Asia–Pacific tourism futures emerging from COVID-19 recovery responses and implications for sustainability

Purpose – The purpose of this paper is to provide contrasting narratives of what the future of Asia Pacific tourism may look like, and to identify how current policy interventions and recommendations made for coronavirus disease 2019 (COVID-19) recovery shape the system's trajectory. Design/methodology/approach – Drawing on a set of four possible futures emerging from COVID-19, tourism policy responses are analysed and a link to their potential contribution to the Sustainable Development Goals is made. Findings – A system goal is presented for each scenario, and what this means for the tourism system. Existing policies indicate that tourism is moving towards a “Discipline” future, although evidence for all four trajectories could be identified. Whilst the “Transform” scenario is most aligned with a sustainable future, the findings highlight that sustainability outcomes are possible in the other scenarios as well, if risks are managed adequately. Research limitations/implications – The limitation is that the core structure of the four futures was not specifically developed for tourism. However, given that tourism is firmly embedded in national and global economies, this limitation is not material. Practical implications – This paper supports decision-makers to develop adaptability in the face of great uncertainty and complexity. Risks and opportunities associated with each of the four tourism futures are identified, and examples are provided how sustainability outcomes can be maximised in each. Social implications – Sustainability is a safe and necessary strategy regardless of the trajectory to any of the four scenarios. The long-term health of the tourism system and anyone involved in it depends on significant progress along the Sustainable Development Goals. Originality/value – This paper explores pathways for system change and how different COVID-19 policy approaches contribute to shaping the system's trajectory. It highlights the risks associated with certain trajectories, and also identifies how short-term recovery priorities might undermine long-term sustainability

Newly Digitized Database Reveals the Lives and Families of Forced Migrants from Finnish Karelia

Studies on displaced persons often suffer from a lack of data on the long-term effects of forced migration. A register created during 1960s and published as a book series ‘Siirtokarjalaisten tie’ in 1970 documented the lives of individuals who fled the southern Karelian district of Finland after its first and second occupation by the Soviet Union in 1940 and 1944. To realize the potential value of these data for scientific research, we have recently scanned the register using optical character recognition (OCR) software, and developed proprietary computer code to extract these data. Here we outline the steps involved in the digitization process, and present an overview of the Migration Karelia (MiKARELIA) database now available to researchers. The digitized register contains over 160000 adults and a wide range of data on births, marriages, occupations and movements of these forced migrants, likely to be of interest to researchers across disciplines including demographers, anthropologists, evolutionary biologists, historians, economists and sociologists.Peer reviewe

Newly Digitized Database Reveals the Lives and Families of Forced Migrants from Finnish Karelia

Studies on displaced persons often suffer from a lack of data on the long-term effects of forced migration. A register created during 1960s and published as a book series ‘Siirtokarjalaisten tie’ in 1970 documented the lives of individuals who fled the southern Karelian district of Finland after its first and second occupation by the Soviet Union in 1940 and 1944. To realize the potential value of these data for scientific research, we have recently scanned the register using optical character recognition (OCR) software, and developed proprietary computer code to extract these data. Here we outline the steps involved in the digitization process, and present an overview of the Migration Karelia (MiKARELIA) database now available to researchers. The digitized register contains over 160000 adults and a wide range of data on births, marriages, occupations and movements of these forced migrants, likely to be of interest to researchers across disciplines including demographers, anthropologists, evolutionary biologists, historians, economists and sociologists.</p

Beyond the air-conditioned boardroom: Bridging western and Fijian Indigenous knowledge in tourism research

The COVID-19 outbreak and increasing natural disasters have intensified concerns about effective water, sanitation and hygiene (WASH) practices in Fiji’s tourism sector. Whilst Indigenous values and customs are recognised in tourism development, socially inclusive WASH research in the sector has inadequately addressed Indigenous cultural nuances, especially in Pacific communities. Drawing from the Fijian Vanua Research Framework (FVRF), a Pacific research methodology that incorporates Fijian values, relationship protocols, and ways of knowing, this research designed a culturally-sensitive and socially-inclusive methodology to respect traditional Fijian protocols, and examine hotel staff and host communities’ WASH practices. The research identified differential access to, and gaps in, the provision of WASH, and provided guidelines for future change. This paper presents the challenges of, and the lessons learnt from, the application of the methodology to field research. The methodology provided invaluable intellectual detail, resulting in the development of contextually appropriate recommendations and tools, and strengthening long-term working relationships

Using Q method to investigate the influence of inclusive water, sanitation and hygiene (WASH) on tourists’ hotel choice in Fiji

Consequent to the COVID-19 pandemic and the reopening of international borders, tourists are increasingly concerned about sanitation and hygiene practices in tourism destinations. There is an evident need to investigate how the COVID-19 pandemic has transformed tourist choices. This paper investigates the perceptions of hotel staff and tourists on the influence of inclusive water, sanitation, and hygiene (WASH) practices on tourists’ hotel choices in Fiji. This study explores the value of Q-methodology through a case study of Fiji with data collected from 80 hotel staff and 75 tourists. The findings demonstrate that Q-methodology is effective in identifying three tourist types who have a strong interest in WASH impacts and aspects of their safety including concerns about how their visit impacts the local community and environment. Similarly, the Q method was useful in identifying four perspectives of staff understanding on WASH impacts that are significant to tourists’ choice of hotel. The findings suggest a significant potential for hotel operators to enact socially inclusive WASH practices to enhance their appeal in the ‘new normal'

Genetic variants in novel pathways influence blood pressure and cardiovascular disease risk.

Blood pressure is a heritable trait influenced by several biological pathways and responsive to environmental stimuli. Over one billion people worldwide have hypertension (≥140 mm Hg systolic blood pressure or  ≥90 mm Hg diastolic blood pressure). Even small increments in blood pressure are associated with an increased risk of cardiovascular events. This genome-wide association study of systolic and diastolic blood pressure, which used a multi-stage design in 200,000 individuals of European descent, identified sixteen novel loci: six of these loci contain genes previously known or suspected to regulate blood pressure (GUCY1A3-GUCY1B3, NPR3-C5orf23, ADM, FURIN-FES, GOSR2, GNAS-EDN3); the other ten provide new clues to blood pressure physiology. A genetic risk score based on 29 genome-wide significant variants was associated with hypertension, left ventricular wall thickness, stroke and coronary artery disease, but not kidney disease or kidney function. We also observed associations with blood pressure in East Asian, South Asian and African ancestry individuals. Our findings provide new insights into the genetics and biology of blood pressure, and suggest potential novel therapeutic pathways for cardiovascular disease prevention

Genetic associations at 53 loci highlight cell types and biological pathways relevant for kidney function.

Reduced glomerular filtration rate defines chronic kidney disease and is associated with cardiovascular and all-cause mortality. We conducted a meta-analysis of genome-wide association studies for estimated glomerular filtration rate (eGFR), combining data across 133,413 individuals with replication in up to 42,166 individuals. We identify 24 new and confirm 29 previously identified loci. Of these 53 loci, 19 associate with eGFR among individuals with diabetes. Using bioinformatics, we show that identified genes at eGFR loci are enriched for expression in kidney tissues and in pathways relevant for kidney development and transmembrane transporter activity, kidney structure, and regulation of glucose metabolism. Chromatin state mapping and DNase I hypersensitivity analyses across adult tissues demonstrate preferential mapping of associated variants to regulatory regions in kidney but not extra-renal tissues. These findings suggest that genetic determinants of eGFR are mediated largely through direct effects within the kidney and highlight important cell types and biological pathways

Rh Incompatibility in Early Medical Abortion, a Misoprostol Case Report

Introduction: The Rhesus factor is an erythrocyte surface antigen which is inherited separately from the AB0 system. The trait Rh+ refers to the presence of the surface antigen whereas Rh- implies its absence.Rhesus incompatibility occurs when an Rh- mother is pregnant with an Rh+ child, leading to formation of Rhesus antibodies in the maternal blood. In 90% of the cases, sensitization occurs during delivery, thus leading to a future second incompatible pregnancy. Other reasons for fetomaternal blood transfusion are trauma, abortion, miscarriage  or invasive methods. In this case report, a medical abortion with misoprostol and Anti D administration at 6 weeks of gestational age of an  Rh minus woman with positive paternal Rhesus status is presented.Materials and Methods: The patient was a 19-year-old Rhesus negative female patient with positive pregnancy urine test seeking abortion. The paternal Rhesus was positive.Beta pregnancy test: 2698 mIU/ml and  ultrasound findings reveal presence of gestational sack (6 weeks gestational age). Full blood examination and ECG  were normal. No contraindications for medical abortion were present and the Misoprostol alone regimen was chosen for medical abortion with 8 tablets of Cytotec (misoprostol) sublingually and intravaginally. The patient was not hospitalized. Prophylactic antibiotics (vibramycin) were administered and NSAIDS were recommended for pain management. There was also administration of Rhophylac, IM, within 72 hrs and patient observation for at least 20 minutes following the administration.Results: One day post misoprostol regimen administration, ultrasound examination  revealed an absence of gestational sack with 11 mm endometrial thickness. This regimen resulted in a complete abortion with no adverse side effects, such as vomiting, diarrhea or abdominal cramps. Follow-up ultrasound, revealed  6.3 millimeters of endometrial thickness.Conclusion: There is not enough evidence concerning the application of Anti D Serum after medical abortion in Rhesus minus pregnancies before the 12th week of gestation. Further longitudinal studies and consecutive follow-up of treated patients are obligatory for establishing evidence-based  guidelines

Preventing and Reducing Coercive Measures-An Evaluation of the Implementation of the Safewards Model in Two Locked Wards in Germany

Introduction: Aggression and violence are highly complex problems in acute psychiatry that often lead to the coercive interventions. The Safewards Model is an evidence-informed conflict-reduction strategy to prevent and reduce such incidents. The aim of this study was to evaluate the implementation of this model with regard to coercive interventions in inpatient care. Materials and Methods: We evaluated outcomes of the implementation of the Safewards Model in two locked psychiatric wards in Germany. Frequency and duration of coercive interventions applied during a period of 10 weeks before and 10 weeks after the implementation period were assessed through routine data. Fidelity to the Safewards Model was assessed by the Organization Fidelity Checklist. Results: Fidelity to the Safewards Model was high in both wards. The overall use of coercive measures differed significantly between wards [case-wise: chi(2) (1, n = 250) = 35.34, p <= 0.001; patient-wise: chi(2) (1, n = 103) = 21.45, p <= 0.001] and decreased post-implementation. In one ward, the number of patients exposed to coercive interventions in relation to the overall number of admissions decreased significantly [chi(2) (1, 182) = 9.30, p = 0.003]. Furthermore, the mean duration of coercive interventions overall declined significantly [U(55,21) = -2.142, p = 0.032] with an effect size of Cohen's d = -0.282 (95% CI: -0.787, 0.222) in that ward. Both aspects declined as well in the other ward, but not significantly. Discussion: Results indicate that the implementation of the Safewards interventions according to the model in acute psychiatric care can reduce coercive measures. They also show the role of enabling factors as well as of obstacles for the implementation process

Changes on Ward Atmosphere and Job Satisfaction after Implementation of the Safewards Model in Two Locked Acute PsychiatricWards - A Multi-Perspective Evaluation

Objective Evaluation of the changes of ward atmosphere and job satisfaction after the implementation of the Safewards model in acute psychiatry in Germany. Method A multi-perspective pre-post study design was conducted in two locked wards among patients (n = 80) and staff (n = 88) before and after the implementation of the Safewards model over a period of 12 months. Results After the implementation of the Safewards model, ward atmosphere and job satisfaction improved. Both correlated positively amongst staff. Furthermore, job satisfaction correlated positively with a high degree of implementation of two interventions. Fidelity to the Safewards model was high. Conclusions Implementing the Safewards model in acute psychiatry with high fidelity can have positive effects on positive ward atmosphere and job satisfaction. Thus, patients as well as staff benefit from this model. With regards to high fluctuation in acute psychiatry, the implementation of the Safewards model can additionally facilitate retention management