An evaluation of power relationships among stakeholders in the tourism industry networks of Agra, India

Tourism-related businesses require a multitude of resources in order to operate successfully and given these resources can be accrued from more than one source, bases of power become complex. This is an inductive study which critically evaluates the application of stakeholder theory to an analysis of the tourism destination networks of Agra, India. It examines the relationships of power and dependency that exist between individual and group organisations and the way in which they motivate their behaviour towards each other. The key findings show that resource-based power is formed from the power of individual businesses, the power of the ancillary services stakeholders and the power of the authorities and that network-based power is acquired from the power of agents and the power of groups. © 2014 © 2014 Taylor & Francis

THE DETERMINANTS OF FOOD STAMP PROGRAM PARTICIPATION

Food Security and Poverty,

Facilitating meaningfulness in the workplace:a field intervention study

This article presents the findings of a field intervention study that sought to address two objectives: (a) what are the psychological effects of a meaningfulness intervention? and (b) what key issues should be considered when developing meaningfulness interventions? Eighty employees from three different organizations based in the UK were allocated to either the intervention condition or a wait-list control group. Compared against the wait-list control group, the meaningfulness intervention facilitated meaningfulness in/at work, job/organization engagement, and personal initiative. Finally, focus group interviews revealed a number of micro (e.g., sustaining motivation), meso (e.g., role of line managers) and macro (e.g., socio-political events) level issues that should be considered when planning and implementing meaningfulness interventions. Overall this study makes use of field intervention research in order to develop the rationale for incorporating meaningfulness theories and concepts within HRM practice, particularly in better aligning personal development, team-based learning and performance management activities

Development of a machine learning algorithm to predict the residual cognitive reserve index

Elucidating the mechanisms by which late-life neurodegeneration causes cognitive decline requires understanding why some individuals are more resilient than others to the effects of brain change on cognition (cognitive reserve). Currently, there is no way of measuring cognitive reserve that is valid (e.g. capable of moderating brain-cognition associations), widely accessible (e.g. does not require neuroimaging and large sample sizes), and able to provide insight into resilience-promoting mechanisms. To address these limitations, this study sought to determine whether a machine learning approach to combining standard clinical variables could (i) predict a residual-based cognitive reserve criterion standard and (ii) prospectively moderate brain-cognition associations. In a training sample combining data from the University of California (UC) Davis and the Alzheimer's Disease Neuroimaging Initiative-2 (ADNI-2) cohort (N = 1665), we operationalized cognitive reserve using an MRI-based residual approach. An eXtreme Gradient Boosting machine learning algorithm was trained to predict this residual reserve index (RRI) using three models: Minimal (basic clinical data, such as age, education, anthropometrics, and blood pressure), Extended (Minimal model plus cognitive screening, word reading, and depression measures), and Full [Extended model plus Clinical Dementia Rating (CDR) and Everyday Cognition (ECog) scale]. External validation was performed in an independent sample of ADNI 1/3/GO participants (N = 1640), which examined whether the effects of brain change on cognitive change were moderated by the machine learning models' cognitive reserve estimates. The three machine learning models differed in their accuracy and validity. The Minimal model did not correlate strongly with the criterion standard (r = 0.23) and did not moderate the effects of brain change on cognitive change. In contrast, the Extended and Full models were modestly correlated with the criterion standard (r = 0.49 and 0.54, respectively) and prospectively moderated longitudinal brain-cognition associations, outperforming other cognitive reserve proxies (education, word reading). The primary difference between the Minimal model-which did not perform well as a measure of cognitive reserve-and the Extended and Full models-which demonstrated good accuracy and validity-is the lack of cognitive performance and informant-report data in the Minimal model. This suggests that basic clinical variables like anthropometrics, vital signs, and demographics are not sufficient for estimating cognitive reserve. Rather, the most accurate and valid estimates of cognitive reserve were obtained when cognitive performance data-ideally augmented by informant-reported functioning-was used. These results indicate that a dynamic and accessible proxy for cognitive reserve can be generated for individuals without neuroimaging data and gives some insight into factors that may promote resilience

An occupational therapy intervention for residents with stroke related disabilities in UK care homes (OTCH): cluster randomised controlled trial

Objective To evaluate the clinical efficacy of an established programme of occupational therapy in maintaining functional activity and reducing further health risks from inactivity in care home residents living with stroke sequelae. Design Pragmatic, parallel group, cluster randomised controlled trial. Setting 228 care homes (>10 beds each), both with and without the provision of nursing care, local to 11 trial administrative centres across the United Kingdom. Participants 1042 care home residents with a history of stroke or transient ischaemic attack, including those with language and cognitive impairments, not receiving end of life care. 114 homes (n=568 residents, 64% from homes providing nursing care) were allocated to the intervention arm and 114 homes (n=474 residents, 65% from homes providing nursing care) to standard care (control arm). Participating care homes were randomised between May 2010 and March 2012. Intervention Targeted three month programme of occupational therapy, delivered by qualified occupational therapists and assistants, involving patient centred goal setting, education of care home staff, and adaptations to the environment. Main outcome measures Primary outcome at the participant level: scores on the Barthel index of activities of daily living at three months post-randomisation. Secondary outcome measures at the participant level: Barthel index scores at six and 12 months post-randomisation, and scores on the Rivermead mobility index, geriatric depression scale-15, and EuroQol EQ-5D-3L questionnaire, at all time points. Results 64% of the participants were women and 93% were white, with a mean age of 82.9 years. Baseline characteristics were similar between groups for all measures, personal characteristics, and diagnostic tests. Overall, 2538 occupational therapy visits were made to 498 participants in the intervention arm (mean 5.1 visits per participant). No adverse events attributable to the intervention were recorded. 162 (11%) died before the primary outcome time point, and 313 (30%) died over the 12 months of the trial. The primary outcome measure did not differ significantly between the treatment arms. The adjusted mean difference in Barthel index score at three months was 0.19 points higher in the intervention arm (95% confidence interval −0.33 to 0.70, P=0.48). Secondary outcome measures also showed no significant differences at all time points. Conclusions This large phase III study provided no evidence of benefit for the provision of a routine occupational therapy service, including staff training, for care home residents living with stroke related disabilities. The established three month individualised course of occupational therapy targeting stroke related disabilities did not have an impact on measures of functional activity, mobility, mood, or health related quality of life, at all observational time points. Providing and targeting ameliorative care in this clinically complex population requires alternative strategies

Catastrophic musculoskeletal injuries in Thoroughbred racehorses on racetracks in Gauteng, South Africa

The incidence and types of catastrophic musculoskeletal injuries in Thoroughbreds that resulted in euthanasia on selected racetracks in South Africa between 1998 and 2012 were investigated by an observational retrospective investigation. Data from the National Horseracing Authority of Southern Africa for these racetracks were used to calculate incidence rates in Thoroughbreds (n = 114) that sustained catastrophic musculoskeletal injuries during racing that required immediate euthanasia, based on the diagnosis made by the on-site veterinarian as well as on fetlock radiographs and dissections of 53 cadaver limbs of horses that sustained a catastrophic musculoskeletal injury. The proximal sesamoid bones and the distal suspensory ligament were involved in 55.26% of horses; 73.58% of the cadaver limb radiographs were of the left forelimb, 64.15% were closed fractures, and 74.47% had biaxial proximal sesamoid bone fractures. Catastrophic musculoskeletal injuries occurred almost exclusively unilaterally and involved mostly the left front leg. The average incidence rate for a catastrophic musculoskeletal injury occurring in a year at any of the tracks was 0.6 of 1000 starts

Catastrophic musculoskeletal injuries in thoroughbred racehorses on racetracks in Gauteng- South Africa

The incidence and types of catastrophic musculoskeletal injuries in Thoroughbreds that resulted in euthanasia on selected racetracks in South Africa between 1998 and 2012 were investigated by an observational retrospective investigation. Data from the National Horseracing Authority of Southern Africa for these racetracks were used to calculate incidence rates in Thoroughbreds (n = 114) that sustained catastrophic musculoskeletal injuries during racing that required immediate euthanasia, based on the diagnosis made by the on-site veterinarian as well as on fetlock radiographs and dissections of 53 cadaver limbs of horses that sustained a catastrophic musculoskeletal injury. The proximal sesamoid bones and the distal suspensory ligament were involved in 55.26% of horses; 73.58% of the cadaver limb radiographs were of the left forelimb, 64.15% were closed fractures, and 74.47% had biaxial proximal sesamoid bone fractures. Catastrophic musculoskeletal injuries occurred almost exclusively unilaterally and involved mostly the left front leg. The average incidence rate for a catastrophic musculoskeletal injury occurring in a year at any of the tracks was 0.6 of 1000 starts.The South African Veterinary Foundation and the University of Pretoria’s Research Committee.http://www.jsava.co.zaam2019Companion Animal Clinical StudiesStatistic