A Case Study of Health Tourism in the Jeju Province, South Korea

The United States Census Bureau (2006) reported that in 2005 more than 46 million Americans lacked health insurance, and that by 2019 national spending for health care would exceed $4.5 trillion (Centers for Medicare & Medicaid Services, 2010). Because those numbers are expected to increase, health tourists are seeking better opportunities for low-cost, high-quality treatment in other countries, plus the added benefit of experiencing foreign cultures. Health tourism is a rapidly growing market in both advanced and developing countries. The purpose of this study was to develop an applicable model of health tourism, the Jeju-Style Health Tourism Model, for Jeju Special Self-Governing Province, in the Republic of Korea (South Korea) and to provide other cities and countries with its implications. This study employed a focus group, indepth interviews, and content analysis to discover important factors in developing the model. The results suggested that four major sources must be executed together to maximize the benefits of health tourism development. On a foundation of natural resources, knowledge-based resources were most important (54.5%), followed by artificial resources (25.7%), and expenses-based resources (19.8%).

Online solid phase extraction liquid chromatography tandem mass spectrometry (SPE-LC-MS/MS) method for the determination of sucralose in reclaimed and drinking waters and its photo degradation in natural waters from South Florida

Background Sucralose has gained popularity as a low calorie artificial sweetener worldwide. Due to its high stability and persistence, sucralose has shown widespread occurrence in environmental waters, at concentrations that could reach up to several μg/L. Previous studies have used time consuming sample preparation methods (offline solid phase extraction/derivatization) or methods with rather high detection limits (direct injection) for sucralose analysis. This study described a faster and sensitive analytical method for the determination of sucralose in environmental samples. Results An online SPE-LC–MS/MS method was developed, being capable to quantify sucralose in 12 minutes using only 10 mL of sample, with method detection limits (MDLs) of 4.5 ng/L, 8.5 ng/L and 45 ng/L for deionized water, drinking and reclaimed waters (1:10 diluted with deionized water), respectively. Sucralose was detected in 82% of the reclaimed water samples at concentrations reaching up to 18 μg/L. The monthly average for a period of one year was 9.1 ± 2.9 μg/L. The calculated mass loads per capita of sucralose discharged through WWTP effluents based on the concentrations detected in wastewaters in the U. S. is 5.0 mg/day/person. As expected, the concentrations observed in drinking water were much lower but still relevant reaching as high as 465 ng/L. In order to evaluate the stability of sucralose, photodegradation experiments were performed in natural waters. Significant photodegradation of sucralose was observed only in freshwater at 254 nm. Minimal degradation (<20%) was observed for all matrices under more natural conditions (350 nm or solar simulator). The only photolysis product of sucralose identified by high resolution mass spectrometry was a de-chlorinated molecule at m/z 362.0535, with molecular formula C12H20Cl2O8. Conclusions Online SPE LC-APCI/MS/MS developed in the study was applied to more than 100 environmental samples. Sucralose was frequently detected (>80%) indicating that the conventional treatment process employed in the sewage treatment plants is not efficient for its removal. Detection of sucralose in drinking waters suggests potential contamination of surface and ground waters sources with anthropogenic wastewater streams. Its high resistance to photodegradation, minimal sorption and high solubility indicate that sucralose could be a good tracer of anthropogenic wastewater intrusion into the environment.

New trends in health architecture for children and the effects of the built environment on young patients

The objective of this thesis was to investigate the effects of the built environment on the outcome of young patients. This investigation included recent innovations in children's hospitals that integrated both medical and architectural case studies as part of their design issues. In addition, the intervention responded to man-made conditions and natural elements of the site. The thesis project, a Children's Rehabilitation Hospital, is located at 1500 N.W. River Drive in Miami, Florida. The thesis intervention emerged from a site analysis that focused on the shifting of the urban grid, the variation in scale of the immediate context and the visual-physical connection to the river's edge. Furthermore, it addressed the issues of overnight accommodation for patient's families, as well as sound control through the use of specific materials in space enclosures and open courtyards. The key to the success of this intervention lies in the special attention given to the integration between nature and the built environment. Issues such as the incorporation of nature within a building through the use of vistas and the exploitation of natural light through windows and skylights, were pivotal in the creation of a pleasant environment for visitors, employees and young patients.