by systems of…

A Comparative Study Examining Academic Cohorts with Transnational Migratory Intentions towards Canada and Australia

ERIC Educational Resources Information Center

Hopkins, John

2016-01-01

This research examines the issue of transnational academic mobility of academic staff, those choosing to migrate to higher education institutions in different countries as part of their career development, and performs a comparative study between the characteristics of academics examining Australia as a possible migratory destination with those…

Predictors of visitors' intention to return to a nature-based recreation area

Treesearch

Jee In Yoon; Gerard Kyle

2010-01-01

This study explored predictors of recreationists' intention to return to Santee Cooper Country (SCC), a popular destination for angling-based tourism in South Carolina. Our hypothesized model indicated that recreationists' experience use history and place satisfaction would positively affect four dimensions of place attachment to SCC. Place attachment was...

Mothers' Parenting Cognitions in Cultures of Origin, Acculturating Cultures, and Cultures of Destination

ERIC Educational Resources Information Center

Bornstein, Marc H.; Cote, Linda R. Y.

2004-01-01

Japanese and South American immigrant mothers' parenting cognitions (attributions and self-perceptions) were compared with mothers from their country of origin (Japan and Argentina, respectively) and European American mothers in the United States. Participants were 231 mothers of 20-month-old children. Generally, South American immigrant mothers'…

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

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.

To what extent does immigration affect inequality?

NASA Astrophysics Data System (ADS)

Berman, Yonatan; Aste, Tomaso

2016-11-01

The current surge in income and wealth inequality in most western countries, along with the continuous immigration to those countries demand a quantitative analysis of the effect immigration has on economic inequality. This paper presents a quantitative analysis framework providing a way to calculate this effect. It shows that in most cases, the effect of immigration on wealth and income inequality is limited, mainly due to the relative small scale of immigration waves. For a large scale flow of immigrants, such as the immigration to the US, the UK and Australia in the past few decades, we estimate that 10 % ÷ 15 % of the wealth and income inequality increase can be attributed to immigration. The results demonstrate that immigration could possibly decrease inequality substantially, if the characteristics of the immigrants resemble the characteristics of the destination middle class population in terms of wealth or income. We empirically found that the simple linear relation ΔS = 0.18 ρ roughly describes the increase in the wealth share of the top 10 % due to immigration of a fraction ρ of the population.

Immigration policy and internationally educated nurses in the United States: A brief history.

PubMed

Masselink, Leah E; Jones, Cheryl B

2014-01-01

Since the 1980s, U.S. policy makers have used immigration policy to influence the supply of nurses by allowing or restricting the entry of internationally educated nurses (IENs) into the U.S. workforce. The methods pursued have shifted over time from temporary visa categories in the 1980s and 1990s to permanent immigrant visas in the 2000s. The impact of policy measures adopted during nursing shortages has often been blunted by political and economic events, but the number and representation of IENs in the U.S. nursing workforce has increased substantially since the 1980s. Even as the United States seeks to increase domestic production of nurses, it remains a desirable destination for IENs and a target market for nurse-producing source countries. Hiring organizations and nurse leaders play a critical role in ensuring that the hiring and integration of IENs into U.S. health care organizations is constructive for nurses, source countries, and the U.S. health care system. Copyright © 2014 Elsevier Inc. All rights reserved.

The Effect of the Social and Physical Environment on Children's Independent Mobility to Neighborhood Destinations.

PubMed

Christian, Hayley E; Klinker, Charlotte D; Villanueva, Karen; Knuiman, Matthew W; Foster, Sarah A; Zubrick, Stephan R; Divitini, Mark; Wood, Lisa; Giles-Corti, Billie

2015-06-16

Relationships between context-specific measures of the physical and social environment and children's independent mobility to neighborhood destination types were examined. Parents in RESIDE's fourth survey reported whether their child (8-15 years; n = 181) was allowed to travel without an adult to school, friend's house, park and local shop. Objective physical environment measures were matched to each of these destinations. Social environment measures included neighborhood perceptions and items specific to local independent mobility. Independent mobility to local destinations ranged from 30% to 48%. Independent mobility to a local park was less likely as the distance to the closest park (small and large size) increased and less likely with additional school grounds (P < .05). Independent mobility to school was less likely as the distance to the closest large park increased and if the neighborhood was perceived as unsafe (P < .05). Independent mobility to a park or shops decreased if parenting social norms were unsupportive of children's local independent movement (P < .05). Independent mobility appears dependent upon the specific destination being visited and the impact of neighborhood features varies according to the destination examined. Findings highlight the importance of access to different types and sizes of urban green space for children's independent mobility to parks.

Medical tourism today: what is the state of existing knowledge?

PubMed

Hopkins, Laura; Labonté, Ronald; Runnels, Vivien; Packer, Corinne

2010-07-01

One manifestation of globalization is medical tourism. As its implications remain largely unknown, we reviewed claimed benefits and risks. Driven by high health-care costs, long waiting periods, or lack of access to new therapies in developed countries, most medical tourists (largely from the United States, Canada, and Western Europe) seek care in Asia and Latin America. Although individual patient risks may be offset by credentialing and sophistication in (some) destination country facilities, lack of benefits to poorer citizens in developing countries offering medical tourism remains a generic equity issue. Data collection, measures, and studies of medical tourism all need to be greatly improved if countries are to assess better both the magnitude and potential health implications of this trade.

Outcomes of surrogacy undertaken by Australians overseas.

PubMed

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

2014-09-15

To describe the outcomes of surrogacy among Australian intended parents who engage in compensated surrogacy overseas. Members of two Australian parenting support forums who were considering surrogacy or were currently or previously in a surrogacy arrangement were invited to complete an anonymous online survey during July 2013. Destination countries; source of eggs; number of surrogates and embryo transfers; proportions who experienced pregnancy loss after 12 weeks' gestation, multiple pregnancy, prematurity, and live birth by destination country; and intentions regarding disclosure to children about the way they were conceived. Of 1135 potential participants 259 (23%) completed the survey. Of these, 112 (43%) had undertaken at least one surrogacy attempt overseas. India and the United States were the two most common destination countries. Most respondents (95/112; 85%) had used donor eggs; half (57/112; 51%) had used more than one surrogate; and the mean number of embryo transfer procedures was 2.9. As a result of surrogacy, 85% (95/112) had at least one child; 55% (62/112) reported that their surrogate had a multiple pregnancy; 10% (11/112) reported that a pregnancy had ended in a late miscarriage or perinatal death; and 45% of births (35/78) were premature. Most respondents (80/112; 71%) were most comfortable with using an identity-release donor, and 87% (97/112) believed that this would also be in their child's best interests. Almost universally, parents were planning to disclose the use of a surrogate and/or a donor to their child. Almost half of the intended parents via surrogacy who completed this survey had undertaken compensated surrogacy overseas; most of these used donor eggs, but few considered Australian donors. A high proportion of surrogates had multiple pregnancies and there was a high rate of premature birth. These adverse outcomes could be avoided if the surrogacy was undertaken in Australia. Removing some of the existing barriers to surrogacy in Australia may reduce the number of surrogacy arrangements carried out overseas.

Regulatory aspects of pharmaceuticals' exports in gulf cooperation council countries.

PubMed

Pateriya, S; Janodia, Md; Deshpande, Pb; Ligade, Vs; Talole, Kb; Kulshrestha, T; Kamariya, Y; Musmade, Pb; Udupa, N

2011-04-01

The Gulf cooperation council (GCC) region is considered as "Emerging market" for pharmaceutical export and bilateral trade. The understanding of the regulatory requirements of this region can be beneficial for pharmaceutical export. Some incidents of the year 2008-09, like recession or economic slowdown in highly well-off and regulated market of the EU and US, raised the demand for alternate destinations for business. The regulations of Gulf countries are encouraging the import of quality generic products, which can be good news to the Indian drug manufacturers.

Regulatory Aspects of Pharmaceuticals’ Exports in Gulf Cooperation Council Countries

PubMed Central

Pateriya, S; Janodia, MD; Deshpande, PB; Ligade, VS; Talole, KB; Kulshrestha, T; Kamariya, Y; Musmade, PB; Udupa, N

2011-01-01

The Gulf cooperation council (GCC) region is considered as “Emerging market” for pharmaceutical export and bilateral trade. The understanding of the regulatory requirements of this region can be beneficial for pharmaceutical export. Some incidents of the year 2008-09, like recession or economic slowdown in highly well-off and regulated market of the EU and US, raised the demand for alternate destinations for business. The regulations of Gulf countries are encouraging the import of quality generic products, which can be good news to the Indian drug manufacturers. PMID:21731362

Immigrant Students' Shifting Identifications in South African Schools

ERIC Educational Resources Information Center

Vandeyar, Saloshna

2012-01-01

The easing of legal and unauthorized entry to South Africa has made the country a new destination for Black immigrants. As this population continues to grow, its children have begun to experience South African schools in an array of uniquely challenging ways. For these immigrant youth, forging a sense of identity may be their single greatest…

78 FR 69535 - Amendments to Existing Validated End-User Authorizations in the People's Republic of China

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-20

..., add a facility to the list of eligible destinations and two items to the list of eligible items for.... DATES: This rule is effective November 20, 2013. FOR FURTHER INFORMATION CONTACT: Karen Nies-Vogel... may be exported, reexported, or transferred (in-country) under a general authorization instead of a...

Motivations of Government-Sponsored Kurdish Students for Pursuing Postgraduate Studies Abroad; An Exploratory Study

ERIC Educational Resources Information Center

Ahmad, Ahmad Bayiz; Hassan, Hemin Ali; Al-Ahmedi, Mustafa Wshyar Abdulla

2017-01-01

This study examines the motivations of government-sponsored Kurdish students to study abroad and the reasons for choosing a particular country as their destination choice. Based on data we collected through an online survey and follow-up interviews, we compare demographic differences to explore the diversity among this cohort. The findings of the…

75 FR 68597 - Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-08

... commitments, and is one means by which USDA seeks to insure fairness and soundness in commodity marketing. U.S... of a reportable commodity to be sold to a foreign buyer; (2) the country of destination; and (3) the marketing year of shipment. The authority to collect this information is found at 7 CFR Part 20 and the...

International Student Destination Choice: The Influence of Home Campus Experience on the Decision to Consider Branch Campuses

ERIC Educational Resources Information Center

Wilkins, Stephen; Huisman, Jeroen

2011-01-01

Previous research has found that the country and institution choices of international students are greatly influenced by recommendations they receive from others who have experience of undertaking higher education overseas. For Western universities, it is of utmost importance to satisfy their international students, who can then encourage the next…

Soft Power and Cultural Diplomacy: Emerging Education Hubs in Asia

ERIC Educational Resources Information Center

Lee, Jack T.

2015-01-01

Several education hubs have emerged in Asia and the Middle East in recent years with a specific focus on cross-border higher education. Through considerable efforts in policy planning and generous funding, these hubs aim to transform a country or city into an eminent destination for education, research, and training. The inherent design of these…

Stress and Coping: Latino Youth Coming of Age in a New Latino Destination

ERIC Educational Resources Information Center

Brietzke, Maria; Perreira, Krista

2017-01-01

Previous research has linked stress to adverse mental health outcomes among Latino adolescents living in the United States. The mechanism through which this process operates continues to be explored, especially in regions of the country where Latin American immigrants and their children have only recently begun to migrate. Our study aimed to…

TNE-Trans-National Education or Tensions between National and External? a Case Study of Malaysia

ERIC Educational Resources Information Center

Hill, Christopher; Cheong, Kee-Cheok; Leong, Yin-Ching; Fernandez-Chung, Rozilini

2014-01-01

Transnational education, primarily at the tertiary level, has been growing rapidly, bringing with it high hopes and expectations of benefits to institutions in the countries of origin and destination. However, these potential benefits come with a set of challenges that must be overcome. These challenges include the need to reconcile the…

Helping Others Travel Abroad: Careers in International Preparation

ERIC Educational Resources Information Center

Vilorio, Dennis

2012-01-01

People travel abroad for reasons as diverse as their destinations. Many travel to sightsee, some to work, and others to study. Some stay indefinitely. Behind a number of these trips, there are workers who help travelers overcome the challenges of going to a different country--such as learning about local customs and finding safe accommodations. As…

Demographic Change and the Life Circumstances of Immigrant Families

ERIC Educational Resources Information Center

Hernandez, Donald J.

2004-01-01

Several major demographic shifts over the past half-century have transformed who we are and how we live in this country in many ways. Most striking, however, is the fact that children today are much more likely to be members of ethnic or racial minority groups. Racial/ethnic minorities are destined, in aggregate, to become the numerical majority…

15 CFR 752.3 - Eligible items.

Code of Federal Regulations, 2010 CFR

2010-01-01

... “Reason for Control” paragraph on the Commerce Control List (CCL) (see Supplement No. 1 to part 774 of the... chemical warfare agents, to destinations listed in Country Group D:3 (see Supplement No. 1 to part 740 of... applicable “Reason for Control” paragraph on the CCL; (5) Items controlled for EI reasons on the CCL; (6...

Changes in the built environment and changes in the amount of walking over time: longitudinal results from the multi-ethnic study of atherosclerosis.

PubMed

Hirsch, Jana A; Moore, Kari A; Clarke, Philippa J; Rodriguez, Daniel A; Evenson, Kelly R; Brines, Shannon J; Zagorski, Melissa A; Diez Roux, Ana V

2014-10-15

Lack of longitudinal research hinders causal inference on the association between the built environment and walking. In the present study, we used data from 6,027 adults in the Multi-Ethnic Study of Atherosclerosis who were 45-84 years of age at baseline to investigate the association of neighborhood built environment with trends in the amount of walking between 2000 and 2012. Walking for transportation and walking for leisure were assessed at baseline and at 3 follow-up visits (median follow-up = 9.15 years). Time-varying built environment measures (measures of population density, land use, number of destinations, bus access, and street connectivity) were created using geographic information systems. We used linear mixed models to estimate the associations between baseline levels of and a change in each built environment feature and a change in the frequency of walking. After adjustment for potential confounders, we found that higher baseline levels of population density, area zoned for retail, social destinations, walking destinations, and street connectivity were associated with greater increases in walking for transportation over time. Higher baseline levels of land zoned for residential use and distance to buses were associated with less pronounced increases (or decreases) in walking for transportation over time. Increases in the number of social destinations, the number of walking destinations, and street connectivity over time were associated with greater increases in walking for transportation. Higher baseline levels of both land zoned for retail and walking destinations were associated with greater increases in leisure walking, but no changes in built environment features were associated with leisure walking. The creation of mixed-use, dense developments may encourage adults to incorporate walking for transportation into their everyday lives. © The Author 2014. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

[Visceral leishmaniasis as a threat for non-endemic countries].

PubMed

Górski, Stanisław; Wiercińska-Drapało, Alicja

2009-01-01

Global warming, globalisation, and constantly increasing number of people involved in long-distance tourism and travel to exotic destinations are likely to increase the number of cases of exotic diseases "imported" to nonendemic countries. One of the often forgotten and neglected diseases has been visceral leishmaniasis (VL or kala-azar). The disease is endemic to 62 countries, with India and Sudan accounting for the majority of the cases. It is typically fatal if left untreated. Each year about 500 000 new cases are reported worldwide, and 50 000 die as a result of the disease. Kala-azar is present in the Mediterranean Europe and 70% of cases are imported to non-endemic countries of European Union from that area. Immunocompromised status of patients, like HIV carriers are the principal prospective target for kala-azar. HIV/VL-coinfected patients have significantly higher relapse rates and decreased life expectancy. There is no formal system of reporting imported cases in Europe, except from Germany. In non-endemic countries, including Poland, there is usually the substantial delay between the onset of symptoms and the final diagnosis, with an average exceeding 3 months. This fact suggests that physicians are not familiar with leishmania infections. Despite progress in vaccine development, the only way to prevent the infection is avoiding sandfly bites. Mosquito nets, wearing appropriate clothes and repellents containing DEET (diethyl toluamide) can reduce number of bites and protect also from the other vector-borne diseases like malaria or dengue. Education concerning kala-azar risk and ways of the disease prevention is a needed for tourists and the other travelers.

Should travellers to rabies-endemic countries be pre-exposure vaccinated? An assessment of post-exposure prophylaxis and pre-exposure prophylaxis given to Danes travelling to rabies-endemic countries 2000-12.

PubMed

Christiansen, Annette H; Rodriguez, Anna B; Nielsen, Jens; Cowan, Susan A

2016-04-01

Since 2000, a steady increase of vaccines used for both rabies Post-exposure prophylaxis (PEP) and rabies Pre-exposure prophylaxis (PrEP) given to Danish travellers was observed. This study aims to evaluate whether the increase of PEP and PrEP was due to increased travelling, increased awareness of the need for PrEP, or more animal bites per travel, leading to more PEP being administered, in order to assess the need for changing the recommendations. We also described in which countries Danish travelers most frequently reported possible exposure to rabies, and evaluated the timeliness of rabies PEP, including rabies immunoglobulin (RIG). We included all Danes reported to the National Database for Rabies Treatment as having started rabies PEP either abroad or after returning to Denmark, between 2000 and 2012. Data on the yearly number of Danish travelers from 2004 to 2012 to Thailand were collected to calculate the incidence of animal bites at this destination. We also included data on rabies vaccines sold for PrEP or for booster vaccination in Denmark. PEP after possible exposure to rabies abroad increased yearly by 8.8 %. Likewise vaccines sold for PrEP increased by 8.2% annually. The number of Danish travelers to Thailand increased by 7.3% per year, resulting in a stable incidence of animal bites per 100,000 travelers. Seventy-five % started PEP in the country of exposure, while only 10 % received RIG. The yearly increase in PEP and PrEP are parallel to the yearly increase in number of travelers, and can thus be explained by the increased rate of traveling, and not by a rise in awareness of rabies risk or more bites per traveler.Even short term travelers should be given the option of including PrEP in their travel immunisation program, as PEP and especially RIG is not always available in rabies-endemic countries. © International Society of Travel Medicine, 2016. All rights reserved. Published by Oxford University Press. For permissions, please e-mail: journals.permissions@oup.com.

The role of ethnic relations and education systems in migration from Southeast Asia to Australia.

PubMed

Sullivan, G; Gunasekaran, S

1993-08-01

"After a brief discussion of the geographical, cultural, and historical characteristics of Southeast Asia [and Hong Kong], a review is provided of the evolution of Australian immigration policy which, in our view, is a strong pull factor. This is followed by stock and flow analyses of Asian-born residents in Australia. The motivations for emigration in countries which exhibit substantial emigration rates are considered next and the article ends with the conclusion that demand factors and social networks play a decisive role in the decision to emigrate." Factors affecting migration significantly include political conditions and ethnic relations in countries of origin, and educational and career opportunities in the country of destination. excerpt

Reabsorption of returning workers from the Gulf: the Asian experience.

PubMed

Kazi, S

1994-01-01

This study examines trends in return labor migration from the Middle East to South Asia and Southeast Asia. Survey data were used to describe trends in outmigration and socioeconomic characteristics of return migrants and to examine the extent to which return migration is associated with skill level and use of savings and remittances on their return. General trends indicate a decline in outmigration during the late 1980s and early 1990s, after oil prices dropped in 1986. Migrants from Pakistan and Korea declined by half during 1981-85 and by 40% among Indian migrants. The demand for service workers and migrants willing to accept cuts in wages was unaffected. Outmigration from Southeast Asian countries grew in the recent past. These increases were due to the replacement of workers from Jordan and Yemen who were expelled from Saudi Arabia after the Gulf crisis. The shift in occupational demand to service and higher level workers is expected to weaken migration from Pakistan and Bangladesh and to strengthen migration from Sri Lanka and other Southeast Asian countries with a skilled migrant labor force. Outmigration from Southeast Asian countries increased to high-growth destination countries such as Japan, Malaysia, and Singapore. Socioeconomic characteristics of migrants varied by country of origin. For instance, Philippine migrants were better educated. Migrants from Thailand, Bangladesh, and Pakistan were from rural and impoverished areas. Sri Lanka and the Philippines had many women migrants. Return migrants encountered high unemployment. Return migrants to Korea had fewer reemployment problems. Reemployment was associated with local country conditions. Unskilled workers had the highest rates of unemployment. Savings tended to be invested in real estate and housing. Savings and investment from remittance income was high in Sri Lanka, Bangladesh, and Thailand.

'Emigration is a matter of self-preservation. The working conditions . . . are killing us slowly': qualitative insights into health professional emigration from Ireland.

PubMed

Humphries, Niamh; McAleese, Sara; Matthews, Anne; Brugha, Ruairi

2015-05-16

Achieving a sustainable health workforce involves training and retaining sufficient staff to deliver health services. The Irish health workforce is characterised by a high level of emigration of Irish-trained staff and a heavy reliance on internationally trained staff. This paper presents qualitative findings from a mixed-method study of doctors, nurses and midwives who have recently emigrated from Ireland. Using Facebook, this study elicited 556 (388 completed) responses to an exploratory mixed-method online survey in July 2014. Respondents provided rich responses to two free-text questions, one on health worker return (N = 343) and another on health professional emigration (N = 209) from the source country (Ireland). Respondents emigrated because of difficult working conditions in the Irish health system (long working hours, uncertain career progression), which compared poorly with conditions in the destination country. Respondents' experiences in the destination country vindicated the decision to emigrate and complicated the decision to return. Their return to Ireland was contingent upon significant reform of the Irish health system and an improvement in working conditions, expressed, for example, as: 'It's not about the money, it's about respect . . . we love working in medicine, but we love our families and health more' (RD283). This paper highlights that doctors, nurses and midwives are emigrating from Ireland in search of better working conditions, clear career progression pathways and a better practice environment. The question for the source country is whether it can retain and attract back emigrant doctors, nurses and midwives by matching their expectations.

Circumvention tourism.

PubMed

Cohen, Glenn

2012-09-01

Under what circumstances should a citizen be able to avoid the penalties set by the citizen's home country's criminal law by going abroad to engage in the same activity where it is not criminally prohibited? Should we view the ability to engage in prohibited activities by traveling outside of the nation state as a way of accommodating cultural or political differences within our polity? These are general questions regarding the power and theory of extraterritorial application of domestic criminal law. In this Article, I examine the issues through a close exploration of one setting that urgently presents them: medical tourism. Medical tourism is a term used to describe the travel of patients who are citizens and residents of one country, the "home country," to another country, the "destination country," for medical treatment. This Article is the first to comprehensively examine a subcategory of medical tourism that I call "circumvention tourism," which involves patients who travel abroad for services that are legal in the patient's destination country but illegal in the patient's home country--that is, travel to circumvent domestic prohibitions on accessing certain medical services. The four examples of this phenomenon that I dwell on are circumvention medical tourism for female genital cutting (FGC), abortion, reproductive technology usage, and assisted suicide. I will briefly discuss the "can" question: assuming that a domestic prohibition on access to one of these services is lawful, as a matter of international law, is the home country forbidden, permitted, or mandated to extend its existing criminal prohibition extraterritorially to home country citizens who travel abroad to circumvent the home country's prohibition? Most of the Article, though, is devoted to the "ought" question: assuming that the domestic prohibition is viewed as normatively well-grounded, under what circumstances should the home country extend its existing criminal prohibition extraterritorially to its citizens who travel abroad to circumvent the prohibition? I show that, contrary to much of current practice, in most instances, home countries should seek to extend extraterritorially their criminal prohibitions on FGC, abortion, assisted suicide, and, to a lesser extent, reproductive technology use to their citizens who travel abroad to circumvent the prohibition. I also discuss the ways in which my analysis of these prohibitions can serve as scaffolding for a more general theory of circumvention tourism.

Assessing the risk of work-related international travel.

PubMed

Druckman, Myles; Harber, Philip; Liu, Yihang; Quigley, Robert L

2014-11-01

To identify factors affecting the likelihood of requiring medical services during international business trips. Data from more than 800,000 international trips and medical assistance cases provided to 48 multinational corporations in 2009. Travel destination countries were grouped into four a priori risk-related categories. Travel to "low" medical risk countries in aggregate accounted for more hospitalizations and medical evacuations than travel to "high" medical risk countries. Nevertheless, the risk per trip was much higher for travel to higher medical risk countries. Corporations with employees on international travel should allocate sufficient resources to manage and ideally prevent medical issues during business travel. Travel medicine must focus on more than infectious diseases, and programs are necessary for both high- and low-risk regions. Improved understanding of travel-related needs determines resource allocation and risk mitigation efforts.

The New Destination Disadvantage: Disparities in Hispanic Health Insurance Coverage Rates in Metropolitan and Nonmetropolitan New and Established Destinations

PubMed Central

Monnat, Shannon M.

2016-01-01

Hispanics have the lowest health insurance rates of any racial/ethnic group, but rates vary significantly across the U.S. The unprecedented growth of the Hispanic population since 1990 in rural areas with previously small or non-existent Hispanic populations raises questions about disparities in access to health insurance coverage. Identifying spatial disparities in Hispanic health insurance rates can illuminate the specific contexts within which Hispanics are least likely to have health care access and inform policy approaches for increasing coverage in different spatial contexts. Using county-level data from the 2009/2013 American Community Survey, I find that early new destinations (i.e., those that experienced rapid Hispanic population growth during the 1990s) have the lowest Hispanic adult health insurance coverage rates, with little variation by metropolitan status. Conversely, among the most recent new destinations that experienced significant Hispanic population growth during the 2000s, metropolitan counties have Hispanic health insurance rates that are similar to established destinations, but rural counties have Hispanic health insurance rates that are significantly lower than those in established destinations. Findings demonstrate that the new destination disadvantage is driven entirely by higher concentrations of immigrant non-citizen Hispanics in these counties, but labor market conditions were salient drivers of the spatially uneven distribution of foreign-born non-citizen Hispanics to new destinations, particularly in rural areas. PMID:28479612

Medical tourism-A New Arena.

PubMed

Puri, S; Singh, A; Yashik

2010-01-01

Globalisation has given birth to medical tourism. Health and medical tourism are the fastest growing segments in not only developed nations but in developing countries too. India has become a hot destination, as the Indian medical standards match up to the highly prescribed international standards at a very low cost. However, it is an unmixed blessing; along with advantages, it has many unintended side effects also.

15 CFR Supplement No. 2 to Part 748 - Unique Application and Submission Requirements

Code of Federal Regulations, 2013 CFR

2013-01-01

... tools, dimensional inspection machines, direct numerical control systems, specially designed assemblies... Commerce Control List (§ 774.1 of the EAR)—see Category 5 Part 1 Notes 1 and 2 and Part 2 Note 1. License... containing computers to destinations in Country Group D:1 (See Supplement No. 1 to part 740 of the EAR), or...

15 CFR Supplement No. 2 to Part 748 - Unique Application and Submission Requirements

Code of Federal Regulations, 2010 CFR

2010-01-01

... tools, dimensional inspection machines, direct numerical control systems, specially designed assemblies... Commerce Control List (§ 774.1 of the EAR)—see Category 5 Part 1 Notes 1 and 2 and Part 2 Note 1. License... containing computers to destinations in Country Group D:1 (See Supplement No. 1 to part 740 of the EAR), or...

15 CFR Supplement No. 2 to Part 748 - Unique Application and Submission Requirements

Code of Federal Regulations, 2011 CFR

2011-01-01

... tools, dimensional inspection machines, direct numerical control systems, specially designed assemblies... Commerce Control List (§ 774.1 of the EAR)—see Category 5 Part 1 Notes 1 and 2 and Part 2 Note 1. License... containing computers to destinations in Country Group D:1 (See supplement No. 1 to part 740 of the EAR), or...

''I'd Love to Put Someone in Jail for This:" An Initial Investigation of English in the Business Processing Outsourcing (BPO) Industry

ERIC Educational Resources Information Center

Forey, Gail; Lockwood, Jane

2007-01-01

In the global workplace, there has been tremendous growth in business processing outsourcing (BPO). Many industries are establishing call centers, back offices and other offshore enterprises in developing countries in an attempt to reduce costs. This development has far-reaching implications for language in these offshore destinations. Despite…

22 CFR 123.9 - Country of ultimate destination and approval of reexports or retransfers.

Code of Federal Regulations, 2010 CFR

2010-04-01

... the amount of $25,000,000 ($25 million) or more; the articles are not defense articles or defense services sold under a contract in the amount of $100,000,000 ($100 million) or more; and are not identified... Australia, Japan, New Zealand, or South Korea, are authorized without the prior written approval of the...

Student Evaluation of University Image Attractiveness and Its Impact on Student Attachment to International Branch Campuses

ERIC Educational Resources Information Center

Wilkins, Stephen; Huisman, Jeroen

2013-01-01

In many countries and regions around the world international students now weigh up the potential advantages and disadvantages of undertaking their higher education at an international branch campus rather than at a home campus located in a traditional destination such as the United States or United Kingdom. The aim of the research is to identify…

Salmonellosis and charter tourism: epidemiology and trends of imported human cases to Norway from the Canary Islands and Thailand, 1994-2008.

PubMed

Emberland, K E; Nygård, K; Aavitsland, P

2012-09-01

More than 70% of reported human Salmonella infections in Norway are infected abroad. The Canary Islands and Thailand are two of the most popular charter tourist destinations for Norwegians. Using surveillance data for the years 1994-2008, and denominator data on travel to the Canary Islands 2000-2008 and to Thailand 1997-2008, we present the epidemiology and trends of Salmonella infections in Norwegian tourists to these destinations. We found a declining trend in risk of salmonellosis in tourists returning from the Canary Islands, and a change in serovar distribution in travellers to Thailand with more S. Enteritidis infections, similar to that observed in Western European countries. The use of denominator data is important when studying risk of travel-related disease, as surveillance data tend to reflect travel activity more than the risk. Infections among tourists do not always affect the local residents and therefore may not be detected by local public health authorities. Sharing knowledge on the epidemiology of infections in tourists could be useful for observation of changes in trends in the countries visited, and in future outbreak investigations.

Skilled migration and health outcomes in developing countries.

PubMed

Uprety, Dambar

2018-04-30

Many studies have found that health outcomes decline when health professionals leave the country, but do such results remain consistent in gender- and income-disaggregated skilled migration? To help uncover explanations for such a pro-migration nature of health outcomes, the present study revisits this topic but allows for associations of skilled migration with mortality and life expectancy to differ between male and female, and between low- and high-income countries. Using a panel of 133 developing countries as source and 20 OECD countries as destination from 1980 to 2010 allowing the coefficient on emigration across different education levels to differ, the study finds the negative effect of high-skilled emigration on health outcomes. Such effect is more pronounced for high-skilled female migration than those for male and for low-income countries than for middle-and high-income countries. Results also show that such adverse effect is larger for African countries than non-African ones. However, the low-skilled migration appears to be insignificant to affect health outcomes in developing countries. Thus, skilled migration is detrimental to longevity in developing countries but unskilled migration is not.

A framework for offshore vendor capability development

NASA Astrophysics Data System (ADS)

Yusuf Wibisono, Yogi; Govindaraju, Rajesri; Irianto, Dradjad; Sudirman, Iman

2016-02-01

Offshore outsourcing is a common practice conducted by companies, especially in developed countries, by relocating one or more their business processes to other companies abroad, especially in developing countries. This practice grows rapidly owing to the ease of accessing qualified vendors with a lower cost. Vendors in developing countries compete more intensely to acquire offshore projects. Indonesia is still below India, China, Malaysia as main global offshore destinations. Vendor capability is among other factors that contribute to the inability of Indonesian vendor in competing with other companies in the global market. Therefore, it is essential to study how to increase the vendor's capability in Indonesia, in the context of global offshore outsourcing. Previous studies on the vendor's capability mainly focus on capabilities without considering the dynamic of capabilities due to the environmental changes. In order to be able to compete with competitors and maintain the competitive advantage, it is necessary for vendors to develop their capabilities continuously. The purpose of this study is to develop a framework that describes offshore vendor capability development along the client-vendor relationship stages. The framework consists of three main components, i.e. the stages of client-vendor relationship, the success of each stage, and the capabilities of vendor at each stage.

Screening for tuberculosis in migrants and visitors from high incidence settings: present and future perspectives.

PubMed

Dobler, Claudia C; Fox, Greg J; Douglas, Paul; Viney, Kerri A; Ahmad Khan, Faiz; Temesgen, Zelalem; Marais, Ben J

2018-05-24

In most settings with a low incidence of tuberculosis (TB), foreign-born people make up the majority of TB cases, but the distribution of the TB risk among different migrant populations is often poorly quantified. In addition, screening practices for TB disease and latent TB infection vary widely. Addressing the risk of TB in international migrants is an essential component of TB prevention and care efforts in low incidence countries, and strategies to systematically screen for, diagnose, treat and prevent TB among this group contribute to national and global TB elimination goals.This review provides an overview and critical assessment of TB screening practices that are focused on migrants and visitors from high to low TB incidence countries, including pre-migration screening and post-migration follow-up of those deemed to be at an increased risk of developing TB. We focus mainly on migrants who enter the destination country via application for a long-stay visa, as well as asylum seekers and refugees, but briefly consider issues related to short-term visitors and those with long duration multiple-entry visas. Issues related to the screening of children and screening for latent TB infection are also explored. Copyright ©ERS 2018.

Tuberculosis Among Temporary Visa Holders Working in the Tourism Industry - United States, 2012-2014.

PubMed

Weinberg, Meghan P; Cherry, Cara; Lipnitz, Julie; Nienstadt, Linus; King-Todd, April; Haddad, Maryam B; Russell, Michelle; Wong, David; Davidson, Peter; McFadden, Jevon; Miller, Corinne

2016-03-25

Tuberculosis (TB) is a contagious bacterial disease of global concern. During 2013, an estimated nine million incident TB cases occurred worldwide (1). The majority (82%) were diagnosed in 22 countries, including South Africa and the Philippines, where annual incidence was 860 TB cases per 100,000 persons and 292 TB cases per 100,000 persons, respectively (1). The 2013 TB incidence in the United States was three cases per 100,000 persons (2). Under the Immigration and Nationality Act, TB screening is required for persons seeking permanent residence in the United States (i.e., immigrants and refugees), but it is not routinely required for nonimmigrants who are issued temporary visas for school or work (3). A portion of the U.S. tourism industry relies on temporary visa holders to accommodate seasonal and fluctuating demand for service personnel (4). This report describes three foreign-born persons holding temporary visas who had infectious TB while working at tourist destinations in the United States during 2012-2014. Multiple factors, including dormitory-style housing, transient work patterns, and diagnostic delays might have contributed to increased opportunity for TB transmission. Clinicians in seasonally driven tourist destinations should be aware of the potential for imported TB disease in foreign-born seasonal workers and promptly report suspected cases to health officials.

Travel health knowledge, attitudes and practices among Australasian travelers.

PubMed

Wilder-Smith, Annelies; Khairullah, Nor S; Song, Jae-Hoon; Chen, Ching-Yu; Torresi, Joseph

2004-01-01

Although the Asia Pacific region is the focus of the fastest-growing tourist and travel industry, few data are available on the knowledge, attitudes and practices (KAP) of travelers from this region with regard to travel-related infectious diseases. We conducted a cross-sectional survey among travelers at the departure lounges of five airports in Australasia (Singapore, Kuala Lumpur, Taipeh, Melbourne, Seoul) whose travel destinations were Asia, Africa or South America. Two standardized questionnaires directed towards KAP in travel health, travel immunizations and malaria were administered. Of 2,101 respondents (82% Asian, 17% Western), 31% had sought pretravel health advice and only 4% sought travel health advice from the travel medicine specialist. The risk of vaccine-preventable infectious diseases and malaria at the destination country was perceived to be low. Overall, fewer than 5% of travelers had been vaccinated in preparation for their trip. The most frequent travel vaccinations were for hepatitis A and B. Only 40% of travelers to malaria-endemic areas carried malaria prophylaxis. Compared to Western travelers, those of Asian nationality were significantly less likely to obtain pretravel advice and malaria prophylaxis and to receive travel vaccinations. There is an urgent need for increased awareness about travel-related infectious diseases among Asian travelers, and greater uptake of pretravel health advice, vaccinations and malaria prophylactic measures.

Risks, prices, and positions: A social network analysis of illegal drug trafficking in the world-economy.

PubMed

Boivin, Rémi

2014-03-01

Illegal drug prices are extremely high, compared to similar goods. There is, however, considerable variation in value depending on place, market level and type of drugs. A prominent framework for the study of illegal drugs is the "risks and prices" model (Reuter & Kleiman, 1986). Enforcement is seen as a "tax" added to the regular price. In this paper, it is argued that such economic models are not sufficient to explain price variations at country-level. Drug markets are analysed as global trade networks in which a country's position has an impact on various features, including illegal drug prices. This paper uses social network analysis (SNA) to explain price markups between pairs of countries involved in the trafficking of illegal drugs between 1998 and 2007. It aims to explore a simple question: why do prices increase between two countries? Using relational data from various international organizations, separate trade networks were built for cocaine, heroin and cannabis. Wholesale price markups are predicted with measures of supply, demand, risks of seizures, geographic distance and global positioning within the networks. Reported prices (in $US) and purchasing power parity-adjusted values are analysed. Drug prices increase more sharply when drugs are headed to countries where law enforcement imposes higher costs on traffickers. The position and role of a country in global drug markets are also closely associated with the value of drugs. Price markups are lower if the destination country is a transit to large potential markets. Furthermore, price markups for cocaine and heroin are more pronounced when drugs are exported to countries that are better positioned in the legitimate world-economy, suggesting that relations in legal and illegal markets are directed in opposite directions. Consistent with the world-system perspective, evidence is found of coherent world drug markets driven by both local realities and international relations. Copyright © 2013 Elsevier B.V. All rights reserved.

Accelerate Implementation of the WHO Global Code of Practice on International Recruitment of Health Personnel: Experiences From the South East Asia Region

PubMed Central

Tangcharoensathien, Viroj; Travis, Phyllida

2016-01-01

Strengthening the health workforce and universal health coverage (UHC) are among key targets in the heath-related Sustainable Development Goals (SDGs) to be committed by the United Nations (UN) Member States in September 2015. The health workforce, the backbone of health systems, contributes to functioning delivery systems. Equitable distribution of functioning services is indispensable to achieve one of the UHC goals of equitable access. This commentary argues the World Health Organization (WHO) Global Code of Practice on International Recruitment of Health Personnel is relevant to the countries in the South East Asia Region (SEAR) as there is a significant outflow of health workers from several countries and a significant inflow in a few, increased demand for health workforce in high- and middle-income countries, and slow progress in addressing the "push factors." Awareness and implementation of the Code in the first report in 2012 was low but significantly improved in the second report in 2015. An inter-country workshop in 2015 convened by WHO SEAR to review progress in implementation of the Code was an opportunity for countries to share lessons on policy implementation, on retention of health workers, scaling up health professional education and managing in and out migration. The meeting noted that capturing outmigration of health personnel, which is notoriously difficult for source countries, is possible where there is an active recruitment management through government to government (G to G) contracts or licensing the recruiters and mandatory reporting requirement by them. According to the 2015 second report on the Code, the size and profile of outflow health workers from SEAR source countries is being captured and now also increasingly being shared by destination country professional councils. This is critical information to foster policy action and implementation of the Code in the Region. PMID:26673648

Macro-conditions and immigrants' happiness: Is moving to a wealthy country all that matters?

PubMed

Hendriks, Martijn; Bartram, David

2016-03-01

Migrants look for a better life. In what kind of country will they live happiest? Many migrants aspire to move to wealthy countries, but non-economic factors might be important as well in making a country livable for migrants. This issue is addressed here by examining the impact of macroeconomic conditions and non-economic macro-conditions (good governance and a pleasant social climate) on immigrants' happiness in twenty European nations. We find that immigrants' happiness depends both on economic and non-economic macro-conditions. The social climate is especially important, particularly in terms of a positive attitude in society towards migrants. Our findings imply that the choice of destination country matters for migrants' happiness and that the discrepancy between migration motives and migration outcomes may constrain immigrants from maximizing subjective gains via migration. Copyright © 2015 Elsevier Inc. All rights reserved.

Trends in the knowledge, attitudes and practices of travel risk groups towards prevention of malaria: results from the Dutch Schiphol Airport Survey 2002 to 2009

PubMed Central

2012-01-01

Background Previous studies investigating the travellers’ knowledge, attitudes and practices (KAP) profile indicated an important educational need among those travelling to risk destinations. Initiatives to improve such education should target all groups of travellers, including business travellers, those visiting friends and relatives (VFRs), and elderly travellers. Methods In the years 2002 to 2009, a questionnaire-based survey was conducted at the Dutch Schiphol Airport with the aim to study trends in KAP of travel risk groups towards prevention of malaria. The risk groups last-minute travellers, solo-travellers, business travellers, VFRs and elderly travellers were specifically studied. Results A total of 3,045 respondents were included in the survey. Travellers to destinations with a high risk for malaria had significantly more accurate risk perceptions (knowledge) than travellers to low-risk destinations. The relative risk for malaria in travellers to high-risk destinations was probably mitigated by higher protection rates against malaria as compared with travellers to low risk destinations. There were no significant differences in intended risk-taking behaviour. Trend analyses showed a significant change over time in attitude towards more risk-avoiding behaviour and towards higher protection rates against malaria in travellers to high-risk destinations. The KAP profile of last-minute travellers substantially increased their relative risk for malaria, which contrasts to the slight increase in relative risk of solo travellers, business travellers and VFRs for malaria. Conclusions The results of this sequential cohort survey in Dutch travellers suggest an annual 1.8% increase in protection rates against malaria coinciding with an annual 2.5% decrease in intended risk-seeking behaviour. This improvement may reflect the continuous efforts of travel health advice providers to create awareness and to propagate safe and healthy travel. The KAP profile of last-minute travellers, in particular, substantially increased their relative risk for malaria, underlining the continuous need for personal protective measures and malaria chemoprophylaxis for this risk group. PMID:22642661

Travelling with medications and medical equipment across international borders.

PubMed

Mutie, M; Cooper, G; Kyle, G; Naunton, M; Zwar, N

2014-01-01

The international traveller needs to plan ahead to ensure medicines are available and used as directed for optimal therapeutic outcome. The planning needs to take account of legal and customs requirements for travelling with medicines for personal use. The standard advice by travel health providers is that travellers should check with the country of destination for requirements when travelling into the country with medicines for personal use. This is akin to introducing a barrier to care for this category of travellers. Innovative method of care for this group of traveller is needed. Copyright © 2014 Elsevier Ltd. All rights reserved.

Visualizing Human Migration Trhough Space and Time

NASA Astrophysics Data System (ADS)

Zambotti, G.; Guan, W.; Gest, J.

2015-07-01

Human migration has been an important activity in human societies since antiquity. Since 1890, approximately three percent of the world's population has lived outside of their country of origin. As globalization intensifies in the modern era, human migration persists even as governments seek to more stringently regulate flows. Understanding this phenomenon, its causes, processes and impacts often starts from measuring and visualizing its spatiotemporal patterns. This study builds a generic online platform for users to interactively visualize human migration through space and time. This entails quickly ingesting human migration data in plain text or tabular format; matching the records with pre-established geographic features such as administrative polygons; symbolizing the migration flow by circular arcs of varying color and weight based on the flow attributes; connecting the centroids of the origin and destination polygons; and allowing the user to select either an origin or a destination feature to display all flows in or out of that feature through time. The method was first developed using ArcGIS Server for world-wide cross-country migration, and later applied to visualizing domestic migration patterns within China between provinces, and between states in the United States, all through multiple years. The technical challenges of this study include simplifying the shapes of features to enhance user interaction, rendering performance and application scalability; enabling the temporal renderers to provide time-based rendering of features and the flow among them; and developing a responsive web design (RWD) application to provide an optimal viewing experience. The platform is available online for the public to use, and the methodology is easily adoptable to visualizing any flow, not only human migration but also the flow of goods, capital, disease, ideology, etc., between multiple origins and destinations across space and time.

Travel Characteristics and Pretravel Health Care Among Pregnant or Breastfeeding U.S. Women Preparing for International Travel.

PubMed

Hagmann, Stefan H F; Rao, Sowmya R; LaRocque, Regina C; Erskine, Stefanie; Jentes, Emily S; Walker, Allison T; Barnett, Elizabeth D; Chen, Lin H; Hamer, Davidson H; Ryan, Edward T

2017-12-01

To study characteristics and preventive interventions of adult pregnant and breastfeeding travelers seeking pretravel health care in the United States. This cross-sectional study analyzed data (2009-2014) of pregnant and breastfeeding travelers seen at U.S. travel clinics participating in Global TravEpiNet. Nonpregnant, nonbreastfeeding adult female travelers of childbearing age were used for comparison. We evaluated the prescription of malaria chemoprophylaxis and antibiotics for this population as well as the administration of three travel-related vaccines: hepatitis A, typhoid, and yellow fever. We also evaluated use of tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis and influenza vaccines, because these are widely recommended in pregnancy. Of 21,138 female travelers of childbearing age in Global TravEpiNet, 170 (0.8%) were pregnant and 139 (0.7%) were breastfeeding. Many traveled to destinations endemic for mosquito-borne illnesses, including malaria (pregnant: 95%; breastfeeding: 94%), dengue (pregnant: 87%; breastfeeding: 81%), or yellow fever (pregnant: 35%; breastfeeding: 50%). Compared with nonpregnant, nonbreastfeeding adult female travelers, eligible pregnant travelers were less likely to be vaccinated against hepatitis A (28% compared with 51%, P<.001) and typhoid (35% compared with 74%, P<.001). More than 20% of eligible pregnant travelers did not receive influenza vaccination. Yellow fever vaccine was occasionally provided to pregnant and breastfeeding travelers traveling to countries entirely endemic for yellow fever (6 [20%] of 30 pregnant travelers and 18 [46%] of 39 breastfeeding travelers). Half of pregnant travelers and two thirds of breastfeeding travelers preparing to travel to malaria-holoendemic countries received a prescription for malaria prophylaxis. Most pregnant and breastfeeding travelers seen for pretravel health consultations traveled to destinations with high risk for vector-borne or other travel-related diseases. Destination-specific preventive interventions were frequently underused.

Summary of the Statement on International Travellers and Typhoid by the Committee to Advise on Tropical Medicine and Travel (CATMAT)

PubMed Central

Greenaway, C; Schofield, S; Henteleff, A; Plourde, P; Geduld, J; Abdel-Motagally, M; Bryson, M

2014-01-01

Background Typhoid fever is an enteric febrile illness with symptoms that range from mild to potentially fatal. Among Canadians it is usually acquired during travel to typhoid endemic countries. The Committee to Advise on Tropical Medicine and Travel (CATMAT) assembled a typhoid working group to update recommendations on typhoid and international travel. This document is a summary of the new typhoid statement. Methods Following a systematic review of the literature, typhoid vaccine recommendations were developed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology to evaluate data quality, benefits and harms, and values and preferences. The literature search focused on systematic reviews of typhoid vaccine efficacy and identified studies of disease burden, pathogenesis, risk factors and prevention. Other recommendations were based on a review of the retrieved literature and expert opinion. Results Typhoid vaccine is moderately effective (~50%), well tolerated, with very low risk of serious adverse events. Studies of typhoid vaccine efficacy, morbidity or mortality among travellers were not found, although studies on populations in typhoid endemic countries were identified. Among travellers, destination of travel is the strongest and most consistent typhoid risk predictor; the highest risk was for travel to South Asia. Confidence in effect estimates for other potential risk factors was very low. Recommendations CATMAT suggests that typhoid vaccine (Ty21a or Vi polysaccharide vaccine) be used for most Canadian travellers visiting South Asia and not used for most Canadian travellers visiting destinations other than South Asia. The recommendations are conditional, due to the moderate confidence in the effect estimate. For destinations other than South Asia, providers should discuss risks and vaccine benefits and harms with the traveller as well as recommend basic hygiene precautions.

Vaccination knowledge, attitude and practice among Chinese travelers who visit travel clinics in Preparation for international travel.

PubMed

Zhang, Min; Zhang, Jianming; Hao, Yutong; Fan, ZhengXing; Li, Lei; Li, Yiguang; Ju, Wendong; Zhang, Hong; Liu, Wei; Zhang, Mengzhang; Wu, Di; He, Hongtao

2016-06-01

Although international travel has become increasingly more common in main land China, few data are available on vaccination knowledge, attitude and practice (KAP) among Chinese travelers. In each of 14 International Travel Healthcare Centers (ITHCs) situated in mainland China 200 volunteers were recruited for a cross-sectional investigation by questionnaire on KAP related to travel vaccinations. For the evaluation the study subjects were grouped by demographic data, past travel experience, travel destination, duration of stay abroad, purpose of travel. Among the 2,800 Chinese travelers who participated in the study, 67.1% were aware of national and travel vaccination recommendations. The knowledge about vaccine preventable diseases was low. The most common sources (73.4%) of information were requirements by destination countries obtained in connection with the visa application, Chinese companies employing workers/laborers for assignments overseas, and foreign schools. The overall acceptance rate of recommended vaccines was 68.7%, but yellow fever was accepted by 99.8% of the participants when recommended. Among 81.1% respondents who recalled to have received vaccinations in the past, only 25.9% of them brought the old vaccination records with them to their ITHC consultations. The results indicate that increased awareness of the importance of pre-travel vaccination is needed among the travellers in order to improve their KAP. © International Society of Travel Medicine, 2016. All rights reserved. Published by Oxford University Press. For permissions, please e-mail: journals.permissions@oup.com.

An exploratory survey of Spanish and English nursing students' views on studying or working abroad.

PubMed

Goodman, Benny; Jones, Ray; Sanchón Macias, Marivi

2008-04-01

Student mobility within Europe is encouraged by the EU's 'Bologna process' and financially supported by the Socrates programme. However, relatively few UK nursing students travel to Europe for study. To compare the willingness to study or work abroad and the perceived barriers and benefits of doing so, amongst students in England and Spain. Third year nursing students completed a 15 item questionnaire on work and study abroad. Spanish students were younger than UK students, had fewer family commitments, and better language skills. There was little difference between Spanish and UK students in wanting to study abroad, UK students named English speaking countries as likely destinations. Spanish students named Italy; the UK and USA were also popular. Perceived barriers for UK students were funding, family, and language. Family commitments were not a major problem for Spanish students. Spanish were more likely than English students to see language as a problem. UK and Spanish Nursing students are equally enthusiastic about studying or working abroad but UK students have limited language skills, are less able to access Socrates funding for European destinations, and given their age and family commitments, funding is a barrier for 'non-Socrates' destinations.

Nurse Migration: A Canadian Case Study

PubMed Central

Little, Lisa

2007-01-01

Objective To synthesize information about nurse migration in and out of Canada and analyze its role as a policy lever to address the Canadian nursing shortage. Principal Findings Canada is both a source and a destination country for international nurse migration with an estimated net loss of nurses. The United States is the major beneficiary of Canadian nurse emigration resulting from the reduction of full-time jobs for nurses in Canada due to health system reforms. Canada faces a significant projected shortage of nurses that is too large to be ameliorated by ethical international nurse recruitment and immigration. Conclusions The current and projected shortage of nurses in Canada is a product of health care cost containment policies that failed to take into account long-term consequences for nurse workforce adequacy. An aging nurse workforce, exacerbated by layoffs of younger nurses with less seniority, and increasing demand for nurses contribute to a projection of nurse shortage that is too great to be solved ethically through international nurse recruitment. National policies to increase domestic nurse production and retention are recommended in addition to international collaboration among developed countries to move toward greater national nurse workforce self sufficiency. PMID:17489918

Emergency Management and Tourism Stakeholder Responses to Crises: A Global Survey.

PubMed

Morakabati, Yeganeh; Page, Stephen J; Fletcher, John

2017-03-01

This article examines the contested area of the responsibility for destinations and tourists, within emergency settings. It incorporates a Delphi-Scenario technique to facilitate a structured discussion of emergency management for different destination stakeholders. The Delphi exercise engaged 123 senior international stakeholders, from 9 different industry sectors, across 34 countries to provide a global perspective. The study's principal focus is on the notion of emergency management, to identify the challenges that stakeholders would face within a disaster scenario. The exercise asked stakeholders to identify with whom the responsibility rests for 18 distinct disaster-related activities. The study proposes a responsibility allocation building-block framework that could help speed up the emergency management responses by "knowing who is going to do what" with a particular focus on dealing with international tourists as a community in a disaster zone.

Emergency Management and Tourism Stakeholder Responses to Crises

PubMed Central

Morakabati, Yeganeh; Page, Stephen J.; Fletcher, John

2016-01-01

This article examines the contested area of the responsibility for destinations and tourists, within emergency settings. It incorporates a Delphi-Scenario technique to facilitate a structured discussion of emergency management for different destination stakeholders. The Delphi exercise engaged 123 senior international stakeholders, from 9 different industry sectors, across 34 countries to provide a global perspective. The study’s principal focus is on the notion of emergency management, to identify the challenges that stakeholders would face within a disaster scenario. The exercise asked stakeholders to identify with whom the responsibility rests for 18 distinct disaster-related activities. The study proposes a responsibility allocation building-block framework that could help speed up the emergency management responses by “knowing who is going to do what” with a particular focus on dealing with international tourists as a community in a disaster zone. PMID:29708106

[Travel medicine and vaccination as a task of infection prevention--data of the special consultation hours of the public health department Frankfurt on the Main, Germany, 2002-2004].

PubMed

Heudorf, U; Tiarks-Jungk, P; Stark, S

2006-05-01

Infection prevention is one of the main tasks of the Public Health authorities. Because of hundreds of travel associated infections imported by travellers every year and considering increasing travel activities to tropical countries, travel medicine and consultation on the correct prevention measures including vaccination is becoming more and more important. Hence the data of the special consultation hours of the public health department of Frankfurt am Main are reported and discussed with regard to possible improvements. The public health department of Frankfurt am Main has been offering special consultation hours for travel medicine for many years. Here, data derived from the anamneses of the clients from 2002 - 2004 are reported: personal data such as age, sex, travel destination as well as medical data such as vaccination and malaria prevention. 2002 - 2004, more than 14,000 persons were seen in the consultation hours, more than 66% of them asked for travel health advice, about 25% of them asked for standard vaccination (such as influenza), some others asked for attestation or certification. More than 20,000 doses of vaccines were given, the most important vaccination against hepatitis A (n = 5791), hepatitis B (n = 4064), typhoid fever (n = 2718) and yellow fever (n = 2473). 2814 were informed with regard to malaria prevention, including recipes. 7814 persons with complete data on their reason for travel were subjected to more detailed analysis: 75% of them were holiday tourists, 18% travelled as "hikers", 7% were business travellers and less than 1% of them planned a round-the-world tour. The most frequent travel destinations were: Asian or African countries about 33% each, 25% Middle or South America. Thailand, South Africa with Namibia, Brazil and India were the most important countries. The time from health consultation to the beginning of the journey was too short for full vaccine protection against typhoid fever and meningococcal disease in 10% and against rabies in 44% of the consultants. There were no significant differences between holiday tourists, business and "hikers" travellers. According to many studies, only one-third of the travellers going abroad, especially to developing countries, obtain travel health information. Hence, the clients of our consultation hours are a positive selection. Nevertheless, great need for improvement could be seen as well. In many of the clients the time from getting health information and vaccination was too short for obtaining complete vaccination protection. People travelling to countries where most hepatitis A infections are obtained and re-imported home, such as Turkey and Tunisia and other Mediterranean countries almost never came for health advice and vaccination. Therefore, public health authorities should improve and increase their publicity campaigns for travel health and vaccination in order to prevent travel-associated infections and re-importation of such diseases.

Destination: Alumni Relations

ERIC Educational Resources Information Center

Scully, Maura King

2010-01-01

Increasingly today, with the growing and sophisticated skill set alumni professionals need to get the job done, alumni relations has become a destination career rather than a stop along the way. Modern alumni relations is "so much more than homecoming and punch-and-cookie receptions." It's marketing, volunteer management, and social networking. To…

India-U.S. Relations

DTIC Science & Technology

2007-06-26

the U.S. State Department’s annual Trafficking in Persons Report said, “ India is a source, destination, and transit country for men, women , and...or Dalits .104 Although these categories are understood throughout India , they describe reality only in the most general terms. National-level...against Dalit women . That U.N. committee itself issued a March 2007 report which criticized the “frequent failure” of Indian law enforcement

Leisure places and modernity: the use and meaning of recreational cottages in Norway and the USA

Treesearch

Daniel R. Williams; Bjorn P. Kaltenborn

1999-01-01

When we think of tourism we often dunk of travel to exotic destinations, but modernization has also dispersed and extended our network of relatives, friends, and acquaintances. Fewer people live out their lives in a single place or even a single region of their natal country. Modern forms of dwelling, working, and playing involve circulating through a geographically...

Medical tourism-A New Arena

PubMed Central

Puri, S; Singh, A; Yashik

2010-01-01

Globalisation has given birth to medical tourism. Health and medical tourism are the fastest growing segments in not only developed nations but in developing countries too. India has become a hot destination, as the Indian medical standards match up to the highly prescribed international standards at a very low cost. However, it is an unmixed blessing; along with advantages, it has many unintended side effects also. PMID:23113017

Is there a financial incentive to immigrate? Examining of the health worker salary gap between India and popular destination countries.

PubMed

George, Gavin; Rhodes, Bruce

2017-10-19

International migration is one of the factors resulting in the shortage of Human Resources for Health (HRH) in India. Literature suggests that migration is fuelled by the prospect of higher salaries available abroad. The extent of these salary differentials are unknown, and this study seeks to examine the salaries of selected HRH in India and four popular destination countries (United States of America, United Kingdom, Canada and the United Arab Emirates), whilst accounting for the in-country cost of living. This study will therefore determine truer financial incentives for Indian HRH to migrate abroad. A purchasing power parity (PPP) ratio is employed to equalise the international price of buying a representative basket of commonly bought goods (including food, entertainment, fuel and utilities). Using the PPP index, real differences in salaries are directly compared for selected work categories and different levels of work experience in the four respective countries. Nurses in the USA can earn up to 82.7% more than their Indian counterparts. Nurses in Canada and the UAE reveal more modest salary differentials, yet still significant better off by up to 28 and 20% respectively. Only nurses in the UK are potentially materially worse off than nurses working in India. We observe significant potential PPP gains of up to 57.4, 99.1 and 94.4% for medical doctors in the USA, Canada and the UAE respectively. Medical specialists potentially experience the greatest income disparities with anaesthetists potentially earning up to 600% more than their counterparts in India. Radiologists operating in the UK and general surgeons working in the USA can potentially earn more than double that of their counterparts working in India. We observe more modest positive or negligible PPP gains in other selected countries for health specialists. Even when considering the differences in the cost of living, the financial incentive for selected cadres of Indian HRH to seek work abroad remains strong. The migration of Indian HRH to countries offering superior salaries makes it difficult for India to retain experienced health personal and compromises government efforts to render health care more accessible across the country.

Perceived neighborhood environmental attributes associated with adults’ transport-related walking and cycling: Findings from the USA, Australia and Belgium

PubMed Central

2012-01-01

Background Active transportation has the potential to contribute considerably to overall physical activity levels in adults and is likely to be influenced by neighborhood-related built environment characteristics. Previous studies that examined the associations between built environment attributes and active transportation, focused mainly on transport-related walking and were conducted within single countries, limiting environmental variability. We investigated the direction and shape of relationships of perceived neighborhood attributes with transport-related cycling and walking in three countries; and examined whether these associations differed by country and gender. Methods Data from the USA (Baltimore and Seattle), Australia (Adelaide) and Belgium (Ghent) were pooled. In total, 6,014 adults (20–65 years, 55.7% women) were recruited in high-/low-walkable and high-/low-income neighborhoods. All participants completed the Neighborhood Environmental Walkability Scale and the International Physical Activity Questionnaire. Generalized additive mixed models were used to estimate the strength and shape of the associations. Results Proximity to destinations, good walking and cycling facilities, perceiving difficulties in parking near local shopping areas, and perceived aesthetics were included in a ‘cyclability’ index. This index was linearly positively related to transport-related cycling and no gender- or country-differences were observed. The ‘walkability’ index consisted of perceived residential density, land use mix access, proximity of destinations and aesthetics. A non-linear positive relationship with transport-related walking was found. This association was stronger in women than in men, and country-specific associations were identified: the strongest association was observed in Seattle, the weakest in Adelaide. In Ghent, the association weakened at higher levels of walkability. Conclusions For cycling, consistent correlates were found in the three countries, but associations were less straightforward for transport-related walking. Moreover, the identified neighborhood environmental correlates were different for walking compared to cycling. In order to further clarify the shape of these associations and reach more specific international guidelines for developing walkable and bikeable neighborhoods, future studies should include even more countries to maximize environmental variability. PMID:22691723

Clonal foraging in perennial wheatgrasses: A strategy for exploiting patchy soil nutrients

USGS Publications Warehouse

Humphrey, L. David; Pyke, David A.

1997-01-01

1. Foraging by means of plasticity in placement of tillers in response to low- and high-nutrient patches was examined in the rhizomatous wheatgrass Elymus lanceolatus ssp. lanceolatus. Its ability to exploit soil nutrient patches was compared to that of the closely related but caespitose E. lanceolatus ssp. wawawaiensis.2. Clones of 14 genets of each taxon were planted in boxes consisting of two 30 × 30 cm cells: the `origin cell' where clones were planted, and the adjacent `destination cell', with each cell containing soil with either low or high levels of nutrients.3. The rhizomatous taxon, which can produce intravaginal, short-rhizome and long-rhizome tillers, preferentially produced short-rhizome and intravaginal tillers in high-nutrient destination cells. Effects of nutrient status of the origin cell as well as of the destination cell on total tiller numbers indicated clonal integration, yet tiller placement responded to local conditions.4. Roots of both taxa accessed nutrients in destination cells (the caespitose subspecies by root growth only), and above-ground biomass of both taxa increased to a similar extent with high-nutrient destination cells. With the patch sizes used in this experiment, root growth was as important as ramet placement in exploiting nutrients in destination cells. 5 There was no relationship between degree of plasticity in ramet placement and biomass of the clone when high-nutrient destination cells were present.

Exploration Space Suit Architecture and Destination Environmental-Based Technology Development

NASA Technical Reports Server (NTRS)

Hill, Terry R.; McFarland, Shane M.; Korona, F. Adam

2013-01-01

This paper continues forward where EVA Space Suit Architecture: Low Earth Orbit Vs. Moon Vs. Mars left off in the development of a space suit architecture that is modular in design and could be reconfigured prior to launch or during any given mission depending on the tasks or destination. This space suit system architecture and technologies required based on human exploration (EVA) destinations will be discussed, and how these systems should evolve to meet the future exploration EVA needs of the US human space flight program. A series of exercises and analyses provided a strong indication that the Constellation Program space suit architecture, with its maximum reuse of technology and functionality across a range of mission profiles and destinations, is postured to provide a viable solution for future space exploration missions. The destination environmental analysis demonstrates that the modular architecture approach could provide the lowest mass and mission cost for the protection of the crew, given any human mission outside of low-Earth orbit. Additionally, some of the high-level trades presented here provide a review of the environmental and nonenvironmental design drivers that will become increasingly important as humans venture farther from Earth. The presentation of destination environmental data demonstrates a logical clustering of destination design environments that allows a focused approach to technology prioritization, development, and design that will maximize the return on investment, largely independent of any particular design reference mission.

The potential influence of privatization on quality tourism

Treesearch

Rebecca L. Riedl; Hans Vogelsong

2003-01-01

Increases in travel and tourism are leading to the destruction and degradation of many of our most pristine natural resources. Privatization, if utilized properly, can prevent these tourist generating destinations from mayhem. Privatization will ensure the quality of a travel experience as well as maintain the beauty and preservation of a destination. Traditionally,...

Internationally educated nurses: profiling workforce diversity.

PubMed

Blythe, Jennifer; Baumann, Andrea

2009-06-01

Nurses with diverse educational and cultural backgrounds are likely to adapt differently to new workforces. The aim of this study was to provide a profile of nurses educated in different countries who are employed in a major settlement jurisdiction. Despite difficulties in measuring its magnitude, it is evident that nurse migration has increased as a result of globalization. Major destinations for internationally educated nurses (IENs) include the USA, Canada, the UK, Australia and the Gulf States. Chief donor countries include the Philippines, India and other South Asian countries. Half of all IENs registered in Canada work in the province of Ontario. Published literature and secondary data were used to profile cohorts of nurses educated in different countries who are employed in the Ontario workforce. Statistics available on IENs in Ontario reveal a largely urban settlement pattern. There are major differences among IEN cohorts in terms of age, gender, work status, and type and place of employment. Although IENs resident in Ontario could not be quantified, a relatively detailed description of IENs in the workforce was possible. Comparison of nurse cohorts indicated that generalizations about IENs should be made with caution. Changes in regulatory conditions have a significant effect on IEN employment. Difficulties associated with international educational and regulatory differences illustrate the need to create global nursing standards. Further investigation of differences in workforce profiles should provide insights leading to improved utilization of IENs.

[Psychosomatics and psychotraumatology of refugees and migrants : A Challenge for the Internist].

PubMed

Schellong, J; Epple, F; Weidner, K

2016-05-01

Many refugees experience severely stressful events in their home countries, during migration and occasionally even after arrival in the country of destination. The individual reactions not only influence the mental health but also somatic well being. Traumatic events may have an essential impact on psychosocial functioning; moreover, the social circumstances during the integration process influence mental stability. Physicians play an important role in identifying possible traumatization and subsequently guiding towards adequate treatment; hence, the healthcare of refugees should regularly include psychosomatic and psychotraumatological aspects. Knowledge of screening instruments, trauma-informed care and interpreter-assisted communication are necessary to meet required standards.

"The School of Life": Differences in U.S. and Canadian Settlement Policies and Their Effect on Individual Haitian Immigrants' Language Learning

ERIC Educational Resources Information Center

Duguay, Annie Laurie

2012-01-01

A growing body of literature suggests that language proficiency in the main language of the destination country is one of the most significant factors in the integration of immigrants. This study examines the overall differences in U.S. and Canadian settlement policy, using the provision of language courses as a specific example of the ways in…

The Forgotten Tundra: America’s Greatest Terrorist Threat

DTIC Science & Technology

2013-02-15

threats that use Canada’s progressive immigration laws as a means of furthering their cause. Each year Canada accepts over 260,000 new immigrants to its...system, immigration laws , infrequent prosecutions and light sentences had turned the country into “a favored destination for terrorists”.10 In a 2003...other federal, state, local and tribal law enforcement entities along the northern border. These law enforcement officers form a layered defense

Reference Material for Health Auxiliaries and Their Teachers. Second Edition = Materiel de Reference Destine aux Auxiliaires Sanitaires et a Leurs Enseignants. Deuxieme Edition.

ERIC Educational Resources Information Center

World Health Organization, Geneva (Switzerland).

This bibliography contains annotations of materials that could be used by health personnel and their teachers in developing countries. Over 600 entries are presented in French and in English sections. Each section consists of 13 subject headings, an author index, and a title index. The annotations describe the contents, level, and uses of the…

Campsite impact in the wilderness of Sequoia and Kings Canyon National Parks: Thirty years of change

Treesearch

David N. Cole; David J. Parsons

2013-01-01

Sequoia and Kings Canyon National Parks are among the premier destinations in the world for wilderness travel and camping. Over 93% of the spectacular mountain country that make up these parks has been designated as wilderness, with another 4% managed as wilderness. The parks are home to the highest peak in the lower 48 states, Mt. Whitney (14,495 feet), a 97-mile...

Trafficking in Persons: U.S. Policy and Issues for Congress

DTIC Science & Technology

2008-01-10

domestic violence; sexual assault; abusive sexual contact; prostitution; sexual exploitation; female genital mutilation ; being held hostage; peonage...countries in the region are destination points for low-skilled workers, both male and female , from South and Southeast Asia who migrate willingly to work...through FY2004, HHS certified 1,076 people; 94% of the victims were female .87 CRS-29 87 (...continued) Department of Labor, Department of Homeland

Mexico and Central America.

PubMed

Bronfman, M

1998-01-01

This article reviews the literature on migration and HIV/AIDS in Mexico and Central America, including Belize, Costa Rica, El Salvador, Guatemala, Honduras, Mexico, Nicaragua, and Panama. Most migrants travel to the US through Mexico. US-Mexico trade agreements created opportunities for increased risk of HIV transmission. The research literature focuses on Mexico. Most countries, with the exception of Belize and Costa Rica, are sending countries. Human rights of migrants are violated in transit and at destination. Migration policies determine migration processes. The Mexican-born population in the US is about 3% of US population and 8% of Mexico's population. About 22% arrived during 1992-97, and about 500,000 are naturalized US citizens. An additional 11 million have a Mexican ethnic background. Mexican migrants are usually economically active men who had jobs before leaving and were urban people who settled in California, Texas, Illinois, and Arizona. Most Mexican migrants enter illegally. Many return to Mexico. The main paths of HIV transmission are homosexual, heterosexual, and IV-drug-injecting persons. Latino migrants frequently use prostitutes, adopt new sexual practices including anal penetration among men, greater diversity of sexual partners, and use of injectable drugs.

Solar Transportation, on the critical path to 100% Renewables

NASA Astrophysics Data System (ADS)

Swenson, R.; Furman, B.

2016-12-01

The path from hydrocarbons and climate change to 100% renewable energy requires a complete transformation of human mobility systems—from oil to solar electricity, and away from personal cars to shared transit. Electric (and autonomous) personal vehicles cannot scale rapidly enough to address CO2 increase and resource depletion. While atmospheric science can characterize the challenge, design science aimed at order of magnitude improvements in energy and resource consumption is needed to achieve carbon free transit that can scale rapidly for urban mobility. An NGO and University engineering team collaboration has led to a multi-disciplinary international program creating prototypes and test tracks to demonstrate the efficacy and economics of solar-powered, automated, non-stop origin-to-destination, elevated on-demand transit systems. With their aptitude for innovation, students in the Solar Skyways challenge have convened from several countries in order to propel development and overcome resistance from the automotive industry incumbency. Innovation has been occurring in lesser developed countries as well as in the industrialized world. An online curriculum has been developed and will be presented to encourage international participation and rapid acceleration for sustainable zero-net-carbon transportation.

Increasing state market share through regional positioning

Treesearch

Muzaffer Uysal; Joseph S. Chen; Daniel R. Williams

2000-01-01

State tourism officials need to know more about the nature of in-state and out-of-state visitor characteristics and how actual and potential visitors perceive local destinations. The main objective of this study was to understand Virginia's image as a travel destination versus competitive states in the Mid-Atlantic region of the USA. The regional competitiveness...

Toward a Theory of School Capacity in New Immigrant Destinations: Instructional and Organizational Considerations

ERIC Educational Resources Information Center

Lowenhaupt, Rebecca; Reeves, Todd

2015-01-01

Across the United States, immigrant enrollments in the public schools have rapidly increased, particularly in locales with little tradition of immigration, known as "new immigrant destinations." Despite the widespread nature of this trend, there is much to be learned about how schools are responding to this influx of immigrant students.…

Disparities in pre-eclampsia and eclampsia among immigrant women giving birth in six industrialised countries

PubMed Central

Urquia, ML; Glazier, RH; Gagnon, AJ; Mortensen, LH; Nybo Andersen, A-M; Janevic, T; Guendelman, S; Thornton, D; Bolumar, F; Río Sánchez, I; Small, R; Davey, M-A; Hjern, A

2014-01-01

Objective To assess disparities in pre-eclampsia and eclampsia among immigrant women from various world regions giving birth in six industrialised countries. Design Cross-country comparative study of linked population-based databases. Setting Provincial or regional obstetric delivery data from Australia, Canada, Spain and the USA and national data from Denmark and Sweden. Population All immigrant and non-immigrant women delivering in the six industrialised countries within the most recent 10-year period available to each participating centre (1995–2010). Methods Data was collected using standardised definitions of the outcomes and maternal regions of birth. Pooled data were analysed with multilevel models. Within-country analyses used stratified logistic regression to obtain odds ratios (OR) with 95% confidence intervals (95% CI). Main outcome measures Pre-eclampsia, eclampsia and pre-eclampsia with prolonged hospitalisation (cases per 1000 deliveries). Results There were 9 028 802 deliveries (3 031 399 to immigrant women). Compared with immigrants from Western Europe, immigrants from Sub-Saharan Africa and Latin America & the Caribbean were at higher risk of pre-eclampsia (OR: 1.72; 95% CI: 1.63, 1.80 and 1.63; 95% CI: 1.57, 1.69) and eclampsia (OR: 2.12; 95% CI: 1.61, 2.79 and 1.55; 95% CI: 1.26, 1. 91), respectively, after adjustment for parity, maternal age and destination country. Compared with native-born women, European and East Asian immigrants were at lower risk in most industrialised countries. Spain exhibited the largest disparities and Australia the smallest. Conclusion Immigrant women from Sub-Saharan Africa and Latin America & the Caribbean require increased surveillance due to a consistently high risk of pre-eclampsia and eclampsia. PMID:24758368

Disparities in pre-eclampsia and eclampsia among immigrant women giving birth in six industrialised countries.

PubMed

Urquia, M L; Glazier, R H; Gagnon, A J; Mortensen, L H; Nybo Andersen, A-M; Janevic, T; Guendelman, S; Thornton, D; Bolumar, F; Río Sánchez, I; Small, R; Davey, M-A; Hjern, A

2014-11-01

To assess disparities in pre-eclampsia and eclampsia among immigrant women from various world regions giving birth in six industrialised countries. Cross-country comparative study of linked population-based databases. Provincial or regional obstetric delivery data from Australia, Canada, Spain and the USA and national data from Denmark and Sweden. All immigrant and non-immigrant women delivering in the six industrialised countries within the most recent 10-year period available to each participating centre (1995-2010). Data was collected using standardised definitions of the outcomes and maternal regions of birth. Pooled data were analysed with multilevel models. Within-country analyses used stratified logistic regression to obtain odds ratios (OR) with 95% confidence intervals (95% CI). Pre-eclampsia, eclampsia and pre-eclampsia with prolonged hospitalisation (cases per 1000 deliveries). There were 9,028,802 deliveries (3,031,399 to immigrant women). Compared with immigrants from Western Europe, immigrants from Sub-Saharan Africa and Latin America & the Caribbean were at higher risk of pre-eclampsia (OR: 1.72; 95% CI: 1.63, 1.80 and 1.63; 95% CI: 1.57, 1.69) and eclampsia (OR: 2.12; 95% CI: 1.61, 2.79 and 1.55; 95% CI: 1.26, 1. 91), respectively, after adjustment for parity, maternal age and destination country. Compared with native-born women, European and East Asian immigrants were at lower risk in most industrialised countries. Spain exhibited the largest disparities and Australia the smallest. Immigrant women from Sub-Saharan Africa and Latin America & the Caribbean require increased surveillance due to a consistently high risk of pre-eclampsia and eclampsia. © 2014 The Authors. BJOG An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd on behalf of Royal College of Obstetricians and Gynaecologists.

Older adults' transportation walking: a cross-sectional study on the cumulative influence of physical environmental factors.

PubMed

Van Cauwenberg, Jelle; Clarys, Peter; De Bourdeaudhuij, Ilse; Van Holle, Veerle; Verté, Dominique; De Witte, Nico; De Donder, Liesbeth; Buffel, Tine; Dury, Sarah; Deforche, Benedicte

2013-08-14

The physical environment may play a crucial role in promoting older adults' walking for transportation. However, previous studies on relationships between the physical environment and older adults' physical activity behaviors have reported inconsistent findings. A possible explanation for these inconsistencies is the focus upon studying environmental factors separately rather than simultaneously. The current study aimed to investigate the cumulative influence of perceived favorable environmental factors on older adults' walking for transportation. Additionally, the moderating effect of perceived distance to destinations on this relationship was studied. The sample was comprised of 50,685 non-institutionalized older adults residing in Flanders (Belgium). Cross-sectional data on demographics, environmental perceptions and frequency of walking for transportation were collected by self-administered questionnaires in the period 2004-2010. Perceived distance to destinations was categorized into short, medium, and large distance to destinations. An environmental index (=a sum of favorable environmental factors, ranging from 0 to 7) was constructed to investigate the cumulative influence of favorable environmental factors. Multilevel logistic regression analyses were applied to predict probabilities of daily walking for transportation. For short distance to destinations, probability of daily walking for transportation was significantly higher when seven compared to three, four or five favorable environmental factors were present. For medium distance to destinations, probabilities significantly increased for an increase from zero to four favorable environmental factors. For large distance to destinations, no relationship between the environmental index and walking for transportation was observed. Our findings suggest that the presence of multiple favorable environmental factors can motivate older adults to walk medium distances to facilities. Future research should focus upon the relationship between older adults' physical activity and multiple environmental factors simultaneously instead of separately.

Older adults’ transportation walking: a cross-sectional study on the cumulative influence of physical environmental factors

PubMed Central

2013-01-01

Background The physical environment may play a crucial role in promoting older adults’ walking for transportation. However, previous studies on relationships between the physical environment and older adults’ physical activity behaviors have reported inconsistent findings. A possible explanation for these inconsistencies is the focus upon studying environmental factors separately rather than simultaneously. The current study aimed to investigate the cumulative influence of perceived favorable environmental factors on older adults’ walking for transportation. Additionally, the moderating effect of perceived distance to destinations on this relationship was studied. Methods The sample was comprised of 50,685 non-institutionalized older adults residing in Flanders (Belgium). Cross-sectional data on demographics, environmental perceptions and frequency of walking for transportation were collected by self-administered questionnaires in the period 2004-2010. Perceived distance to destinations was categorized into short, medium, and large distance to destinations. An environmental index (=a sum of favorable environmental factors, ranging from 0 to 7) was constructed to investigate the cumulative influence of favorable environmental factors. Multilevel logistic regression analyses were applied to predict probabilities of daily walking for transportation. Results For short distance to destinations, probability of daily walking for transportation was significantly higher when seven compared to three, four or five favorable environmental factors were present. For medium distance to destinations, probabilities significantly increased for an increase from zero to four favorable environmental factors. For large distance to destinations, no relationship between the environmental index and walking for transportation was observed. Conclusions Our findings suggest that the presence of multiple favorable environmental factors can motivate older adults to walk medium distances to facilities. Future research should focus upon the relationship between older adults’ physical activity and multiple environmental factors simultaneously instead of separately. PMID:23945285

Comparing cryptomarkets for drugs. A characterisation of sellers and buyers over time.

PubMed

Tzanetakis, Meropi

2018-06-01

Cryptomarkets operating on the darknet are a recent phenomenon that has gained importance only over the last couple of years (Barratt, 2012). However, they now constitute an evolving part of illicit drug markets. Although selling and buying a variety of psychoactive substances on the Internet has a long history, new technological developments enable systematic drug trading on the net.These technological innovations on the Internet allow users to proceed with (illicit) drug transactions with almost completely anonymous identities and locations. In this paper, we provide a systematic measurement analysis of structures and trends on the most popular anonymous drug marketplace, and discuss the role of cryptomarkets in drug distribution. Data collection and analysis include a long-term measurement of the cryptomarket 'AlphaBay', the most popular platform during the survey period. By developing and applying a web-scraping tool, market data was extracted from the marketplace on a daily basis during a period of twelve months between September 2015 and August 2016. The data was analysed by using business-intelligence software, which allows the linking of various data sets. We found 2188 unique vendors offering 11,925 drug items. The findings of our long-term monitoring and data analysis are compared over time and across marketplaces, offering a detailed understanding of the development of revenues generated, characterisation of countries of origin and destination, and distribution of vendors and customers over time. We provide a nuanced and highly detailed longitudinal analysis of drug trading on the darknet marketplace 'AlphaBay', which was the largest cryptomarket in operation. 1) Total sales volumes for the 'drugs' section was estimated at approximately USD 94 million for the period from September 2015 to August 2016. 2) In addition, about 64% of all sales are made with cocaine-, cannabis-, heroin-, and ecstasy-related products. 3) Average selling prices increase over time for categories including cannabis and hashish, ecstasy, opioids, psychedelics and stimulants. 4) The five most frequent countries of origin as indicated by vendors are the United States, United Kingdom, Australia, the Netherlands and Germany. Moreover, it was demonstrated that drug distribution on cryptomarkets is conducted at a regional rather than global level. 6) Furthermore, 4.88% of vendors made over USD 200,000 and were responsible for 52.9% of total revenues generated over the period analysed. In contrast, 57.51% of vendors managed to sell drug items worth less than USD 10,000 within a period of twelve months. The findings suggest that 'AlphaBay' was a cryptomarket mainly from and for Western industrialised countries. In contrast, countries of the global South are neither among the main countries of origin nor destination countries. Copyright © 2018 Elsevier B.V. All rights reserved.

Web-based medical facilitators in medical tourism: the third party in decision-making.

PubMed

Wagle, Suchitra

2013-01-01

The emergence of web-based medical tourism facilitators (MTFs) has added a new dimension to the phenomenon of cross-border travel. These facilitators are crucial connectors between foreign patients and host countries. They help patients navigate countries, doctors and specialties. However, little attention has been paid to the authenticity of information displayed on the facilitators' web portals, and whether they follow ethical guidelines and standards. This paper analyses the available information on MTF portals from an ethics perspective. It compares 208 facilitators across 47 countries for the services offered. Data were collected from the databases of the Medical Tourism Association and World Medical Resources. India was the most common destination country linked to 81 facilitators. The five countries with the maximum number of facilitators were the USA, the UK, India, Canada and Poland. This paper identifies concerns regarding the information displayed about patients' safety, and the maintenance of confidentiality. There is a need to develop ethical standards for this field.

The knowledge, attitudes and practices of wintersun vacationers to the Gambia toward prevention of malaria: is it really that bad?

PubMed Central

2014-01-01

Background Each year clusters of imported malaria cases are observed in Dutch wintersun vacationers returning from The Gambia. To gain more insight in the travel health preparation and awareness of these travellers, the knowledge, attitudes and practices (KAP) of this travel group was studied by analysing the data of the Continuous Dutch Schiphol Airport Survey. Methods In the years 2002 to 2009 a questionnaire-based survey was conducted at the Dutch Schiphol Airport with the aim to study the KAP, i.e. accuracy of risk perception (“knowledge”), intended risk-avoiding behaviour (“attitude”) and use of personal protective measures and malaria chemoprophylaxis (“practice”) toward prevention malaria in travellers to The Gambia. Travellers to other high-risk destinations served as controls. Results The KAP of travellers to The Gambia toward prevention of malaria was significantly better than that observed in other travellers. Trend analyses indicated that attitude improved over time in both groups but knowledge did not change. Only in travellers to high-risk countries other than The Gambia significant increases in protection rates were observed over time. Conclusions The KAP of travellers to The Gambia toward prevention of malaria was better than that observed in travellers to destinations other than The Gambia. Trend analyses revealed a significant improvement of intended risk avoiding behaviour but not in protection rates or risk perception. PMID:24581328

Amplification or suppression: Social networks and the climate change-migration association in rural Mexico.

PubMed

Nawrotzki, Raphael J; Riosmena, Fernando; Hunter, Lori M; Runfola, Daniel M

2015-11-01

Increasing rates of climate migration may be of economic and national concern to sending and destination countries. It has been argued that social networks - the ties connecting an origin and destination - may operate as "migration corridors" with the potential to strongly facilitate climate change-related migration. This study investigates whether social networks at the household and community levels amplify or suppress the impact of climate change on international migration from rural Mexico. A novel set of 15 climate change indices was generated based on daily temperature and precipitation data for 214 weather stations across Mexico. Employing geostatistical interpolation techniques, the climate change values were linked to 68 rural municipalities for which sociodemographic data and detailed migration histories were available from the Mexican Migration Project. Multi-level discrete-time event-history models were used to investigate the effect of climate change on international migration between 1986 and 1999. At the household level, the effect of social networks was approximated by comparing the first to the last move, assuming that through the first move a household establishes internal social capital. At the community level, the impact of social capital was explored through interactions with a measure of the proportion of adults with migration experience. The results show that rather than amplifying , social capital may suppress the sensitivity of migration to climate triggers, suggesting that social networks could facilitate climate change adaptation in place.

Internal travel and risk of dengue transmission in Colombia.

PubMed

Chaparro, Pablo E; de la Hoz, Fernando; Lozano Becerra, Juan C; Repetto, Silvia A; Alba Soto, Catalina D

2014-09-01

Human behavior plays a key role in the dynamics of dengue transmission. However, research on the relationship between human movement and dengue transmission within endemic countries is limited. From January 2008 to December 2011, the authors of this study conducted a retrospective analysis of imported dengue infections in Bogotá, Colombia. Bogotá is a vector-transmission-free city that is also the capital district and most populated municipality in Colombia. The study revealed that 1) Bogotá inhabitants acquired dengue infection in diverse localities throughout the country but the largest proportion of cases (35.6%) were contracted at popular tourist destinations in dengue-endemic areas near Bogotá (<200-km radius from city limits), and 2) the number of imported dengue cases increased after major holidays, a transmission pattern not seen in dengue-endemic areas, where disease incidence correlates with rainy periods. It is therefore recommended that physicians consider the effect of travel when diagnosing their patients' illnesses, especially outside dengue-endemic areas where diagnosis of the disease can be challenging due to its nonspecific symptoms. The study also showed that analysis of dengue cases imported to regions free of vector transmission can generate an evidence-based model for characterizing the impact of human movement on the spread of diseases like dengue in countries where they are endemic.

Romance tourism or female sex tourism?

PubMed

Bauer, Irmgard L

2014-01-01

Love, sex and the female traveller: romance tourism or female sex tourism? The phenomenon of women travelling in search of relationships with local men in developing countries has been studied for the last 20 years. However, it appears little known in travel medicine. Relevant literature was found through PubMed, Science Direct, ProQuest and Google Scholar. The reference lists of selected articles identified further sources. Historical records of women travellers to far-away countries abound. Then, as now, women not only searched for the erotic 'other' but made romance and sex the purpose of their trip. Today, increasing numbers of women travel to destinations in developing countries where sex with local men is the main attraction. This pastime raises concerns not only for the women themselves but for the local men involved as well as their sex partners and the local communities. Although more research is necessary, comparing the criteria that describe men travelling for sex and relationships and women travelling for sex and relationships appears to suggest that there is very little difference between the two, regardless of what the pursuit is called. Women looking for sex with local men are sex tourists, too. Recognition of this fact needs to influence the pre and post travel care of female travellers. Copyright © 2013 Elsevier Ltd. All rights reserved.

Results of the JIMO Follow-on Destinations Parametric Studies

NASA Technical Reports Server (NTRS)

Noca, Muriel A.; Hack, Kurt J.

2005-01-01

NASA's proposed Jupiter Icy Moon Orbiter (JIMO) mission currently in conceptual development is to be the first one of a series of highly capable Nuclear Electric Propulsion (NEP) science driven missions. To understand the implications of a multi-mission capability requirement on the JIMO vehicle and mission, the NASA Prometheus Program initiated a set of parametric high-level studies to be followed by a series of more in-depth studies. The JIMO potential follow-on destinations identified include a Saturn system tour, a Neptune system tour, a Kuiper Belt Objects rendezvous, an Interstellar Precursor mission, a Multiple Asteroid Sample Return and a Comet Sample Return. This paper shows that the baseline JIMO reactor and design envelop can satisfy five out of six of the follow-on destinations. Flight time to these destinations can significantly be reduced by increasing the launch energy or/and by inserting gravity assists to the heliocentric phase.

The Impact of Out-Migration on the Nursing Workforce in Kenya

PubMed Central

Gross, Jessica M; Rogers, Martha F; Teplinskiy, Ilya; Oywer, Elizabeth; Wambua, David; Kamenju, Andrew; Arudo, John; Riley, Patricia L; Higgins, Melinda; Rakuom, Chris; Kiriinya, Rose; Waudo, Agnes

2011-01-01

Objective To examine the impact of out-migration on Kenya's nursing workforce. Study Setting This study analyzed deidentified nursing data from the Kenya Health Workforce Informatics System, collected by the Nursing Council of Kenya and the Department of Nursing in the Ministry of Medical Services. Study Design We analyzed trends in Kenya's nursing workforce from 1999 to 2007, including supply, deployment, and intent to out-migrate, measured by requests for verification of credentials from destination countries. Principle Findings From 1999 to 2007, 6 percent of Kenya's nursing workforce of 41,367 nurses applied to out-migrate. Eighty-five percent of applicants were registered or B.Sc.N. prepared nurses, 49 percent applied within 10 years of their initial registration as a nurse, and 82 percent of first-time applications were for the United States or United Kingdom. For every 4.5 nurses that Kenya adds to its nursing workforce through training, 1 nurse from the workforce applies to out-migrate, potentially reducing by 22 percent Kenya's ability to increase its nursing workforce through training. Conclusions Nurse out-migration depletes Kenya's nursing workforce of its most highly educated nurses, reduces the percentage of younger nurses in an aging nursing stock, decreases Kenya's ability to increase its nursing workforce through training, and represents a substantial economic loss to the country. PMID:21413982

[Where internists work?].

PubMed

Ramiro-H, Manuel; Casares-Queralt, Salvador; Arévalo-Vargas, Angel; Juárez, Irina Elizabeth; Pons-Álvarez, Octavio Noel; Castañeda-Del Toro, Alejandro

2016-01-01

For health institutions, knowing the fate of human resources within their classrooms is an extremely complicated task. Within the Instituto Mexicano del Seguro Social, where most specialists are trained in our country, with a clear orientation towards the pursuit of excellence and satisfaction of their needs human resources for health in Mexico is provided, hence the need to identify the professional profile and career destination of its graduates, which will be useful in the training of human resources for health.

Trafficking in Persons: U.S. Policy and Issues for Congress

DTIC Science & Technology

2007-06-20

well-paying jobs in foreign countries as au pairs, models, dancers, domestic workers, etc. Traffickers advertise these “jobs” as well as marriage...bondage. While there is no single victim stereotype , a majority of trafficked women are under the age of 25, with many in their mid to late teens...Favored sex tourism destinations are Brazil, Argentina , the Dominican Republic, Mexico, Honduras, Costa Rica, Trinidad and Tobago. Although it tends to

41 CFR 301-10.136 - What exceptions to the Fly America Act requirements apply when I travel between the United States...

Code of Federal Regulations, 2010 CFR

2010-07-01

... destination, you must use the U.S. flag air carrier service unless such use would extend your travel time... the U.S. by 2 or more; or (2) Extend your travel time by at least 6 hours or more; or (3) Require a... Fly America Act requirements apply when I travel between the United States and another country? 301-10...

41 CFR 301-10.136 - What exceptions to the Fly America Act requirements apply when I travel between the United States...

Code of Federal Regulations, 2012 CFR

2012-07-01

... destination, you must use the U.S. flag air carrier service unless such use would extend your travel time... the U.S. by 2 or more; or (2) Extend your travel time by at least 6 hours or more; or (3) Require a... Fly America Act requirements apply when I travel between the United States and another country? 301-10...

41 CFR 301-10.136 - What exceptions to the Fly America Act requirements apply when I travel between the United States...

Code of Federal Regulations, 2013 CFR

2013-07-01

... destination, you must use the U.S. flag air carrier service unless such use would extend your travel time... the U.S. by 2 or more; or (2) Extend your travel time by at least 6 hours or more; or (3) Require a... Fly America Act requirements apply when I travel between the United States and another country? 301-10...

41 CFR 301-10.136 - What exceptions to the Fly America Act requirements apply when I travel between the United States...

Code of Federal Regulations, 2014 CFR

2014-07-01

... destination, you must use the U.S. flag air carrier service unless such use would extend your travel time... the U.S. by 2 or more; or (2) Extend your travel time by at least 6 hours or more; or (3) Require a... Fly America Act requirements apply when I travel between the United States and another country? 301-10...

41 CFR 301-10.136 - What exceptions to the Fly America Act requirements apply when I travel between the United States...

Code of Federal Regulations, 2011 CFR

2011-07-01

... destination, you must use the U.S. flag air carrier service unless such use would extend your travel time... the U.S. by 2 or more; or (2) Extend your travel time by at least 6 hours or more; or (3) Require a... Fly America Act requirements apply when I travel between the United States and another country? 301-10...

China’s Foreign Aid and Government-Sponsored Investment Activities: Scale, Content, Destinations, and Implications

DTIC Science & Technology

2013-01-01

Ecuador , Brazil, Chile, and Venezuela. Before 2005, many of the regional programs focused on infrastructure, including power plants...prior academic work on China’s pro- grams have focused on Africa and include Davies et al. and Brautigam. Both these provide detailed case studies...Chinese engage- ment there is concentrated on four resource-rich countries: Venezuela, Brazil, Argentina, and Ecuador . 26 China’s Foreign Aid and

Are Muslim Diaspora in the U.S. Vulnerable to Islamic Extremism?

DTIC Science & Technology

2015-06-12

it is common for at least one member of the group to travel overseas to a country with known terrorist training camps. Destinations include Pakistan...Dagestan and Chechnya.39 The Federal Bureau of Investigation interviewed Tamerlan but found no links to terrorism. Subsequently, Tamerlan traveled to...eventually had two children. Born in Colorado, Huma often traveled to Pakistan for summer vacations and had lived in Qatar with her family for an

MEXICAN DRUG CARTELS AND TERRORIST ORGANIZATIONS, A NEW ALLIANCE

DTIC Science & Technology

2016-02-16

two countries is basic market opportunism responding to supply and demand. Having originated from U.S. demand for marijuana and heroin after WWII and...billion a year.18 Accordingly, Mexico has grown to be a major producer of heroin, marijuana , and methamphetamine destined for the United States which...according to the Central Intelligence Agency (CIA), is the world’s largest consumer of cocaine, Colombian heroin, and Mexican heroin and marijuana .19

Accounting for the daily locations visited in the study of the built environment correlates of recreational walking (the RECORD Cohort Study).

PubMed

Perchoux, Camille; Kestens, Yan; Brondeel, Ruben; Chaix, Basile

2015-12-01

Understanding how built environment characteristics influence recreational walking is of the utmost importance to develop population-level strategies to increase levels of physical activity in a sustainable manner. This study analyzes the residential and non-residential environmental correlates of recreational walking, using precisely geocoded activity space data. The point-based locations regularly visited by 4365 participants of the RECORD Cohort Study (Residential Environment and CORonary heart Disease) were collected between 2011 and 2013 in the Paris region using the VERITAS software (Visualization and Evaluation of Regular Individual Travel destinations and Activity Spaces). Zero-inflated negative binomial regressions were used to investigate associations between both residential and non-residential environmental exposure and overall self-reported recreational walking over 7 days. Density of destinations, presence of a lake or waterway, and neighborhood education were associated with an increase in the odds of reporting any recreational walking time. Only the density of destinations was associated with an increase in time spent walking for recreational purpose. Considering the recreational locations visited (i.e., sports and cultural destinations) in addition to the residential neighborhood in the calculation of exposure improved the model fit and increased the environment-walking associations, compared to a model accounting only for the residential space (Akaike Information Criterion equal to 52797 compared to 52815). Creating an environment supportive to walking around recreational locations may particularly stimulate recreational walking among people willing to use these facilities. Copyright © 2015 Elsevier Inc. All rights reserved.

Why do medical tourists travel to where they do? The role of networks in determining medical travel.

PubMed

Hanefeld, J; Lunt, N; Smith, R; Horsfall, D

2015-01-01

Evidence on medical tourism, including patient motivation, is increasing. Existing studies have focused on identifying push and pull factors across different types of treatment, for example cosmetic or bariatric surgery, or on groups, such as diaspora patients returning 'home' for treatment. Less attention has been on why individuals travel to specific locations or providers and on how this decision is made. The paper focused on the role of networks, defined as linkages - formal and informal - between individual providers, patients and facilitators to explain why and where patients travel. Findings are based on a recently completed, two year research project, which examined the effects of medical tourism on the UK NHS. Research included in-depth interviews with 77 returning medical tourists and over sixty managers, medical travel facilitators, clinicians and providers of medical tourism in recipient countries to understand the medical tourism industry. Interviews were conducted between 2011 and 2012, recorded and transcribed, or documented through note taking. Authors undertook a thematic analysis of interviews to identify treatment pathways by patients, and professional linkages between clinicians and facilitators to understand choice of treatment destination. The results highlight that across a large sample of patients travelling for a variety of conditions from dental treatment, cosmetic and bariatric surgery, through to specialist care the role of networks is critical to understand choice of treatment, provider and destination. While distance, costs, expertise and availability of treatment all were factors influencing patients' decision to travel, choice of destination and provider was largely the result of informal networks, including web fora, personal recommendations and support groups. Where patients were referred by UK clinicians or facilitators these followed informal networks. In conclusion, investigating medical travel through focus on networks of patients and providers opens up novel conception of medical tourism, deepening understanding of patterns of travel by combining investigation of industry with patient motivation. Copyright © 2014 Elsevier Ltd. All rights reserved.

The centrality of social ties to climate migration and mental health.

PubMed

Torres, Jacqueline M; Casey, Joan A

2017-07-06

Climate change-related hazards and disasters, known to adversely impact physical and mental health outcomes, are also expected to result in human migration above current levels. Environmentally-motivated migration and displacement may lead to the disruption of existing social ties, with potentially adverse consequences for mobile populations as well as their family members who remain in places of origin. We propose that the disruption of social ties is a key mechanism by which climate-related migration may negatively impact mental health, in particular. Existing social ties may provide social and material resources that buffer mental health stressors related to both prolonged and acute climate events. Preparation for such events may also strengthen these same ties and protect mental health. Communities may leverage social ties, first to mitigate climate change, and second, to adapt and rebuild post-disaster in communities of origin. Additionally, social ties can inform migration decisions and destinations. For example, scholars have found that the drought-motivated adaptive migration of West African Fulbe herders only occurred because of the long-term development of social networks between migrants and non-migrants through trade and seasonal grazing. On the other hand, social ties do not always benefit mental health. Some migrants, including those from poor regions or communities with no formal safety net, may face considerable burden to provide financial and emotional resources to family members who remain in countries of origin. In destination communities, migrants often face significant social marginalization. Therefore, policies and programs that aim to maintain ongoing social ties among migrants and their family and community members may be critically important in efforts to enhance population resilience and adaptation to climate change and to improve mental health outcomes. Several online platforms, like Refugee Start Force, serve to integrate refugees by connecting migrants directly to people and services in destination communities. These efforts may increasingly draw upon novel technologies to support and maintain social networks in the context of population mobility due to climatic and other factors.

[Visiting friends and relatives (VFRs) role on imported malaria: a literature review].

PubMed

Casuccio, Alessandra; Immordino, Palmira

2014-01-01

In the last decades, increased numbers of travel to tropical destinations in combination with the enormous influx of immigrants have led to an increased number of imported malaria cases in developed countries. There is a group of immigrants regularly resident in malaria free areas, which travel to malaria endemic countries to visit their friends and relatives (VFRs). VFRs represent a high-risk group of contracting malaria. Publications presenting original data on malaria in VFRs were selected for a literature review. We considered all data regarding prevalence of malaria in VFRs compared to the other groups of travelers, length of trip, group characteristics such as age, sex, country visited, and adherence to pre-travel recommendations, in particular, the compliance on the use of chemoprophylaxis, where such information was available. Studies related to malaria importation in VFRs in children and pregnant women were also included. Review of the literature revealed significant variations in the proportion of VFRs among imported malaria cases which may be due to differences in immigrant populations across the reporting countries. However, in studies focused on those at higher risk such as children and pregnant women, the prevalence of imported malaria was significantly higher compared to other types of travelers. Adherence to adequate preventive measures was low in VFRs. Significant reasons for not seeking pre-travel advice were economic and cultural issues, fear of the side effects due to chemoprophylaxis, and misconception about life-long immunity against malaria, and consequently, a low awareness about malaria risk. In order to implement preventive strategies focused on this high-risk group, prospective studies, which better define determinants of the risk of malaria in VFRs, are needed.

Determining factors affecting tourism demand for Malaysia using ARDL modeling: A case of Europe countries

NASA Astrophysics Data System (ADS)

Borhan, Nurbaizura; Arsad, Zainudin

2016-10-01

Tourism industry is the second largest foreign exchange earner after manufacturing in Malaysia. With regards to the importance of tourism industry in Malaysia, any factors that influence tourism demand should be considered cautiously by the government and tourism authorities in order to attract more international tourists in the near future. The purpose of this study is to investigate the dynamic long-run and short-run relationship between the number of international tourist arrivals from six European countries and four selected economic variables. The economic variables used in this study are exchange rate, gross domestic product, relative price and substitute relative price. This study also examines the impact of the European Sovereign crisis on the number of arrivals from the selected European countries to Malaysia. The data covers the period from quarter 1 (Q1) of 1999 to quarter 3 (Q3) of 2014 and employs the autoregressive distributed lag (ARDL) bounds testing approach proposed by Pesaran et al. (2001). The results of unit root test show a mixture of integrated at level and order one, I(0) and I(1). The results show that there exist long-run cointegration between the number of international tourist arrivals and exchange rate, level of income, tourism price and substitute tourism price for all countries. Generally, the results show that level of income is in line with the economic theory and Thailand is a competing destination for the tourism industry in Malaysia. Surprisingly, relative price is found to have positive impact on the number of arrivals to Malaysia and this suggests that an increase in the price level in Malaysia is unexpectedly increase the number of international tourist arrivals to Malaysia. Therefore the Malaysian government and tourism authorities should continue the efforts to withstand the growth of the tourism industry.

The ethical physician encounters international medical travel.

PubMed

Crozier, G K D; Baylis, Françoise

2010-05-01

International medical travel occurs when patients cross national borders to purchase medical goods and services. On occasion, physicians in home countries will be the last point of domestic contact for patients seeking healthcare information before they travel abroad for care. When this is the case, physicians have a unique opportunity to inform patients about their options and help guide them towards ethical practices. This opportunity brings to the fore an important question: What role should physicians in more-developed home countries play in promoting or constraining international medical travel towards less-developed destination countries? In our view, critical attention to the decision spaces of patients-defined by the personal circumstances, socio-cultural cues, and legal constraints that inform decision-making-is a useful starting point for evaluating the proper response of physicians to various forms of international medical travel.

Travel Characteristics and Pretravel Health Care Among Pregnant or Breastfeeding U.S. Women Preparing for International Travel

PubMed Central

Hagmann, Stefan H. F.; Rao, Sowmya R.; LaRocque, Regina C.; Erskine, Stefanie; Jentes, Emily S.; Walker, Allison T.; Barnett, Elizabeth D.; Chen, Lin H.; Hamer, Davidson H.; Ryan, Edward T.

2018-01-01

OBJECTIVE To study characteristics and preventive interventions of adult pregnant and breastfeeding travelers seeking pretravel health care in the United States. METHODS This cross-sectional study analyzed data (2009–2014) of pregnant and breastfeeding travelers seen at U.S. travel clinics participating in Global TravEpiNet. Nonpregnant, nonbreastfeeding adult female travelers of childbearing age were used for comparison. We evaluated the prescription of malaria chemoprophylaxis and antibiotics for this population as well as the administration of three travel-related vaccines: hepatitis A, typhoid, and yellow fever. We also evaluated use of tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis and influenza vaccines, because these are widely recommended in pregnancy. RESULTS Of 21,138 female travelers of childbearing age in Global TravEpiNet, 170 (0.8%) were pregnant and 139 (0.7%) were breastfeeding. Many traveled to destinations endemic for mosquito-borne illnesses, including malaria (pregnant: 95%; breastfeeding: 94%), dengue (pregnant: 87%; breastfeeding: 81%), or yellow fever (pregnant: 35%; breastfeeding: 50%). Compared with nonpregnant, nonbreastfeeding adult female travelers, eligible pregnant travelers were less likely to be vaccinated against hepatitis A (28% compared with 51%, P<.001) and typhoid (35% compared with 74%, P<.001). More than 20% of eligible pregnant travelers did not receive influenza vaccination. Yellow fever vaccine was occasionally provided to pregnant and breastfeeding travelers traveling to countries entirely endemic for yellow fever (6 [20%] of 30 pregnant travelers and 18 [46%] of 39 breastfeeding travelers). Half of pregnant travelers and two thirds of breastfeeding travelers preparing to travel to malaria-holoendemic countries received a prescription for malaria prophylaxis. CONCLUSION Most pregnant and breastfeeding travelers seen for pretravel health consultations traveled to destinations with high risk for vector-borne or other travel-related diseases. Destination-specific preventive interventions were frequently underused. PMID:29112671

Can migration health assessments become a mechanism for global public health good?

PubMed

Wickramage, Kolitha; Mosca, Davide

2014-09-26

Migrant health assessments (HAs) consist of a medical examination to assess a migrant's health status and to provide medical clearance for work or residency based on conditions defined by the destination country and/or employer. We argue that better linkages between health systems and migrant HA processors at the country level are needed to shift these from being limited as an instrument of determining non-admissibility for purposes of visa issuance, to a process that may enhance public health. The importance of providing appropriate care and follow-up of migrants who "fail" their HA and the need for global efforts to enable data-collection and research on HAs are also highlighted.

Exploration Space Suit Architecture and Destination Environmental-Based Technology Development

NASA Technical Reports Server (NTRS)

Hill, Terry R.; McFarland, Shane M.; Korona, F. Adam

2013-01-01

This paper continues forward where EVA Space Suit Architecture: Low Earth Orbit Vs. Moon Vs. Mars1 left off in the development of a space suit architecture that is modular in design and could be reconfigured prior to launch or during any given mission depending on the tasks or destination. This paper addresses the space suit system architecture and technologies required based on human exploration (EVA) destinations, and describes how these systems should evolve to meet the future exploration EVA needs of the US human space flight program. A series of exercises and analyses provided a strong indication that the Constellation Program space suit architecture, with its maximum reuse of technology and functionality across a range of mission profiles and destinations, is postured to provide a viable solution for future space exploration missions. The destination environmental analysis demonstrates that the modular architecture approach could provide the lowest mass and mission cost for the protection of the crew, given any human mission outside of low-Earth orbit. Additionally, some of the high-level trades presented here provide a review of the environmental and non-environmental design drivers that will become increasingly important as humans venture farther from Earth. This paper demonstrates a logical clustering of destination design environments that allows a focused approach to technology prioritization, development, and design that will maximize the return on investment, largely independent of any particular design reference mission.

The cutting of cocaine and heroin: A critical review.

PubMed

Broséus, Julian; Gentile, Natacha; Esseiva, Pierre

2016-05-01

The illicit drug cutting represents a complex problem that requires the sharing of knowledge from addiction studies, toxicology, criminology and criminalistics. Therefore, cutting is not well known by the forensic community. Thus, this review aims at deciphering the different aspects of cutting, by gathering information mainly from criminology and criminalistics. It tackles essentially specificities of cocaine and heroin cutting. The article presents the detected cutting agents (adulterants and diluents), their evolution in time and space and the analytical methodology implemented by forensic laboratories. Furthermore, it discusses when, in the history of the illicit drug, cutting may take place. Moreover, researches studying how much cutting occurs in the country of destination are analysed. Lastly, the reasons for cutting are addressed. According to the literature, adulterants are added during production of the illicit drug or at a relatively high level of its distribution chain (e.g. before the product arrives in the country of destination or just after its importation in the latter). Their addition seems hardly justified by the only desire to increase profits or to harm consumers' health. Instead, adulteration would be performed to enhance or to mimic the illicit drug effects or to facilitate administration of the drug. Nowadays, caffeine, diltiazem, hydroxyzine, levamisole, lidocaïne and phenacetin are frequently detected in cocaine specimens, while paracetamol and caffeine are almost exclusively identified in heroin specimens. This may reveal differences in the respective structures of production and/or distribution of cocaine and heroin. As the relevant information about cutting is spread across different scientific fields, a close collaboration should be set up to collect essential and unified data to improve knowledge and provide information for monitoring, control and harm reduction purposes. More research, on several areas of investigation, should be carried out to gather relevant information. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Commercializing diarrhea vaccines for travelers

PubMed Central

López-Gigosos, Rosa; Segura-Moreno, Marina; Díez-Díaz, Rosa; Plaza, Elena; Mariscal, Alberto

2014-01-01

Continued growth in international travel and forecasts for a great increase in the number of people who travel from industrialized to emerging and developing countries make it necessary to develop and improve the capacity to provide health protection to travelers. Measures available to prevent some diseases include a currently limited number of marketed vaccines which represent extremely useful tools to protect travelers. Travelers very often experience diarrheal and gastrointestinal diseases for which some vaccines are available. Use of these vaccines should be evaluated based on traveler and travel destination and characteristics. Vaccines available include those against cholera, typhoid fever, hepatitis A, hepatitis E (only available in China), and rotavirus. The aim of this review is to provide an updated summary about each of the abovementioned vaccines that may be useful for making decisions regarding their use and assessing their indications in recommendations for travelers. PMID:24496054

Infectious disease risk and international tourism demand.

PubMed

Rosselló, Jaume; Santana-Gallego, Maria; Awan, Waqas

2017-05-01

 For some countries, favourable climatic conditions for tourism are often associated with favourable conditions for infectious diseases, with the ensuing development constraints on the tourist sectors of impoverished countries where tourism's economic contribution has a high potential. This paper evaluates the economic implications of eradication of Malaria, Dengue, Yellow Fever and Ebola on the affected destination countries focusing on the tourist expenditures.  A gravity model for international tourism flows is used to provide an estimation of the impact of each travel-related disease on international tourist arrivals. Next the potential eradication of these diseases in the affected countries is simulated and the impact on tourism expenditures is estimated.  The results show that, in the case of Malaria, Dengue, Yellow Fever and Ebola, the eradication of these diseases in the affected countries would result in an increase of around 10 million of tourist worldwide and a rise in the tourism expenditure of 12 billion dollars.  By analysing the economic benefits of the eradication of Dengue, Ebola, Malaria, and Yellow Fever for the tourist sector-a strategic economic sector for many of the countries where these TRD are present-this paper explores a new aspect of the quantification of health policies which should be taken into consideration in future international health assessment programmes. It is important to note that the analysis is only made of the direct impact of the diseases' eradication and consequently the potential multiplicative effects of a growth in the GDP, in terms of tourism attractiveness, are not evaluated. Consequently, the economic results can be considered to be skeleton ones. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

How Much are Built Environments Changing, and Where?: Patterns of Change by Neighborhood Sociodemographic Characteristics across Seven U.S. Metropolitan Areas

PubMed Central

Hirsch, Jana A.; Grengs, Joe; Schulz, Amy; Adar, Sara D.; Rodriguez, Daniel A.; Brines, Shannon J.; Diez Roux, Ana V.

2016-01-01

Investments in neighborhood built environments could increase physical activity and overall health. Disproportionate distribution of these changes in advantaged neighborhoods could inflate health disparities. Little information exists on where changes are occurring. This paper aims to 1) identify changes in the built environment in neighborhoods and 2) investigate associations between high levels of change and sociodemographic characteristics. Using Geographic Information Systems, neighborhood land-use, local destinations (for walking, social engagement, and physical activity), and sociodemographics were characterized in 2000 and 2010 for seven U.S. cities. Linear and change on change models estimated associations of built environment changes with baseline (2000) and change (2010–2000) in sociodemographics. Spatial patterns were assessed using Global Moran’s I to measure overall clustering of change and Local Moran’s I to identify statistically significant clusters of high increases surrounded by high increases (HH). Sociodemographic characteristics were compared between HH cluster and other tracts using Analysis of Variance (ANOVA). We observed small land-use changes but increases in the destination types. Greater increases in destinations were associated with higher percentage non-Hispanic whites, percentage households with no vehicle, and median household income. Associations were present for both baseline sociodemographics and changes over time. Greater increases in destinations were associated with lower baseline percentage over 65 but higher increases in percentage over 65 between 2000 and 2010. Global Moran’s indicated changes were spatially clustered. HH cluster tracts started with a higher percentage non-Hispanic whites and higher percentage of households without vehicles. Between 2000 and 2010, HH cluster tracts experienced increases in percent non-Hispanic white, greater increases in median household income, and larger decreases in percent of households without a vehicle. Changes in the built environment are occurring in neighborhoods across a diverse set of U.S. metropolitan areas, but are patterned such that they may lead to increased health disparities over time. PMID:27701020

Relevance and Effectiveness of the WHO Global Code Practice on the International Recruitment of Health Personnel--Ethical and Systems Perspectives.

PubMed

Brugha, Ruairí; Crowe, Sophie

2015-05-20

The relevance and effectiveness of the World Health Organization's (WHO's) Global Code of Practice on the International Recruitment of Health Personnel is being reviewed in 2015. The Code, which is a set of ethical norms and principles adopted by the World Health Assembly (WHA) in 2010, urges members states to train and retain the health personnel they need, thereby limiting demand for international migration, especially from the under-staffed health systems in low- and middle-income countries. Most countries failed to submit a first report in 2012 on implementation of the Code, including those source countries whose health systems are most under threat from the recruitment of their doctors and nurses, often to work in 4 major destination countries: the United States, United Kingdom, Canada and Australia. Political commitment by source country Ministers of Health needs to have been achieved at the May 2015 WHA to ensure better reporting by these countries on Code implementation for it to be effective. This paper uses ethics and health systems perspectives to analyse some of the drivers of international recruitment. The balance of competing ethics principles, which are contained in the Code's articles, reflects a tension that was evident during the drafting of the Code between 2007 and 2010. In 2007-2008, the right of health personnel to migrate was seen as a preeminent principle by US representatives on the Global Council which co-drafted the Code. Consensus on how to balance competing ethical principles--giving due recognition on the one hand to the obligations of health workers to the countries that trained them and the need for distributive justice given the global inequities of health workforce distribution in relation to need, and the right to migrate on the other hand--was only possible after President Obama took office in January 2009. It is in the interests of all countries to implement the Global Code and not just those that are losing their health personnel through international recruitment, given that it calls on all member states "to educate, retain and sustain a health workforce that is appropriate for their (need) ..." (Article 5.4), to ensure health systems' sustainability. However, in some wealthy destination countries, this means tackling national inequities and poorly designed health workforce strategies that result in foreign-trained doctors being recruited to work among disadvantaged populations and in primary care settings, allowing domestically trained doctors work in more attractive hospital settings. © 2015 by Kerman University of Medical Sciences.

Romania: Brand-New Engineering Solutions

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

Ken Allen; Lucian Biro; Nicolae Zamfir

The HEU spent nuclear fuel transport from Romania was a pilot project in the framework of the Russian Research Reactor Fuel Return Program (RRRFR), being the first fully certified spent nuclear fuel shipment by air. The successful implementation of the Romanian shipment also brought various new technology in the program, further used by other participating countries. Until 2009, the RRRFR program repatriated to the Russian Federation HEU spent nuclear fuel of Russian origin from many countries, like Uzbekistan, Czech Republic, Latvia, Hungary, Kazakhstan and Bulgaria. The means of transport used were various; from specialized TK-5 train for the carriage ofmore » Russian TUK-19 transport casks, to platform trains for 20 ft freight ISO containers carrying Czech Skoda VPVR/M casks; from river barge on the Danube, to vessel on the Mediterranean Sea and Atlantic Ocean. Initially, in 2005, the transport plan of the HEU spent nuclear fuel from the National Institute for R&D in Nuclear Physics and Nuclear Engineering 'Horia Hulubei' in Magurele, Romania considered a similar scheme, using the specialized TK-5 train transiting Ukraine to the destination point in the Russian Federation, or, as an alternative, using the means and route of the spent nuclear fuel periodically shipped from the Bulgarian nuclear power plant Kosloduy (by barge on the Danube, and by train through Ukraine to the Russian Federation). Due to impossibility to reach an agreement in due time with the transit country, in February 2007 the US, Russian and Romanian project partners decided to adopt the air shipment of the spent nuclear fuel as prime option, eliminating the need for agreements with any transit countries. By this time the spent nuclear fuel inspections were completed, proving the compliance of the burn-up parameters with the international requirements for air shipments of radioactive materials. The short air route avoiding overflying of any other countries except the country of origin and the country of destination also contributed to the decision making in this issue. The efficient project management and cooperation between the three countries (Russia, Romania and USA) made possible, after two and a half years of preparation work, for the first fully certified spent nuclear fuel air shipment to take place on 29th of June 2009, from Romanian airport 'Henri Coanda' to the Russian airport 'Koltsovo' near Yekaterinburg. One day before that, after a record period of 3 weeks of preparation, another HEU cargo was shipped by air from Romanian Institute for Nuclear Research in Pitesti to Russia, containing fresh pellets and therefore making Romania the third HEU-free country in the RRRFR program.« less

Structure and evolution of the global seafood trade network

NASA Astrophysics Data System (ADS)

Gephart, Jessica A.; Pace, Michael L.

2015-12-01

The food production system is increasingly global and seafood is among the most highly traded commodities. Global trade can improve food security by providing access to a greater variety of foods, increasing wealth, buffering against local supply shocks, and benefit the environment by increasing overall use efficiency for some resources. However, global trade can also expose countries to external supply shocks and degrade the environment by increasing resource demand and loosening feedbacks between consumers and the impacts of food production. As a result, changes in global food trade can have important implications for both food security and the environmental impacts of production. Measurements of globalization and the environmental impacts of food production require data on both total trade and the origin and destination of traded goods (the network structure). While the global trade network of agricultural and livestock products has previously been studied, seafood products have been excluded. This study describes the structure and evolution of the global seafood trade network, including metrics quantifying the globalization of seafood, shifts in bilateral trade flows, changes in centrality and comparisons of seafood to agricultural and industrial trade networks. From 1994 to 2012 the number of countries trading in the network remained relatively constant, while the number of trade partnerships increased by over 65%. Over this same period, the total quantity of seafood traded increased by 58% and the value increased 85% in real terms. These changes signify the increasing globalization of seafood products. Additionally, the trade patterns in the network indicate: increased influence of Thailand and China, strengthened intraregional trade, and increased exports from South America and Asia. In addition to characterizing these network changes, this study identifies data needs in order to connect seafood trade with environmental impacts and food security outcomes.

Network analysis to detect common strategies in Italian foreign direct investment

NASA Astrophysics Data System (ADS)

De Masi, G.; Giovannetti, G.; Ricchiuti, G.

2013-03-01

In this paper we reconstruct and discuss the network of Italian firms investing abroad, exploiting information from complex network analysis. This method, detecting the key nodes of the system (both in terms of firms and countries of destination), allows us to single out the linkages among firms without ex-ante priors. Moreover, through the examination of affiliates’ economic activity, it allows us to highlight different internationalization strategies of “leaders” in different manufacturing sectors.

The Proposed U.S.-Panama Free Trade Agreement

DTIC Science & Technology

2010-02-22

China ). About one-third of all cargo passing through the canal has its origin or destination in the United States. The canal’s total economic...has begun the expansion project. With transfer of the canal and its operations to Panama, the country also inherited a substantial amount of land ...prospects as a business venture, but because it is forward looking rather than relying on the “maquiladora” business model common in much of the region.12

Changes in resident attitudes towards tourism development and conservation in the Okavango Delta, Botswana.

PubMed

Mbaiwa, Joseph E; Stronza, Amanda L

2011-08-01

Negative attitudes of resident communities towards conservation are associated with resource decline in developing countries. In Botswana, Community-Based Natural Resource Management (CBNRM) was adopted to address this challenge. CBNRM links rural development and conservation. However, the impact of CBNRM on changes of resident attitudes towards conservation and tourism is not adequately researched. This paper, therefore, assesses the impacts of CBNRM on resident attitudes towards tourism development and conservation in the Okavango Delta, Botswana. The study purposively sampled villages of Khwai, Mababe and Sankoyo. Household data using variables like: economic benefits from CBNRM; level of satisfaction with CBNRM; co-management of natural resources between resident communities and government agencies; and collective action was collected. This data was supplemented by secondary and ethnographic data. Using qualitative and quantitative analysis, results indicate changes in resident attitudes from being negative to positive towards tourism and conservation. These changes are triggered by economic benefits residents derived from CBNRM, co-management in resource management; and, collective action of communities in CBNRM development. Positive attitudes towards conservation and tourism are the first building blocks towards achieving conservation in nature-based tourism destinations. As a result, decision-makers should give priority to CBNRM and use it as a tool to achieve conservation and improved livelihoods in nature-based tourism destinations of developing countries. Copyright © 2011 Elsevier Ltd. All rights reserved.

Rush to the border? Market liberalization and urban- and rural-origin internal migration in Mexico.

PubMed

Villarreal, Andrés; Hamilton, Erin R

2012-09-01

In this study we examine the social and economic factors driving internal migration flows in Mexico. We pay particular attention to the effect that economic liberalization has had in encouraging migration to border cities. Our analysis of the origin and destination of migrants is carried out at a finer level of geographical detail than ever before. Microdata files from the 2000 population census allow us to distinguish urban- and rural-origin migrants to the largest 115 cities and metropolitan areas in the country. Our results indicate that economic liberalization, measured by the level of foreign investment and employment in the maquiladora export industry, strongly influences migrants' choice of destinations. However, economic liberalization fails to fully account for the attraction of the border, as do the higher emigration rates to the United States from border cities. Our analysis also reveals that migrants to the border region and to cities with high levels of foreign investment are younger, less educated and more likely to be men than migrants to other parts of Mexico. Rural migrants are significantly more likely to move to the border and to cities with high levels of foreign investment than urban migrants. The results of our study have important implication for other countries opening their economies to foreign investment and international trade. Copyright © 2012 Elsevier Inc. All rights reserved.

Management of severe ischemic cardiomyopathy: left ventricular assist device as destination therapy versus conventional bypass and mitral valve surgery.

PubMed

Maltais, Simon; Tchantchaleishvili, Vahtang; Schaff, Hartzell V; Daly, Richard C; Suri, Rakesh M; Dearani, Joseph A; Topilsky, Yan; Stulak, John M; Joyce, Lyle D; Park, Soon J

2014-04-01

Patients with severe ischemic cardiomyopathy (left ventricular ejection fraction <25%) and severe ischemic mitral regurgitation have a poor survival with medical therapy alone. Left ventricular assist device as destination therapy is reserved for patients who are too high risk for conventional surgery. We evaluated our outcomes with conventional surgery within this population and the comparative effectiveness of these 2 therapies. We identified patients who underwent conventional surgery or left ventricular assist device as destination therapy for severe ischemic cardiomyopathy (left ventricular ejection fraction <25%) and severe mitral regurgitation. The era for conventional surgery spanned from 1993 to 2009 and from 2007 to 2011 for left ventricular assist device as destination therapy. We compared baseline patient characteristics and outcomes in terms of end-organ function and survival. A total of 88 patients were identified; 55 patients underwent conventional surgery (63%), and 33 patients (37%) received a left ventricular assist device as destination therapy. Patients who received left ventricular assist device as destination therapy had the increased prevalence of renal failure, inotrope dependency, and intra-aortic balloon support. Patients undergoing conventional surgery required longer ventilatory support, and patients receiving a left ventricular assist device required more reoperation for bleeding. Mortality rates were similar between the 2 groups at 30 days (7% in the conventional surgery group vs 3% in the left ventricular assist device as destination therapy group, P = .65) and at 1 year (22% in the conventional surgery group vs 15% in the left ventricular assist device as destination therapy group, P = .58). There was a trend toward improved survival in patients receiving a left ventricular assist device compared with the propensity-matched groups at 1 year (94% vs 71%, P = .171). The operative mortality and early survival after conventional surgery seem to be acceptable. For inoperable or prohibitive-risk patients, left ventricular assist device as destination therapy can be offered with similar outcomes. Copyright © 2014 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

A universal model for predicting human migration under climate change: examining future sea level rise in Bangladesh

NASA Astrophysics Data System (ADS)

Frankel Davis, Kyle; Bhattachan, Abinash; D’Odorico, Paolo; Suweis, Samir

2018-06-01

Climate change is expected to impact the habitability of many places around the world in significant and unprecedented ways in the coming decades. While previous studies have provided estimates of populations potentially exposed to various climate impacts, little work has been done to assess the number of people that may actually be displaced or where they will choose to go. Here we modify a diffusion-based model of human mobility in combination with population, geographic, and climatic data to estimate the sources, destinations, and flux of potential migrants as driven by sea level rise (SLR) in Bangladesh in the years 2050 and 2100. Using only maps of population and elevation, we predict that 0.9 million people (by year 2050) to 2.1 million people (by year 2100) could be displaced by direct inundation and that almost all of this movement will occur locally within the southern half of the country. We also find that destination locations should anticipate substantial additional demands on jobs (594 000), housing (197 000), and food (783 × 109 calories) by mid-century as a result of those displaced by SLR. By linking the sources of migrants displaced by SLR with their likely destinations, we demonstrate an effective approach for predicting climate-driven migrant flows, especially in data-limited settings.

Psychosocial and Environmental Correlates of Walking, Cycling, Public Transport and Passive Transport to Various Destinations in Flemish Older Adolescents

PubMed Central

Verhoeven, Hannah; Simons, Dorien; Van Dyck, Delfien; Van Cauwenberg, Jelle; Clarys, Peter; De Bourdeaudhuij, Ilse; de Geus, Bas; Vandelanotte, Corneel; Deforche, Benedicte

2016-01-01

Background Active transport is a convenient way to incorporate physical activity in adolescents’ daily life. The present study aimed to investigate which psychosocial and environmental factors are associated with walking, cycling, public transport (train, tram, bus, metro) and passive transport (car, motorcycle, moped) over short distances (maximum eight kilometres) among older adolescents (17–18 years), to school and to other destinations. Methods 562 older adolescents completed an online questionnaire assessing socio-demographic variables, psychosocial variables, environmental variables and transport to school/other destinations. Zero-inflated negative binomial regression models were performed. Results More social modelling and a higher residential density were positively associated with walking to school and walking to other destinations, respectively. Regarding cycling, higher self-efficacy and a higher social norm were positively associated with cycling to school and to other destinations. Regarding public transport, a higher social norm, more social modelling of siblings and/or friends, more social support and a higher land use mix access were positively related to public transport to school and to other destinations, whereas a greater distance to school only related positively to public transport to school. Regarding passive transport, more social support and more perceived benefits were positively associated with passive transport to school and to other destinations. Perceiving less walking and cycling facilities at school was positively related to passive transport to school only, and more social modelling was positively related to passive transport to other destinations. Conclusions Overall, psychosocial variables seemed to be more important than environmental variables across the four transport modes. Social norm, social modelling and social support were the most consistent psychosocial factors which indicates that it is important to target both older adolescents and their social environment in interventions promoting active transport. Walking or cycling together with siblings or friends has the potential to increase social norm, social modelling and social support towards active transport. PMID:26784933

Psychosocial and Environmental Correlates of Walking, Cycling, Public Transport and Passive Transport to Various Destinations in Flemish Older Adolescents.

PubMed

Verhoeven, Hannah; Simons, Dorien; Van Dyck, Delfien; Van Cauwenberg, Jelle; Clarys, Peter; De Bourdeaudhuij, Ilse; de Geus, Bas; Vandelanotte, Corneel; Deforche, Benedicte

2016-01-01

Active transport is a convenient way to incorporate physical activity in adolescents' daily life. The present study aimed to investigate which psychosocial and environmental factors are associated with walking, cycling, public transport (train, tram, bus, metro) and passive transport (car, motorcycle, moped) over short distances (maximum eight kilometres) among older adolescents (17-18 years), to school and to other destinations. 562 older adolescents completed an online questionnaire assessing socio-demographic variables, psychosocial variables, environmental variables and transport to school/other destinations. Zero-inflated negative binomial regression models were performed. More social modelling and a higher residential density were positively associated with walking to school and walking to other destinations, respectively. Regarding cycling, higher self-efficacy and a higher social norm were positively associated with cycling to school and to other destinations. Regarding public transport, a higher social norm, more social modelling of siblings and/or friends, more social support and a higher land use mix access were positively related to public transport to school and to other destinations, whereas a greater distance to school only related positively to public transport to school. Regarding passive transport, more social support and more perceived benefits were positively associated with passive transport to school and to other destinations. Perceiving less walking and cycling facilities at school was positively related to passive transport to school only, and more social modelling was positively related to passive transport to other destinations. Overall, psychosocial variables seemed to be more important than environmental variables across the four transport modes. Social norm, social modelling and social support were the most consistent psychosocial factors which indicates that it is important to target both older adolescents and their social environment in interventions promoting active transport. Walking or cycling together with siblings or friends has the potential to increase social norm, social modelling and social support towards active transport.

Mortality by Cause of Death Among Immigrants and Natives in a South European Country: The Case of Greece, 2011.

PubMed

Verropoulou, Georgia; Tsimbos, Cleon

2016-04-01

The aim of the paper is to examine for the first time in Greece mortality by cause of death among immigrants. The analysis makes use of vital registration statistics for 2010-2012 and census data for 2011; standardised mortality ratios are estimated for four distinct groups: natives, migrants from EU-27 (excluding Greece), other Europeans (mainly Albanians) and those from all other countries (mainly Asia/Africa). All immigrants seem to experience favourable mortality from neoplasms but higher mortality from external causes in comparison to Greeks. The results regarding cardiovascular diseases are mixed. Persons originating in Asian/African regions exhibit higher mortality from infectious diseases and TB. The findings highlight the specificities of immigrant mortality which stem from pre-existing conditions in the country of origin as well as from the adverse socio-economic environment in the country of destination. As immigrants experience some excessive 'avoidable' mortality implementation of appropriate measures should be a social policy priority.

The Gravity of High-Skilled Migration Policies.

PubMed

Czaika, Mathias; Parsons, Christopher R

2017-04-01

Combining unique, annual, bilateral data on labor flows of highly skilled immigrants for 10 OECD destinations between 2000 and 2012, with new databases comprising both unilateral and bilateral policy instruments, we present the first judicious cross-country assessment of policies aimed to attract and select high-skilled workers. Points-based systems are much more effective in attracting and selecting high-skilled migrants than requiring a job offer, labor market tests, and shortage lists. Offers of permanent residency, while attracting the highly skilled, overall reduce the human capital content of labor flows because they prove more attractive to non-high-skilled workers. Bilateral recognition of diploma and social security agreements foster greater flows of high-skilled workers and improve the skill selectivity of immigrant flows. Conversely, double taxation agreements deter high-skilled migrants, although they do not alter overall skill selectivity. Our results are robust to a variety of empirical specifications that account for destination-specific amenities, multilateral resistance to migration, and the endogeneity of immigration policies.

A profile of travelers--an analysis from a large swiss travel clinic.

PubMed

Bühler, Silja; Rüegg, Rolanda; Steffen, Robert; Hatz, Christoph; Jaeger, Veronika K

2014-01-01

Globally, the Swiss have one of the highest proportions of the population traveling to tropical and subtropical countries. Large travel clinics serve an increasing number of customers with specific pre-travel needs including uncommon destinations and preexisting medical conditions. This study aims to identify health characteristics and travel patterns of travelers seeking advice in the largest Swiss travel clinic so that tailored advice can be delivered. A descriptive analysis was performed on pre-travel visits between July 2010 and August 2012 at the Travel Clinic of the Institute of Social and Preventive Medicine, University of Zurich, Switzerland. A total of 22,584 travelers sought pre-travel advice. Tourism was the main reason for travel (17,875, 81.5%), followed by visiting friends and relatives (VFRs; 1,715, 7.8%), traveling for business (1,223, 5.6%), and "other reasons" (ie, volunteer work, pilgrimage, study abroad, and emigration; 1,112, 5.1%). The main travel destination was Thailand. In the VFR group, the highest proportions of traveling children (258, 15.1%) and of pregnant or breastfeeding women (23, 3.9%) were observed. Mental disorders were more prominent in VFRs (93, 5.4%) and in travel for "other reasons" (63, 5.7%). The latter stayed for the longest periods abroad; 272 (24.9%) stayed longer than 6 months. VFR travelers received the highest percentage of yellow fever vaccinations (523, 30.5%); in contrast, rabies (269, 24.2%) and typhoid vaccinations (279, 25.1%) were given more often to the "other travel reasons" group. New insights into the characteristics of a selected and large population of Swiss international travelers results in improved understanding of the special needs of an increasingly diverse population and, thus, in targeted preventive advice and interventions. © 2014 International Society of Travel Medicine.

Internationally educated nurses in Canada: predictors of workforce integration.

PubMed

Covell, Christine L; Primeau, Marie-Douce; Kilpatrick, Kelley; St-Pierre, Isabelle

2017-04-04

Global trends in migration accompanied with recent changes to the immigrant selection process may have influenced the demographic and human capital characteristics of internationally educated nurses (IENs) in Canada and in turn the assistance required to facilitate their workforce integration. This study aimed to describe the demographic and human capital profile of IENs in Canada, to explore recent changes to the profile, and to identify predictors of IENs' workforce integration. A cross-sectional, descriptive, correlational survey design was used. Eligible IENs were immigrants, registered and employed as regulated nurses in Canada. Data were collected in 2014 via online and paper questionnaires. Descriptive statistics were used to examine the data by year of immigration. Logistic regression modeling was employed to identify predictors of IENs' workforce integration measured as passing the licensure exam to acquire professional recertification and securing employment. The sample consisted of 2280 IENs, representative of all Canadian provincial jurisdictions. Since changes to the immigrant selection process in 2002, the IEN population in Canada has become more racially diverse with greater numbers emigrating from developing countries. Recent arrivals (after 2002) had high levels of human capital (knowledge, professional experience, language proficiency). Some, but not all, benefited from the formal and informal assistance available to facilitate their workforce integration. Professional experience and help studying significantly predicted if IENs passed the licensure exam on their first attempt. Bridging program participation and assistance from social networks in Canada were significant predictors if IENs had difficulty securing employment. Nurses will continue to migrate from a wide variety of countries throughout the world that have dissimilar nursing education and health systems. Thus, IENs are not a homogenous group, and a "one size fits all" model may not be effective for facilitating their professional recertification and employment in the destination country. Canada, as well as other countries, could consider using a case management approach to develop and tailor education and forms of assistance to meet the individual needs of IENs. Using technology to reach IENs who have not yet immigrated or have settled outside of urban centers are other potential strategies that may facilitate their timely entrance into the destination countries' nursing workforce.

The two cultures of health worker migration: a Pacific perspective.

PubMed

Connell, John

2014-09-01

Migration of health workers from relatively poor countries has been sustained for more than half a century. The rationale for migration has been linked to numerous factors relating to the economies and health systems of source and destination countries. The contemporary migration of health workers is also embedded in a longstanding and intensifying culture of migration, centred on the livelihoods of extended households, and a medical culture that is oriented to superior technology and advanced skills. This dual culture is particularly evident in small island states in the Pacific, but is apparent in other significant migrant source countries in the Caribbean, Sub-Saharan Africa and Asia. Family expectations of the benefits of migration indicate that regulating the migration and attrition of health workers necessitates more complex policies beyond those evident within health care systems alone. Copyright © 2014. Published by Elsevier Ltd.

Transplant tourism: the ethics and regulation of international markets for organs.

PubMed

Cohen, I Glenn

2013-01-01

"Medical Tourism" is the travel of residents of one country to another country for treatment. In this article I focus on travel abroad to purchase organs for transplant, what I will call "Transplant Tourism." With the exception of Iran, organ sale is illegal across the globe, but many destination countries have thriving black markets, either due to their willful failure to police the practice or more good faith lack of resources to detect it. I focus on the sale of kidneys, the most common subject of transplant tourism, though much of what I say could be applied to other organs as well. Part I briefly reviews some data on sellers, recipients, and brokers. Part II discusses the bioethical issues posed by the trade, and Part III focuses on potential regulation to deal with these issues. © 2013 American Society of Law, Medicine & Ethics, Inc.

Amplification or suppression: Social networks and the climate change—migration association in rural Mexico

PubMed Central

Riosmena, Fernando; Hunter, Lori M.; Runfola, Daniel M.

2015-01-01

Increasing rates of climate migration may be of economic and national concern to sending and destination countries. It has been argued that social networks – the ties connecting an origin and destination – may operate as “migration corridors” with the potential to strongly facilitate climate change-related migration. This study investigates whether social networks at the household and community levels amplify or suppress the impact of climate change on international migration from rural Mexico. A novel set of 15 climate change indices was generated based on daily temperature and precipitation data for 214 weather stations across Mexico. Employing geostatistical interpolation techniques, the climate change values were linked to 68 rural municipalities for which sociodemographic data and detailed migration histories were available from the Mexican Migration Project. Multi-level discrete-time event-history models were used to investigate the effect of climate change on international migration between 1986 and 1999. At the household level, the effect of social networks was approximated by comparing the first to the last move, assuming that through the first move a household establishes internal social capital. At the community level, the impact of social capital was explored through interactions with a measure of the proportion of adults with migration experience. The results show that rather than amplifying, social capital may suppress the sensitivity of migration to climate triggers, suggesting that social networks could facilitate climate change adaptation in place. PMID:26692656

Will They Stay or Will They Go? International Graduate Students and Their Decisions to Stay or Leave the U.S. upon Graduation

PubMed Central

Han, Xueying; Stocking, Galen; Gebbie, Matthew A.; Appelbaum, Richard P.

2015-01-01

The U.S. currently enjoys a position among the world’s foremost innovative and scientifically advanced economies but the emergence of new economic powerhouses like China and India threatens to disrupt the global distribution of innovation and economic competitiveness. Among U.S. policy makers, the promotion of advanced education, particularly in the STEM (Science, Technology, Engineering and Mathematics) fields, has become a key strategy for ensuring the U.S.’s position as an innovative economic leader. Since approximately one third of science and engineering post-graduate students in the U.S. are foreign born, the future of the U.S. STEM educational system is intimately tied to issues of global competitiveness and American immigration policy. This study utilizes a combination of national education data, a survey of foreign-born STEM graduate students, and in-depth interviews of a sub-set of those students to explain how a combination of scientists’ and engineers’ educational decisions, as well as their experience in school, can predict a students’ career path and geographical location, which can affect the long-term innovation environment in their home and destination country. This study highlights the fact that the increasing global competitiveness in STEM education and the complex, restrictive nature of U.S. immigration policies are contributing to an environment where the American STEM system may no longer be able to comfortably remain the premier destination for the world’s top international students. PMID:25760327

Final treatment of spent batteries by thermal plasma.

PubMed

Cubas, Anelise Leal Vieira; Machado, Marina de Medeiros; Machado, Marília de Medeiros; Dutra, Ana Regina de Aguiar; Moecke, Elisa Helena Siegel; Fiedler, Haidi D; Bueno, Priscila

2015-08-15

The growth in the use of wireless devices, notebooks and other electronic products has led to an ever increasing demand for batteries, leading to these products being commonly found in inappropriate locations, with adverse effects on the environment and human health. Due to political pressure and according to the environmental legislation which regulates the destination of spent batteries, in several countries the application of reverse logistics to hazardous waste is required. Thus, some processes have been developed with the aim of providing an appropriate destination for these products. In this context, a method for the treatment of spent batteries using thermal plasma technology is proposed herein. The efficiency of the method was tested through the determination of parameters, such as total organic carbon, moisture content and density, as well as analysis by atomic absorption spectrometry, scanning electron microscopy and X-ray fluorescence using samples before and after inertization. The value obtained for the density was 19.15%. The TOC results indicated 8.05% of C in the batteries prior to pyrolisis and according to the XRF analysis Fe, S, Mn and Zn were the most stable elements in the samples (highest peaks). The efficiency of the paste inertization was 97% for zinc and 99.74% for manganese. The results also showed that the most efficient reactor was that with the DC transferred arc plasma torch and quartzite sand positively influenced by the vitrification during the pyrolysis of the electrolyte paste obtain from batteries. Copyright © 2015. Published by Elsevier Ltd.

Will they stay or will they go? International graduate students and their decisions to stay or leave the U.S. upon graduation.

PubMed

Han, Xueying; Stocking, Galen; Gebbie, Matthew A; Appelbaum, Richard P

2015-01-01

The U.S. currently enjoys a position among the world's foremost innovative and scientifically advanced economies but the emergence of new economic powerhouses like China and India threatens to disrupt the global distribution of innovation and economic competitiveness. Among U.S. policy makers, the promotion of advanced education, particularly in the STEM (Science, Technology, Engineering and Mathematics) fields, has become a key strategy for ensuring the U.S.'s position as an innovative economic leader. Since approximately one third of science and engineering post-graduate students in the U.S. are foreign born, the future of the U.S. STEM educational system is intimately tied to issues of global competitiveness and American immigration policy. This study utilizes a combination of national education data, a survey of foreign-born STEM graduate students, and in-depth interviews of a sub-set of those students to explain how a combination of scientists' and engineers' educational decisions, as well as their experience in school, can predict a students' career path and geographical location, which can affect the long-term innovation environment in their home and destination country. This study highlights the fact that the increasing global competitiveness in STEM education and the complex, restrictive nature of U.S. immigration policies are contributing to an environment where the American STEM system may no longer be able to comfortably remain the premier destination for the world's top international students.

[The management of foreign workers in Italy].

PubMed

Iavicoli, Sergio; Valenti, Antonio; Persechino, Benedetta

2011-01-01

Over the last decades, the globalisation and important geopolitical changes have widened the spatial boundaries of international migrations which have reached a so global scope today that they influence the economic, political and social trend of countries of origin, transit and destination. According to the UN, the international labour mobility involved more than 200 million people in 2010, that is approximately 10% of the world's total population. In Italy, in the beginning of 2010 foreign residents amounted to 4.2 million, that is to say, 7% of the total population (ISTAT, 2011). Host countries have been forced to implement a series of policies aimed at combating illegal immigration and employment of foreign people. Special attention must be given to the issue of migrant workers who have become increasingly important actors in the social and productive sectors and, as a consequence, the need for preventive and protective measures taking into consideration the specific work-related hazards is growing more and more urgent. With this respect, the regulatory framework for occupational health and safety now contains explicit references to migrant workers as provided in the Leg. Decree 81/08 with subsequent integrations and modifications. First of all, the issue of occupational health and safety for migrant workers must take into account of the linguistic, social and cultural problems of the different ethnical groups that are present in our country.

Nurses on the move: a global overview.

PubMed

Kingma, Mireille

2007-06-01

To look at nurse migration flows in the light of national nursing workforce imbalances, examine factors that encourage or inhibit nurse mobility, and explore the potential benefits of circular migration. The number of international migrants has doubled since 1970 and nurses are increasingly part of the migratory stream. Critical nursing shortages in industrialized countries are generating a demand that is fueling energetic international recruitment campaigns. Structural adjustments in the developing countries have created severe workforce imbalances and shortfalls often coexist with large numbers of unemployed health professionals. A nurse's motivation to migrate is multifactorial, not limited to financial incentives, and barriers exist that discourage or slow the migration process. The migration flows vary in direction and magnitude over time, responding to socioeconomic factors present in source and destination countries. The dearth of data on which to develop international health human resource policy remains. There is growing recognition, however, that migration will continue and that temporary migration will be a focus of attention in the years to come. Today's search for labor is a highly organized global hunt for talent that includes nurses. International migration is a symptom of the larger systemic problems that make nurses leave their jobs. Nurse mobility becomes a major issue only in a context of migrant exploitation or nursing shortage. Injecting migrant nurses into dysfunctional health systems-ones that are not capable of attracting and retaining staff domestically-will not solve the nursing shortage.

Comparative evaluation of environmental contamination and DNA damage induced by electronic-waste in Nigeria and China.

PubMed

Alabi, Okunola A; Bakare, Adekunle A; Xu, Xijin; Li, Bin; Zhang, Yuling; Huo, Xia

2012-04-15

In the last decade, China and Nigeria have been prime destinations for the world's e-waste disposal leading to serious environmental contamination. We carried out a comparative study of the level of contamination using soils and plants from e-waste dumping and processing sites in both countries. Levels of polyaromatic hydrocarbons (PAHs), polychlorinated biphenyls (PCBs), and polybrominated diphenyl ethers (PBDEs) were analyzed using gas chromatography/spectrophotometry and heavy metals using atomic absorption spectrophotometry. DNA damage was assayed in human peripheral blood lymphocytes using an alkaline comet assay. Soils and plants were highly contaminated with toxic PAHs, PCBs, PBDEs, and heavy metals in both countries. Soil samples from China and plant samples from Nigeria were more contaminated. There was a positive correlation between the concentrations of organics and heavy metals in plant samples and the surrounding soils. In human lymphocytes, all tested samples induced significant (p<0.05) concentration-dependent increases in DNA damage compared with the negative control. These findings suggest that e-waste components/constituents can accumulate, in soil and surrounding vegetation, to toxic and genotoxic levels that could induce adverse health effects in exposed individuals. Copyright © 2012 Elsevier B.V. All rights reserved.

Global spatio-temporal patterns in human migration: a complex network perspective.

PubMed

Davis, Kyle F; D'Odorico, Paolo; Laio, Francesco; Ridolfi, Luca

2013-01-01

Migration is a powerful adaptive strategy for humans to navigate hardship and pursue a better quality of life. As a universal vehicle facilitating exchanges of ideas, culture, money and goods, international migration is a major contributor to globalization. Consisting of countries linked by multiple connections of human movements, global migration constitutes a network. Despite the important role of human migration in connecting various communities in different parts of the world, the topology and behavior of the international migration network and its changes through time remain poorly understood. Here we show that the global human migration network became more interconnected during the latter half of the twentieth century and that migrant destination choice partly reflects colonial and postcolonial histories, language, religion, and distances. From 1960 to 2000 we found a steady increase in network transitivity (i.e. connectivity between nodes connected to the same node), a decrease in average path length and an upward shift in degree distribution, all of which strengthened the 'small-world' behavior of the migration network. Furthermore, we found that distinct groups of countries preferentially interact to form migration communities based largely on historical, cultural and economic factors.

Uncovering Offshore Financial Centers: Conduits and Sinks in the Global Corporate Ownership Network.

PubMed

Garcia-Bernardo, Javier; Fichtner, Jan; Takes, Frank W; Heemskerk, Eelke M

2017-07-24

Multinational corporations use highly complex structures of parents and subsidiaries to organize their operations and ownership. Offshore Financial Centers (OFCs) facilitate these structures through low taxation and lenient regulation, but are increasingly under scrutiny, for instance for enabling tax avoidance. Therefore, the identification of OFC jurisdictions has become a politicized and contested issue. We introduce a novel data-driven approach for identifying OFCs based on the global corporate ownership network, in which over 98 million firms (nodes) are connected through 71 million ownership relations. This granular firm-level network data uniquely allows identifying both sink-OFCs and conduit-OFCs. Sink-OFCs attract and retain foreign capital while conduit-OFCs are attractive intermediate destinations in the routing of international investments and enable the transfer of capital without taxation. We identify 24 sink-OFCs. In addition, a small set of five countries - the Netherlands, the United Kingdom, Ireland, Singapore and Switzerland - canalize the majority of corporate offshore investment as conduit-OFCs. Each conduit jurisdiction is specialized in a geographical area and there is significant specialization based on industrial sectors. Against the idea of OFCs as exotic small islands that cannot be regulated, we show that many sink and conduit-OFCs are highly developed countries.

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.

Women trafficking: causes, concerns, care!

PubMed

Khowaja, Shaneela Sadaruddin; Tharani, Ambreen Jawed; Agha, Ajmal; Karamaliani, Rozina Sherali

2012-08-01

Pakistan is both a country of origin and destination as far as women trafficking is concerned. Poverty, gender discrimination, lack of education, and ignorance about legal rights are some of the underlying causes. Available data suggest several areas of concern, like, for instance: direct health effects, maladaptive coping leading to the use of illicit drugs, and inaccessibility to healthcare facilities. Therefore, numerous interventions would be required at three levels: the prevention of trafficking, the protection of victims and the prosecution of the traffickers.

Physician emigration from sub-Saharan Africa to the United States: analysis of the 2011 AMA physician masterfile.

PubMed

Tankwanchi, Akhenaten Benjamin Siankam; Ozden, Cağlar; Vermund, Sten H

2013-01-01

The large-scale emigration of physicians from sub-Saharan Africa (SSA) to high-income nations is a serious development concern. Our objective was to determine current emigration trends of SSA physicians found in the physician workforce of the United States. We analyzed physician data from the World Health Organization (WHO) Global Health Workforce Statistics along with graduation and residency data from the 2011 American Medical Association Physician Masterfile (AMA-PM) on physicians trained or born in SSA countries who currently practice in the US. We estimated emigration proportions, year of US entry, years of practice before emigration, and length of time in the US. According to the 2011 AMA-PM, 10,819 physicians were born or trained in 28 SSA countries. Sixty-eight percent (n = 7,370) were SSA-trained, 20% (n = 2,126) were US-trained, and 12% (n = 1,323) were trained outside both SSA and the US. We estimated active physicians (age ≤ 70 years) to represent 96% (n = 10,377) of the total. Migration trends among SSA-trained physicians increased from 2002 to 2011 for all but one principal source country; the exception was South Africa whose physician migration to the US decreased by 8% (-156). The increase in last-decade migration was >50% in Nigeria (+1,113) and Ghana (+243), >100% in Ethiopia (+274), and >200% (+244) in Sudan. Liberia was the most affected by migration to the US with 77% (n = 175) of its estimated physicians in the 2011 AMA-PM. On average, SSA-trained physicians have been in the US for 18 years. They practiced for 6.5 years before US entry, and nearly half emigrated during the implementation years (1984-1999) of the structural adjustment programs. Physician emigration from SSA to the US is increasing for most SSA source countries. Unless far-reaching policies are implemented by the US and SSA countries, the current emigration trends will persist, and the US will remain a leading destination for SSA physicians emigrating from the continent of greatest need. Please see later in the article for the Editors' Summary.

Physician Emigration from Sub-Saharan Africa to the United States: Analysis of the 2011 AMA Physician Masterfile

PubMed Central

Tankwanchi, Akhenaten Benjamin Siankam; Özden, Çağlar; Vermund, Sten H.

2013-01-01

Background The large-scale emigration of physicians from sub-Saharan Africa (SSA) to high-income nations is a serious development concern. Our objective was to determine current emigration trends of SSA physicians found in the physician workforce of the United States. Methods and Findings We analyzed physician data from the World Health Organization (WHO) Global Health Workforce Statistics along with graduation and residency data from the 2011 American Medical Association Physician Masterfile (AMA-PM) on physicians trained or born in SSA countries who currently practice in the US. We estimated emigration proportions, year of US entry, years of practice before emigration, and length of time in the US. According to the 2011 AMA-PM, 10,819 physicians were born or trained in 28 SSA countries. Sixty-eight percent (n = 7,370) were SSA-trained, 20% (n = 2,126) were US-trained, and 12% (n = 1,323) were trained outside both SSA and the US. We estimated active physicians (age ≤70 years) to represent 96% (n = 10,377) of the total. Migration trends among SSA-trained physicians increased from 2002 to 2011 for all but one principal source country; the exception was South Africa whose physician migration to the US decreased by 8% (−156). The increase in last-decade migration was >50% in Nigeria (+1,113) and Ghana (+243), >100% in Ethiopia (+274), and >200% (+244) in Sudan. Liberia was the most affected by migration to the US with 77% (n = 175) of its estimated physicians in the 2011 AMA-PM. On average, SSA-trained physicians have been in the US for 18 years. They practiced for 6.5 years before US entry, and nearly half emigrated during the implementation years (1984–1999) of the structural adjustment programs. Conclusion Physician emigration from SSA to the US is increasing for most SSA source countries. Unless far-reaching policies are implemented by the US and SSA countries, the current emigration trends will persist, and the US will remain a leading destination for SSA physicians emigrating from the continent of greatest need. Please see later in the article for the Editors' Summary PMID:24068894

Sálvese Quien Pueda: Structural Adjustment and Emigration from Lima

PubMed Central

MASSEY, DOUGLAS S.; CAPOFERRO, CHIARA

2010-01-01

Beginning in 1987, Peru imposed a regime of structural adjustment to transform its economy along neoliberal lines. This analysis suggests that a shift resulted in the odds of international migration and the motivations for leaving among inhabitants of Peru’s largest labor market. Before 1987, under the regime of import substitution industrialization, jobs at wages capable of sustaining a basic standard of living were widely available; those few who left the country self-selected for higher human capital and moved abroad to improve their earnings. Under neoliberalism, however, both employment and wages fell to levels that made it difficult for families to sustain themselves. In response, households—with the assistance of friends and relatives with foreign experience—diversified their labor portfolios away from the local job market structural adjustment zones. The number of migrants then rose, the diversity of foreign destinations increased, and migration became less selective with respect to human capital. PMID:20824152

Detection of hepatitis E virus (HEV) through the different stages of pig manure composting plants

PubMed Central

García, M; Fernández-Barredo, S; Pérez-Gracia, M T

2014-01-01

Hepatitis E virus (HEV) is an increasing cause of acute hepatitis in industrialized countries. The aim of this study was to evaluate the presence of HEV in pig manure composting plants located in Spain. For this purpose, a total of 594 samples were taken in 54 sampling sessions from the different stages of composting treatment in these plants as follows: slurry reception ponds, anaerobic ponds, aerobic ponds, fermentation zone and composting final products. HEV was detected by reverse transcription polymerase chain reaction (RT-nested PCR) in four (80%) of five plants studied, mainly in the first stages of the process. HEV was not detected in any final product (compost) sample, destined to be commercialized as a soil fertilizer, suggesting that composting is a suitable method to eliminate HEV and thus, to reduce the transmission of HEV from pigs to humans. PMID:24206540

Dumbo heavy lifter aircraft

NASA Technical Reports Server (NTRS)

Riester, Peter; Ellis, Colleen; Wagner, Michael; Orren, Scott; Smith, Byron; Skelly, Michael; Zgraggen, Craig; Webber, Matt

1992-01-01

The world is rapidly changing from one with two military superpowers, with which most countries were aligned, to one with many smaller military powers. In this environment, the United States cannot depend on the availability of operating bases from which to respond to crises requiring military intervention. Several studies (e.g. the SAB Global Reach, Global Power Study) have indicated an increased need to be able to rapidly transport large numbers of troops and equipment from the continental United States to potential trouble spots throughout the world. To this end, a request for proposals (RFP) for the concept design of a large aircraft capable of 'projecting' a significant military force without reliance on surface transportation was developed. These design requirements are: minimum payload of 400,000 pounds at 2.5 g maneuver load factor; minimum unfueled range of 6,000 nautical miles; and aircraft must operate from existing domestic air bases and use existing airbases or sites of opportunity at the destination.

International nurse migration: impacts on New Zealand.

PubMed

North, Nicola

2007-08-01

As a source and destination country, nurse flows in and out of New Zealand (NZ) are examined to determine impacts and regional contexts. A descriptive statistics method was used to analyze secondary data on nurses added to the register, NZ nurse qualifications verified by overseas authorities, nursing workforce data, and census data. It found that international movement of nurses was minimal during the 1990s, but from 2001 a sharp jump in the verification of NZ-registered nurses (RNs) by overseas authorities coincided with an equivalent increase in international RNs (IRNs) added to the NZ nursing register-a pattern that has been sustained to the present. Movement of NZ RNs to Australia is expedited by the Trans-Tasman Agreement, whereas entry of IRNs to NZ is facilitated by nursing being an identified Priority Occupation. Future research needs to consider health system and nurse workforce contexts and take a regional perspective on migration patterns.

Internal Migration and Sexual Initiation among Never Married Youths in Nigeria

PubMed Central

Mberu, Blessing Uchenna; White, Michael J

2013-01-01

The high rates of youth migration to urban and economic centers, in the context of persistent poverty and devastating HIV/AIDS burden, raises intricate social policy challenges in developing countries. This study examines patterns of internal migration and sexual initiation among Nigerian youths, using the 2003 Nigeria DHS data, descriptive statistics, Kaplan-Meier survival curves and discrete-time hazard regression models. Migrants generally show stronger association than non-migrants, and urban-urban migrants show the strongest independent association to early sexual initiation. These outcomes underscore that loss of social capital and exposure to sexually lenient urban environment increase youth's propensity to sexual engagement. Other significant covariates are age, gender, ethnic origin, education, independent living arrangement and formal employment. The findings highlight the inadequacy of policy perspectives that neglect complex contextual nuances across groups and the need to address limited livelihood opportunities that fuel youth migration to urban destinations. PMID:21435767

Gone for good? An online survey of emigrant health professionals using Facebook as a recruitment tool.

PubMed

McAleese, Sara; Clyne, Barbara; Matthews, Anne; Brugha, Ruairí; Humphries, Niamh

2016-06-30

Health professionals, particularly doctors, nurses and midwives, are in high demand worldwide. Therefore, it is important to assess the future plans and likelihood of return of emigrating health professionals. Nevertheless, health professionals are, by definition, a difficult population to track/survey. This exploratory study reports on the migration intentions of a sample of doctors, nurses and midwives who had emigrated from Ireland, a high-income country which has experienced particularly high outward and inward migration of health professionals since the year 2000. Health professionals who had emigrated from Ireland were identified via snowball sampling through Facebook and invited to complete a short online survey composed of closed and open response questions. A total of 388 health professionals (307 doctors, 73 nurses and 8 midwives) who had previously worked in Ireland completed the survey. While over half had originally intended to spend less than 5 years in their destination country at the time of emigration, these intentions changed over time, with the desire to remain abroad on a permanent basis increasing from 10 to 34 % of doctor respondents. Only a quarter of doctors and a half of nurses and midwives intended to return to practice in Ireland in the future. The longer health professionals remain abroad, the less likely they are to return to their home countries. Countries should focus on the implementation of retention strategies if the 'carousel' of brain drain is to be interrupted. This would allow source countries to benefit from their investments in training health professionals, rather than relying on international recruitment to meet health system staffing needs. Improved data collection systems are also needed to track the migratory patterns and changing intentions of health professionals. Meanwhile, social networking platforms offer alternative methods of filling this information gap.

Out-of-hospital cardiac arrest survival in international airports.

PubMed

Masterson, Siobhán; McNally, Bryan; Cullinan, John; Vellano, Kimberly; Escutnaire, Joséphine; Fitzpatrick, David; Perkins, Gavin D; Koster, Rudolph W; Nakajima, Yuko; Pemberton, Katherine; Quinn, Martin; Smith, Karen; Jónsson, Bergþór Steinn; Strömsöe, Anneli; Tandan, Meera; Vellinga, Akke

2018-03-14

The highest achievable survival rate following out-of-hospital cardiac arrest is unknown. Data from airports serving international destinations (international airports) provide the opportunity to evaluate the success of pre-hospital resuscitation in a relatively controlled but real-life environment. This retrospective cohort study included all cases of out-of-hospital cardiac arrest at international airports with resuscitation attempted between January 1st, 2013 and December 31st, 2015. Crude incidence, patient, event characteristics and survival to hospital discharge/survival to 30 days (survival) were calculated. Mixed effect logistic regression analyses were performed to identify predictors of survival. Variability in survival between airports/countries was quantified using the median odds ratio. There were 800 cases identified, with an average of 40 per airport. Incidence was 0.024/100,000 passengers per year. Percentage survival for all patients was 32%, and 58% for patients with an initial shockable heart rhythm. In adjusted analyses, initial shockable heart rhythm was the strongest predictor of survival (odds ratio, 36.7; 95% confidence interval [CI], 15.5-87.0). In the bystander-witnessed subgroup, delivery of a defibrillation shock by a bystander was a strong predictor of survival (odds ratio 4.8; 95% CI, 3.0-7.8). Grouping of cases was significant at country level and survival varied between countries. In international airports, 32% of patients survived an out-of-hospital cardiac arrest, substantially more than in the general population. Our analysis suggested similarity between airports within countries, but differences between countries. Systematic data collection and reporting are essential to ensure international airports continually maximise activities to increase survival. Copyright © 2018 Elsevier B.V. All rights reserved.

Dengue Sentinel Traveler Surveillance: Monthly and Yearly Notification Trends among Japanese Travelers, 2006–2014

PubMed Central

Fukusumi, Munehisa; Arashiro, Takeshi; Arima, Yuzo; Matsui, Tamano; Shimada, Tomoe; Kinoshita, Hitomi; Arashiro, Ashley; Takasaki, Tomohiko; Sunagawa, Tomimasa; Oishi, Kazunori

2016-01-01

Background Dengue is becoming an increasing threat to non-endemic countries. In Japan, the reported number of imported cases has been rising, and the first domestic dengue outbreak in nearly 70 years was confirmed in 2014, highlighting the need for greater situational awareness and better-informed risk assessment. Methods Using national disease surveillance data and publically available traveler statistics, we compared monthly and yearly trends in the destination country-specific dengue notification rate per 100,000 Japanese travelers with those of domestic dengue cases in the respective country visited during 2006–2014. Comparisons were made for countries accounting for the majority of importations; yearly comparisons were restricted to countries where respective national surveillance data were publicly available. Results There were 1007 imported Japanese dengue cases (Bali, Indonesia (n = 202), the Philippines (n = 230), Thailand (n = 160), and India (n = 152)). Consistent with historic local dengue seasonality, monthly notification rate among travelers peaked in August in Thailand, September in the Philippines, and in Bali during April with a smaller peak in August. While the number of travelers to Bali was greatest in August, the notification rate was highest in April. Annually, trends in the notification rate among travelers to the Philippines and Thailand also closely reflected local notification trends. Conclusion Travelers to dengue-endemic countries appear to serve as reliable “sentinels”, with the trends in estimated risk of dengue infection among Japanese travelers closely reflecting local dengue trends, both seasonally and annually. Sentinel traveler surveillance can contribute to evidence-based pretravel advice, and help inform risk assessments and decision-making for importation and potentially for subsequent secondary transmission. As our approach takes advantage of traveler data that are readily available as a proxy denominator, sentinel traveler surveillance can be a practical surveillance tool that other countries could consider for implementation. PMID:27540724

The geography of imported malaria to non-endemic countries: a meta-analysis of nationally reported statistics.

PubMed

Tatem, Andrew J; Jia, Peng; Ordanovich, Dariya; Falkner, Michael; Huang, Zhuojie; Howes, Rosalind; Hay, Simon I; Gething, Peter W; Smith, David L

2017-01-01

Malaria remains a problem for many countries classified as malaria free through cases imported from endemic regions. Imported cases to non-endemic countries often result in delays in diagnosis, are expensive to treat, and can sometimes cause secondary local transmission. The movement of malaria in endemic countries has also contributed to the spread of drug resistance and threatens long-term eradication goals. Here we focused on quantifying the international movements of malaria to improve our understanding of these phenomena and facilitate the design of mitigation strategies. In this meta-analysis, we studied the database of publicly available nationally reported statistics on imported malaria in the past 10 years, covering more than 50 000 individual cases. We obtained data from 40 non-endemic countries and recorded the geographical variations. Infection movements were strongly skewed towards a small number of high-traffic routes between 2005 and 2015, with the west Africa region accounting for 56% (13 947/24 941) of all imported cases to non-endemic countries with a reported travel destination, and France and the UK receiving the highest number of cases, with more than 4000 reported cases per year on average. Countries strongly linked by movements of imported cases are grouped by historical, language, and travel ties. There is strong spatial clustering of plasmodium species types. The architecture of the air network, historical ties, demographics of travellers, and malaria endemicity contribute to highly heterogeneous patterns of numbers, routes, and species compositions of parasites transported. With global malaria eradication on the international agenda, malaria control altering local transmission, and the threat of drug resistance, understanding these patterns and their drivers is increasing in importance. Bill & Melinda Gates Foundation, National Institutes of Health, UK Medical Research Council, UK Department for International Development, Wellcome Trust. Copyright © 2017 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY license. Published by Elsevier Ltd.. All rights reserved.

Substance Use Across Different Phases Of The Migration Process: A Survey Of Mexican Migrants Flows

PubMed Central

Zhang, Xiao; Martinez-Donate, Ana P.; Nobles, Jenna; Hovell, Melbourne F.; Rangel, Maria Gudelia; Rhoads, Natalie M.

2015-01-01

Background This study examined the levels of substance use and changes across different migration stages, including pre-departure, travel, destination, and return, among Mexican migrants converging on the U.S.-Mexico border. Method A cross-sectional survey was conducted in Tijuana, Mexico, between 2009 and 2010 among Mexican migrants returning from the U.S. and those travelling from other Mexican regions. Results The overall prevalence of last 12-month at-risk drinking, illicit drug use, and current smoking, was 42.3%, 17.7% and 31.4%, respectively. Compared to pre-departure migrants, males were at increased risk for illicit drug use at the destination and return stages. In contrast, females’ alcohol consumption at the destination stage was lower than at pre-departure (p<0.05). The level of smoking was stable across all stages for both genders. In the destination stage, undocumented migrants were more likely to use illicit drugs relative to their documented peers (p<0.05). Conclusions Binational interventions promoting substance use reduction are needed among this mobile population. PMID:25595206

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.

Case-Case Analysis Using 7 Years of Travelers' Diarrhea Surveillance Data: Preventive and Travel Medicine Applications in Cusco, Peru.

PubMed

Jennings, Mary Carol; Tilley, Drake H; Ballard, Sarah-Blythe; Villanueva, Miguel; Costa, Fernando Maldonado; Lopez, Martha; Steinberg, Hannah E; Luna, C Giannina; Meza, Rina; Silva, Maria E; Gilman, Robert H; Simons, Mark P; Maves, Ryan C; Cabada, Miguel M

2017-05-01

AbstractIn Cusco, Peru, and South America in general, there is a dearth of travelers' diarrhea (TD) data concerning the clinical features associated with enteropathogen-specific infections and destination-specific risk behaviors. Understanding these factors would allow travel medicine providers to tailor interventions to patients' risk profiles and travel destination. To characterize TD etiology, evaluate region-specific TD risk factors, and examine relationships between preventive recommendations and risk-taking behaviors among medium- to long-term travelers' from high-income countries, we conducted this case-case analysis using 7 years of prospective surveillance data from adult travelers' presenting with TD to a physician in Cusco. At the time of enrollment, participants provided a stool sample and answered survey questions about demographics, risk behaviors, and the clinical features of illness. Stool samples were tested for norovirus (NV), bacteria, and parasites using conventional methods. Data obtained were then analyzed using case-case methods. NV (14%), enterotoxigenic Escherichia coli (11%), and Campylobacter (9%), notably ciprofloxacin-resistant Campylobacter , were the most frequently identified pathogens among adults with TD. Coinfection with multiple enteropathogens occurred in 5% of cases. NV caused severe disease relative to other TD-associated pathogens identified, confining over 90% of infected individuals to bed. Destination-specific risk factors include consumption of the local beverage "chicha," which was associated with Cryptosporidium infection. Preventive interventions, such as vaccines, directed against these pathogens could significantly reduce the burden of TD.

Case–Case Analysis Using 7 Years of Travelers' Diarrhea Surveillance Data: Preventive and Travel Medicine Applications in Cusco, Peru

PubMed Central

Jennings, Mary Carol; Tilley, Drake H.; Ballard, Sarah-Blythe; Villanueva, Miguel; Costa, Fernando Maldonado; Lopez, Martha; Steinberg, Hannah E.; Luna, C. Giannina; Meza, Rina; Silva, Maria E.; Gilman, Robert H.; Simons, Mark P.; Maves, Ryan C.; Cabada, Miguel M.

2017-01-01

In Cusco, Peru, and South America in general, there is a dearth of travelers' diarrhea (TD) data concerning the clinical features associated with enteropathogen-specific infections and destination-specific risk behaviors. Understanding these factors would allow travel medicine providers to tailor interventions to patients' risk profiles and travel destination. To characterize TD etiology, evaluate region-specific TD risk factors, and examine relationships between preventive recommendations and risk-taking behaviors among medium- to long-term travelers' from high-income countries, we conducted this case–case analysis using 7 years of prospective surveillance data from adult travelers' presenting with TD to a physician in Cusco. At the time of enrollment, participants provided a stool sample and answered survey questions about demographics, risk behaviors, and the clinical features of illness. Stool samples were tested for norovirus (NV), bacteria, and parasites using conventional methods. Data obtained were then analyzed using case–case methods. NV (14%), enterotoxigenic Escherichia coli (11%), and Campylobacter (9%), notably ciprofloxacin-resistant Campylobacter, were the most frequently identified pathogens among adults with TD. Coinfection with multiple enteropathogens occurred in 5% of cases. NV caused severe disease relative to other TD-associated pathogens identified, confining over 90% of infected individuals to bed. Destination-specific risk factors include consumption of the local beverage “chicha,” which was associated with Cryptosporidium infection. Preventive interventions, such as vaccines, directed against these pathogens could significantly reduce the burden of TD. PMID:28167602

Migration and AIDS.

PubMed

Decosas, J; Kane, F; Anarfi, J K; Sodji, K D; Wagner, H U

1995-09-23

A successful short-term solution to transmission of AIDS in Western Africa by migrants involves provision of accessible and acceptable basic health and social services to migrants at their destination. The aim is to establish a sense of security and community, which is a health requirement. When migrants are excluded from community life or victimized as carriers of HIV infections, they will be driven by basic survival needs and dysfunctional social organization, which results in the rapid spread of HIV. Closing borders and mass deportation may not be an option. The long-term solution is population policy, environmental protection, and economic development. The focus on mapping the spread of AIDS must shift to a consideration of the migrant social conditions that make them vulnerable to AIDS. The issue of migration and AIDS will be addressed at the First European Conference on Tropical Medicine in October 1995 in Hamburg, Germany. In Uganda, HIV seroprevalence rates ranged from 5.5% among the stable population to 12.4% among internal migrants moving between villages to 16.3% among migrants from other areas. A World Bank project is operating in Western Africa, which traces seasonal male migration from the Cameroon to Liberia, Senegal to Nigeria, and from the Sahel to the coast during dry seasons. National border rules may influence the routes but not the extent of migration. A major destination place is Cote d' Ivoire, which has 25% of total population comprised of migrants from other countries and one of the highest HIV prevalence rates in Western Africa. On plantations prostitutes are brought in. Each prostitute serves about 25 workers. The pattern of sexual mixing contributes to the high HIV rates. Female migration is smaller and usually concentrated in prostitution at place of destination. Illiteracy and poverty drive women migrants into the trade. Their frequent health problems are malaria, pelvic pain, menstrual irregularity, vaginal discharge, and genital sores. Drugs are bought on the streets or from friends and may be of questionable efficacy. Health services may be sought upon return to the home country.

How to regulate medical tourism (and why it matters for bioethics).

PubMed

Cohen, I Glenn

2012-04-01

A growing literature examines descriptive and normative questions about medical tourism such as: How does it operate? What are its effects? Are home country patients or their governments failing in moral duties by engaging in or permitting medical tourism? By contrast, much less has been written on the regulatory dimension: What might be done about medical tourism if we were convinced that it posed ethical issues and were motivated to act? I shall argue that this kind of regulatory analysis is essential for bioethical analysis of medical tourism. This article focuses on these regulatory questions more directly, evaluating available methods, restrictions, costs, and benefits of home and destination country unilateral regulatory moves. This article also discusses more briefly multilateral treaty and private sector responses. © 2012 Blackwell Publishing Ltd.

Destination memory in social interaction: better memory for older than for younger destinations in normal aging?

PubMed

El Haj, Mohamad; Raffard, Stéphane; Fasotti, Luciano; Allain, Philippe

2018-05-01

Destination memory, a memory component allowing the attribution of information to its appropriate receiver (e.g., to whom did I lend my pen?), is compromised in normal aging. The present paper investigated whether older adults might show better memory for older destinations than for younger destinations. This hypothesis is based on empirical research showing better memory for older faces than for younger faces in older adults. Forty-one older adults and 44 younger adults were asked to tell proverbs to older and younger destinations (i.e., coloured faces). On a later recognition test, participants had to decide whether they had previously told some proverb to an older/younger destination or not. Prior to this task, participants reported their frequency of contact with other-age groups. The results showed lower destination memory in older adults than in younger adults. Interestingly, older adults displayed better memory for older than for younger destinations. The opposite pattern was seen in younger adults. The low memory for younger destinations, as observed in older adults, was significantly correlated with limited exposure to younger individuals. These findings suggest that for older adults, the social experience can play a crucial role in the destination memory, at least as far as exposure to other-age groups is concerned.

7 CFR 35.11 - Minimum requirements.

Code of Federal Regulations, 2012 CFR

2012-01-01

... applicable to the variety and destination specified: (a) Any such variety for export to destinations in Japan... for export to any foreign destination, other than destinations in Japan, Europe, Greenland, Canada, or...

7 CFR 35.11 - Minimum requirements.

Code of Federal Regulations, 2014 CFR

2014-01-01

... applicable to the variety and destination specified: (a) Any such variety for export to destinations in Japan... for export to any foreign destination, other than destinations in Japan, Europe, Greenland, Canada, or...

7 CFR 35.11 - Minimum requirements.

Code of Federal Regulations, 2013 CFR

2013-01-01

... applicable to the variety and destination specified: (a) Any such variety for export to destinations in Japan... for export to any foreign destination, other than destinations in Japan, Europe, Greenland, Canada, or...

48 CFR 52.247-34 - F.o.b. Destination.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 2 2010-10-01 2010-10-01 false F.o.b. Destination. 52.247....o.b. Destination. As prescribed in 47.303-6(c), insert the following clause: F.o.b. Destination (JAN 1991) (a) The term f.o.b. destination, as used in this clause, means— (1) Free of expense to the...

7 CFR 35.11 - Minimum requirements.

Code of Federal Regulations, 2010 CFR

2010-01-01

... applicable to the variety and destination specified: (a) Any such variety for export to destinations in Japan... requirements. (b) Any such variety for export to any foreign destination, other than destinations in Japan...

The possible effects of health professional mobility on access to care for patients.

PubMed

Glinos, Irene A

2014-01-01

The chapter explains how health professional mobility impacts on the resources and capacity available within a health system, and how this affects service delivery and access. The contrasting experiences of destination countries, which receive foreign inflows of health professionals, and of source countries, which loose workforce due to outflows, are illustrated with country examples. The evidence opens the debate on how EU countries compete for health workforce, what this means for resource-strained, crisis-hit Member States, and whether there is any room for intra-European solidarity. The nexus between patient mobility and health professional mobility is moreover highlighted. This take on free mobility in the EU has received little attention, and while evidence is scarce, it calls for careful analysis when considering the possible effects of free movement on access to care in national health systems. The chapter reformulates the question on 'who wins' and 'who looses' from freedom of movement in the EU to turn our attention away from those who go abroad for care and instead focus on those who stay at home.

Potential damage of GM crops to the country image of the producing country.

PubMed

Knight, John G; Clark, Allyson; Mather, Damien W

2013-01-01

Frequently heard within New Zealand are arguments that release of genetically modified organisms (GMOs) into the environment will harm the "clean green" image of the country, and therefore do irreparable harm to export markets for food products and also to the New Zealand tourism industry. But where is the evidence? To investigate the likelihood of harmful effects on New Zealand's clean green image in relation to food exports, we have previously used face-to-face interviews with gatekeepers in the food distribution channel in five countries in Europe, in China, and in India. To investigate potential impacts on the New Zealand tourism sector, we have surveyed first-time visitors to New Zealand at Auckland International Airport soon after arrival. We conclude that it is highly unlikely that introduction of GM plants into New Zealand would have any long-term deleterious effect on perceptions in overseas markets of food products sourced from New Zealand. Furthermore it is highly unlikely that New Zealand's image as a tourist destination would suffer if GM plants were introduced.

Destination Memory and Cognitive Theory of Mind in Alzheimer's Disease.

PubMed

El Haj, Mohamad; Gély-Nargeot, Marie-Christine; Raffard, Stéphane

2015-01-01

Destination memory, or the ability to remember the destination to whom a piece of information was addressed, is found to be compromised in Alzheimer's disease (AD). Our paper investigated the relationship between destination memory and theory of mind in AD since both destination memory and theory of mind are social abilities that require processing attributes of interlocutors. Mild AD participants and controls were administered tasks tapping destination memory, affective theory of mind, and 1st and 2nd order cognitive theory of mind. Relative to controls, AD participants showed compromise in destination memory and 2nd order cognitive theory of mind, but preserved performance on affective and 1st order cognitive theory of mind. Significant correlations were observed between destination memory, and 1st and 2nd order cognitive theory of mind in AD participants and controls. By demonstrating a relationship between compromises in 2nd order theory of mind and in destination memory, our work highlights links between social cognition and memory functioning in AD.

Antimicrobial resistance and the current refugee crisis.

PubMed

Maltezou, Helena C; Theodoridou, Maria; Daikos, George L

2017-09-01

In the past few years, Europe has experienced an enormous influx of refugees and migrants owing to the ongoing civil war in Syria as well as conflicts, violence and instability in other Asian and African countries. Available data suggest that refugees carry a significant burden of multidrug-resistant (MDR) organisms, which is attributed to the rising antimicrobial resistance (AMR) rates in their countries of origin, both in healthcare settings and in the community. Transmission of MDR pathogens among refugees is facilitated by the collapsed housing, hygiene and healthcare infrastructures in several communities as well as poor hygiene conditions during their trip to destination countries. These findings highlight the fact that refugees may serve as vehicles of AMR mechanisms from their countries of origin along the immigration route. Following risk assessment, routine microbiological screening for MDR organism carriage of refugees and migrants as well as effective infection control measures should be considered upon admission. This will on the one hand address the possibility of dissemination of novel AMR mechanisms in non- or low-endemic countries and on the other will ensure safety for all patients. Copyright © 2017 International Society for Chemotherapy of Infection and Cancer. Published by Elsevier Ltd. All rights reserved.

Destination memory in Alzheimer's Disease: when I imagine telling Ronald Reagan about Paris.

PubMed

El Haj, Mohamad; Postal, Virginie; Allain, Philippe

2013-01-01

Destination memory refers to remembering the destination of information that people output. This present paper establishes a new distinction between external and internal processes within this memory system for both normal aging and Alzheimer's Disease (AD). Young adults, older adults, and mild AD patients were asked either to tell facts (i.e., external destination memory condition) or to imagine telling facts (i.e., internal destination memory condition) to pictures of famous people. The experiment established three major findings. First, the destination memory performance of the AD patients was significantly poorer than that of older adults, which in turn was poorer than that of the young adults. Furthermore, internal destination processes were more prone to being forgotten than external destination memory processes. In other words, participants had more difficulty in remembering whether they had previously imagined telling the facts to the pictures or not (i.e., imagined condition) than in remembering whether they had previously told the facts to the pictures or not (i.e., enacted condition). Second, significant correlations were detected between performances on destination memory and several executive measures such as the Stroop, the Plus-Minus and the Binding tasks. Third, among the executive measures, regression analyses showed that performance on the Stroop task was a main factor in explaining variance in destination memory performance. Our findings reflect the difficulty in remembering the destination of internally generated information. They also demonstrate the involvement of inhibitory processes in destination memory. Copyright © 2011 Elsevier Ltd. All rights reserved.

The neighbourhood physical environment and active travel in older adults: a systematic review and meta-analysis.

PubMed

Cerin, Ester; Nathan, Andrea; van Cauwenberg, Jelle; Barnett, David W; Barnett, Anthony

2017-02-06

Perceived and objectively-assessed aspects of the neighbourhood physical environment have been postulated to be key contributors to regular engagement in active travel (AT) in older adults. We systematically reviewed the literature on neighbourhood physical environmental correlates of AT in older adults and applied a novel meta-analytic approach to statistically quantify the strength of evidence for environment-AT associations. Forty two quantitative studies that estimated associations of aspects of the neighbourhood built environment with AT in older adults (aged ≥ 65 years) and met selection criteria were reviewed and meta-analysed. Findings were analysed according to five AT outcomes (total walking for transport, within-neighbourhood walking for transport, combined walking and cycling for transport, cycling for transport, and all AT outcomes combined) and seven categories of the neighbourhood physical environment (residential density/urbanisation, walkability, street connectivity, access to/availability of services/destinations, pedestrian and cycling infrastructure, aesthetics and cleanliness/order, and safety and traffic). Most studies examined correlates of total walking for transport. A sufficient amount of evidence of positive associations with total walking for transport was found for residential density/urbanisation, walkability, street connectivity, overall access to destinations/services, land use mix, pedestrian-friendly features and access to several types of destinations. Littering/vandalism/decay was negatively related to total walking for transport. Limited evidence was available on correlates of cycling and combined walking and cycling for transport, while sufficient evidence emerged for a positive association of within-neighbourhood walking with pedestrian-friendly features and availability of benches/sitting facilities. Correlates of all AT combined mirrored those of walking for transport. Positive associations were also observed with food outlets, business/institutional/industrial destinations, availability of street lights, easy access to building entrance and human and motorised traffic volume. Several but inconsistent individual- and environmental-level moderators of associations were identified. Results support strong links between the neighbourhood physical environment and older adults' AT. Future research should focus on the identification of types and mixes of destinations that support AT in older adults and how these interact with individual characteristics and other environmental factors. Future research should also aim to clarify dose-response relationships through multi-country investigations and data-pooling from diverse geographical regions.

Determinants of Mexico-U.S. Outward and Return Migration Flows: A State-Level Panel Data Analysis.

PubMed

Chort, Isabelle; de la Rupelle, Maëlys

2016-10-01

Using a unique panel data set of state-to-state outward and return migration flows between Mexico and the United States from 1995 to 2012, this study is the first to analyze Mexico-U.S. migration at the state level and explore simultaneously the effect of economic, environmental, and social factors in Mexico over two decades. Pairing origin and destination states and controlling for a rich structure of fixed effects, we find that income positively impacts migration outflows, especially for Mexican states of origin with a recent migration history and for low-educated migrant flows, suggesting the existence of credit constraints. We find evidence that drought causes more out-migration, while other climatic shocks have no effect. Violence is found to increase out-migration flows from border states and to decrease migration from other Mexican states, especially where violence is directed at migrants. Last, return flows are larger when income growth at destination is lower, consistent with the accumulation of savings as a primary motivation of migrants. Exploring the impact of the crisis, we find evidence of significant changes in the geography of migration flows. Traditional flows are drying up, and new migration corridors are rising, with implications on the composition of the Mexican population in the United States. Although the effect of income on flows in both directions is unchanged by the crisis, the negative effect of violence on out-migration tends to reverse at the end of the period. Overall, this study emphasizes the interest of analyzing disaggregated flows at the infra-country level.

Overseas visitor deaths in Australia, 2001 to 2003.

PubMed

Leggat, Peter A; Wilks, Jeff

2009-01-01

The health and safety of international visitors remain an important issue for Australia and other tourist destinations. The death of visitors remains an important indicator of safety. The aim of this study was to provide updated figures on deaths of overseas travelers in Australia. Data were sourced from the Australian Bureau of Statistics concerning deaths of overseas visitors for the years 2001 to 2003. There were 1,068 overseas visitor deaths (701 males, 66%) during the study period 2001 to 2003. Death by natural causes increased with age, while deaths associated with accidents were more frequent among younger age groups. The majority of deaths were from natural causes (782, 73%), particularly ischemic heart diseases (26%). There were a total of 247 accidental deaths (23% of all deaths) with the main causes being transportation accidents (14% of all deaths) and accidental drowning/submersion (5% of all deaths). The countries contributing the most deaths were the UK (247, 23%), New Zealand (108, 10%) Melanesia/Micronesia (95, 9%), and the United States (57, 5%). Australia remains a relatively safe destination for international travelers, at least in terms of fatalities, which appear to be declining. Most deaths of overseas tourists in Australia are due to natural causes with cardiovascular disease being the predominant cause of death in this group. Accidents remain the most common preventable cause of death of travelers, with road and water safety being the major issues. It is important that tourism and travel medicine groups continue to advocate for improved health and safety of international travelers visiting Australia.

Tourism sector preparedness in zones with a high seismic risk: Case study of the Capital Region of Japan

NASA Astrophysics Data System (ADS)

Lihui, W.; Wang, D.

2017-12-01

Japan is a country highly vulnerable to natural disasters, especially earthquakes. Tourism, as a strategic industry in Japan, is especially vulnerable to destructive earthquake disasters owing to the characteristics of vulnerability, sensitivity and substitutability. Here we aim to provide theoretical understanding of the perception and responses of tourism managers towards damaging disasters in tourism destinations with high seismic risks. We conducted surveys among the mangers of tourism businesses in the capital area of Japan in 2014 and applied structural equation modeling techniques to empirically test the proposed model with four latent variables, which are risk perception, threat knowledge, disaster preparedness and earthquake preparedness. Our results show that threat knowledge affects risk perception and disaster preparedness positively. In addition, disaster preparedness positively affects earthquake preparedness. However, the proposed paths from risk perception to disaster preparedness, risk perception to earthquake preparedness, and threat knowledge to earthquake preparedness were not statistically significant. Our results may provide references for policymakers in promoting crisis planning in tourism destination with high seismic risks.

'Vacation for your teeth' - dental tourists in Hungary from the perspective of Hungarian dentists.

PubMed

Kovacs, E; Szocska, G

2013-10-01

Hungary has become a popular destination for foreign patients in the last two decades, particularly in dental care. Since 2008, increasing prices in Western Europe coupled with Hungary's accessibility and availability of dental treatment, has meant the country has become a leader in 'dental tourism'. As the quality of care in Hungary is high and prices are more affordable than in Western Europe, and due to the freedom of movement of people, services and goods within the EU, patient flow into Hungary has increased progressively. The aim of this article is to provide comprehensive empirical evidence from the perspective of a recipient country in dental tourism. A questionnaire survey was conducted among Hungarian dentists (n = 273). Qualitative in-depth interviews were conducted with representatives of dental professional bodies (n = 10). Both research methods aimed to elicit dentists' views on the presence of dental tourism - particularly the push and pull factors (for example, source countries, competitors, information sources, patient motivation). The findings show that there are several reasons why Hungary could maintain a leading position in dental tourism. First, the cost/benefit ratio is outstanding. The affordable price and value for money were already recognised in the early 1990s and were appreciated even before Hungary joined the EU. Secondly, the high quality of Hungary's dental profession: a) dental professionals in Hungary are well-qualified dental practitioners who have received high level dental training; b) dental professional standards are up-to-date and often supervised; c) in Hungary dental technology, the quality of materials and equipment used in dental practices is of European level quality. The rate of complications in dental care is around 5%, similar to other European countries. Finally, previous treatment experiences are positive and patient satisfaction levels are high. More and more patients seek care in Hungary, and more and more patients state that they would be willing to return for further treatment in the future.

Unfair trade: e-waste in Africa.

PubMed

Schmidt, Charles W

2006-04-01

Africa is quickly becoming a destination for information technology in the form of tons of used computers, fax machines, cell phones, and other electronics. Although many of these machines can be repaired and resold, up to 75% of the electronics shipped to Africa is junk. This equipment, when dumped, may leach lead, mercury, and cadmium into the environment; when burned, it may release carcinogenic dioxins and polyaromatic hydrocarbons. In the United States, activists are working to limit the flow of e-waste to developing countries through international agreements and voluntary e-waste export reduction efforts.

An Irony of War: Human Development as Warfare in Afghanistan (Colloquium, Volume 3, Number 3, October 2010)

DTIC Science & Technology

2010-10-01

near genius” because of the quick impact it was designed to have to boost the quality of life for the Afghans. LTG Vines was particularly optimistic...destined to play a role for many years. It is a country beset by an insurgency that threatens to destroy the 9-year economic progress that many Afghans...have enjoyed since the end of Taliban rule. Many students of insurgency, or any other type of warfare, do not associate human develop- ment with

[The sanitary protection of Armed Forces employed abroad].

PubMed

Pasini, W

2006-01-01

After recalling the numerous peace expeditions of the Italian Armed Forces in foreign countries, the author underlines the several health risk factors that such missions imply. The assessment of the biological risk should be based on the knowledge of the local sanitary situation and on the analysis of the operative characteristics of the mission: prevention is based on vaccinations (with plans based on the operative tasks and destinations) and on antimalaric chemoprophylaxis, carried out following WHO indications. In conclusion, the current organization of military field hospitals is briefly described.

Global Optimization of Emergency Evacuation Assignments

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

Han, Lee; Yuan, Fang; Chin, Shih-Miao

2006-01-01

Conventional emergency evacuation plans often assign evacuees to fixed routes or destinations based mainly on geographic proximity. Such approaches can be inefficient if the roads are congested, blocked, or otherwise dangerous because of the emergency. By not constraining evacuees to prespecified destinations, a one-destination evacuation approach provides flexibility in the optimization process. We present a framework for the simultaneous optimization of evacuation-traffic distribution and assignment. Based on the one-destination evacuation concept, we can obtain the optimal destination and route assignment by solving a one-destination traffic-assignment problem on a modified network representation. In a county-wide, large-scale evacuation case study, the one-destinationmore » model yields substantial improvement over the conventional approach, with the overall evacuation time reduced by more than 60 percent. More importantly, emergency planners can easily implement this framework by instructing evacuees to go to destinations that the one-destination optimization process selects.« less

Re-emergence of Cholera in the Americas: Risks, Susceptibility, and Ecology

PubMed Central

Poirier, Mathieu JP; Izurieta, Ricardo; Malavade, Sharad S; McDonald, Michael D

2012-01-01

Background: The re-emergence of cholera in Haiti has established a new reservoir for the seventh cholera pandemic which threatens to spread to other countries in the Americas. Materials and Methods: Statistics from this new epidemic are compared to the 1991 Peru epidemic, which demonstrated the speed and complexity with which this disease can spread from country to country. Environmental factors implicated in the spread of Vibrio cholerae such as ocean currents and temperatures, as well as biotic factors from zooplankton to waterfowl pose a risk for many countries in the Americas. Results: The movement of people and goods from Hispaniola are mostly destined for North America, but occur to some degree throughout the Americas. These modes of transmission, and the probability of uncontrolled community spread beyond Hispaniola, however, are completely dependent upon risk factors within these countries such as water quality and availability of sanitation. Although North America has excellent coverage of these deterrents to the spread of infectious gastrointestinal diseases, many countries throughout Latin America and the Caribbean lack these basic services and infrastructures. Conclusions: In order to curb the immediate spread of cholera in Hispaniola, treatment availability should be expanded to all parts of the island and phase II epidemic management initiatives must be developed. PMID:23055647

High-skilled labour mobility in Europe before and after the 2004 enlargement.

PubMed

Petersen, Alexander M; Puliga, Michelangelo

2017-03-01

The extent to which international high-skilled mobility channels are forming is a question of great importance in an increasingly global knowledge-based economy. One factor facilitating the growth of high-skilled labour markets is the standardization of certifiable degrees meriting international recognition. Within this context, we analysed an extensive high-skilled mobility database comprising roughly 382 000 individuals from five broad profession groups (Medical, Education, Technical, Science & Engineering and Business & Legal) over the period 1997-2014, using the 13-country expansion of the European Union (EU) to provide insight into labour market integration. We compare the periods before and after the 2004 enlargement, showing the emergence of a new east-west migration channel between the 13 mostly eastern EU entrants (E) and the rest of the western European countries (W). Indeed, we observe a net directional loss of human capital from E → W, representing 29% of the total mobility after 2004. Nevertheless, the counter-migration from W → E is 7% of the total mobility over the same period, signalling the emergence of brain circulation within the EU. Our analysis of the country-country mobility networks and the country-profession bipartite networks provides timely quantitative evidence for the convergent integration of the EU, and highlights the central role of the UK and Germany as high-skilled labour hubs. We conclude with two data-driven models to explore the structural dynamics of the mobility networks. First, we develop a reconfiguration model to explore the potential ramifications of Brexit and the degree to which redirection of high-skilled labourers away from the UK may impact the integration of the rest of the European mobility network. Second, we use a panel regression model to explain empirical high-skilled mobility rates in terms of various economic 'push-pull' factors, the results of which show that government expenditure on education, per capita wealth, geographical proximity and labour force size are significant attractive features of destination countries. © 2017 The Author(s).

Health risks of travelers in South Africa.

PubMed

Waner, S

1999-09-01

Large numbers of tourists visit South Africa every year. Travelers to urban areas are at little risk of contracting an infectious disease, however the adventure traveler is at increased risk. Yellow fever is not known to occur in South Africa. Malaria is endemic in Mpumalanga and KwaZula-Natal. Schistosomiasis is endemic in large parts of the country. Although rabies is found throughout the country, only a small number of human cases is reported. High risk areas are KwaZulu-Natal, the eastern Cape and Mpumalanga provinces. The incidence of human immunodeficiency virus (HIV) infection is high and counseling regarding sexually transmitted diseases is important. Sanitation of water is excellent in most large cities and towns; however travelers to rural areas should exercise caution. Arbovirus infections do occur but relatively few cases are reported. The hiker is at risk for tick bite fever and should be counseled. Since the abolition of apartheid, South Africa has been seen as an inexpensive, high quality destination by many tourists. In 1997, a total of 5,436,848 travelers from many different countries visited the country. Areas most frequently visited include Johannesburg, Cape Town, Durban, the Garden Route, Kruger National Park, KwaZulu-Natal and Pretoria. The most common reason for visiting the country was holiday (44%), followed by visiting friends and relatives (23%), business travel (27%) other (6%).1 Travelers, to the larger cities such as Johannesburg, Cape Town and Durban are at little risk of acquiring an infectious disease. The adventure traveler however is at greater risk as parts of the country are endemic for malaria, schistosomiasis, rabies, food and waterborne diseases, sexually transmitted diseases and arbovirus infections. Accidental deaths due to motor vehicle accidents and interpersonal violence are important health risks in South Africa. Travelers visiting popular attractions are at significantly lower risk. However this has never been quantified. This review aims to address the occurrence of infectious diseases and attempts to give guidelines to practitioners caring for travelers.

Regulating clinical trials in India: the economics of ethics.

PubMed

Porter, Gerard

2017-07-09

The relationship between the ethical standards for the governance of clinical trials and market forces can be complex and problematic. This article uses India as a case study to explore this nexus. From the mid-2000s, India became a popular destination for foreign-sponsored clinical trials. The Indian government had sought to both attract clinical trials and ensure these would be run in line with internationally accepted ethical norms. Reports of controversial medical research, however, triggered debate about the robustness and suitability of India's regulatory system. In response to civil society pressure and interventions by the Supreme Court, the Indian government proposed additional measures aimed at strengthening protections for clinical trial participants. Whilst the reforms can be seen as a victory for human rights activists, they have also been criticised as being overly burdensome for sponsors. Indeed, their announcement prompted an exodus of clinical trials from India. Fearful of losing business to 'rival' countries, the Indian government is revisiting some of its proposals. The Indian example suggests that research ethics frameworks and national policies for economic development are increasingly intertwined. Host countries are in theory free to improve the lot of research participants, but doing so may make them appear less attractive to foreign sponsors, who can simply shift their activities to more industry-friendly jurisdictions. Although these economic pressures are unlikely to lead to a regulatory 'race to the bottom', they may limit host countries' ability to enact socially desirable reforms. © 2017 John Wiley & Sons Ltd.

Nurses on the Move: A Global Overview

PubMed Central

Kingma, Mireille

2007-01-01

Objective To look at nurse migration flows in the light of national nursing workforce imbalances, examine factors that encourage or inhibit nurse mobility, and explore the potential benefits of circular migration. Principal Findings The number of international migrants has doubled since 1970 and nurses are increasingly part of the migratory stream. Critical nursing shortages in industrialized countries are generating a demand that is fueling energetic international recruitment campaigns. Structural adjustments in the developing countries have created severe workforce imbalances and shortfalls often coexist with large numbers of unemployed health professionals. A nurse's motivation to migrate is multifactorial, not limited to financial incentives, and barriers exist that discourage or slow the migration process. The migration flows vary in direction and magnitude over time, responding to socioeconomic factors present in source and destination countries. The dearth of data on which to develop international health human resource policy remains. There is growing recognition, however, that migration will continue and that temporary migration will be a focus of attention in the years to come. Conclusions Today's search for labor is a highly organized global hunt for talent that includes nurses. International migration is a symptom of the larger systemic problems that make nurses leave their jobs. Nurse mobility becomes a major issue only in a context of migrant exploitation or nursing shortage. Injecting migrant nurses into dysfunctional health systems—ones that are not capable of attracting and retaining staff domestically—will not solve the nursing shortage. PMID:17489915

Vaccination for safe travel to India.

PubMed

Mehta, Bharti; Jindal, Harashish; Bhatt, Bhumika; Kumar, Vijay; Singh Choudhary, Satvinder

2014-01-01

Worldwide more than 900 million international journeys are undertaken every year. India is one of the favorite tourist destinations around the world. International travel exposes travelers to a range of health risks. Traveling to India possess a threat to travelers with waterborne diseases like bacterial diarrhea, hepatitis A and E, and typhoid fever; vector borne diseases like dengue fever, Japanese encephalitis, and malaria; animal contact disease like rabies. Furthermore diseases spreading through behavior aspects cannot be ruled out hence posing a risk for hepatitis B, HIV/AIDS, hepatitis C as well. Hence, before travel the travelers are advised about the risk of disease in the country or countries they plan to visit and the steps to be taken to prevent illness. Vaccination offers the possibility of avoiding a number of infectious diseases that may be countered abroad. There is no single vaccination schedule that fits all travelers. Each schedule must be individualized according to the traveler's previous immunizations, countries to be visited, type and duration of travel, and the amount of time available before departure.

The Basel Convention: effect on the Asian secondary lead industry

NASA Astrophysics Data System (ADS)

Elmer, J. W.

The Basel Convention has had a dramatic effect on the world trade in scrap materials. The scope of implementation is broader than was originally intended. This is due mainly to uncertainties created by a failure to distinguish between waste for disposal and waste destined for recycling. Spent lead/acid batteries and other lead scrap flows from OECD to non-OECD countries have been restricted to the point where secondary lead production is being affected. Export-import flows between OECD members have also changed as recycling is being contained within those countries. The economics of recycling in OECD countries may result in a smaller percentage of scrap being recycled. The established lead/acid battery industry in the Asian region, which relies heavily on imported scrap, will now be forced to import more finished metal, to maintain output. With strong economic growth forecast for the region, and no substitute for the lead-based battery, the supply situation is unlikely to ease.

Brain Drain: Post Graduation Migration Intentions and the influencing factors among Medical Graduates from Lahore, Pakistan.

PubMed

Imran, Nazish; Azeem, Zahra; Haider, Imran I; Amjad, Naeem; Bhatti, Muhammad R

2011-10-17

The increasing migration of health professionals to affluent countries is not a recent phenomenon and has been addressed in literature. However the various facets of physician migration from Pakistan, the third leading source of International medical graduates has not been rigorously evaluated. The objective of the current study was to survey final year students and recent medical graduates in Lahore, Pakistan about their intentions to train abroad, their post training plans as well as to identify the factors responsible for their motivation for international migration. A self administered structured questionnaire was developed to collect respondents' demographic and educational characteristics, intention to train abroad, their preferred destination & post training intentions of returning to Pakistan. Various influencing factors which impact on medical graduate's motivation to train abroad or stay in Pakistan were explored using a 10 point scale. SPSS software was used for data entry and analysis. Of the 400 eligible respondents, 275 responded (response rate 68.7%). One hundred and sixty six respondents (60.4%) intended to train abroad either for a specialty (54.9%) or a subspecialty (5.5%) The United States and United Kingdom were the most preferred destination. While 14.2% intended to return to Pakistan immediately after training, a significant percentage (10%) never intended to return to Pakistan or wished to stay abroad temporarily (37%). Professional excellence and establishing quickly in the competitive market were the most important goal to be achieved by the respondents for intention for postgraduate training abroad. The most common reasons cited for training abroad were the impact of residency training on future career (mean score 8.20 ± 2.3), financial conditions of doctors (mean score 7.97 ± 2.37) and job opportunities (mean score7.90 ± 2.34). An alarming percentage of medical graduates from Lahore, Pakistan intend to migrate for post graduate training, mainly to United States. A significant proportion wished to stay in the host country either temporarily or indefinitely. Impact of residency abroad on future career, financial conditions of doctors, job opportunities and better working conditions were some of the motivating factors behind the migration.

Brain Drain: Post Graduation Migration Intentions and the influencing factors among Medical Graduates from Lahore, Pakistan

PubMed Central

2011-01-01

Background The increasing migration of health professionals to affluent countries is not a recent phenomenon and has been addressed in literature. However the various facets of physician migration from Pakistan, the third leading source of International medical graduates has not been rigorously evaluated. The objective of the current study was to survey final year students and recent medical graduates in Lahore, Pakistan about their intentions to train abroad, their post training plans as well as to identify the factors responsible for their motivation for international migration. Method A self administered structured questionnaire was developed to collect respondents' demographic and educational characteristics, intention to train abroad, their preferred destination & post training intentions of returning to Pakistan. Various influencing factors which impact on medical graduate's motivation to train abroad or stay in Pakistan were explored using a 10 point scale. SPSS software was used for data entry and analysis. Results Of the 400 eligible respondents, 275 responded (response rate 68.7%). One hundred and sixty six respondents (60.4%) intended to train abroad either for a specialty (54.9%) or a subspecialty (5.5%) The United States and United Kingdom were the most preferred destination. While 14.2% intended to return to Pakistan immediately after training, a significant percentage (10%) never intended to return to Pakistan or wished to stay abroad temporarily (37%). Professional excellence and establishing quickly in the competitive market were the most important goal to be achieved by the respondents for intention for postgraduate training abroad. The most common reasons cited for training abroad were the impact of residency training on future career (mean score 8.20 ± 2.3), financial conditions of doctors (mean score 7.97 ± 2.37) and job opportunities (mean score7.90 ± 2.34). Conclusion An alarming percentage of medical graduates from Lahore, Pakistan intend to migrate for post graduate training, mainly to United States. A significant proportion wished to stay in the host country either temporarily or indefinitely. Impact of residency abroad on future career, financial conditions of doctors, job opportunities and better working conditions were some of the motivating factors behind the migration. PMID:22005296

"Forget to whom you have told this proverb": directed forgetting of destination memory in Alzheimer's disease.

PubMed

El Haj, Mohamad; Gandolphe, Marie-Charlotte; Allain, Philippe; Fasotti, Luciano; Antoine, Pascal

2015-01-01

Destination memory is the ability to remember the receiver of transmitted information. By means of a destination memory directed forgetting task, we investigated whether participants with Alzheimer's Disease (AD) were able to suppress irrelevant information in destination memory. Twenty-six AD participants and 30 healthy elderly subjects were asked to tell 10 different proverbs to 10 different celebrities (List 1). Afterwards, half of the participants were instructed to forget the destinations (i.e., the celebrities) whereas the other half were asked to keep them in mind. After telling 10 other proverbs to 10 other celebrities (List 2), participants were asked to read numbers aloud. Subsequently, all the participants were asked to remember the destinations of List 1 and List 2, regardless of the forget or remember instructions. The results show similar destination memory in AD participants who were asked to forget the destinations of List 1 and those who were asked to retain them. These findings are attributed to inhibitory deficits, by which AD participants have difficulties to suppress irrelevant information in destination memory.

“Forget to Whom You Have Told This Proverb”: Directed Forgetting of Destination Memory in Alzheimer's Disease

PubMed Central

El Haj, Mohamad; Gandolphe, Marie-Charlotte; Allain, Philippe; Fasotti, Luciano; Antoine, Pascal

2015-01-01

Destination memory is the ability to remember the receiver of transmitted information. By means of a destination memory directed forgetting task, we investigated whether participants with Alzheimer's Disease (AD) were able to suppress irrelevant information in destination memory. Twenty-six AD participants and 30 healthy elderly subjects were asked to tell 10 different proverbs to 10 different celebrities (List 1). Afterwards, half of the participants were instructed to forget the destinations (i.e., the celebrities) whereas the other half were asked to keep them in mind. After telling 10 other proverbs to 10 other celebrities (List 2), participants were asked to read numbers aloud. Subsequently, all the participants were asked to remember the destinations of List 1 and List 2, regardless of the forget or remember instructions. The results show similar destination memory in AD participants who were asked to forget the destinations of List 1 and those who were asked to retain them. These findings are attributed to inhibitory deficits, by which AD participants have difficulties to suppress irrelevant information in destination memory. PMID:25918456

[Expansion of the tobacco industry and smuggling: challenges for public health in developing countries].

PubMed

Enrique Armendares, Pedro; Reynales Shigematsu, Luz Myriam

2006-01-01

The international tobacco industry, in its constant quest for new markets, has expanded aggressively to middle- and low-income nations. At the same time there has been a marked increase in tobacco smuggling, especially of cigarettes. Smuggling produces serious fiscal losses to governments the world over, erodes tobacco control policies and is an incentive to international organized crime. In addition, smuggling results in increased demand for and consumption of tobacco, which in turn benefits the tobacco companies. Moreover, there is evidence indicating that the international tobacco industry has instigated cigarette smuggling and has participated directly in these activities, while at the same time carrying out costly lobbying campaigns to pressure governments against tax increases and to promote their own interests. Academic studies and empirical evidence show that tobacco control can be promoted through high tax rates without causing significant increases in smuggling. To achieve this tobacco smuggling must be attacked through the use of strategies including multilateral controls and actions such as those included in the Framework Convention on Tobacco Control, which establishes the basis for combating smuggling through an international, global approach. It is also necessary to increase the penalties for smuggling and to make the tobacco industry, including producers and distributors, responsible for the final destination of their exports.

HMO penetration and the geographic mobility of practicing physicians.

PubMed

Polsky, D; Kletke, P R; Wozniak, G D; Escarce, J J

2000-09-01

In this study, we assessed the influence of changes in health maintenance organization (HMO) penetration on the probability that established patient care physicians relocated their practices or left patient care altogether. For physicians who relocated their practices, we also assessed the impact of HMO penetration on their destination choices. We found that larger increases in HMO penetration decreased the probability that medical/surgical specialists in early career stayed in patient care in the same market, but had no impact on generalists, hospital-based specialists, or mid career medical/surgical specialists. We also found that physicians who relocated their practices were much more likely to choose destination markets with the same level of HMO penetration or lower HMO penetration compared with their origin markets than they were to choose destination markets with higher HMO penetration. The largely negligible impact of changes in HMO penetration on established physicians' decisions to relocate their practices or leave patient care is consistent with high relocation and switching costs. Relocating physicians' attraction to destination markets with the same level of HMO penetration as their origin markets suggests that, while physicians' styles of medical practice may adapt to changes in market conditions, learning new practice styles is costly.

[Cardiovascular disease and aircraft transportation: specificities and issues].

PubMed

Touze, Jean-Étienne; Métais, Patrick; Zawieja, Philippe

2012-02-01

With the development of air transport and travel to distant destinations, the number of passengers and elderly passengers on board increases each year. In this population, cardiovascular events are a major concern. Among medical incidents occurring in-flight they are second-ranked (10%) behind gastrointestinal disorders (25%). Their occurrence may involve life-threatening events and require resuscitation, difficult to perform during flight or in a precarious health environment. Coronary heart disease and pulmonary thromboembolic disease are the most serious manifestations. They are the leading cause of hospitalization in a foreign country and sudden cardiac death occurring during or subsequent to the flight. Their occurrence is explained on aircraft by hypoxia, hypobaria and decreased humidity caused by cabin pressurization and upon arrival by a different environmental context (extreme climates, tropical diseases). Moreover, the occurrence of a cardiovascular event during flight can represent for the air carrier a major economic and logistic problem when diversion occurred. Furthermore, the liability of the practitioner passenger could be involved according to airlines or to the country in which the aircraft is registered. In this context, cardiovascular events during aircraft transportation can be easily prevented by identifying high risk patients, respect of cardiovascular indications to travel, the implementation of simple preventive measures and optimization of medical equipment in commercial flights. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

Plasmodium falciparum malaria importation from Africa to China and its mortality: an analysis of driving factors

NASA Astrophysics Data System (ADS)

Lai, Shengjie; Wardrop, Nicola A.; Huang, Zhuojie; Bosco, Claudio; Sun, Junling; Bird, Tomas; Wesolowski, Amy; Zhou, Sheng; Zhang, Qian; Zheng, Canjun; Li, Zhongjie; Tatem, Andrew J.; Yu, Hongjie

2016-12-01

Plasmodium falciparum malaria importation from Africa to China is rising with increasing Chinese overseas investment and international travel. Identifying networks and drivers of this phenomenon as well as the contributors to high case-fatality rate is a growing public health concern to enable efficient response. From 2011-2015, 8653 P. falciparum cases leading to 98 deaths (11.3 per 1000 cases) were imported from 41 sub-Saharan countries into China, with most cases (91.3%) occurring in labour-related Chinese travellers. Four strongly connected groupings of origin African countries with destination Chinese provinces were identified, and the number of imported cases was significantly associated with the volume of air passengers to China (P = 0.006), parasite prevalence in Africa (P < 0.001), and the amount of official development assistance from China (P < 0.001) with investment in resource extraction having the strongest relationship with parasite importation. Risk factors for deaths from imported cases were related to the capacity of malaria diagnosis and diverse socioeconomic factors. The spatial heterogeneity uncovered, principal drivers explored, and risk factors for mortality found in the rising rates of P. falciparum malaria importation to China can serve to refine malaria elimination strategies and the management of cases, and high risk groups and regions should be targeted.

Neighborhood built environment and cognition in non-demented older adults: The Multi-Ethnic Study of Atherosclerosis.

PubMed

Besser, Lilah M; Rodriguez, Daniel A; McDonald, Noreen; Kukull, Walter A; Fitzpatrick, Annette L; Rapp, Stephen R; Seeman, Teresa

2018-03-01

Preliminary studies suggest that neighborhood social and built environment (BE) characteristics may affect cognition in older adults. Older adults are particularly vulnerable to the neighborhood environment due to a decreasing range of routine travel with increasing age. We examined if multiple neighborhood BE characteristics are cross-sectionally associated with cognition in a diverse sample of older adults, and if the BE-cognition associations vary by individual-level demographics. The sample included 4539 participants from the Multi-Ethnic Study of Atherosclerosis. Multivariable linear regression was used to examine the associations between five BE measures and four cognitive measures, and effect modification by individual-level education and race/ethnicity. In the overall sample, increasing social destination density, walking destination density, and intersection density were associated with worse overall cognition, whereas increasing proportion of land dedicated to retail was associated with better processing speed. Effect modification results suggest that the association between urban density and worse cognition may be limited to or strongest in those of non-white race/ethnicity. Although an increase in neighborhood retail destinations was associated with better cognition in the overall sample, these results suggest that certain BE characteristics in dense urban environments may have a disproportionately negative association with cognition in vulnerable populations. However, our findings must be replicated in longitudinal studies and other regional samples. Copyright © 2018 Elsevier Ltd. All rights reserved.

Does the presence and mix of destinations influence walking and physical activity?

PubMed

King, Tania Louise; Bentley, Rebecca Jodie; Thornton, Lukar Ezra; Kavanagh, Anne Marie

2015-09-17

Local destinations have previously been shown to be associated with higher levels of both physical activity and walking, but little is known about how specific destinations are related to activity. This study examined associations between types and mix of destinations and both walking frequency and physical activity. The sample consisted of 2349 residents of 50 urban areas in metropolitan Melbourne, Australia. Using geographic information systems, seven types of destinations were examined within three network buffers (400 meters (m), 800 m and 1200 m) of respondents' homes. Multilevel logistic regression was used to estimate effects of each destination type separately, as well as destination mix (variety) on: 1) likelihood of walking for at least 10 min ≥ 4/week; 2) likelihood of being sufficiently physically active. All models were adjusted for potential confounders. All destination types were positively associated with walking frequency, and physical activity sufficiency at 1200 m. For the 800 m buffer: all destinations except transport stops and sports facilities were significantly associated with physical activity, while all except sports facilities were associated with walking frequency; at 400 m, café/takeaway food stores and transport stops were associated with walking frequency and physical activity sufficiency, and sports facilities were also associated with walking frequency. Strongest associations for both outcomes were observed for community resources and small food stores at both 800 m and 1200 m. For all buffer distances: greater mix was associated with greater walking frequency. Inclusion of walking in physical activity models led to attenuation of associations. The results of this analysis indicate that there is an association between destinations and both walking frequency and physical activity sufficiency, and that this relationship varies by destination type. It is also clear that greater mix of destinations positively predicts walking frequency and physical activity sufficiency.

Environmental perceptions as mediators of the relationship between the objective built environment and walking among socio-economically disadvantaged women.

PubMed

Van Dyck, Delfien; Veitch, Jenny; De Bourdeaudhuij, Ilse; Thornton, Lukar; Ball, Kylie

2013-09-19

Women living in socio-economically disadvantaged neighbourhoods are at increased risk for physical inactivity and associated health outcomes and are difficult to reach through personally tailored interventions. Targeting the built environment may be an effective strategy in this population subgroup. The aim of this study was to examine the mediating role of environmental perceptions in the relationship between the objective environment and walking for transportation/recreation among women from socio-economically disadvantaged neighbourhoods. Baseline data of the Resilience for Eating and Activity Despite Inequality (READI) study were used. In total, 4139 women (18-46 years) completed a postal survey assessing physical environmental perceptions (aesthetics, neighbourhood physical activity environment, personal safety, neighbourhood social cohesion), physical activity, and socio-demographics. Objectively-assessed data on street connectivity and density of destinations were collected using a Geographic Information System database and based on the objective z-scores, an objective destinations/connectivity score was calculated. This index was positively scored, with higher scores representing a more favourable environment. Two-level mixed models regression analyses were conducted and the MacKinnon product-of-coefficients test was used to examine the mediating effects. The destinations/connectivity score was positively associated with transport-related walking. The perceived physical activity environment mediated 6.1% of this positive association. The destinations/connectivity score was negatively associated with leisure-time walking. Negative perceptions of aesthetics, personal safety and social cohesion of the neighbourhood jointly mediated 24.1% of this negative association. For women living in socio-economically disadvantaged neighbourhoods, environmental perceptions were important mediators of the relationship between the objective built environment and walking. To increase both transport-related and leisure-time walking, it is necessary to improve both objective walkability-related characteristics (street connectivity and proximity of destinations), and perceptions of personal safety, favourable aesthetics and neighbourhood social cohesion.

14 CFR Sec. 19-7 - Passenger origin-destination survey.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 14 Aeronautics and Space 4 2013-01-01 2013-01-01 false Passenger origin-destination survey. Sec... AIR CARRIERS Operating Statistics Classifications Sec. 19-7 Passenger origin-destination survey. (a... carriers) shall participate in a Passenger Origin-Destination (O & D) Survey covering domestic and...

14 CFR 19-7 - Passenger origin-destination survey.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 14 Aeronautics and Space 4 2012-01-01 2012-01-01 false Passenger origin-destination survey. Sec... AIR CARRIERS Operating Statistics Classifications Sec. 19-7 Passenger origin-destination survey. (a... carriers) shall participate in a Passenger Origin-Destination (O & D) Survey covering domestic and...

14 CFR Sec. 19-7 - Passenger origin-destination survey.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 14 Aeronautics and Space 4 2014-01-01 2014-01-01 false Passenger origin-destination survey. Sec... AIR CARRIERS Operating Statistics Classifications Sec. 19-7 Passenger origin-destination survey. (a... carriers) shall participate in a Passenger Origin-Destination (O & D) Survey covering domestic and...

Church, place, and crime: Latinos and homicide in new destinations.

PubMed

Shihadeh, Edward S; Winters, Lisa

2010-01-01

Latinos are moving beyond traditional areas and settling in new, potentially disorganized destinations. Without an established immigrant community, new destinations appear to rely more on the local religious ecology to regulate community life and to keep crime low. We examine the link between religious ecology and Latino homicide victimization for traditional and new destination counties. We observe four findings. (1) A Catholic presence has no effect on Latino violence in the old and well-organized traditional settlement areas. But in new Latino settlement areas, a Catholic presence substantially lowers violence against Latinos. In contrast, mainline Protestantism is linked to high levels of violence against Latinos in new destinations. (2) Previous claims that Latino communities are safe do not apply to new destinations, where Latinos are murdered at a high rate. (3) Previous claims that areas with high Latino immigration are safe for Latinos are not true for new destinations. (4) New Latino destinations offer little insulation from the effects of economic deprivation on violence. We discuss the implications of the findings.

Destination Information System for Bandung City Using Location-Based Services (LBS) on Android

NASA Astrophysics Data System (ADS)

Kurniawan, B.; Pranoto, H.

2018-02-01

Bandung is a city in West Java, Indonesia with many interesting locations to visit. For most favourite destinations, we can easily look for it on Google and we will find some blogs there discussing about related content. The problem is we can not guarantee that the destination is frequented by visitor. In this research, we utilizes an application to help everyone choosing destination frequented by visitor. The use of information technology in the form of picture, maps, and textual on Android application makes it possible for user to have information about destination with its visitor in a period of time. If destination has visit history, selection of proper destination will be given with fresh informations. This application can run well on Android Lollipop (API Level 21) or above with a minimum RAM of 2 GB since it will compare two coordinates for every data. The use of this app make it possible to access information about location with its visitor history and could help choosing proper destinations for the users.

Infectious diseases in North Africa and North African immigrants to Europe.

PubMed

Khyatti, Meriem; Trimbitas, Roxana-Delia; Zouheir, Yassine; Benani, Abdelouaheb; El Messaoudi, Moulay-Driss; Hemminki, Kari

2014-08-01

The epidemiological transition has reduced infectious diseases mortality in most European countries, yet increased migrant influx risks importing diseases. All reported prevalence rates must be considered on a case-by-case basis depending on the disease in question, respective European Union (EU) country and migratory patterns at work. Tuberculosis has seen a re-emergence in Europe and is concentrated among migrants. Migrants arriving from North Africa (NA) and sub-Saharan Africa (SSA) carry higher rates of hepatitis C and B than the local EU population. The human immunodeficiency virus (HIV) impact of NA migrants to Europe is very low but a hallmark of the HIV epidemic is the penetration and circulation of non-B strains, recombinant forms and HIV-drug-resistant profiles through SSA migrants using NA as a transit point into Europe. Leishmaniasis is a re-emerging zoonotic disease prevalent to Southern Europe although not specifically isolated in migrant groups. Although not endemic in NA countries, malaria represent S: a risk in terms of re-emergence in Europe through transitory migrants arriving from SSA with the destination to Europe. Schistosomiasis has been largely eliminated from NA. High migrant flux into European countries has resulted in changing patterns of communicable disease and collectively requires a continuous surveillance. World Health Organization guidelines recommend targeted screening and preventative vaccination, followed by integration of migrants into the local health-care systems allowing for long-term treatment and follow-up. Finally, effective public health campaigns as a form of prevention are essential for the mitigation of disease dissemination in the migrant pool and for second-generation children of migrants. © The Author 2014. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

South-South medical tourism and the quest for health in Southern Africa.

PubMed

Crush, Jonathan; Chikanda, Abel

2015-01-01

Intra-regional South-South medical tourism is a vastly understudied subject despite its significance in many parts of the Global South. This paper takes issue with the conventional notion of South Africa purely as a high-end "surgeon and safari" destination for medical tourists from the Global North. It argues that South-South movement to South Africa for medical treatment is far more significant, numerically and financially, than North-South movement. The general lack of access to medical diagnosis and treatment in SADC countries has led to a growing temporary movement of people across borders to seek help at South African institutions in border towns and in the major cities. These movements are both formal (institutional) and informal (individual) in nature. In some cases, patients go to South Africa for procedures that are not offered in their own countries. In others, patients are referred by doctors and hospitals to South African facilities. But the majority of the movement is motivated by lack of access to basic healthcare at home. The high demand and large informal flow of patients from countries neighbouring South Africa has prompted the South African government to try and formalise arrangements for medical travel to its public hospitals and clinics through inter-country agreements in order to recover the cost of treating non-residents. The danger, for 'disenfranchised' medical tourists who fall outside these agreements, is that medical xenophobia in South Africa may lead to increasing exclusion and denial of treatment. Medical tourism in this region and South-South medical tourism in general are areas that require much additional research. Copyright © 2014. Published by Elsevier Ltd.

Devices as destination therapy.

PubMed

Kukuy, Eugene L; Oz, Mehmet C; Rose, Eric A; Naka, Yoshifumi

2003-02-01

The use of circulatory support as destination therapy has been a goal for the treatment of endstage heart failure for several decades. Current investigations are evaluating several circulatory pumps with that particular objective. With continued modification of design, the current and future pumps will become more reliable and provide improved quality of life to patients in need of mechanical circulatory assistance. The new pumps on the horizon specifically address reliability, size, and cost, and are based on the centrifugal system. These devices use the Maglev (Magnetic Levitation) concept that allows for frictionless pumping, low thrombogenicity, minimal noise, and increased durability. Further research with this goal in mind and support from the federal government will be the key to the future use of circulatory assistance as destination therapy for heart failure patients. In addition, the cost-effectiveness of these devices will need to be maintained as the technology improves, as in any new technology that confronts a more intuitive option like the native heart.

Spatial differentiation of China's summer tourist destinations based on climatic suitability using the Universal Thermal Climate Index

NASA Astrophysics Data System (ADS)

Yang, Jun; Zhang, Zhenchao; Li, Xueming; Xi, Jianchao; Feng, Zhangxian

2017-11-01

As a result of global warming and the gradual exacerbation of the urban heat island effect, vacationing in the summer to escape the heat has become a compelling tourism demand. This study examines the spatial differentiation of China's summer tourist destinations based on meteorological observations and tourism resources data from 1960 to 2014. The Universal Thermal Climate Index and analytic hierarchy process model were used to analyze climatic suitability. The findings are as follows. First, the spatial distribution of China's summer tourism resources exhibits a double-peak characteristic, with concentrations in the mid- and high-latitude and high-altitude regions. Second, the most influential destinations in China based on the composite index were Guiyang, Qingdao, Harbin, and Dalian. These findings can helpful for people who are planning their summer vacations, as well as tourism managers who benefit from such increases in the number of tourists.

[Anaesthetic management in left ventricular assist device implantation as destination therapy: Our first experience].

PubMed

del Barrio Gómez, E; Rodríguez, J M; Martínez, S; García, E; Vargas, M C; Sastre, J A

2016-03-01

Left ventricular assist devices have emerged as one of the main therapies of advanced cardiac failure due the increase of this disease and lack of organ supply for cardiac transplantation. The anaesthetic management is described on a patient without cardiac transplantation criteria. The device was successfully implanted as a destination therapy. Copyright © 2015 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

Safe travels? HIV transmission among Britons travelling abroad.

PubMed

Rice, B; Gilbart, V L; Lawrence, J; Smith, R; Kall, M; Delpech, V

2012-05-01

The aim of the study was to identify and describe the characteristics of persons born in the UK who acquire HIV infection abroad. Analyses using case reports and follow-up data from the national HIV database held at the Health Protection Agency were performed. Fifteen per cent (2066 of 13 891) of UK-born adults diagnosed in England, Wales and Northern Ireland between 2002 and 2010 acquired HIV infection abroad. Thailand (534), the USA (117) and South Africa (108) were the countries most commonly reported. As compared with UK-born adults acquiring HIV infection in the UK, those acquiring HIV infection abroad were significantly (P < 0.01) more likely to have acquired it heterosexually (70% vs. 22%, respectively), to be of older age at diagnosis (median 42 years vs. 36 years, respectively), and to have reported sex with a commercial sex worker (5.6% vs. 1%, respectively). Among men infected in Thailand, 11% reported sex with a commercial sex worker. A substantial number of UK-born adults are acquiring HIV infection in countries with generalized HIV epidemics, and in common holiday destinations. Of particular concern is the high proportion of men infected reporting sex with a commercial sex worker. We recommend HIV prevention and testing efforts be extended to include travellers abroad, and that sexual health advice be provided routinely in travel health consultations and in occupational health travel advice packs, particularly to those travelling to high HIV prevalence areas and destinations for sex tourism. Safer sex messages should include an awareness of the potential detrimental health and social impacts of the sex industry. © 2012 British HIV Association.

The dire need for primary care specialization in India: Concerns and challenges.

PubMed

Faizi, Nafis; Khalique, Najam; Ahmad, Anees; Shah, Mohammad Salman

2016-01-01

Primary health care is an evidence-based priority, but it is still inadequately supported in many countries. Ironically, on one hand, India is a popular destination for medical tourism due to the affordability of high quality of health care and, on the other hand, ill health and health care are the main reasons for becoming poor through medical poverty traps. Surprisingly, this is despite the fact that India was committed to 'Health for All by 2000' in the past, and is committed to 'Universal Health Coverage' by 2022! Clearly, these commitments are destined to fail unless something is done to improve the present state of affairs. This study argues for the need to develop primary care as a specialization in India as a remedial measure to reform its health care in order to truly commit to the commitments. Three critical issues for this specialization are discussed in this review: (1) The dynamic and distinct nature of primary care as opposed to other medical specializations, (2) the intersection of primary care and public health which can be facilitated by such a specialization, and (3) research in primary care including the development of screening and referral tools for early diagnosis of cancers, researches for evidence-based interventions via health programs, and primary care epidemiology. Despite the potential challenges and difficulties, India is a country in dire need for primary care specialization. India's experience in providing low-cost and high quality healthcare for medical tourism presages a more cost-effective and efficient primary care with due attention and specialization.

Knowledge, attitudes and practices of business travelers regarding malaria risk and prevention.

PubMed

Weber, Roger; Schlagenhauf, Patricia; Amsler, Lorenz; Steffen, Robert

2003-01-01

This study aimed to determine the knowledge, attitudes and practices of Swiss business travelers with regard to malaria. Questionnaires printed in three languages were distributed by employers, travel agencies and tropical medicine specialists to business travelers with destinations in malaria endemic countries. In total, 401 questionnaires were evaluated. Thirty-three percent visited high-risk areas, 27% visited low-risk areas, and 40% visited only malaria-free areas within endemic countries. Among the investigated business travelers, 6% had experienced malaria infection, and 29% had previously had blood smears tested for malaria at least once. Almost all business travelers, 95%, knew that mosquitoes are the main vectors of malaria. The infection risk between dusk and dawn was known to 71%, and the incubation time to 36%. Apart from fever (99%) and headache (63%), other malaria symptoms were known to only 13% to 36% of the travelers. If signs of illness such as fever and headache occurred, 63% would react adequately and seek medical advice within 24 h. Only 16% of the travelers to African high-risk areas followed the recommended behavior concerning anti-mosquito and antimalarial strategies; 31% of those on trips to low-risk areas used an adequate protective strategy. Of the business travelers using chemoprophylaxis during travel, just 50% continued intake post travel, as requested, after leaving the endemic area. Business travelers are well informed regarding the mode of transmission and the risk of malaria at specific destinations but tend to comply poorly with anti-mosquito and chemoprophylactic strategies. The knowledge, attitudes and practices of business travelers with regard to malaria prevention need to be improved.

The dire need for primary care specialization in India: Concerns and challenges

PubMed Central

Faizi, Nafis; Khalique, Najam; Ahmad, Anees; Shah, Mohammad Salman

2016-01-01

Primary health care is an evidence-based priority, but it is still inadequately supported in many countries. Ironically, on one hand, India is a popular destination for medical tourism due to the affordability of high quality of health care and, on the other hand, ill health and health care are the main reasons for becoming poor through medical poverty traps. Surprisingly, this is despite the fact that India was committed to 'Health for All by 2000’ in the past, and is committed to 'Universal Health Coverage’ by 2022! Clearly, these commitments are destined to fail unless something is done to improve the present state of affairs. This study argues for the need to develop primary care as a specialization in India as a remedial measure to reform its health care in order to truly commit to the commitments. Three critical issues for this specialization are discussed in this review: (1) The dynamic and distinct nature of primary care as opposed to other medical specializations, (2) the intersection of primary care and public health which can be facilitated by such a specialization, and (3) research in primary care including the development of screening and referral tools for early diagnosis of cancers, researches for evidence-based interventions via health programs, and primary care epidemiology. Despite the potential challenges and difficulties, India is a country in dire need for primary care specialization. India's experience in providing low-cost and high quality healthcare for medical tourism presages a more cost-effective and efficient primary care with due attention and specialization. PMID:27843818

Apprentice and Trainee Destinations 2010: Technical Notes. Support Document

ERIC Educational Resources Information Center

National Centre for Vocational Education Research (NCVER), 2010

2010-01-01

"Apprentice and Trainee Destinations" presents information about the destinations of apprentices and trainees approximately nine months after leaving their training. Information in this publication is derived from the Apprentice and Trainee Destinations Survey that covered apprentices and trainees who, between April and June 2009, either…

Multi-destination trip patterns

Treesearch

Susan I. Stewart; Christine A. Vogt

1996-01-01

In a 1993 article in Annals, Leu, Crompton, and Fesenmaier (LCF) presented a model of multi-destination pleasure trips. In the article, they question the practice of modeling pleasure trips as single destination trips, and put forward conceptual arguments suggesting that most trips "are not simple origin-destination trips: (1993:291) but...

48 CFR 47.303-7 - F.o.b. destination, within consignee's premises.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false F.o.b. destination, within... REGULATION CONTRACT MANAGEMENT TRANSPORTATION Transportation in Supply Contracts 47.303-7 F.o.b. destination, within consignee's premises. (a) Explanation of delivery term. F.o.b. destination, within consignee's...

48 CFR 47.305-4 - F.o.b. destination solicitations.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false F.o.b. destination... CONTRACT MANAGEMENT TRANSPORTATION Transportation in Supply Contracts 47.305-4 F.o.b. destination solicitations. (a) When preparing f.o.b destination solicitations, the contracting officer shall refer to 47.303...

19 CFR 122.93 - Procedure at destination or exportation airport.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 19 Customs Duties 1 2013-04-01 2013-04-01 false Procedure at destination or exportation airport... Transit § 122.93 Procedure at destination or exportation airport. (a) Delivery to port director. When a bonded shipment arrives at the destination or exportation airport, the aircraft commander or agent shall...

19 CFR 122.93 - Procedure at destination or exportation airport.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 19 Customs Duties 1 2010-04-01 2010-04-01 false Procedure at destination or exportation airport... Transit § 122.93 Procedure at destination or exportation airport. (a) Delivery to port director. When a bonded shipment arrives at the destination or exportation airport, the aircraft commander or agent shall...

19 CFR 122.93 - Procedure at destination or exportation airport.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 19 Customs Duties 1 2014-04-01 2014-04-01 false Procedure at destination or exportation airport... Transit § 122.93 Procedure at destination or exportation airport. (a) Delivery to port director. When a bonded shipment arrives at the destination or exportation airport, the aircraft commander or agent shall...

19 CFR 122.93 - Procedure at destination or exportation airport.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 19 Customs Duties 1 2012-04-01 2012-04-01 false Procedure at destination or exportation airport... Transit § 122.93 Procedure at destination or exportation airport. (a) Delivery to port director. When a bonded shipment arrives at the destination or exportation airport, the aircraft commander or agent shall...

19 CFR 122.93 - Procedure at destination or exportation airport.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 19 Customs Duties 1 2011-04-01 2011-04-01 false Procedure at destination or exportation airport... Transit § 122.93 Procedure at destination or exportation airport. (a) Delivery to port director. When a bonded shipment arrives at the destination or exportation airport, the aircraft commander or agent shall...

48 CFR 47.305-4 - F.o.b. destination solicitations.

Code of Federal Regulations, 2012 CFR

2012-10-01

... CONTRACT MANAGEMENT TRANSPORTATION Transportation in Supply Contracts 47.305-4 F.o.b. destination solicitations. (a) When preparing f.o.b destination solicitations, the contracting officer shall refer to 47.303... 48 Federal Acquisition Regulations System 1 2012-10-01 2012-10-01 false F.o.b. destination...

[Role of context recall in destination memory decline in normal aging].

PubMed

El Haj, Mohamad; Allain, Philippe

2014-12-01

Until recently, little was known about destination memory, or memory for the destination of outputted information. In the present work, this memory was evaluated in 32 older adults and 36 younger adults, who had to associate proverbs to pictures of famous people and decide, on a subsequent recognition task, whether they had previously told that proverb to that face or not. When deciding about the destination, participants had to provide contextual judgment, that is, whether each picture had been previously exposed in color or in black and white. Participants also performed a neuropsychological battery tapping episodic memory and executive functions. Findings showed poor destination recall in older participants. Destination recall in older adults was reliably predicted by with their context recall. Destination memory seems to be particularly affected by aging, a deterioration that can be related to deficits in processing contextual features during encoding.

Destination memory in traumatic brain injuries.

PubMed

Wili Wilu, Amina; Coello, Yann; El Haj, Mohamad

2018-06-01

Destination memory, which is socially driven, refers to the ability to remember to whom one has sent information. Our study investigated destination memory in patients with traumatic brain injuries (TBIs). Patients and control participants were invited to tell proverbs (e.g., "the pen is mightier than the sword") to pictures of celebrities (e.g., Barack Obama). Then they were asked to indicate to which celebrity they had previously told the proverbs. Besides the assessment of destination memory, participants performed a binding task in which they were required to associate letters with their corresponding location. Analysis demonstrated less destination memory and binding in patients with TBIs than in controls. In both populations, significant correlations were observed between destination memory and performances on the binding task. These findings demonstrate difficulty in the ability to attribute information to its appropriate destination in TBI patients, perhaps owing to difficulties in binding separate information together to form a coherent representation of an event in memory.

Occupational Channels for Mexican Migration: New Destination Formation in a Binational Context

ERIC Educational Resources Information Center

Sanderson, Matthew; Painter, Matthew, II

2011-01-01

In the 1990s, Mexican immigration dispersed spatially, leading to the emergence of many "new destinations," in nonmetropolitan areas of the United States. Previous studies constrain the scope of the analysis to the United States, limiting our understanding of how new destinations are formed. We place new destination formation into a…

The Changing Relationship between Origins, Education and Destinations in the 1990s and 2000s

ERIC Educational Resources Information Center

Devine, Fiona; Li, Yaojun

2013-01-01

This paper examines the changing relationship between origins, education and destinations in mobility processes. The meritocracy thesis suggests the relationships between origins and education and between origins and destination will weaken while the relationship between education and destinations will strengthen. Comparing data from the 1991…

Portfolio analysis of a destination's tourism "product line"

Treesearch

Harold Daniel

2007-01-01

If we think of a tourist destination as a platform from which a variety of tourist experiences can be delivered, we could conceptualize these experiences as the "product line" offered by or associated with the tourist destination. That conceptualization enables the manager of the destination to employ the logic and discipline associated with product line...

48 CFR 47.303-6 - F.o.b. destination.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false F.o.b. destination. 47.303... MANAGEMENT TRANSPORTATION Transportation in Supply Contracts 47.303-6 F.o.b. destination. (a) Explanation of delivery term. F.o.b. destination means— (1) Free of expense to the Government delivered, on board the...

14 CFR 121.621 - Alternate airport for destination: Flag operations.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 14 Aeronautics and Space 3 2013-01-01 2013-01-01 false Alternate airport for destination: Flag... § 121.621 Alternate airport for destination: Flag operations. (a) No person may dispatch an airplane under IFR or over-the-top unless he lists at least one alternate airport for each destination airport in...

14 CFR 121.621 - Alternate airport for destination: Flag operations.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 14 Aeronautics and Space 3 2011-01-01 2011-01-01 false Alternate airport for destination: Flag... § 121.621 Alternate airport for destination: Flag operations. (a) No person may dispatch an airplane under IFR or over-the-top unless he lists at least one alternate airport for each destination airport in...

14 CFR 121.621 - Alternate airport for destination: Flag operations.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 14 Aeronautics and Space 3 2012-01-01 2012-01-01 false Alternate airport for destination: Flag... § 121.621 Alternate airport for destination: Flag operations. (a) No person may dispatch an airplane under IFR or over-the-top unless he lists at least one alternate airport for each destination airport in...

14 CFR 121.621 - Alternate airport for destination: Flag operations.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Alternate airport for destination: Flag... § 121.621 Alternate airport for destination: Flag operations. (a) No person may dispatch an airplane under IFR or over-the-top unless he lists at least one alternate airport for each destination airport in...

14 CFR 121.621 - Alternate airport for destination: Flag operations.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 14 Aeronautics and Space 3 2014-01-01 2014-01-01 false Alternate airport for destination: Flag... § 121.621 Alternate airport for destination: Flag operations. (a) No person may dispatch an airplane under IFR or over-the-top unless he lists at least one alternate airport for each destination airport in...

Source and destination memory in face-to-face interaction: A multinomial modeling approach.

PubMed

Fischer, Nele M; Schult, Janette C; Steffens, Melanie C

2015-06-01

Arguing that people are often in doubt concerning to whom they have presented what information, Gopie and MacLeod (2009) introduced a new memory component, destination memory: remembering the destination of output information (i.e., "Who did you tell this to?"). They investigated source (i.e., "Who told you that?") versus destination memory in computer-based imagined interactions. The present study investigated destination memory in real interaction situations. In 2 experiments with mixed-gender (N = 53) versus same-gender (N = 89) groups, source and destination memory were manipulated by creating a setup similar to speed dating. In dyads, participants completed phrase fragments with personal information, taking turns. At recognition, participants decided whether fragments were new or old and, if old, whether they were listened to or spoken and which depicted person was the source or the destination of the information. A multinomial model was used for analyses. Source memory significantly exceeded destination memory, whereas information itself was better remembered in the destination than in the source condition. These findings corroborate the trade-off hypothesis: Context is better remembered in input than in output events, but information itself is better remembered in output than in input events. We discuss the implications of these findings for real-world conversation situations. (c) 2015 APA, all rights reserved).

Evaluation of the Efficiency of Selective Collection in a Small Town on the State of Rio Grande do Sul - Brazil

NASA Astrophysics Data System (ADS)

Schneider, V. E.; Poletto, M.; Peresin, D.; Carra, S. H. Z.; Vanni, D.

2017-07-01

With the increase of population concentration in urban areas, there is an increase in the solid waste generation, which demands the search for alternatives and solutions for the environmentally correct destination of these. In this context, this work presents an evaluation on the forms of organic and selective domestic waste collection and the potential for the recyclability of the waste destined to the same, based on the physical characterization and gravimetric composition of the solid wastes generated in the town of Antônio Prado, located in the state of Rio Grande do Sul, Brazil, between 2014 and 2016. It is observed that the population has significant information regarding the correct disposal of waste in the selective collection, since 60% of the waste destined to the same is effectively recyclable. Plastic (24.8%), paper (10.9%), glass (8.8%) and cardboard (8.4%) are the most representative materials in recycled waste samples in the urban area. The importance of continuity and improvement of environmental education programs is essential, due to the evolution in the quantity and complexity of products and materials currently manufactured, and to the method of mechanized waste collection used by the municipality.

International nurse recruitment in India.

PubMed

Khadria, Binod

2007-06-01

This paper describes the practice of international recruitment of Indian nurses in the model of a "business process outsourcing" of comprehensive training-cum-recruitment-cum-placement for popular destinations like the United Kingdom and United States through an agency system that has acquired growing intensity in India. Despite the extremely low nurse to population ratio in India, hospital managers in India are not concerned about the growing exodus of nurses to other countries. In fact, they are actively joining forces with profitable commercial ventures that operate as both training and recruiting agencies. Most of this activity is concentrated in Delhi, Bangalore, and Kochi. Gaps in data on nursing education, employment, and migration, as well as nonstandardization of definitions of "registered nurse," impair the analysis of international migration of nurses from India, making it difficult to assess the impact of migration on vacancy rates. One thing is clear, however, the chain of commercial interests that facilitate nurse migration is increasingly well organized and profitable, making the future growth of this business a certainty.

Geo-located Twitter as proxy for global mobility patterns.

PubMed

Hawelka, Bartosz; Sitko, Izabela; Beinat, Euro; Sobolevsky, Stanislav; Kazakopoulos, Pavlos; Ratti, Carlo

2014-05-27

Pervasive presence of location-sharing services made it possible for researchers to gain an unprecedented access to the direct records of human activity in space and time. This article analyses geo-located Twitter messages in order to uncover global patterns of human mobility. Based on a dataset of almost a billion tweets recorded in 2012, we estimate the volume of international travelers by country of residence. Mobility profiles of different nations were examined based on such characteristics as mobility rate, radius of gyration, diversity of destinations, and inflow-outflow balance. Temporal patterns disclose the universally valid seasons of increased international mobility and the particular character of international travels of different nations. Our analysis of the community structure of the Twitter mobility network reveals spatially cohesive regions that follow the regional division of the world. We validate our result using global tourism statistics and mobility models provided by other authors and argue that Twitter is exceptionally useful for understanding and quantifying global mobility patterns.

STS-73 Cmdr Kenneth D. Bowersox arrives at SLF

NASA Technical Reports Server (NTRS)

1995-01-01

STS-73 Mission Commander Kenneth D. Bowersox arrives at KSC's Shuttle Landing Facility (SLF), ready to fly one spaceship into orbit as another vehicle is prepared for a different destination behind him. Bowersox and his six-member crew flew into KSC just hours after the countdown clock began ticking toward a scheduled liftoff of the Space Shuttle Columbia from Pad 39B at 9:35 a.m EDT, Sept. 28. The orbiter Discovery was towed to the SLF for a cross-country trip to the West Coast and a regularly scheduled refurbishment and checkout period.

Preparing America for Deep Space Exploration Episode 11: Committed to Exploration

NASA Image and Video Library

2015-12-09

Engineers around the country are making progress developing NASA’s Space Launch System, Orion spacecraft and the ground systems at Kennedy Space Center in Florida needed to send astronauts on missions to deep space destinations. Between July and September, progress continued as pieces of Orion’s crew module and the SLS core stage tanks were welded together at NASA’s Michoud Assembly Facility in New Orleans, modifications were made to the mobile launcher at Kennedy, astronauts tested techniques for exiting Orion after a mission, and an RS-25 engine was tested at Stennis Space Center in Mississippi.

The tropics and the crime they did not commit.

PubMed

Goorhuis, A; van Thiel, P P A M; Middeldorp, S; van Eck, B L F; Grobusch, M P

2013-02-01

Travellers to tropical destinations who seek medical attention after returning to their home country often present with fever, frequently as a result of an imported infectious disease. For this reason, clinicians initially focus on an infectious cause when a clear relationship in time exists between travel and disease onset. We present a case of a patient, who developed fever 2 weeks after his return from Ghana and who was finally diagnosed with an auto-immune disease: arteritis of the large arteries. This case illustrates that broad differential diagnostic thinking is paramount in the assessment of returned travellers.

International rescue? Managing the dental tourist.

PubMed

Iqbal, Junaid; Shah, Shilpa; Ashley, Martin

2014-01-01

The concept of dental tourism can be considered two-fold. On one side it is a term used to describe non-UK residing patients who visit, requesting NHS dental care whilst here in the U.K. Alternatively, it also encompasses patients who travel to destinations outside their residing countries to receive care. The latter has become an ever-growing issue in the U.K.; one that warrants appropriate management and knowledge of current legislation amongst dental professionals. Clarity and guidance on who is eligible for care under the NHS when visiting the U.K. and who, if anyone, is ultimately responsible when treatment abroad fails.

International travel and exposure risks in solid-organ transplant recipients.

PubMed

Uslan, Daniel Z; Patel, Robin; Virk, Abinash

2008-08-15

Although solid-organ transplant recipients (SOTR) have an increased risk of acquiring illnesses, they may not receive optimal pretravel care. We conducted a cross-sectional survey of travel activities and outcomes among SOTR. Two thousand five hundred fifty-four consecutive living SOTR from Mayo Clinic were surveyed regarding travel practices, pretravel counseling, exposure risks, and illness using a previously standardized and validated questionnaire. One thousand one hundred thirty SOTR (44%) responded to the survey and were included in the study. The most common transplanted organs were liver (519 patients) and kidney (515 patients). Three hundred and three (27%) respondents reported travel outside of the United States or Canada after their transplant. Liver recipients were more likely to travel than other organ recipients. Ninety-six percent of travelers reported that they did not seek specific pretravel healthcare before their trip. Forty-nine SOTR (16%) traveled to destinations at higher risk for infectious diseases; travelers to these destinations were more likely to be men (73% vs. 54% of low-infection risk travelers, P=0.018) or born outside the United Stated or Canada (29% vs. 6% P<0.0001). Twenty-four travelers (8%) required medical attention because of illness; illness was more likely among travelers to high-infection risk (18%) than low-risk (6%) destinations, P=0.004. International travel was common after solid organ transplantation, although the majority traveled to destinations at low risk for infectious disease. Although generally SOTR were able to travel safely, travelers to destinations at high-risk for infection had a significant rate of illness. Pretravel counseling and interventions were infrequent and should be improved.

48 CFR 52.247-35 - F.o.b. Destination, Within Consignee's Premises.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 2 2010-10-01 2010-10-01 false F.o.b. Destination, Within... Clauses 52.247-35 F.o.b. Destination, Within Consignee's Premises. As prescribed in 47.303-7(c), insert the following clause in solicitations and contracts when the delivery term is f.o.b. destination...

48 CFR 3052.247-72 - F.o.b. destination only.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 7 2010-10-01 2010-10-01 false F.o.b. destination only... CLAUSES Text of Provisions and Clauses 3052.247-72 F.o.b. destination only. As prescribed in (HSAR) 48 CFR 3047.305-70(c), insert the following provision: F.O.B. Destination Only (DEC 2003) Offers are invited...

14 CFR 125.367 - Alternate airport for destination: IFR or over-the-top.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Alternate airport for destination: IFR or... Flight Release Rules § 125.367 Alternate airport for destination: IFR or over-the-top. (a) Except as... over-the-top shall list at least one alternate airport for each destination airport in the flight...

14 CFR 125.367 - Alternate airport for destination: IFR or over-the-top.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 14 Aeronautics and Space 3 2013-01-01 2013-01-01 false Alternate airport for destination: IFR or... Flight Release Rules § 125.367 Alternate airport for destination: IFR or over-the-top. (a) Except as... over-the-top shall list at least one alternate airport for each destination airport in the flight...

14 CFR 125.367 - Alternate airport for destination: IFR or over-the-top.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 14 Aeronautics and Space 3 2011-01-01 2011-01-01 false Alternate airport for destination: IFR or... Flight Release Rules § 125.367 Alternate airport for destination: IFR or over-the-top. (a) Except as... over-the-top shall list at least one alternate airport for each destination airport in the flight...

14 CFR 125.367 - Alternate airport for destination: IFR or over-the-top.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 14 Aeronautics and Space 3 2012-01-01 2012-01-01 false Alternate airport for destination: IFR or... Flight Release Rules § 125.367 Alternate airport for destination: IFR or over-the-top. (a) Except as... over-the-top shall list at least one alternate airport for each destination airport in the flight...

14 CFR 125.367 - Alternate airport for destination: IFR or over-the-top.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 14 Aeronautics and Space 3 2014-01-01 2014-01-01 false Alternate airport for destination: IFR or... Flight Release Rules § 125.367 Alternate airport for destination: IFR or over-the-top. (a) Except as... over-the-top shall list at least one alternate airport for each destination airport in the flight...

Case Report: Severe Imported Influenza Infections Developed during Travel in Reunion Island.

PubMed

Allyn, Jérôme; Brottet, Elise; Antok, Emmanuel; Dangers, Laurence; Persichini, Romain; Coolen-Allou, Nathalie; Roquebert, Bénédicte; Allou, Nicolas; Vandroux, David

2017-12-01

We report two cases of severe influenza infection imported by tourist patients from their country of origin and developed during travel. While studies have reported cases of influenza infections acquired during travel, here we examine two cases of severe influenza infection contracted in the country of origin that led to diagnosis and therapeutic problems in the destination country. No international recommendation exists concerning influenza vaccination before travel, and few countries recommend it for all travelers. Our study suggests that travel should be canceled when infectious signs are observed before departure. Influenza is a very common infection that is often benign, but sometimes very severe. The most severe cases include shock, acute respiratory distress syndrome (ARDS), myocarditis, rhabdomyolysis, and multiple organ failure. Management can require exceptional therapies, such as extracorporeal membrane oxygenation. A number of studies have focused on influenza infection in travelers. Cases of influenza acquired during travel have been reported in this literature, but no study has examined cases of influenza imported from the country of origin and developed while abroad. The latter situation may lead to 1) diagnostic problems during the nonepidemic season or in places where diagnostic techniques are lacking and 2) therapeutic difficulties resulting from the unavailability of techniques for the management of severe influenza infection in tourist areas. Here, we report two cases of extremely severe influenza infection imported by tourists from their country of origin and developed during travel.