bluuebunny/crossref_metadata_2025 huggingface dataset:
The tourist experience life cycle: a perspective article
Authors: Dodds Rachel
Published: September 2019

Purpose

The purpose of this paper is to review the past literature of the tourist experience and propose a new model of behavior.

Design/methodology/approach

It is proposed that understanding of the visitors experience from a development standpoint may be useful in understanding how tourism destinations or indeed products may be experienced so differently. Therefore, a tourist experience life cycle has been put forth as a model.

Findings

This model may help to outline how tourists, like destinations, also go through a life cycle. The implications may help destinations better understand the different motivations of their visitors.

Originality/value

While the literature has discussed the tourism experience and how the customer experience has changed, there has been little focus on the longitudinal development of how the actual tourist experiences a destination.
Airport management: a perspective article
Authors: Graham Anne
Published: September 2019

Purpose

The purpose of this paper is to present an overall viewpoint on the past (1946-2020) and future (2020-2095) development of airport management.

Design/methodology/approach

The paper is based on a review of secondary literature.

Findings

The paper finds that the airport industry has transformed from a public utility to a modern enterprise, with private sector ownership, more competition, the expansion of commercial facilities and more diverse business models.

Originality/value

The paper provides a unique long-term and comprehensive view of past, current and future airport management, bringing together a number of linked developments, which is not found elsewhere.
Holistic theory development in tourism and hospitality: a perspective article
Authors: Tasci Asli D.A.
Published: September 2019

Purpose

This opinion piece calls for a consolidation of theories through integrative literature reviews to set forth the path for holistic theory development in future research.

Design/methodology/approach

This is a perspective article.

Findings

It is difficult to substantiate the value of tourism and hospitality researchers’ contribution due to the fragmented nature of research because researchers typically conduct their studies in silos, sometimes completely detached from others who study similar or even the same concepts using different terminology.

Originality/value

This perspective article suggests critical and integrative literature reviews to consolidate concepts, models, theories, taxonomies and typologies for more holistic theories.
Emotional intelligence and tourist experience: a perspective article
Authors: Prentice Catherine
Published: September 2019

Purpose

This paper aims to discuss how emotional intelligence can be incorporated into the tourism sector to enhance tourist experience.

Design/methodology/approach

The paper reviews and synthetises current research on emotional intelligence and tourism research.

Findings

Emotional intelligence is proposed to be incepted into the tourism context through its influence on the service encounter between tourism service representatives and tourists.

Originality/value

The paper provides a fresh view on tourist experience and suggests applying emotional intelligence into the tourism context to enhance tourist experience.
Co-creating tourism experiences through a traveler’s journey: a perspective article
Authors: Zhang Tingting
Published: September 2019

Purpose

This perspective article aims to summarize research on value co-creation and tourism experience management from the past decades and to propose several future research priorities related to the topic.

Design/methodology/approach

This perspective article reviews the previous work and offers a process model on co-creating tourism experiences through a traveler’s journey. In addition, the article proposes five future research priorities related to value co-creation strategies in tourism experience management.

Findings

This perspective article depicts value co-creation activities during the pre-, mid-, and post-travel stages and proposes five research priorities: (1) big data and real-time co-creation will become ubiquitous in future travel experiences, (2) social media will continue to empower travelers throughout their travels, (3) human–robot interactions will increase for travelers’ co-creation activities, and (4) the diversity of travelers and younger generations (Generation Z) will impact co-created travel journeys.

Originality/value

Co-creation of tourism experiences has been increasing in the travel industry. It is necessary to review what has been said in the past and to project future research priorities and directions for travel academia and practitioners.
Tourism and on-site humour: a perspective article
Authors: Pabel Anja , Pearce Philip L.
Published: September 2019

Purpose

This paper aims to outline major theoretical concepts relating to the tourism-humour relationship and provide commentary on opportunities for further research in this area.

Design/methodology/approach

Papers for this perspective research were sourced by conducting a systematic review which critically appraised relevant research on this topic to provide evidence on humour and its current use in tourism settings.

Findings

Humour has received attention from many academic tribes and disciplines; however, investigations in the context of tourism are only in its early stages.

Research limitations/implications

The paper is based on a select number of peer-reviewed literature studies on the topic of tourism and humour.

Practical implications

The paper outlines some of the challenges that tourism operators face regarding authenticity, i.e. when the delivery of scripted humour is performed in such a way that it is considered spontaneous and meaningful.

Originality/value

The paper provides a brief overview of how humour is currently used in tourism settings and recommends future research opportunities to guide further studies into this topic.
Destination management: a perspective article
Authors: Fyall Alan , Garrod Brian
Published: September 2019

Purpose

Destinations are focal points for tourist activity and thus for the study of tourism. They are, however, notoriously difficult to manage due to their complex systems of stakeholders. Such complexity implies that destinations are driven by a wide range of forces in their internal and external environments. The purpose of this paper is to highlight the diversity and depth of the challenges at play in destination management and, in doing so, review the primary contributions in the field.

Design/methodology/approach

This is a "perspective" paper (i.e. critical literature review).

Findings

The study of destinations remains an area of active research interest, with the many challenges that arise from within and external to destinations offering much food for thought with respect to their longevity as viable, sustainable and competitive places for tourists to visit. For the future, the need to view destinations as part of a wider system is paramount with them being inescapable from debates on urban planning, economic inequality, transportation and housing and the omnipresence of all things “smart”. Such debates need to incorporate both tourists and resident communities, as the well-being and quality of life of both groups is under threat in many destinations, particularly heritage and culturally rich city destinations around the world, where the term “overtourism” is increasingly heard.

Research limitations/implications

This study has implications for the integrated and more holistic management of tourist destinations.

Practical implications

This is a "perspective" paper, so it does not offer individual practical implications for destinations. Moreover, it offers a concise and precise summary of core studies in the field and provides a platform for a more future-looking critical debate on the sustainable management of tourist destinations.

Social implications

Looking ahead, destinations need to be considered as part of a wider system, one that is inclusive of urban planning, economic inequality, transportation and housing, and “smart” initiatives among others. Most importantly, the views of tourist and resident communities need to be considered and incorporated into future planning at the destination level with wellbeing and quality of life indicators being used to identify the real benefits of tourism to both communities.

Originality/value

Integrated and holistic forms of destination management is the way forward, with the exponential growth of technology, as well as the need to manage the exchange of knowledge and data at the destination level, critical to the sustainability of the competitive destination long into the future.
The role of familiarity in consumer destination image formation
Authors: Kim Soyeon , Lehto Xinran , Kandampully Jay
Published: September 2019

Purpose

The primary purpose of this study is to examine the effects of destination familiarity on consumers’ evaluations (cognitive image) and feelings (affective image) about the destination, leading to their intention to visit.

Design/methodology/approach

The data for this study were collected through a Web-based survey. Based on a sample of 460 respondents, structural equation modeling was used to test the proposed hypotheses.

Findings

The results showed that familiarity with a destination not only influences consumers’ cognitive evaluations of the destination but also affects their feelings about it, which translates into their intentions in travelling to the destination. The findings indicate that destination familiarity can enhance consumers’ knowledge about the destination, but more importantly, their affective perceptions can lead to a higher likelihood of visiting a destination.

Practical implications

The findings provide useful guidance for efficient marketing programs to attract more visitors to a certain tourist destination. Destination marketers must assess the level of familiarity of potential travelers in the development, design and promotion of a destination. This understanding will enable the marketers to more effectively communicate with their target markets and allow them to tailor advertising to different segments of their customers based on their familiarity.

Originality/value

The majority of previous studies regarding destination familiarity tend to measure the overall familiarity or experiential familiarity (e.g. a comparison between visitors vs non-visitors) without considering consumers’ indirect familiarity with a destination. This study attempts to conceptualize and empirically test the role of destination familiarity on consumers’ cognitive and affective images and intentions.
A 7‐year follow‐up study on untreated deep or mixed facial infantile hemangioma in East‐Asian patients: When propranolol was not yet an option
Authors: Chang Shih‐Jen , Qiao Congzhen , Chang Lei , Gao Wei , Jin Yunbo , Ma Gang , Qiu Yajing , Lin Xiaoxi
Published: September 2019

Infantile hemangioma (IH) is a type of benign tumor that develops during infancy and spontaneously involutes after 1 year of age. Before the introduction of propranolol in 2008, some patients with IH were instructed to wait for the involution without treatment. This long‐term follow‐up study was conducted to assess the prognosis of East‐Asian children with untreated deep or mixed facial IH. Skin sequelae were assessed by comparing images obtained during the patients’ first and last visits in our clinic. Possible factors were assessed for their association with IH prognosis. The mean follow‐up time was 7.4 years. Among the 48 patients with deep or mixed facial IH, 26 (54%) achieved complete involution without sequelae and 22 encountered various sequelae, including telangiectasia (36.3%), fibrofatty residue (68.2%), and scars (4%). The complete regression rate of deep or mixed IH occurring in the central facial region was significantly lower than for those in the perifacial region (33.3% vs 66.7%, respectively, χ2, P = 0.025). Further, the most common sequelae in this area are fibrofatty residue.
Untold stories of living with a bariatric body: long‐term experiences of weight‐loss surgery
Authors: Berg Anita
Published: September 2019

This article explores patients' long‐term experiences after undergoing bariatric surgery (BS) by individual interviews and the interplay between biographical disruption and biographical flow when the body's normal physiology and anatomy are intentionally altered. Based on interpretative phenomenological analysis the findings show that the bariatric body is still prominent in daily life, positively by displacing the overweight body and negatively due to the development of unexpected health problems after surgery. Due to individual informed consent to the treatment, the negative consequences are perceived as self‐inflicted. The feelings of responsibility and shame make it difficult to seek help and to be open about undesirable long‐term effects and other health problems after surgery. The study argues that undergoing BS is a disruptive event with uncertain long‐term outcomes and living with a bariatric body as a vulnerable life continuously at the intersection of biographical disruption, flow and reinforcement. This study reinforces the importance of doing critical sociological studies of standardised medical interventions which aim to improve patients health problems. Included in these types of studies should be the patients' long‐term experiences and the awareness not to uncritically present their experiences as universal and the treatment result solely as the patients' own responsibility.
Moving beyond classic readability formulas: new methods and new models
Authors: Crossley Scott A. , Skalicky Stephen , Dascalu Mihai
Published: September 2019

Background

Advances in natural language processing (NLP) and computational linguistics have facilitated major improvements on traditional readability formulas that aim at predicting the overall difficulty of a text. Recent studies have identified several types of linguistic features that are theoretically motivated and predictive of human judgments of text readability, which outperform predictions made by traditional readability formulas, such as Flesch–Kincaid. The purpose of this study is to develop new readability models using advanced NLP tools to measure both text comprehension and reading speed.

Methods

This study used crowdsourcing techniques to collect human judgments of text comprehension and reading speed across a diverse variety of topic domains (science, technology and history). Linguistic features taken from state‐of‐the‐art NLP tools were used to develop models explaining human judgments of text comprehension and reading speed. The accuracy of these models was then compared with classic readability formulas.

Results

The results indicated that models employing linguistic features more theoretically related to text comprehension and reading speed outperform classic readability models.

Conclusions

This study developed new readability formulas based on advanced NLP tools for both text comprehension and reading speed. These formulas, based on linguistic features that better represent theoretical and behavioural accounts of the reading process, significantly outperformed classic readability formulas.
Fostering mutual gains: Explaining the influence of high‐performance work systems and leadership on psychological health and service performance
Authors: Jo Hyunyoung , Aryee Samuel , Hsiung Hsin‐Hua , Guest David
Published: September 2019

Despite the growing importance of sustainable management of human resources, human resource management and leadership research on mutuality in the employment relationship has proceeded in a parallel fashion. Drawing on self‐determination theory, this study proposes an integrative model of human growth by addressing two interrelated questions: (a) how and why experienced service‐oriented high‐performance work systems (HPWS) and unit service leadership relate to psychological health and service performance and (b) whether thriving at work and psychological health serially mediate the relationships between the two contextual antecedents and service performance. Our findings revealed that experienced service‐oriented HPWS and unit service leadership related to service performance but indirectly through thriving at work. However, experienced service‐oriented HPWS but not unit service leadership related to psychological health through thriving at work. Furthermore, thriving at work and psychological health serially mediated the relationship between experienced service‐oriented HPWS (but not unit service leadership) and service performance.
Greek Coffee Quality Loss During Home Storage: Modeling the Effect of Temperature and Water Activity
Authors: Orfanou Foteini , Dermesonlouoglou Efimia K. , Taoukis Petros S.
Published: September 2019

The aim of this study was to monitor and characterize Greek coffee staling during home storage (secondary shelf life, SSL) using sensory evaluation techniques. Storage temperature (T) and product water activity (aw) are considered as the major factors affecting SSL. Water sorption isotherms fitted to Guggenheim Anderson–de Boer model were used to predict product stability; coffee samples were stable at aw < 0.52. Coffee samples equilibrated at aw = 0.15 (the fresh sample), 0.22, 0.33, and 0.52 were stored at T = 25 °C, 35 °C, and 45 °C under simulated home storage conditions. Samples were obtained at appropriate times for each T and aw condition and sensorially evaluated. Greek coffee brews were prepared and freshly served during sensory evaluation. The use of Weibull hazard analysis provided an effective approach to SSL determination as a function of T and aw. SSL values ranged from 20 (Τ = 45 °C, aw = 0.52) to 104 days (Τ = 25 °C, aw = 0.15). Quality loss based on coffee aroma changes (aroma quality, aroma intensity, aftertaste, off‐flavor) was also studied (Si, sensory scoring using 9‐point magnitude scale) and kinetically modeled. Quality loss rates (ki) were calculated and used to predict SSL values. Based on the results of both Weibull hazard analysis and sensory scoring of individual aroma characteristics, it was concluded that the lowest SSL was calculated for aw = 0.52 at T = 35 °C to 45 °C. The temperature dependence of aftertaste, aroma quality loss, and off‐flavor production was not statistically significant for 0.15 < aw < 0.33 (P > 0.05); the aroma intensity was the most sensitive parameter.

Practical Applications

Secondary shelf life (SSL) represents the time after pack opening during which a food maintains an acceptable quality level. During home/catering usage, coffee is not consumed immediately after pack opening. During consumption, quality degradation reactions proceed with higher rates due to variable storage conditions mainly related to atmosphere changes in the pack, leading to the entrance of oxygen/moisture and temperature. Therefore, SSL is important, and can be used as a tool for product management during consumption reducing food waste. There is a lack of studies dealing with SSL prediction of coffee, while no studies have been carried out on Greek coffee.
Absorption of Phenolic Acids in Rice Kernels after Boiling in Spearmint Aqueous Extracts of Different Concentrations. A Diffusion Study
Authors: Igoumenidis Panagiotis E. , Iosifidis Sergios V. , Lopez‐Quiroga Estefania , Bakalis Serafim , Karathanos Vaios T.
Published: September 2019

In this study, an attempt was made to fortify white milled rice grains with phenolic compounds using a hydrothermal process and spearmint aqueous extracts of different % w/v concentrations. In addition, a mathematical model was acquired in order to simulate the diffusion of specific phenolic acids in rice kernels during boiling inside the extracts. Results showed that the amount of phenolic acids in rice, the potential equilibrium concentration values, as well as the diffusivity of these compounds in rice material were positively affected by the increase in % w/v bulk concentration of the aqueous extract. It was also shown that the diffusion process could be sufficiently described by a Fickian model and the estimated diffusion coefficients ranged from 6.86 × 10−12 to 3.56 × 10−11 m2/s, with the p‐coumaric acid presenting the highest average diffusivity in boiling rice material among all examined compounds. The chemical affinity of each phenolic acid to rice macromolecules was believed to play the most important role concerning their diffusivity in rice during fortification process.

Practical Application

Consumer's interest for functional food products is constantly growing during the last decades. This study may act as preliminary for the production of fortified rice products, possessing adjusted bioactive content, in industrial scale. The proposed methodology for the production of quick‐cooking or ready‐to‐eat fortified rice may be adopted by rice industries and applied by only making slight modifications in their existing parboiling units.
Late toxicities of prostate cancer radiotherapy with and without hydrogel SpaceAOR insertion
Authors: te Velde Bridget L , Westhuyzen Justin , Awad Nader , Wood Maree , Shakespeare Thomas P
Published: September 2019

Introduction

To investigate whether the implantation of a hydrogel spacer (SpaceOAR) reduces long‐term rectal toxicity for prostate cancer patients treated with intensity‐modulated radiotherapy (IMRT).

Methods

Patients with localised prostate cancer treated with 81 Gy in 45 fx of IMRT over 9 weeks were retrospectively compared: 65 patients with SpaceOAR and 56 patients without SpaceOAR. Planning aims restricted rectal doses to V40 Gy < 35%, V65 Gy < 17%, V75 Gy < 10%. Toxicities were evaluated between 3 months and 3 years after the completion of radiotherapy and were based on the common terminology criteria for adverse events (CTCAE) assessment tool for diarrhoea, haemorrhoids, faecal incontinence and proctitis.

Results

The cumulative incidence of low‐grade diarrhoea (G1) was significantly higher in the non‐SpaceOAR group (21.4% vs 6.2%; P = 0.016). The cumulative incidence of proctitis (grades G1 and G2) was also higher in the non‐SpaceOAR group (26.7% vs 9.2%; P = 0.015); the cumulative incidence of G2 proctitis was higher in the latter group (P = 0.043). There were no differences between the treatment groups for cumulative incidences of faecal incontinence and/or haemorrhoids. Three years after IMRT, diarrhoea and proctitis were higher in the non‐SpaceOAR group, without reaching statistical significance. This finding was unchanged after correcting for baseline symptoms.

Conclusion

SpaceOAR is of benefit in reducing the cumulative incidence of low‐grade diarrhoea and proctitis for up to 3 years after intensity‐modulated radiotherapy.
Radionuclide lung scans for suspected acute pulmonary embolism: Single photon emission computed tomography (SPECT) or hybrid SPECT/CT?
Authors: Liu Jui , Larcos George
Published: September 2019

Introduction

Hybrid single photon emission computed tomography (SPECT) with CT (SPECT/CT) may improve diagnostic accuracy in suspected acute pulmonary embolism, but further research is needed. We evaluated whether the use of attenuation correction and/or the depiction of lung pathology with hybrid SPECT/CT could significantly reduce potentially false‐positive ventilation–perfusion (VQ) SPECT studies or obviate the need for a ventilation study.

Methods

Two specialists (S1 and S2) reviewed prospectively acquired VQ SPECT/CT in 165 patients. Studies were reported using standard criteria and compared to VQ SPECT and Q SPECT/CT.

Results

S1 and S2 recorded positive VQ SPECT in 54 (32.7%) and 42 (25.6%) cases, respectively. Hybrid SPECT/CT showed non‐embolic pathology in 41 (S1) and 46 (S2) patients, but compared to VQ SPECT, neither hybrid SPECT/CT nor attenuation correction SPECT/CT had significantly fewer positive studies. Intra‐observer agreement with VQ SPECT/CT was almost perfect (k = 0.91 for S1 and k = 0.95 for S2; P < 0.001), but not with Q SPECT/CT (k = 0.4 for S1 and k = 0.62 for S2; P < 0.001). Inter‐observer agreement was moderate for VQ SPECT (k = 0.65) and VQ SPECT/CT (k = 0.63).

Conclusion

In our study, hybrid VQ SPECT/CT did not reduce the number of potentially false‐positive VQ SPECT, nor did the CT obviate the need for a ventilation study. Thus, the routine use of hybrid SPECT/CT for suspected pulmonary embolism is not justified.
AIIB Membership for African Countries: Drawcards and Drawbacks
Authors: Prinsloo Cyril
Published: September 2019

The Asian Infrastructure Investment Bank's (AIIB) establishment was inspired by the significant infrastructure investment needs that Asian countries will experience over the coming decade. African countries face an equally daunting challenge: the estimated infrastructure finance deficit is between $68 and $108 billion annually. Several African countries have already joined the AIIB (Egypt, Ethiopia, Madagascar and Sudan), some have been approved to join (Benin, Djibouti, Guinea, Ivory Coast, Rwanda and Tunisia), and select others are designated as ‘prospective founding members’ of this new bank, but are yet to join (Algeria, Ghana, Kenya, Libya, Morocco and South Africa). AIIB membership offers an alluring proposition for African economies: low‐cost finance from a new source. Yet its limited support for technical capacity‐building and financial instruments for low‐income countries, outside of Asia, makes membership less desirable for many African countries. This brief essay analyses the primary motivations, and the benefits and challenges for African countries in joining the AIIB. It surmises that middle‐income African countries are more likely to benefit from AIIB membership than their low‐income peers.
Occupancy and density of a habitat specialist and a sympatric generalist songbird species in Tasmania
Authors: Alves Fernanda , López‐Iborra Germán M. , Stojanovic Dejan , Webb Matthew H. , Langmore Naomi , Heinsohn Robert
Published: September 2019

Patterns of distribution and abundance of species are dependent on their particular ecological requirements. Taking specialisation into account is important for interpreting population parameters. Here, we evaluate population parameters of an endangered habitat specialist, the forty‐spotted pardalote (Pardalotus quadragintus; dependent on white gumEucalyptus viminalisin south‐eastern Tasmania), and a sympatric congeneric habitat generalist, the striated pardalote (Pardalotus striatus). We used occupancy models to estimate occupancy of both species, and distance sampling models to estimate population density and size on North Bruny Island. Within their shared habitat (i.e. white gum forest), we also fitted hierarchical distance sampling models to estimate density in relation to fine‐scale habitat features. We show that forty‐spotted pardalotes only occurred in forests where white gums were present, with a mean density of 2.7 birds per hectare. The density of forty‐spotted pardalotes decreased in areas with abundant small trees and trees with dead crowns, but they increased in areas where larger white gums were abundant. The striated pardalote was widespread, but where white gums were present, they occurred at 2.1 birds per hectare, compared to 0.6 birds per hectare in forests where white gums were absent. Within white gum habitat, the relative abundance of forty‐spotted pardalotes and dead trees had a positive effect on the density of striated pardalotes while small trees had a negative effect. Our study reveals that although widespread, the generalist is most abundant in the limited areas of habitat suitable for the specialist, and this indicates the need of future research to look at whether this pattern of occurrence exacerbates competition in resource depleted habitats.
The Orange Declaration on rural and remote mental health
Authors: Perkins David , Farmer Jane , Salvador‐Carulla Luis , Dalton Hazel , Luscombe Georgina
Published: September 2019

Rural mental health outcomes have been persistently poorer than those in larger cities suggesting that the prevailing investments to improve matters are not working. Mental health researchers and service providers from New South Wales, Victoria, Western Australia and the Australian Capital Territory met in Orange in October 2018 to explore issues pertaining to rural mental health and well‐being. The group recognised and acknowledged that rural residents experience a series of interconnected geographical, demographic, social, economic and environmental challenges which are not addressed adequately by the current mix of services. This declaration has been endorsed by those listed below and we welcome further support. We list ten interrelated problems and ten solutions. As a group, we take this declaration as an opportunity to invite discussion about how we can collectively improve the mental health of rural residents through research, service design and delivery. We invite the reader to consider endorsing this declaration. A short summary of supporting evidence is available online at https://www.crrmh.com.au/.
Effects of Whole‐Body Cryostimulation (−90°C) on Somnolence and Psychological Well‐Being in an Older Patient with Restless Legs Syndrome
Authors: Kasmi S. , Filliard J.‐R. , Polidori G. , Bouchet B. , Blancheteau Y. , Legrand F.D.
Published: September 2019

Background

We aimed at evaluating the feasibility and effects of intense (i.e. −90°C) whole‐body cryostimulation (WBC) on somnolence and psychological well‐being in an older‐adult patient diagnosed with restless legs syndrome (RLS).

Methods

An interrupted time series approach was used in which the efficacy of cryostimulation was evaluated by measuring self‐reported fatigue, wake time sleepiness, and well‐being several times prior to, during, and after exposure to treatment (i.e. daily 3‐min sessions of intense WBC).

Results

No adverse event occurred. Reported levels of sleepiness decreased immediately following the beginning of the treatment phase. In the same time, self‐reported well‐being significantly increased. Effects sizes were of large magnitude.

Conclusion

In summary, the present study demonstrated that daily exposure to extremely cold air in an enclosed space for 2 weeks was feasible and effective in promoting physical and psychological states in an older patient with sleep disturbances.
Upskilling healthcare professionals to manage clinical allergy
Authors: Michaelis Louise J. , Skypala Isabel J. , Gardner James , Sheikh Aziz , Fox Adam T. , Holloway Judith A.
Published: September 2019

It has long been recognised that given the high prevalence and considerable impact of allergic disease globally, there needs to be a focus on appropriate training for clinical professionals. The health‐economic consequences of allergic disease are significant, with both direct healthcare costs (doctor, nurse and dietitian consultations, hospital admissions and prescribed medications) and indirect costs (lost school and work time, reduced productivity and over‐the‐counter medications). There is also a well‐recognised impairment of quality of life, with less tangible costs including anxiety, distress, discomfort, disability and, occasionally, death. To help to mitigate these effects, there is a need to upskill the professional workforce at all levels, and also to equip those trained with the skills to become future healthare professional trainers. Upskilling the workforce from the grass‐roots of undergraduate study in Medical, Nursing and Allied Health Professionals (AHP) through the entirety of training to senior consultant levels could have a major beneficial impact on the patient and their families, lead to a reduction in emergency use of clinical service, and help increase economic productivity.
Contact allergy to isothiazolinones epidemic: Current situation
Authors: Magdaleno‐Tapial Jorge , Valenzuela‐Oñate Cristian , Ortiz‐Salvador José M. , García‐Legaz‐Martínez Marta , Martínez‐Domenech Álvaro , Alonso‐Carpio Miriam , Sierra Talamantes Concepción , Zaragoza‐Ninet María G. , Zaragoza‐Ninet Violeta
Published: September 2019

Background

Since 2009, an increasing number of published cases of allergic contact dermatitis (ACD) from isothiazolinones in Europe was observed, amounting to an epidemic. However, only few studies have assessed the current situation after changes in European regulation.

Objectives

To analyze the incidence of isothiazolinone‐related ACD in our area in the last decade.

Methods

A retrospective study analyzed all patients patch tested in the allergy unit in a tertiary hospital in Spain between January 2010 and June 2019. Positive patch‐test reactions to methylchloroisothiazolinone (MCI)/methylisothiazolinone (MI) and/or MI alone were recorded.

Results

A total of 243 patients (9.55%) with positive patch‐test reactions to MCI/MI and/or MI alone among 2544 consecutively patch‐tested patients were recorded. An initial increase in the prevalence of MCI/MI allergy was observed, from 4.5% in 2010 reaching a peak in 2015, which was followed by a significant decrease until July 2019 with 3.1% prevalence in 2019.

Conclusions

As shown in our data, regulatory interventions have resulted in a dramatic decrease in the prevalence of MCI and MI ACD, reaching a pre‐epidemic level of 3.1% in 2019.
Knowing who knows: Metacognitive and causal learning abilities guide infants’ selective social learning
Authors: Kuzyk Olivia , Grossman Shawna , Poulin‐Dubois Diane
Published: September 2019

Given the widespread interest in the development of children's selective social learning, there is mounting evidence suggesting that infants prefer to learn from competent informants (Poulin‐Dubois & Brosseau‐Liard, Current Directions in Psychological Science, 2016, 25). However, little research has been dedicated to understanding how this selectivity develops. The present study investigated whether causal learning and precursor metacognitive abilities govern discriminant learning in a classic word‐learning paradigm. Infants were exposed to a speaker who accurately (reliable condition) or inaccurately (unreliable condition) labeled familiar objects and were subsequently tested on their ability to learn a novel word from the informant. The predictive power of causal learning skills and precursor metacognition (as measured through decision confidence) on infants' word learning was examined across both reliable and unreliable conditions. Results suggest that infants are more inclined to accept an unreliable speaker's testimony on a word learning task when they also lack confidence in their own knowledge on a task measuring their metacognitive ability. Additionally, when uncertain, infants draw on causal learning abilities to better learn the association between a label and a novel toy. This study is the first to shed light on the role of causal learning and precursor metacognitive judgments in infants' abilities to engage in selective trust.
Special care dentistry trainee views on the medical and oral medicine elements of the specialist training curriculum
Authors: Atkin Philip A. , Cunningham Adele , Andrews Laura
Published: September 2019

Introduction

Specialty training curricula are subject to periodic update, and trainee views are an important element in identifying which areas need particular focus. In this study, we wished to examine specialty trainee opinions on two areas of a curriculum for special care dentistry, in particular oral medicine, and the component elements of related systemic disease and therapies (RSDT), namely pathology, pharmacology and therapeutics, and human systemic disease.

Materials and methods

Following ethical approval, we identified 35 specialty registrars in special care dentistry in the UK and Ireland who were invited to use an online survey tool to gather demographic data and then to ask their views on the delivery of training in oral medicine and RSDT. Respondents were also asked whether sufficient importance was placed on these topics and whether they could be accessed and delivered appropriately.

Results

The 23 registrars surveyed comprised a representative group from all parts of the UK and Ireland and were at different stages of specialty training. The majority thought oral medicine and RSDT were key elements of the curriculum and could be given more prominence, especially in the context of an increasingly ageing population with associated oral manifestations of chronic disease, multiple drugs and disabilities.

Discussion and conclusion

The registrars surveyed felt that oral medicine and RSDT and were integral to training and that emphasis and opportunities for training in these areas could be improved, especially for those trainees based outside of a dental hospital setting.
MarCHGen: A framework for generating a malware concept hierarchy
Authors: Nguyen Thien Binh , Tran Cong Doi , Quan Thanh Tho , Nguyen Minh Hai , Le Tuan Anh
Published: September 2019

Automatic classification of virus instances into a concept hierarchy has been attracting much attention from malware research community. However, it is definitely not a trivial work, because malwares usually come in binary forms whose actions are complicated and obfuscated. Therefore, the typical data mining approaches based on feature extraction are not easily applied. In this paper, we tackle this problem by introducing a framework known as MarCHGen (Malware Concept Hierarchy Generation). In this framework, we first apply virus logical concept analysis, which incorporates formal concept analysis with temporal logic to capture malware behaviours and generalize a virus concept lattice accordingly. Second, we propose an on‐the‐fly conceptual clustering technique to generate a malware concept hierarchy. In the MarCHGen framework, the malware concept hierarchy will be monitored by the prelarge data set management technique to avoid reclustering several times unnecessarily. Our approach has been applied in a real data set of virus, and promising experimental results have been acquired.
Long‐term variation in the abundance of Pacific herring (Clupea pallasii) from the Yellow Sea in the western North Pacific and its relation to climate over the past 590 years
Authors: Li Haoyu , Yang Shu , Tang Qisheng , Zhou Xin , Sun Yao
Published: September 2019

A qualitative understanding of the long‐term variation in the population dynamics of Yellow Sea (YS) herring is particularly important for clarifying the evolutionary processes and driving mechanisms of the YS large marine ecosystem. Unfortunately, because of a lack of long‐term, continuous, and simultaneous monitoring data, the specific driving processes and mechanisms of climate effects on the population dynamics of YS herring remain largely unknown. In response to this scientific issue, we preliminarily propose the idea of reconstructing long‐term changes in YS herring abundance over the past 590 years (AD 1417–2004) based on historical documents and attempt to explore the impacts of climate on the population. Our results show that YS herring abundance maintained at a relatively high level from AD 1417 to 1870 (during the Little Ice Age); in contrast, the population declined significantly from AD 1870 to 2004 at different rates. In addition, we also found that there were strong relationships between the population abundance of YS herring and the Pacific decadal oscillation (PDO) and drought/flood cycles. We suggest that the fluctuations in YS herring abundance may be influenced by ocean–climatic circulation shifts throughout the North Pacific, especially the PDO.
Clinical evaluation of bleeds and response to haemostatic treatment in patients with acquired haemophilia: A global expert consensus statement
Authors: Tiede Andreas , Giangrande Paul , Teitel Jerome , Amano Kagehiro , Benson Gary , Nemes László , Jiménez‐Yuste Victor , d'Oiron Roseline , Benchikh El Fegoun Soraya , Kessler Craig M.
Published: September 2019

Background

Acquired haemophilia (AH) is a rare bleeding disorder with significant morbidity and mortality. Most patients initially present to physicians without experience of the disease, delaying diagnosis and potentially worsening outcomes. Existing guidance in AH is limited to clinical opinion of few experts and does not address monitoring bleeds in specific anatomical locations.

Aim

Derive consensus from a large sample of experts around the world in monitoring bleeding patients with AH.

Methods

Using the Delphi methodology, a structured survey, designed to derive consensus on how to monitor bleeding patients with AH, was developed by a steering committee for completion by a group of haematologists with an interest in AH. Consensus was defined as ≥75% agreement with a given survey statement. After three rounds of survey refinement, a final list of consensus statements was compiled.

Results

Thirty‐six global specialists in AH participated. The participants spanned 20 countries and had treated a median of 12.0 (range, 1‐50) patients with AH within the preceding 5 years. Consensus was achieved in all items after three survey rounds. In addition to statements on general management of bleeding patients, consensus statements in the following areas were presented: urinary tract, gastrointestinal tract, muscles, skin, joints, nose, pharynx, mouth, intracranial and postpartum.

Conclusions

Here, we present consensus statements derived from a broad sample of global specialists to address monitoring of location‐specific bleeds and evaluating efficacy of bleeding treatment in patients with AH. These statements could be applied in practice by treating physicians and validated by individual population surveys.
A multicentre, open‐label study of emicizumab given every 2 or 4 weeks in children with severe haemophilia A without inhibitors
Authors: Shima Midori , Nogami Keiji , Nagami Sayaka , Yoshida Seitaro , Yoneyama Koichiro , Ishiguro Akira , Suzuki Takashi , Taki Masashi
Published: September 2019

Introduction

Emicizumab is a recombinant humanized bispecific monoclonal antibody mimicking the cofactor function of activated factor VIII.

Aim

In this multicentre, open‐label study (HOHOEMI), we evaluated the efficacy, safety and pharmacokinetics of emicizumab in Japanese paediatric patients aged <12 years with severe haemophilia A without factor VIII (FVIII) inhibitors.

Methods

Emicizumab was administered subcutaneously, with four loading doses of 3 mg/kg every week followed by maintenance doses of 3 mg/kg every 2 weeks (Q2W) or 6 mg/kg every 4 weeks (Q4W) in 6 and 7 patients, respectively.

Results

All patients completed at least 24 weeks of treatment. Baseline ages ranged from 4 months to 10 years, and all patients had been treated with FVIII prophylaxis prior to enrolment except a 4‐month‐old patient untreated with FVIII previously. In the respective Q2W and Q4W cohorts, 2/6 and 5/7 patients experienced no treated bleeding events, and annualized bleeding rates for treated bleeding events were 1.3 (95% confidence interval [CI], 0.6‐2.9) and 0.7 (95% CI, 0.2‐2.6). All caregivers preferred emicizumab to the patient's previous treatment. Only one related adverse event (injection site reaction) was observed. There were no thromboembolic events or thrombotic microangiopathy. Individual trough plasma concentrations of emicizumab were within the variability observed in preceding adult/adolescent studies. All patients tested negative for anti‐emicizumab antibodies.

Conclusions

Emicizumab administered Q2W or Q4W was efficacious and safe in paediatric patients with severe haemophilia A without inhibitors. This study was registered at http://www.clinicaltrials.jp (JapicCTI‐173710).
Public Attitudes and the Chinese Migrants in Central‐Eastern Europe
Authors: Liu Amy H.
Published: September 2019

The Chinese are one of the largest migrant groups in Central‐Eastern Europe. While governments have welcomed these newcomers, we do not know whether locals share this sentiment. This is because we have not had the requisite data. In this article, I address this shortcoming. I draw on two oft‐cited explanations in the migration literature to examine public attitudes toward the Chinese. The first is about competition over scarce economic resources; the second is about conflicts between two distinct cultures. Using two different survey samples, I find strong evidence to corroborate the second hypothesis. Attitudes toward the Chinese are generally negative when the aggregate Chinese population is large. Public discourse (i.e., passive contact) reinforces cultural stereotypes. There is, however, a caveat: An increasing Chinese presence in a person's neighbourhood (i.e., active contact) can offset these negative effects. As the spatial gap between the two cultures closes, the social ones correspondingly narrow.
Nurse and midwife researcher collaboration in eastern sub‐Saharan Africa: a social network analysis
Authors: Cato K.D. , Sun C. , Dohrn J. , Ferng Y.‐h. , Klopper H.C. , Larson E.
Published: September 2019

Aim

To investigate the collaborative networks among expert clinical nurse and midwifery researchers in eastern and southern Africa.

Methods

Thirty‐eight clinical nurse and midwifery researchers completed an online survey to analyse collaboration between respondents. Data were analysed using social network analysis, generating a network map and associated measurements.

Results

Regional collaboration was poor. Those links that did exist centred on geographic proximity and participation in regional and international organizations.

Conclusion

These results help us to understand better ways to strengthen and support nursing and midwifery clinical research in eastern and southern Africa.

Implications for nursing policy

Clinical nursing and midwifery research capacity building efforts should focus on supporting collaboration networks among individuals and institutions in the region.
Aged garlic extract preserves cutaneous microcirculation in patients with increased risk for cardiovascular diseases: A double‐blinded placebo‐controlled study
Authors: Wlosinska Martine , Nilsson Ann‐Christin , Hlebowicz Joanna , Malmsjö Malin , Fakhro Mohammed , Lindstedt Sandra
Published: September 2019

Laser Doppler velocimetry estimates tissue perfusion providing a record of microvascular blood flow. Patients with heart disease or diabetes mellitus have impaired microvascular perfusion leading to impaired wound healing. Aged garlic extract (AGE) has a positive effect on vascular elasticity. This study aimed to assess the effect of long‐term treatment with AGE on cutaneous tissue perfusion. A total of 122 patients with Framingham Risk Score ≥ 10 were randomised in a double‐blinded manner to placebo or 2400 mg AGE daily for 1 year and monitored. Cutaneous microcirculation was measured at 0 and 12 months using laser Doppler velocimetry. A repeated measures analysis of variance (ANOVA) with a Greenhouse–Geisser correction determined that mean post‐occlusive reactive hyperaemia differed significantly between time points. The mean percent change between the two time points 0 and 12 months was 102, 64 (174, 15)% change for AGE and 78, 62 (107, 92)% change for the placebo group (F[1, 120] = 5. 95, P < 0.016), 12 months of AGE increases the microcirculation in patients with an increased risk for cardiovascular events estimated using the Framingham risk score. Increased microcirculation could hypothetically facilitate wound healing.