THE IMPACT OF RELIGIOUS TOURISTS’ SATISFACTION WITH HAJJ SERVICES ON THEIR EXPERIENCE AT THE SACRED PLACES IN SAUDI ARABIA

To identify the impact of satisfaction with the provided services (food quality, transportation, accommodation, medical services and the religious guidance) on the spiritual experience of religious tourists, as well as the potential moderating role of pilgrims’ demographic characteristics on the relationship between service satisfaction and experience. A structured survey was distributed among the domestic pilgrims in Mecca, Saudi Arabia who performed Hajj under the control of three licensed agencies. Results showed that the satisfaction with transportation services and religious guidance were independent antecedent predictors of the spiritual experience. Furthermore, pilgrims’ age had significantly moderated the relationship between satisfaction with medical services and experience. National authorities can effectively improve the spiritual experience by providing comfortable means of transportation and reliable religious scholars to guide the pilgrims at different sacred destinations

THE POWER OF INTEGRATION TOWARDS SUSTAINABLE PERFORMANCE: A MODEL TO MINIMIZE TECHNOSTRESS AMONG FRONTLINE RESTAURANT EMPLOYEES BY COMBINING JOB AND EMPLOYEE RESOURCES

To develop a model that integrates restaurant and employee resources to overcome technostress and achieve sustainable performance. This qualitative study is based on twenty-two semi-structured interviews with restaurant managers and frontline employees (FLEs) to comprehensively understand how restaurant resources and personnel can be employed to combat technostress and achieve sustainable performance. Restaurant FLEs experience technostress from multiple sources, including unclear work-life boundaries, complex new systems, job insecurity, and the frequent use of new technologies. In addition, restaurant managers and FLEs concur that integrating restaurant and FLE resources is an effective model for reducing technostress and achieving FLEs' sustainable performance. The study expands the JD-R model to address the challenges faced by FLEs in managing technology-induced job demands, offering a comprehensive solution that benefits restaurants and employees. This approach considers the role of both employers and employees in managing technostress, leading to a supportive work environment and improved sustainable performance

LOCUS OF CONTROL THEORY IN TREATING TOURIST BEHAVIOR: THE THEORY ROOTS AND RESEARCH DIRECTION IN DESTINATION BRANDING FIELD

We aim to shed light on this issue by reviewing the roots and development of the locus of control theory. Moreover, we will introduce how we can use this development, in theory, to provide a new research direction in the tourism service field. A theory-based review was conducted to investigate the locus of control theory roots and its potential implications in the tourism industry using the Australian Business Deans Council (ABDC) list to explore the current literature. We followed the PRISMA methodology to collect the data from the Scopus database as well as Google Scholar and ResearchGate. The study found that the locus of control theory has its roots in social psychology and has been developed over the years to explain individual differences in behavior and decision-making. In the tourism service field, we found that understanding the locus of control can help service providers tailor their services to meet the needs and expectations of different types of tourists. This will contribute to attribution literature in psychological aspects and tourism literature with a deep understanding of how tourists behave and interpret differently

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Impact of Service Quality of Low-Cost Carriers on Airline Image and Consumers&rsquo; Satisfaction and Loyalty during the COVID-19 Outbreak

Low-cost carriers (LCCs) in Saudi Arabia operate in a competitive, highly demanding environment. Customer-related attributes may be influenced by the levels of service quality in a no-frills airline, which might impact satisfaction and loyalty. Given the unique traveler and market characteristics of the aviation sector in the kingdom, we sought to investigate the impact of service quality of LCCs on customer satisfaction and loyalty and the perceived airline image. A total of 299 passengers at two international airports were approached using a modified SERVQUAL scale. Results revealed that service quality was a significant predictor of customer satisfaction (&beta; = 0.46, p &lt; 0.0001), airline image (&beta; = 0.55, p &lt; 0.0001), and customer loyalty (&beta; = 0.16, p = 0.006). The responsiveness dimension was the most important dimension of service quality, since it predicted all other constructs (satisfaction, loyalty, and brand image). Airline tangibles and reliability were independently associated with brand image and loyalty, respectively. Based on these results, LCCs should tailor future strategic plans that rely heavily on improving different service quality measures, particularly the responsiveness domain

The Importance of Safety and Security Measures at Sharm El Sheikh Airport and Their Impact on Travel Decisions after Restarting Aviation during the COVID-19 Outbreak

Travel decisions during the COVID-19 pandemic might be substantially influenced by destination-based attributes, in particular, health safety measures at airports. In the current study, we aimed to assess the effects of the perceived importance of safety measures at the Sharm El Sheikh airport on the intention of international passengers to revisit the destination, which might reflect their behavioral control for traveling to other tourism destinations. A total of 954 international travelers were asked to fill out a survey to reveal their travel risk perceptions, the importance of airport safety measures, and their future intentions to revisit the destination, and the data were integrated in an SEM model. The results showed that passengers with low-risk perceptions and highly perceived importance of logistic and sanitization procedures, as well as traveler- and staff-related safety measures, were more likely to exhibit greater intentions to revisit the city and lower intentions to cancel or change future travel plans to other touristic regions. Health safety at airports should be stressed in future strategic plans by governmental authorities and stakeholder activities to mitigate the psychological barriers of tourists

The Impact of Eatmarna Application Usability on Improving Performance Expectancy, Facilitating the Practice of Rituals and Improving Spirituality Feelings during Umrah Amid the COVID-19 Outbreak

The electronic tourism era has rapidly emerged during the explosive spread of the COVID-19 pandemic worldwide. The role of information technology was also evident in the religious tourism sector, and this facilitated the organization of religious events for Muslims, such as Hajj and Umrah. In the present study, we assessed the usability of a mobile application (Eatmarna) which provides permits to perform Umrah and other religious practices in Makkah and Madina in Saudi Arabia. We sought also to assess the impact of usability on the app effectiveness in improving Umrah experience. Pilgrims were asked to fill out an electronic survey distributed by the coordinators of Umrah service providers. Results showed that the perceived effectiveness was predicted by two domains of usability, namely system information arrangement (&beta; = 0.27, 95% CI, 0.09 to 0.46, p = 0.004) and app usefulness (&beta; = 0.52, 95% CI, 0.34 to 0.69, p &lt; 0.0001). Both the usability domains were independently associated with all the subdomains of app effectiveness, including performance expectancy, facilitating the practice of rituals, and feelings of spirituality. The Eatmarna application was effective in providing a safe environment for pilgrims, which was accounted for by the app usability, and this facilitated the improvement of Umrah experience. National authorities can further integrate additional services in the app to improve pilgrims&rsquo; perceptions

Impact of Rural Tourism Development on Residents&rsquo; Satisfaction with the Local Environment, Socio-Economy and Quality of Life in Al-Ahsa Region, Saudi Arabia

Tourism has a significant role in destination development, particularly in rural regions. However, within the context of the highly sensitive nature of rural areas to the ecological, economic, and socio-cultural effects of tourism development, it is important to assess the levels of satisfaction among the residents of rural destinations. The current study aimed to assess the impact of rural tourism development in the Al-Ahsa region, Saudi Arabia on the overall resident satisfaction and three relevant subdomains. The findings revealed that the three tourism development impacts under investigation, including the social, economic and environmental effects, were positively associated with resident overall satisfaction. The three influential developmental categories were also independent predictors of the satisfaction with the quality of life and environment subdomains. National policy makers are required to implement adequate rural tourism development measures and regulations to improve tourism services and activities, which would eventually be reflected in the quality of life of local residents

Religious Tourists’ Satisfaction with Services and Their Impacts on Spirituality in the Post-COVID-19 Era

Islamic pilgrimage has social, political, and economic benefits, but there are major challenges in the management of large numbers of groups at one time. This spiritually healing journey is likely to be influenced by the overall experience and the quality of logistical services provided while performing the rituals. In the postpandemic period, challenges were more apparent in preventing the spread of infection while maintaining acceptable levels of spiritual atmosphere. Pilgrims’ characteristics might mediate or moderate the changes in spirituality based on individuals’ satisfaction with service quality. In the current study, we investigated the potential service quality predictors of spiritual satisfaction among Muslim pilgrims and investigated the potential mediators and/or moderators of such relationships. The results showed that higher spirituality satisfaction scores were independently associated with enhanced satisfaction with medical services, religious guidance, and the overall Hajj experience. These relationships were not mediated by any demographic characteristics. The Hajj experience significantly moderated the relationship between satisfaction with religious guidance and spirituality. It is recommended that the national authorities should ensure the highest levels of spiritual satisfaction via improving medical and guidance services to achieve the spiritual healing of pilgrims