Insights on medical tourism: markets as networks and the role of strong ties

Despite a huge amount of speculation and expectation surrounding medical tourism, hard empirical evidence is only now beginning to emerge. This paper widens the focus of discussion by contrasting two country experiences (UK and Korea) which on the surface illustrate the diversity of medical tourism and little else. However, considered more comparatively, the accounts contribute toward wider, albeit tentative, theoretical understandings, and insights. The paper is drawn from two broad programs of empirical study conducted over three years in UK and Korea, respectively. The article is structured in three parts: first, a brief overview of policy, legislative, and accreditation frameworks that exist to govern medical tourist flows. Second, we present evidence around flows, demographics, treatment, and medical tourism for Korea and UK (both for supply and demand). Third, we examine conceptual and theoretical implications of this evidence. We argue that viewing medical tourism as a global market is problematic; some medical tourist markets are best viewed as networks with long-term exchange relationships; some specific areas of activity do function more strongly as price-related; decision making around medical tourism frequently involves a range of information and social networks (economic action as embedded social structure); and medical tourism is a function of globalization.     

To Invade or Not to Invade? A New Look at Gomulka,Nagy, and Soviet Foreign Policy in 1956

Why did the Soviet Union intervene in Hungary but not in Poland? This article argues that the crisis in Hungary was much deeper. Hungarian communist officials were perhaps more willing to tolerate Soviet military “assistance,” because they were haunted by the political rightist “reaction” and their collective memory of the “white terror” that had overthrown Bela Kun’s communist regime in 1919 and made the communist party illegal in Hungary. There was no real Hungarian “Poznan.” Thus, Kremlin leaders, Hungarian party officials, Hungarian reform communist intellectuals, and even the student organizers of the October 23 demonstration were caught off guard by the revolution; it seemed to come from nowhere. Kremlin leaders could understand Polish workers’ demands for bread, but had a harder time understanding Hungarian demands for freedom. Both Gomulka and Nagy attempted to bridge the fundamental contradictions of de-Stalinization, namely, that to achieve political consolidation, their party leaderships had to strike a compromise between the aspirations of their populations and the demands of the Kremlin. Reasons whv Gomulka succeeded. at least in the shortrun, and Nagy failed can be found both in their different personalities and the differences in the natures of the Polish and Hungarian crises.     

A general causal model to guide alcohol, tobacco, and illicit drug prevention: assessing the research evidence

The problems associated with the use of alcohol, tobacco, and other drugs (ATOD) extract a significant health, social, and economic toll on American society. While the field of substance abuse prevention has made great strides during the past decade, two major challenges remain. First, the field has been disorganized and fragmented with respect to its research and prevention practices; that is, there are often separate ATOD prevention "specialists." Second, both the prevention researchers who test the efficacy of specific prevention strategies and the practitioners who implement prevention efforts often lack an overall perspective to guide strategy selection. To address these limitations, we present an ATOD causal model that seeks to identify those variables (Domains) that are theoretically salient and empirically connected across alcohol, tobacco, and illicit drugs. For the researcher, the model demonstrates important commonalities, as well as gaps, in the literature. For the practitioner, the model is a means to recognize both the complexity of the community system that produces ATOD problems and the multiple intervention points that are possible within this system. Researchers and practitioners are thus challenged to work synergistically to find effective and cost-effective approaches to change or reduce ATOD use and associated problems.     

“Invisible During My Own Crisis”: Responses of LGBT People of Color to the Orlando Shooting

On June 12, 2016, the Pulse nightclub in Orlando, Florida was the target of one of the country’s deadliest mass shootings. Pulse, a gay nightclub, was hosting a Latin Pride Night the evening of the tragedy, which resulted in the death of 49 victims and 53 casualties, over 90% of whom were lesbian, gay, bisexual, and transgender (LGBT) Latinx people, specifically. The present research investigates the narrative responses from LGBT people of color (LGBT-POC) following the tragedy. Results included an analysis of 94 participant narrative responses. Results were collected online from a sample of LGBT-POC with varying sexual, gender, and racial identities. Thematic analysis revealed four major themes: (1) Violence is Not New for LGBT-POC; (2) Personal Identification with Victims; (3) Lack of Intersectionality in Others’ Responses to Orlando; and (4) Acknowledgment of Intersectionality across LGBT-POC. Discussion focuses on describing the ways in which LGBT-POC responded to the shooting regarding their multiple minority identities. Implications of this research reinforce the need for continued intersectional research with LGBT-POC.     

The effects of traditional cigarette and e-cigarette tax rates on adult tobacco product use

We study the effects of traditional cigarette and e-cigarette taxes on use of these products among adults in the United States. Data are drawn from the Behavioral Risk Factor Surveillance System and National Health Interview Survey over the period 2011 to 2018. Using two-way fixed effects models, we find evidence that higher traditional cigarette tax rates reduce adult traditional cigarette use and increase adult e-cigarette use. Similarly, we find that higher e-cigarette tax rates increase traditional cigarette use and reduce e-cigarette use. Cross-tax effects imply that the products are economic substitutes. Our results suggest that a proposed national e-cigarette tax of $1.65 per milliliter of vaping liquid would raise the proportion of adults who smoke cigarettes daily by approximately 1 percentage point, translating to 2.5 million extra adult daily smokers compared to the counterfactual of not having the tax.

     

Occupational shifts across sex-type boundaries in the Swedish labour market

This study examines sex differences in employees’ patterns of mobility between occupations of different sex proportions between 2002 and 2003 and how occupational sex segregation in Sweden is influenced by employees’ occupational shifts. The empirical analysis is based on large-scale and nationwide data sets with a panel design. The results show that employees’ occupational shifts strengthen sex segregation across occupations, especially female ones. Moreover, when we compare employees who in 2002 were in occupations with a given sex proportion, employees shift towards more sex-typical occupations relative to employees of the opposite sex, and this is particularly true for women and older employees. The analysis also shows that whereas the outflow from occupations of certain sex proportions is sex-biased, the sex composition of the inflow of other employees is mostly equal in magnitude to the outflow, partly explaining why the level of overall occupational sex segregation remains almost unchanged between these 2 years.     

Relationship Education in Community Settings: Effectiveness with Distressed and Non‐Distressed Low‐Income Racial Minority Couples

Couple relationship education (CRE) programs are intended to prevent negative couple outcomes, however, some evidence suggests couples in greater distress may still benefit. The current study examined pre‐ and postchanges in relationship functioning of 362 low‐income African American and Hispanic couples. Outcomes (dedication and communication) were assessed by examining differences between two distinct groupings of couples; distressed (both partners reporting clinically significant distress) and nondistressed (neither partner reporting clinically significant distress) couples. Distressed couples at predemonstrated large‐sized gains in all outcome variables, as compared to nondistressed couples. Those who participated in the single‐couple format demonstrated lower gains in positive communication as compared to those in the group format. Implications for distressed couples in CRE programs are offered.     

Effects of Impact-Absorbing Flooring in Residential Care from the Perspectives of Enrolled Nurses

Falls are a daily occurrence in nursing homes and few interventions for reducing fall-related injuries have proven to be effective. Impact absorbing flooring (IAF) in residential care has shown promising results in reducing fall-injuries and in the process of developing and implementing IAF all aspects are valuable to explore. Therefore, the aim of this qualitative study is to describe the enrolled nurses (ENs) experiences of IAF. We carried out focus group interviews with ENs and used content analysis to process the data. The ENs experienced both negative and positive aspects with the IAF. Importantly, the ENs perceived the IAF as effective in preventing fall-injuries. They also appreciated the improvements in acoustics. Negative aspects were that the flooring initially was challenging to walk on and that it made it harder to maneuver heavy equipment. A significant and transferable finding in this study was the importance of the ENs' perceived difficulty in preventing fall-injuries amongst elderly people living in nursing homes. This seemed to be a driving force to accept the intervention. Although IAF affects the working conditions in a nursing home, ENs are willing to accept these issues given the perceived effectiveness of the intervention.