Last Chance Before It’s Gone: Last Chance Tourism on Hasankeyf

Last chance tourism also known “doom tourism”, “extinction tourism”, “climate tourism”, “doomsday tourism”, “climate change tourism”, “climate change voyeurism”, “disappearing or vanishing tourism”, “dying tourism”, and “endangered tourism” is an emerging tourism segment for disappearing destinations (Piggott-McKellar and McNamara,2016; Eijgelaar, Thaper and Peeters, 2010; Lemelin, Dawson and Stewart, 2013; Wilson et al., 2014; Lemelin et al., 2010) . Tourists involve in this kind of tourism have a desire to see the places that will soon disappear or to witness disappearing species (Lemelin et al., 2010). Hasankeyf, which is in danger of being submerged in the Ilısu Dam Project’s reservoir lake, has positioned it as a last chance tourism destination. It is one of the places that tourists travel to experience before it is gone. However, there is no empirical evidence has identified that this is actually occurring. This article will explore if tourists are motivated to visit Hasankeyf to see it before it’s gone. Situated on the banks of Tigris River Hasankeyf has been an important settlement through history. It has been home to every major Mesopotamian civilization, and it has witnessed huge transformations over its long life-span, from a Byzantine bishopric to an Arab fortress and an outpost in the Ottoman Empire (Holloway, 2014). Standing as a guard for centuries over the Anatolian Peninsula at the gate of northern Mesopotamia (Perrier, 2008; Stern, 2008), Hasankeyf fulfills 9 out of 10 criteria’s of UNESCO’s natural and cultural evaluation (Kocabaş, 2013), but unfortunately today it faces its greatest threat, one that challenges its very existence. The main issue the authors are addressing in this research is to explore if visitors are motivated to visit Hasankeyf to see it before it’s gone. Both primary and secondary data sources were used to answer research questions. Primary data principally obtained through the questionnaire while as secondary data sources, related past studies were utilized as theoretical background and literature review (Piggott et al., 2016; Kvasova, 2011; Kang & Moscardo, 2006; Miller, Merrilees & Coghla, 2014). The questionnaire was established after a profound analysis of literature review and was newly developed which consisted of three parts. The first set of the questions consisted of sixteen items and were composed to measure visit motivations of Hasankeyf. Twelve questions were composed to measure to what extent the participants were responsible visitors. The third part of the questionnaire consisted of questions related to demographics of participants. All variables were carried out by a five-point Likert scale, ranging from strongly disagree (1) to strongly agree (5). An online questionnaire survey was conducted in June, July and August 2017. Since summer is low season in Hasankeyf, it was very difficult to find on site visitor in the destination. Therefore, an invitation message with the online questionnaire URL was posted on a number of people, who had visited Hasankeyf thus far, through social media tools such as Forums, Facebook, and Twitter. Besides, the online questionnaire was sent to people who had visited Hasankeyf via e-mail. Mailing list was obtained from the tour guides of Hasankeyf region. Sixty questionnaire were evaluated as a pre-test in order to determine whether the questionnaire was understood by the respondents and was reliable. After factor analysis one item from the visit motivations was extracted from the survey. Cronbach Alpha for the first set of questionnaire was determined as 0,828 and 0,904 for the second part of the questionnaire. A total of 302 responses were collected in the research. According to demographic variables; the participants are mostly female with a slight different, mostly aged between 36-45. Most of the participants (57.6%) are single, 28% of those earn between 1500-3000 TL. Majority of respondents (64.2%) have bachelor degree. Most of the respondents came to Hasankeyf with friends. They were asked if they came by tour, individually, business or school trip. Most of them came individually, without accommodation (82%). This is most likely because there are not enough accommodation facilities in Hasankeyf, so most of the people came from the surrounding cities for daily trip. Participants were asked to select how important sixteen motivations influenced them to travel to Hasankeyf. As mentioned above a factor analysis was set to simplify these motivations for comparison. According to factor analysis, they were grouped into three categories; 1-“last chance visit”, 2-“enrichment”, and 3-“non-Hasankeyf-focused”. Enrichment was the top motivation of travel with 3.99 mean value, followed by last chance visit with a slight different of 3.97 mean value. The lowest ranking motivation was non-Hasankeyf-focused dimension with a mean value of 2.57. When comparing mean values of three motivations, it was identified that “last chance visit” was the second motivation with a high level of 3.97. The people who rated “last chance visit” more than 3 points out of 5 Likert scale were considered as “last chance visitor” (LCV). It was found that last chance visitors are almost a fifty-fifty women to men ratio, mostly aged between 18 to 35 (78.5%). Majority of the LCV have bachelor degree or higher (86.2%), were daily visitor (81.2%) and have less than 3000 TL family income (52.5%). 56.3% of LCV were single, mostly came to Hasankeyf individually (74.7%) with friends (88.6%). The researchers checked for normality test, and it was found that data was not normally distributed according to Kolmogorov-Smirnov test result (p0.05. Considering marital status there is statistically significant difference for “Enrichment” and “Non-Hasankeyf Focused” dimensions (p0.05) in terms of marital status. Kruskal-Wallis test shows that there is significant difference between age groups and visit motivations. 18-25 aged visitors have a low level of interest in last chance to experience, but have a high level of motivation like visiting Hasankeyf to spend time with friends and family, adventure, etc. On the contrary, visitors older than 46 have a high level of interest in last chance to experience. Kruskal-Wallis test for education variable reveals that there is no significant difference between education levels and visit motivations. It is also worth noting that visitors who have family income of less than 3000TL have high level of interest in “enrichment” and “non-Hasankeyf-focused” motivations. However, there is no evidence that there is a statistically significant difference between “last chance visit” motivation and income level. The main purpose of this paper is to examine if the visitors are motivated to visit Hasankeyf for last chance experience. Statistical analysis show that there is no statistical significance between “last chance visit” motivation and demographic characteristics. It is also of interest to note that the level of concern about last chance to experience is high regarding the visitors ranking of “last chance visit” motivation. The data revealed that 86.4% of the respondents are considerably motivated to travel to Hasankeyf before it’s flooded under Ilısu Dam reservoir. This research contributes to the limited empirical studies identifying that visitors are motivated by last chance to experience, or visit destinations before they disappear. The last chance tourism phenomenon has been commonly linked to global warming or climate change. This paper is the first to identify that “last chance tourism” is occurring in a destination which is directly being destroyed by human hand because of financial concerns. Further studies needs to be conducted to identify the possible impacts of shareholders in the disappearing destinations

The success of the Cystic Fibrosis Registry of Turkey for improvement of patient care

Background Cystic fibrosis (CF) registries play an essential role in improving disease outcomes of people with CF. This study aimed to evaluate the association of newly established CF registry system in Turkey on follow-up, clinical, growth, treatment, and complications of people with this disease. Methods Age at diagnosis, current age, sex, z-scores of weight, height and body mass index (BMI), neonatal screening results, pulmonary function tests, history of meconium ileus, medications, presence of microorganisms, and follow-up were evaluated and compared to data of people with CF represented in both 2017 and 2019 registry data. Results There were 1170 people with CF in 2017 and 1637 in 2019 CF registry. Eight hundred and fourteen people were registered in both 2017 and 2019 of whom z-scores of heights and BMI were significantly higher in 2019 (p = 0.002, p =0.039, respectively). Inhaled hypertonic saline, bronchodilator, and azithromycin usages were significantly higher in 2019 (p =0.001, p = 0.001, p = 0.003, respectively). The percent predicted of forced expiratory volume in 1 sec and forced vital capacity were similar in 2017 and 2019 (88% and 89.5%, p = 0.248 and 84.5% and 87%, p =0.332, respectively). Liver diseases and osteoporosis were significantly higher, and pseudo-Bartter syndrome (PBS) was significantly lower in 2019 (p = 0.011, p = 0.001, p = 0.001, respectively). Conclusions The z-scores of height and BMI were higher, the use of medications that protect and improve lung functions was higher and incidence of PBS was lower in 2019. It was predicted that registry system increased the care of people with CF regarding their follow-up. The widespread use of national CF registry system across the country may be beneficial for the follow-up of people with CF

The success of the Cystic Fibrosis Registry of Turkey for improvement of patient care

Background Cystic fibrosis (CF) registries play an essential role in improving disease outcomes of people with CF. This study aimed to evaluate the association of newly established CF registry system in Turkey on follow-up, clinical, growth, treatment, and complications of people with this disease. Methods Age at diagnosis, current age, sex, z-scores of weight, height and body mass index (BMI), neonatal screening results, pulmonary function tests, history of meconium ileus, medications, presence of microorganisms, and follow-up were evaluated and compared to data of people with CF represented in both 2017 and 2019 registry data. Results There were 1170 people with CF in 2017 and 1637 in 2019 CF registry. Eight hundred and fourteen people were registered in both 2017 and 2019 of whom z-scores of heights and BMI were significantly higher in 2019 (p = 0.002, p =0.039, respectively). Inhaled hypertonic saline, bronchodilator, and azithromycin usages were significantly higher in 2019 (p =0.001, p = 0.001, p = 0.003, respectively). The percent predicted of forced expiratory volume in 1 sec and forced vital capacity were similar in 2017 and 2019 (88% and 89.5%, p = 0.248 and 84.5% and 87%, p =0.332, respectively). Liver diseases and osteoporosis were significantly higher, and pseudo-Bartter syndrome (PBS) was significantly lower in 2019 (p = 0.011, p = 0.001, p = 0.001, respectively). Conclusions The z-scores of height and BMI were higher, the use of medications that protect and improve lung functions was higher and incidence of PBS was lower in 2019. It was predicted that registry system increased the care of people with CF regarding their follow-up. The widespread use of national CF registry system across the country may be beneficial for the follow-up of people with CF