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Articles 1981 - 2010 of 4627
Full-Text Articles in Entire DC Network
Perceptions Of Climate Change And Occupational Heat Stress Risks And Adaptation Strategies Of Mining Workers In Ghana, Victor Fannam Nunfam, Jacques Oosthuizen, Kwadwo Adusei-Asante, Eddie Van Etten, Kwasi Frimpong
Perceptions Of Climate Change And Occupational Heat Stress Risks And Adaptation Strategies Of Mining Workers In Ghana, Victor Fannam Nunfam, Jacques Oosthuizen, Kwadwo Adusei-Asante, Eddie Van Etten, Kwasi Frimpong
Research outputs 2014 to 2021
Heavy physical workload for long hours coupled with increasing workplace heat exposure due to rising temperatures stemming from climate change, especially where there are inadequate prevention and control policies, adversely affect workers' health and safety, productive capacity and social well-being. However, variations in workers' concerns and awareness of occupational heat stress and climate change risks impede the effectiveness of heat stress management. A mixed method approach was used to assess climate change perceptions and occupational heat stress risks and adaptation strategies of Ghanaian mining workers. Questionnaires and focus group discussions were used to collect data from 320 respondents. Quantitative and …
Undergraduate Bulletin, 2019-2020, Minnesota State University Moorhead
Undergraduate Bulletin, 2019-2020, Minnesota State University Moorhead
Undergraduate Bulletins (Catalogs)
No abstract provided.
Using Physical Contact Heterogeneity And Frequency To Characterize Dynamics Of Human Exposure To Nonhuman Primate Bodily Fluids In Central Africa, Victor Narat, Mamdou Kampo, Thibut Heyer, Stephanie Rupp, Philippe Ambata, Richard Njouom, Tamara Giles-Vernick
Using Physical Contact Heterogeneity And Frequency To Characterize Dynamics Of Human Exposure To Nonhuman Primate Bodily Fluids In Central Africa, Victor Narat, Mamdou Kampo, Thibut Heyer, Stephanie Rupp, Philippe Ambata, Richard Njouom, Tamara Giles-Vernick
Publications and Research
Emerging infectious diseases of zoonotic origin constitute a recurrent threat to global health. Nonhuman primates (NHPs) occupy an important place in zoonotic spillovers (pathogenic transmissions from animals to humans), serving as reservoirs or amplifiers of multiple neglected tropical diseases, including viral hemorrhagic fevers and arboviruses, parasites and bacteria, as well as retroviruses (simian foamy virus, PTLV) that are pathogenic in human beings. Hunting and butchering studies in Africa characterize at-risk human social groups, but overlook critical factors of contact heterogeneity and frequency, NHP species differences, and meat processing practices. In southeastern Cameroon, a region with a history of zoonotic emergence …
When Care Becomes Futile: Perspectives Of Acute Care Medical-Surgical Nurses, Angela Mulcahy
When Care Becomes Futile: Perspectives Of Acute Care Medical-Surgical Nurses, Angela Mulcahy
Nursing Theses and Dissertations
Caring for patients at end-of-life is a difficult patient assignment for a nurse. Possessing the knowledge, skills, and means to communicate with and advocate for patients is key to providing quality care. A concept analysis of death literacy identified one specific challenge for nurses, futile care. Futile care has been linked to increased patient suffering, increased health care costs, use of scarce resources, and moral distress. Futile care exists in the medical-surgical acute care setting, but the concept has not been explored within this population. More knowledge from bedside nurses was needed to explore the concept and identify ways to …
Assessment Of Patient-Centered Approaches To Collect Sexual Orientation And Gender Identity Information In The Emergency Department: The Equality Study, Adil H. Haider, Rachel R. Adler, Eric Schneider, Tarsicio Uribe Leitz, Anju Ranjit, Christina Ta, Adele Levine, Omar Harfouch, Danielle Pelaez, Lisa Kodadek
Assessment Of Patient-Centered Approaches To Collect Sexual Orientation And Gender Identity Information In The Emergency Department: The Equality Study, Adil H. Haider, Rachel R. Adler, Eric Schneider, Tarsicio Uribe Leitz, Anju Ranjit, Christina Ta, Adele Levine, Omar Harfouch, Danielle Pelaez, Lisa Kodadek
Section of General Surgery
Importance: Health care and government organizations call for routine collection of sexual orientation and gender identity (SOGI) information in the clinical setting, yet patient preferences for collection methods remain unknown.
Objective: To assess of the optimal patient-centered approach for SOGI collection in the emergency department (ED) setting.
Design, setting, and participants: This matched cohort study (Emergency Department Query for Patient-Centered Approaches to Sexual Orientation and Gender Identity [EQUALITY] Study) of 4 EDs on the east coast of the United States sequentially tested 2 different SOGI collection approaches between February 2016 and March 2017. Multivariable ordered logistic regression was used to …
A Need For Occupational Justice: The Impact Of Racial Microaggression On Occupations, Wellness, And Health Promotion, Emily Grullon, Carlneshia Hunnicutt, Melisa Morrison, Olandria Langford, Mirtha M. Whaley
A Need For Occupational Justice: The Impact Of Racial Microaggression On Occupations, Wellness, And Health Promotion, Emily Grullon, Carlneshia Hunnicutt, Melisa Morrison, Olandria Langford, Mirtha M. Whaley
OCCUPATION: A Medium of Inquiry about Health through Occupation
“Ism,” in general terms describes a practice that denotes oppression of a group based on the characteristics of its members: racism, sexism, and ageism, are the three types most commonly identified. “Isms” often impose limits on people, and while we have been aware of those limits at the macro level, we have been less aware of acts that happen at the level of the individual, the micro level. These acts, which are frequently heard and seen in the media, have personal, occupational, and health implications for those affected by them. The purpose of this paper is to raise awareness about …
Self-Care Vs. Self-Sacrifice In Medical-Surgical Nursing Culture: A Critical Ethnography, Elise Jordan Juergens
Self-Care Vs. Self-Sacrifice In Medical-Surgical Nursing Culture: A Critical Ethnography, Elise Jordan Juergens
Dissertations
The critical ethnography research examines need prioritization culture among medical-surgical nurses. Grove, Burns, and Gray (2013) define the problem statement as an explicit identification of the research need. Literature search yields scarce ethnographic research on the nursing population as a culture-sharing group, and no qualitative research exists regarding medical-surgical nurses’ self-need prioritization. The purpose of this critical ethnography is to observe medical-surgical nursing culture, related to personal need prioritization, as reflected by behavior and dialogue.
Qualitative research methodology is appropriate where statistical data is not. Research motivation involves seeking insight and sociocultural understanding. Critical ethnography is the chosen qualitative research …
Variables Predicting The Severity Of A Mass Shooting: The Connection To White Supremacy, Sarina Resnick
Variables Predicting The Severity Of A Mass Shooting: The Connection To White Supremacy, Sarina Resnick
Honors Projects in History and Social Sciences
Since mass shootings have become increasingly relevant in today’s society, the subject of what makes a mass shooting deadly has become more and more popular. This project focuses on how selected variables correlate with the severity of a mass shooting, and especially focuses on the impact of white supremacy ideology. Theoretically, a shooter imbued with this ideology will likely be more violent, thus causing a higher victim count (injuries + deaths). The other variables included in the model are: the use of a long gun, the use of multiple guns, the use of semi-automatic guns, mental illness, and shooter suicide. …
Developing Cultural Competency In Anesthesia Through Student Registered Nurse Anesthetists, Emma To
Developing Cultural Competency In Anesthesia Through Student Registered Nurse Anesthetists, Emma To
Doctoral Projects
Certified Registered Nurse Anesthetists (CRNAs) are the main anesthesia providers in over 70% of rural hospitals providing anesthesia. Each year, over 2,000 student registered nurse anesthetists (SRNAs) graduate and continue as licensed CRNAs. This Doctor of Nurse Practice (DNP) project emphasizes the importance of developing culturally competent providers in anesthesia by promoting early outreach in cultural competence education of SRNAs. Cultural competence is described as possessing characteristics of congruent attitudes, awareness, and conduct that provides and enables effective skills in cross-cultural encounters. Encompassing cultural competency education early in the SRNAs profession may provide valuable lifelong cultural skills that will benefit …
Blended With The Savior: Gregory Of Nyssa's Eucharistic Pharmacology In The Catechetical Oration, John David Penniman
Blended With The Savior: Gregory Of Nyssa's Eucharistic Pharmacology In The Catechetical Oration, John David Penniman
Faculty Journal Articles
Humankind, for Gregory of Nyssa, was poisoned through a primordial act of eating the forbidden fruit from the Garden of Eden. As a result, the toxin of sin and death has been blended into the body and soul of each person, dispersing itself throughout the component parts of their nature. If eating and drinking initiated the spiritual and physical degradation of humanity, Gregory argues, then it must also be through eating and drinking—namely, through the Eucharist—that humanity will be healed. This article proposes that Gregory's instruction on the Eucharist in his Catechetical Oration should be understood as more than merely …
Quantitative Microbial Risk Assessment For Parts, Ground, And Msc Poultry Product Including Intervention Analysis And Exploration Of Enterobacteriaceae As An Indicator Organism In Poultry Processing, Leigh Ann Parette
Graduate Theses and Dissertations
Samples collected at five different large bird poultry processing facilities over a period of 7 months from prescald to post debone locations were enumerated for Enterobacteriaceae, Salmonella spp., and Campylobacter spp. and the results were used to create Quantitative Microbial Risk Analyses (QMRA) models for parts, ground, and mechanically separated chicken (MSC) products. Sensitivity analyses indicated the points in the process at which reductions would be most advantageous to the endpoint and simulation models were run to test reductions required to meet the current USDA performance standards.
These data were analyzed to determine the reductions from one node (location) to …
Lead And Crime: An Ecological Study Between Lead Contaminated Topsoil And Violent Crime., Brian Guinn
Lead And Crime: An Ecological Study Between Lead Contaminated Topsoil And Violent Crime., Brian Guinn
Electronic Theses and Dissertations
Lead is a known neurotoxicant. Human exposure to lead comes primarily through environmental exposures, including remnant lead paint, lead contaminated topsoil and lead contaminated water. Prenatal and early life lead exposure has been associated with numerous neurocognitive and neuropsychiatric disorders. This dissertation presents findings from an ecological study which evaluated the geospatial association between topsoil lead content and the incidence of FBI designated violent crime in Jefferson County, Kentucky. A total of 412 topsoil samples were collected along roadways (n=300) and from Louisville Metro Parks (n=112). Jefferson County crime data was obtained from the Louisville Metro Police Department – Crime …
Changes In Cultural Competency Of Nurses Caring For Marshallese Islanders Following An Educational Intervention, Abigail Childers
Changes In Cultural Competency Of Nurses Caring For Marshallese Islanders Following An Educational Intervention, Abigail Childers
The Eleanor Mann School of Nursing Undergraduate Honors Theses
Abstract
Background: Marshall Islanders are one of the fastest growing migrant populations in the US and Northwest Arkansas. Health disparities and maintenance of strong cultural values and norms may adversely affect the Marshallese participation in the health care system. Evidence shows that cultural competency training can improve the attitudes, knowledge, skills and behaviors of health professionals and has many positive impacts. The Clinical Cultural Competency Questionnaire (CCCQ) is a research-validated tool that can be used to measure perceived cultural competency through many subscale categories.
Objective: The purpose of this study is to implement a cultural awareness educational program and to …
Trying To Cover The Sun With Your Thumb: A Critical Ethnography Of Maternity Care Provision In Rural Northern New Mexico, Abigail Reese
Trying To Cover The Sun With Your Thumb: A Critical Ethnography Of Maternity Care Provision In Rural Northern New Mexico, Abigail Reese
Nursing ETDs
Access to maternity care is disappearing for women across rural America. In the state of New Mexico, women often travel long distances to access hospitals and providers that offer childbirth services, as these resources are concentrated primarily in metropolitan areas. Although data on provider distribution is available, very few studies have explored the maternity care access crisis from the perspectives of the midwives and physicians who work in rural areas. The purpose of this critical ethnographic study was to explore barriers and facilitators to the provision of childbirth services from providers’ perspectives with the intent of informing policy debates around …
Childhood Obesity And Academic Outcomes In Young Adulthood, Igor Ryabov
Childhood Obesity And Academic Outcomes In Young Adulthood, Igor Ryabov
Sociology Faculty Publications
The present study used nationally representative data from the National Longitudinal Study of Adolescent Health (a.k.a., Add Health) to examine the impact of childhood obesity on young adult educational attainment. In addition to weight status, independent variables included race–ethnicity, immigrant generational status, family socio-economic status (SES), preference for overweight and obese friends in school, school socio-economic and race–ethnic composition, and other important predictors. Educational attainment was measured as a categorical variable with the categories reflecting key educational benchmarks: (1) being a high school graduate; (2) having some college education; and (3) having completed a bachelor’s or higher degree. The results …
The Role Of Migration-Related Stress In Depression Among Haitian Immigrants In Florida: A Mixed Method Sequential Explanatory Approach, Dany Amanda C. Fanfan
The Role Of Migration-Related Stress In Depression Among Haitian Immigrants In Florida: A Mixed Method Sequential Explanatory Approach, Dany Amanda C. Fanfan
USF Tampa Graduate Theses and Dissertations
Recognizing, appropriately treating depression, and meeting the mental health needs of the growing number of Haitian immigrants in the United States (US), continue to pose a challenge because of differences in culture, beliefs, idiom of distress, expression of depression as well as specific stressors associated with the migration process. Previous studies, while limited, document high levels of depression among Haitian migrants, and postulated that migration-related stress (MRS) may play a significant role. Aspects of the migration process, more specifically stressors endured during settlement in the US may negatively precipitate the development of depression.
This study used a mixed method sequential …
"They Destroy The Reproductive System": Exploring The Belief That Modern Contraceptive Use Causes Infertility, Erica Sedlander, Jeffrey B. Bingenheimer, Mary Thiongo, Peter Gichangi, Rajiv N. Rimal, Mark Edberg, Wolfgang Munar
"They Destroy The Reproductive System": Exploring The Belief That Modern Contraceptive Use Causes Infertility, Erica Sedlander, Jeffrey B. Bingenheimer, Mary Thiongo, Peter Gichangi, Rajiv N. Rimal, Mark Edberg, Wolfgang Munar
Prevention and Community Health Faculty Publications
No abstract provided.
I Was Clear With My Goals, Where I’M Heading, And What I Wanted With My Life: Life History Of An Omani Woman And Nurse Leader, Christie Emerson
I Was Clear With My Goals, Where I’M Heading, And What I Wanted With My Life: Life History Of An Omani Woman And Nurse Leader, Christie Emerson
Doctorate of Nursing Science Dissertations
This study uses life history methodology to examine the personal experience of being an Omani woman during the Omani Renaissance, choosing a career in nursing, and evolving into a nurse leader. There is a lack of research on why Omani women choose to enter the workforce, choose nursing career paths, and what sustains them in the nursing workforce. There is also a lack of research on the path to Omani nurse leadership. The research question is: What is the personal experience of being an Omani woman during the Omani Renaissance, choosing a career in nursing, and becoming a nurse leader? …
The Politics Of Medicine At The Late Medici Court: The Recipe Collection Of Anna Maria Luisa De’ Medici (1667 – 1743), Ashley Lynn Buchanan
The Politics Of Medicine At The Late Medici Court: The Recipe Collection Of Anna Maria Luisa De’ Medici (1667 – 1743), Ashley Lynn Buchanan
USF Tampa Graduate Theses and Dissertations
This dissertation analyzes the social, cultural, and political significance of recipes at the late Medici court. In doing so, it examines how the late Medici court used medicinal and pharmaceutical patronage to maneuver politically and socially as well as increase the court’s cultural cache throughout Europe. By the beginning of the eighteenth century, it was clear that the Medici line would end and that the Grand Duchy of Tuscany would become a satellite state of a larger European power. Yet while the late Medici court found themselves increasingly sidelined in the cultural and political landscape of Europe, science and medicine …
Initiating Patient Discussions About Oocyte Cryopreservation: Attitudes Of Obstetrics And Gynaecology Resident Physicians, Brennan Peterson, C. Gordon, Julia K. Boehm, M. C. Inhorn, P. Patrizio
Initiating Patient Discussions About Oocyte Cryopreservation: Attitudes Of Obstetrics And Gynaecology Resident Physicians, Brennan Peterson, C. Gordon, Julia K. Boehm, M. C. Inhorn, P. Patrizio
Marriage and Family Therapy Faculty Articles and Research
This study examined the attitudes of obstetrics and gynaecology (OB/GYN) resident physicians to initiating patient discussions regarding medical and elective oocyte cryopreservation (OC). The study used a cross-sectional online survey of OB/GYN medical residents in the USA, sampled from residency programmes approved by the American Council for Graduate Medical Education. In total, 208 medical residents, distributed evenly between postgraduate years 1–4, participated in the study. Residents' fertility knowledge and attitudes to initiating discussions about OC were gathered. Forty percent (n = 83) believed that OB/GYN residents should initiate discussions about OC with patients (initiators), while 60% (n = 125) did …
Exploring Explicit Fanfiction As A Vehicle For Sex Education Among Adolescents And Young Adults, Donna Jeanne Barth
Exploring Explicit Fanfiction As A Vehicle For Sex Education Among Adolescents And Young Adults, Donna Jeanne Barth
USF Tampa Graduate Theses and Dissertations
Fanfiction consists of works written by amateurs using pre-existing characters and plots, often shared online for free. Although fanfiction began long before the advent of the internet, the worldwide web has created a platform wherein fanfiction is allowed and encouraged to spread almost unconditionally, reaching new populations and rising slowly but surely into the public eye. As the internet has made fanfiction more accessible and public, it has also increased the number of children and young adults involved in the process. And in the unsupervised wilderness of the internet, sexual content is a common feature of fanfiction, with a varying …
Odontogenic Abscesses In Rhesus Macaques (Macaca Mulatta) Of Cayo Santiago, Hong Li, Wenjing Luo, Anna Feng, Michelle L. Tang, Terry B. Kensler, Elizabeth Maldonado, Octavio A. Gonzalez, Matthew J. Kessler, Paul C. Dechow, Jeffrey L. Ebersole, Qian Wang
Odontogenic Abscesses In Rhesus Macaques (Macaca Mulatta) Of Cayo Santiago, Hong Li, Wenjing Luo, Anna Feng, Michelle L. Tang, Terry B. Kensler, Elizabeth Maldonado, Octavio A. Gonzalez, Matthew J. Kessler, Paul C. Dechow, Jeffrey L. Ebersole, Qian Wang
Center for Oral Health Research Faculty Publications
Objectives
Odontogenic abscesses are one of the most common dental diseases causing maxillofacial skeletal lesions. They affect the individual's ability to maintain the dental structures necessary to obtain adequate nutrition for survival and reproduction. In this study, the prevalence and pattern of odontogenic abscesses in relation to age, sex, matriline, and living periods were investigated in adult rhesus macaque skeletons of the free-ranging colony on Cayo Santiago, Puerto Rico.
Materials and Methods
The skulls used for this study were from the skeletons of 752 adult rhesus macaques, aged 8–31 years, and born between 1951 and 2000. They came from 66 …
Predicting First Term Success In An Associates Degree Nursing Program Using Cognitive And Noncognitive Factors, Richard Hilton Turner
Predicting First Term Success In An Associates Degree Nursing Program Using Cognitive And Noncognitive Factors, Richard Hilton Turner
Doctoral Dissertations and Projects
Since the late 1990s the nursing field has experienced increased demand for RN’s as well as a number of internal and external factors that have worsened this problem. College admissions officers have struggled to identify those students who are most likely to persist in an associate degree nursing (ADN) program. Estimates of programmatic attrition vary, but fall somewhere between 25-50%. A great deal of research has been expended in an attempt to determine which preadmission variables are most likely to indicate programmatic success. Unfortunately, no “best set” of admissions variables has been identified. The purpose of this research was to …
The Phylogenetic Signal In Tooth Wear: What Does It Mean?, Larisa Desantis, Mikael Fortelius, Frederick E Grine, Christine Janis, Thomas M Kaiser, Gildas Merceron, Mark A Purnell, Ellen Schulz-Kornas, Juha Saarinen, Mark F. Teaford, Peter S Ungar, Indrė Žliobaitė
The Phylogenetic Signal In Tooth Wear: What Does It Mean?, Larisa Desantis, Mikael Fortelius, Frederick E Grine, Christine Janis, Thomas M Kaiser, Gildas Merceron, Mark A Purnell, Ellen Schulz-Kornas, Juha Saarinen, Mark F. Teaford, Peter S Ungar, Indrė Žliobaitė
Faculty Publications & Research of the TUC College of Osteopathic Medicine
A new study by Fraser et al (2018) urges the use of phylogenetic comparative methods, whenever possible, in analyses of mammalian tooth wear. We are concerned about this for two reasons. First, this recommendation may mislead the research community into thinking that phylogenetic signal is an artifact of some sort rather than a fundamental outcome of the evolutionary process. Secondly, this recommendation may set a precedent for editors and reviewers to enforce phylogenetic adjustment where it may unnecessarily weaken or even directionally alter the results, shifting the emphasis of analysis from common patterns manifested by large clades to rare cases.
Positive Deviance As A Framework For Understanding Motivations And Barriers To Exercise For University Students At Campus Recreation, René Dario Herrera
Positive Deviance As A Framework For Understanding Motivations And Barriers To Exercise For University Students At Campus Recreation, René Dario Herrera
USF Tampa Graduate Theses and Dissertations
The purpose of this thesis was to use qualitative research methodologies to better understand motivations and barriers to exercise for university students at campus recreation. The secondary purpose was to identify any correlations between physical activity habits and academic success. Ethnographic data obtained from a positive deviance sample and critically analyzed with feminist and postmodern theory could provide additional validation for campus recreation's value in positively contributing to the academic success of university students.
Participant observation, questionnaire, cultural domain analysis, interview, and focus group provided qualitative data.
Results indicate university students who frequent campus recreation to exercise are highly motivated …
Cancer Patient Experience Using Integrative Health Techniques, Spencer R. Bockover
Cancer Patient Experience Using Integrative Health Techniques, Spencer R. Bockover
USF Tampa Graduate Theses and Dissertations
Objective:
From a patient-centered perspective, this study sought to explore cancer patient experiences using integrative health techniques, while undergoing or after having completed conventional cancer therapy.
Methods:
Recruitment and data collection both occurred within the Supportive Care Medicine Department of a comprehensive cancer center in the southeastern United States. The primary collection method was semi-structured interviews, of which 13 were conducted.
Results:
Patients using integrative therapies experienced a variety of physical and mental/emotional benefits from their chosen therapy, such as management of lymphedema and nerve damage, increased mobility, and improved self-confidence.
Conclusion:
Integrative therapies can provide many benefits to patients …
2018 Celebration Of Scholarship, Creativity And Engagement, Eastern Illinois University
2018 Celebration Of Scholarship, Creativity And Engagement, Eastern Illinois University
Programs
Scholarship, creativity, innovation, and the many forms of collaborative engagement that shape faculty life and student learning are central to the mission of Eastern Illinois University. For that reason, our faculty, department chairs, college deans, the provost, and the entire campus community celebrate the achievements and outstanding contributions of our colleagues and students to their disciplines and professions every year.
And, as the following pages illustrate, faculty engaged in continuing scholarly and creative activities provide outstanding mentoring experiences for our undergraduate and graduate students.
In addition to recognizing faculty performances, shows, publications, grants and other professional efforts, the University will …
Hominoid Intraspecific Cranial Variation Mirrors Neutral Genetic Diversity, Julia M. Zichello, Karen L. Baab, Kieran P. Mcnulty, Christopher J. Raxworthy, Michael E. Steiper
Hominoid Intraspecific Cranial Variation Mirrors Neutral Genetic Diversity, Julia M. Zichello, Karen L. Baab, Kieran P. Mcnulty, Christopher J. Raxworthy, Michael E. Steiper
Publications and Research
Natural selection, developmental constraint, and plasticity have all been invoked as explanations for intraspecific cranial variation in humans and apes. However, global patterns of human cranial variation are congruent with patterns of genetic variation, demonstrating that population history has influenced cranial variation in humans. Here we show that this finding is not unique to Homo sapiens but is also broadly evident across extant ape species. Specifically, taxa that exhibit greater intraspecific cranial shape variation also exhibit greater genetic diversity at neutral autosomal loci. Thus, cranial shape variation within hominoid taxa reflects the population history of each species. Our results suggest …
The Santa Clara, 2018-10-11, Santa Clara University
The Santa Clara, 2018-10-11, Santa Clara University
The Santa Clara
No abstract provided.
Medical Tourism And Its Effect On United State Healthcare Industry In A Highly Connected Global Landscape, Katarina Haist
Medical Tourism And Its Effect On United State Healthcare Industry In A Highly Connected Global Landscape, Katarina Haist
The Hilltop Review
For centuries people have traveled to other countries to obtain the best healthcare. Traditionally these popular destinations were highly developed countries; the trend of people traveling to less developed areas for treatment is relatively new. The average person is more connected to the world around them than ever before through globalization. Information about the best practices are more widely available than ever before. The importance of physical barriers to business such as geography and time are being eliminated. Due to this “flattening” per Friedman, the competition and expertise for areas in Science, Technology, Engineering, and Mathematics (STEM) can be shifted …