Developing an informational tool for ethical engagement in medical tourism

Background

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.

Methods

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.

Results

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.

     

Relationships,Human Nature,and the Four “Words” of Inspector Gamache1

The Inspector Gamache mysteries by Louise Penny are very popular, in no small part because of the appeal of the main character, Chief Inspector Armand Gamache. However, another main draw of the series is the small set of recurring main characters. In this article, I delve deeply into their lives and relationships, using as a lens the four sayings of Gamache as a means of illuminating both the brokenness and grace that characterize human relationality.     

Is regret for inaction relatively self‐enhancing?

Previous accounts of regret suggest that people report greater regret for inaction than for action because the former is longer lasting and more painful than the latter. We suggest instead that the tendency for people's greatest regrets to concern inaction more than action may be due to the relatively self‐enhancing nature of regrets for inaction. In Study 1 we asked people to think about their greatest recent regret and to code it as being due to action or inaction. In Study 2 participants described their greatest regret from across their entire life. In both studies we observed an inaction effect only amongst individuals high in self‐esteem (HSE). In Study 2 we found that the inaction effect was confined to HSE people whose greatest regret was personal in nature. These results support the claim that regret for inaction is relatively self‐enhancing and suggest that the inaction effect found in real‐life regrets may be due, in part at least, to the self‐enhancement goals of HSE individuals. Copyright © 2005 John Wiley & Sons, Ltd.     

Changing Kinematics as a Means of Reducing Vulnerability to Physical Attack1

Three experiments investigated whether women can change their walking style and hence reduce their vulnerability to physical attack. In Experiment 1, women were videotaped walking normally and when imagining themselves in a situation of low personal safety. Women were rated as harder to attack in the low safety condition. Differences in walking style accounted for differences in ease‐of‐attack ratings. Experiment 2 compared walking styles and vulnerability of women before and after completing a self‐defense course. No differences were seen across sessions. Experiment 3 investigated walking styles and vulnerability of women before and after completing individualized walking training programs. Differences in vulnerability between sessions were revealed and could be accounted for by changes in walking‐style features.     

An Examination of the Individual‐Difference Approach to the Role of Norms in the Theory of Reasoned Action1

The relationship between subjective norm and behavioral intentions is the weakest link of the theory of reasoned action. Numerous approaches have addressed this issue, including the assertion that the weak contribution is a result of a small number of individuals who are under normative control. The present research examines this individual‐difference approach in the domain of health behaviors. Respondents were 287 students who rated their intentions, attitudes, and subjective norms in relation to 32 health behaviors and 5 substance‐use behaviors. Regression analyses, between subjects and within subjects, demonstrated that both behaviors and people can be under attitudinal or normative control. Support for an individual‐difference approach was less conclusive when findings were examined separately for specific health behaviors.     

Children's activities and their meanings for parents: a mixed-methods study in six Western cultures

Theoretical perspectives and research in sociology, anthropology, sociolinguistics, and cultural psychology converge in recognizing the significance of children's time spent in various activities, especially in the family context. Knowing how children's time is deployed, however, only gives us a partial answer to how children acquire competence; the other part must take into account the culturally constructed meanings of activities, from the perspective of those who organize and direct children's daily lives. In this article, we report on a study of children's routine daily activities and on the meanings that parents attribute to them in six Western middle-class cultural communities located in Italy, The Netherlands, Poland, Spain, Sweden, and the United States (N = 183). Using week-long time diaries kept by parents, we first demonstrate similarities as well as significant differences in children's daily routines across the cultural samples. We then present brief vignettes--"a day in the life" --of children from each sample. Parent interviews were coded for themes in the meanings attributed to various activities. Excerpts from parent interviews, focusing on four major activities (meals, family time, play, school- or developmentally related activities), are presented to illustrate how cultural meanings and themes are woven into parents' organization and understanding of their children's daily lives. The results of this mixed-method approach provide a more reliable and nuanced picture of children's and families' daily lives than could be derived from either method alone.     

The influence of heightened body‐awareness on walking through apertures

The reported study measured the ratio between aperture‐width and hip‐width that marked the critical transition from frontal walking to body rotation for male and female participants. Half of the participants of each sex wore form‐fitting lycra clothes and half loose‐fitting jogging suits. Participants wearing the form‐fitting clothing reported heightened body awareness relative to those wearing the loose‐fitting clothing. For male participants this difference was reflected in a smaller aperture‐to‐hip ratio in the form‐fitting than loose‐fitting clothing condition. That is, males walked frontally through smaller apertures when wearing form‐fitting than when wearing loose‐fitting clothing. For females there was no difference in walking action as a function of clothing style. Results are discussed in terms of the perception of action opportunities in the environment, the influence of body awareness on such perception and sex differences. Copyright © 2009 John Wiley & Sons, Ltd.