Destination Online Communication: Why Less is Sometimes More. A Study of Online Communications of English Destinations

This research investigates the relationship between Web site design and the Web site end-user experience of a vast number of English tourism destinations, both local and regional ones. Following recent research in the field, this paper evaluates destinations' online communication based on the implemented Web site features and on the effectiveness of the communication itself, borrowing its research methodology from different domains. After content and functionality analysis, a user-experience, scenario-based investigation has been carried out, which demonstrated that complex Web sites do not always serve end-users' needs properly; in other words, Web site complexity is not directly related with good user experience. This research may help destination managers to foster their online communication if they have fewer content and functionalities but are better focused and clearly user-oriented. © 2014 Taylor & Francis

The representation of voluntourism in search engines: The case of South Africa

© 2015, © 2015 Government Technical Advisory Centre (GTAC). This paper responds to the paucity of research on the linkages between voluntourism and digital technology and seeks to understand the online representation of the phenomenon in a developing context. In particular, the researchers investigate the so-called ‘online domain’ of voluntourism in South Africa. The researchers collected a series of web results from search engines and analysed the presence of traditional and social media websites, the most relevant presented topics, and the type of argumentation found. Results identify the context and representation of voluntourism as it transpires virtually. This will contribute to the understanding of the interplay between voluntourism and digital technology, with specific emphasis on web presence. Ultimately, results will shed light on how digitally accessible voluntourism is in South Africa and will set the basis for future investigations

Cohexisting Medullary and Papillary Thyroid Cancer

Purpose: Papillary thyroid carcinomas (PTCs) and medullary thyroid carcinomas (MTCs) have always been considered different in terms of their incidence rates, cell origins, and histopathological features. Simultaneous occurrence of both disease entities is very rare. Methods: We describe a series of cases with simultaneous MTC and PTC occurrences in the thyroid gland. Results: From 2,897 patients (mean age, 49.2±12.5; 81% women) who underwent thyroidectomy for cancer between 2000 and 2015, we reviewed 11 cases of simultaneous occurrence of MTCs and PTCs. Multifocal PTC with simultaneous MTC was detected in 5 of the 11 cases (45%). Of these PTC patients, 2 had 2 foci, 2 had 3 foci, and 1 had 4 foci. There was 1 case of multifocal MTC with solitary PTC. One patient presented with “composite thyroid carcinoma” with mixed features of MTCs and PTCs. Eight patients (72%) presented an association with diffuse lymphocytic thyroiditis. The sizes of the tumors were 1.95±0.23 cm vs. 1.20±0.20 cm for PTCs and MTCs, respectively (P=0.531). The prevalence of extrathyroidal extension was 33.1% vs. 30.2% for PTCs and MTCs, respectively (P=0.282). All patients underwent total thyroidectomy and central neck node dissection. Radio iodine was delivered to 44% of patients. Follow-up review revealed 9 disease-free patients and 1 with local neck recurrence, while 1 patient died due to non-thyroid reasons. Conclusion: There are only 30 reports describing a total of 50 cases in the English literature regarding concurrent PTC and MTC in the same gland. This study represents one of the largest case series. Whether the incidence of another cancer in these patients is coincidental, or due to the possible activation of a common tumorigenic pathway for both follicular and parafollicular thyroid cells, remains to be elucidated

Consumer behaviour in tourism: Concepts, influences and opportunities

Although consumer behaviour (CB) is one of the most researched areas in the field of tourism, few extensive reviews of the body of knowledge in this area exist. This review article examines what we argue are the key concepts, external influences and opportune research contexts in contemporary tourism CB research. Using a narrative review, we examine the CB literature published in three major tourism journals from 2000 to 2012. Of 519 articles identified and reviewed, 191 are included in this article. We examine the development of and scope for future research on nine key concepts, including decision-making, values, motivations, self-concept and personality, expectations, attitudes, perceptions, satisfaction, trust and loyalty. We then examine three important external influences on tourism behaviour, technology, Generation Y and the rise in concern over ethical consumption. Finally, we identify and discuss five research contexts that represent major areas for future scholarship: group and joint decision-making, under-researched segments, cross-cultural issues in emerging markets, emotions and consumer misbehaviour. Our examination of key research gaps is concluded by arguing that the hedonic and affective aspects of CB research in tourism must be brought to bear on the wider CB and marketing literature

Impact of lymph node ratio on survival of colorectal cancer patients

Background and Purpose: This study analyzed the prognostic significance of the staging system based on the metastatic Node Ratio (NR) compared with the TNM staging system in patients with colorectal cancer. Methods: We reviewed the data of 444 patients who underwent colorectal resection for cancer between January 2005 and December 2011. NR categories NR0 (0%), NR1 (1-19%) and NR2 (≥20%) were determined by the best cut-off approach at log-rank test. To compare the prognostic power of the NR versus pN, we plotted these different factors against the mortality estimates. Additionally, we evaluated the relationship between these variables and the extent of lymphadenectomy. Results: Both the NR and the pN classification significantly stratified patient outcomes (p < 0.0001), but the NR system seems to better discriminate prognostic subgroups than the pN. Furthermore, NR is less dependent on the extent of lymphadenectomy than pN. Conclusions: NR is a simple and reliable tool to stratify survival of colorectal cancer patients and it seems to have a higher prognostic power than the current pN system, because it is less dependent on the extent of lymphadenectomy

Google Glass Augmented Reality: Generic Learning Outcomes for Art Galleries

Art galleries are increasingly asked to provide evidence of their efforts towards facilitating visitors’ learning experience. Augmented reality (AR) and wearable computing has the potential to create a realistic learning environment. Using Google Glass allows art gallery visitors to receive augmented information while looking at paintings. The Generic Learning Outcomes (GLO) framework was specifically designed to investigate visitors’ learning experience in museums and art galleries however, research on art galleries visitors’ learning experience through wearable computing and AR applications is scarce. This study aims to assess how Google Glass enhances visitors’ learning outcomes within the art gallery environment. Twenty-two visitors participated in a test of the Google Glass Museum Zoom application. Visitors were interviewed and the data were analysed using thematic analysis and revealed that Google Glass helps visitors to see connections and enhance the knowledge and understanding of paintings

Peri-operative blood transfusion in gastric cancer surgery : prognostic or confounding factor?

Background and Purpose: The relationship between peri-operative blood transfusions (PBTs) and poor prognosis in gastric cancer (GC) patients is still debated. The aim of this study is to examine the real prognostic impact of PBTs in comparison to well-known prognostic factors. Methods: We retrospectively analyzed a series of 224 patients who underwent surgery with curative intent for GC from January 1995 to December 2011. Among 224 patients, 46 (20%) required PBTs. Results: The overall 5-year survival was 77% in non-transfused patients and 65% in patients who received PBTs (p = 0.03). PBTs did not further stratify any recognized prognostic category (such as pT or pN according to the 7th edition of the TNM staging system). Multivariate analysis including all known prognostic variables (both cancer- and non-cancer-related) did not select PBTs as an independent prognostic factor. Only preoperative hemoglobin and albumin level, pT and operative time were significantly associated with the requirement for PBTs. Conclusions: The study showed a worse prognosis for transfused patients, but PBTs seem a confounding factor more than a prognostic indicator, as they are obviously affected by other variables

Understanding the impact of ChatGPT on tourism and hospitality: Trends, prospects and research agenda

The prevalence of ChatGPT (and generative artificial intelligence in general) has precipitated a paradigm shift in diverse industries, including tourism and hospitality. ChatGPT revolutionalises all business functions (from marketing to operations), empowering tourism and hospitality organisations to transform and innovate their business models. This study seeks to comprehensively examine the use and implications of ChatGPT in tourism and hospitality by discussing the current and future state of the technology, while also suggesting an agenda for future research. To that end, six areas, namely, business intelligence and tourism analytics, tourism marketing and experience, hospitality services, cultural and heritage tourism, travel services, and destination management, are elaborated on in depth. By compiling views solicited from international experts, this groundbreaking opinion piece unveils profound insights into the evolutionary journey of an emerging technology that is shaping tourism and hospitality. The paper provides useful implications for tourism scholars and professionals alike

Association between multimorbidity and postoperative mortality in patients undergoing major surgery: a prospective study in 29 countries across Europe

BackgroundMultimorbidity poses a global challenge to healthcare delivery. This study aimed to describe the prevalence of multimorbidity, common disease combinations and outcomes in a contemporary cohort of patients undergoing major abdominal surgery.MethodsThis was a pre-planned analysis of a prospective, multicentre, international study investigating cardiovascular complications after major abdominal surgery conducted in 446 hospitals in 29 countries across Europe. The primary outcome was 30-day postoperative mortality. The secondary outcome measure was the incidence of complications within 30 days of surgery.ResultsOf 24,227 patients, 7006 (28.9%) had one long-term condition and 10,486 (43.9%) had multimorbidity (two or more long-term health conditions). The most common conditions were primary cancer (39.6%); hypertension (37.9%); chronic kidney disease (17.4%); and diabetes (15.4%). Patients with multimorbidity had a higher incidence of frailty compared with patients <= 1 long-term health condition. Mortality was higher in patients with one long-term health condition (adjusted odds ratio 1.93 (95%CI 1.16-3.23)) and multimorbidity (adjusted odds ratio 2.22 (95%CI 1.35-3.64)). Frailty and ASA physical status 3-5 mediated an estimated 31.7% of the 30-day mortality in patients with one long-term health condition (adjusted odds ratio 1.30 (95%CI 1.12-1.51)) and an estimated 36.9% of the 30-day mortality in patients with multimorbidity (adjusted odds ratio 1.61 (95%CI 1.36-1.91)). There was no improvement in 30-day mortality in patients with multimorbidity who received pre-operative medical assessment.ConclusionsMultimorbidity is common and outcomes are poor among surgical patients across Europe. Addressing multimorbidity in elective and emergency patients requires innovative strategies to account for frailty and disease control. The development of such strategies, that integrate care targeting whole surgical pathways to strengthen current systems, is urgently needed for multimorbid patients. Interventional trials are warranted to determine the effectiveness of targeted management for surgical patients with multimorbidity