Sociality and transnational social space in the making of medical tourism: local actors and Indonesian patients in Malaysia

ABSTRACT

We investigate international medical travel between Indonesia and Malaysia through the conceptual lens of sociality, transnational social space and therapeutic mobilities. Drawing upon narratives of local persons, medical traveller-patients, accompanying family members, hospital staff and medical travel facilitators, we illustrate how multifaceted linkages and processes generate and sustain the flow of patients across the border. In these narratives, we see multiple mobilities articulate and cross-cut in the building of transnational connections. This paper stretches the concept of transnational social space to apply to medical travel and contributes to the literature framing of international medical travel as a complex and multifaceted arena.     

Ownership concentration,contestability, family firms,and capital structure

This study analyses the distribution of power among the several blockholders of a firm and the identity of those blockholders as a determinant of firm leverage. Using a sample of 694 firms from 12 Western European countries, our results support a negative relationship between ownership concentration in the hands of the main blockholder and firm leverage. Moreover, we detect that the presence of a second and third large shareholder (beyond the first blockholder) has a significant positive effect on the leverage ratio. In addition, the results show that contestability in family firms plays a more relevant role. Finally, we show that family firms do have significant impact on firm leverage level, and this impact varies depending on the legal framework and institutional environment. In our main sample the results show family firms negatively affect market leverage, supporting the theory that family firms are more averse to an increase in the debt level due to the risk of bankruptcy and financial distress as a result of having an under-diversified portfolio. In contrast, the opposite effect is found in the sample that excludes the United Kingdom. This last result cannot be explained by agency theory, given that family businesses are those that suffer less from Type I agency problems. This result suggests either some difficulty in financing their investments by issuing new equity or the need to use debt as a signal of the quality of its investments. Our results prove to be stable against a battery of robustness tests.     

Cross-Cultural Adaptation,Validity and Reliability of the Escala Pessoal de Resultados

The present article aims to examine the validity and reliability of the Portuguese version of Personal Outcomes Scale the Escala Pessoal de Resultados (EPR). This scale represents an instrument to measure the quality of life (QOL) in people with intellectual disabilities (ID). The study was initiated with the application of international guidelines in cross-cultural adaptation, culminating with an evaluation of 10 experts for the quantitative evidence of the content validity. All EPR’s items were considered relevant and there was a moderated agreement (k > .40) among the experts in the calculation of Cohen’s kappa, finding some coefficients’ that are considered as an excellent agreement (k > .75). In test field, our sample comprised 335 adults with ID on level of intermittent and limited support needs, even as the respective proxies. The scale showed an excellent internal consistency (α = .94). EPR’s construct validity indexes are also reported and discussed. The study provides EPR as a valid instrument for assess the QOL in ID field, and the scale seems to be useful for improvement of Portuguese rehabilitation practices and services.     

Five Changes Emerge from Chinese Families

正Official from National Health and Family Planning Commission(NHFPC)of China said on December 3,2013in Berlin that,economic and social development and population structure adjustment had led to prominent changes to the size,structure,form and function of Chinese families,so family development was facing certain challenges.     

Positive Action in Minority Ethnic Employment: The Role of Scottish Housing Organizations

This paper focuses on Scottish housing organizations, where the relative absence of black and minority ethnic employees is beginning to be addressed by programmes of positive action. The paper defines positive action, discusses experiences elsewhere in Europe and the USA, and identifies issues that have arisen from such programmes. Schemes targeted at the housing profession, such as PATH in both England and Scotland, are described in some detail. The attitudes and experiences of Scottish housing organizations were examined as part of an evaluation of the Scottish PATH programme carried out in 1998, and these are discussed. The paper concludes that a reservoir of goodwill exists towards positive action programmes and that there is a need for such programmes to be extended, possibly with the support of the Scottish Parliament.     

<Emphasis Type="Italic">R</Emphasis>-charts for the exponential,Laplace and logistic processes

This paper (i) discusses theR-chart with asymmetric probability control limits under the assumption that the distribution of the quality characteristic under study is either exponential, Laplace, or logistic, (ii) examines the effect of the estimated probability limits on the performance of theR-chart, and (iii) obtains the desired probability limits of theR-chart that has a specified false alarm rate when probability limits must be estimated from preliminary samples taken from either the exponential, Laplace, or logistic processes.     

Analysis of discrete data by Conway–Maxwell Poisson distribution

In this paper, we further study the Conway–Maxwell Poisson distribution having one more parameter than the Poisson distribution and compare it with the Poisson distribution with respect to some stochastic orderings used in reliability theory. Likelihood ratio test and the score test are developed to test the importance of this additional parameter. Simulation studies are carried out to examine the performance of the two tests. Two examples are presented, one showing overdispersion and the other showing underdispersion, to illustrate the procedure. It is shown that the COM-Poisson model fits better than the generalized Poisson distribution.     

Integration policy in Singapore: a transnational inclusion approach

A number of models of integration have been developed to highlight the experiences of immigration and integration in the Western world. However, the existing models do not adequately capture the complexities of contemporary international immigration and integration, especially the integration process in the light of migrant transnationalism in Asia. This study examines the models of integration through a case study of Singapore. This paper introduces a new concept ‘transnational inclusion’ to conceptualize Singapore's initiative to embrace its transnational global Singaporeans as well as its transnational immigrants, estimated to make up one-fourth of the total population. The paper shows that a transnational inclusion model of integration can provide better insights into the dynamics of transnationalism and integration in today's complex migration scenario. We point to Singapore's integration approach that regards integrating migrants into the different spheres of the society as a process rather than an end.     

When having many children pays: a case study from Taiwan

The objective of this paper is to investigate the direct financial cost and benefit of raising children during a demographic transition in Taiwan, and to examine whether fertility decline is consistent with Caldwell’s wealth flow theory, which states that fertility decline is caused by reduced benefits of children. The paper describes a method of estimating the average economic returns of children over the entire parental lifecycle, using a 42-year span of Taiwanese household and individual economic pseudo-panel data. Results show that returns to children may turn positive and are not highly negative all the time, as found in the previous literature.     

A New Multidimensional Approach to Measuring Precarious Employment

This article proposes a new methodology to measure precarious employment with a multidimensional approach. The adjusted multidimensional precariousness rate employed to measure job precariousness is calculated on a counting approach and exhibit several advantages, including its decomposability according to the relative contribution to total precariousness of different dimensions and sub-populations. For illustrative purposes, the methodology is applied to the Spanish case using microdata from the Encuesta de Estructura Salarial (Wage Structure Survey) and considering three precariousness dimensions of jobs (low wages, fixed-term contracts and part-time work). The evidence obtained shows that at the beginning of the economic crisis there was an increase in the incidence and intensity of precariousness for new jobs created in the Spanish economy. Moreover, obtained evidence shows that the incidence of precarious employment is particularly high in certain economic sectors and for females.