Recovery priorities in degenerative cervical myelopathy: a cross-sectional survey of an international, online community of patients.

OBJECTIVES: To establish the recovery priorities of individuals suffering with degenerative cervical myelopathy (DCM). DESIGN: A cross-sectional, observational study. SETTING: Patients from across the world with a diagnosis of DCM accessed the survey over an 18-month period on Myelopathy.org, an international myelopathy charity. PARTICIPANTS: 481 individuals suffering from DCM completed the online survey fully. MAIN OUTCOME MEASURES: Functional recovery domains were established through qualitative interviews and a consensus process. Individuals were asked about their disease characteristics, including limb pain (Visual Analogue Scale) and functional disability (patient-derived version of the modified Japanese Orthopaedic Association score). Individuals ranked recovery domains (arm and hand function, walking, upper body/trunk function, sexual function, elimination of pain, sensation and bladder/bowel function) in order of priority. Priorities were analysed as the modal first priority and mean ranking. The influence of demographics on selection was analysed, with significance p<0.05. RESULTS: Of 659 survey responses obtained, 481 were complete. Overall, pain was the most popular recovery priority (39.9%) of respondents, followed by walking (20.2%), sensation (11.9%) and arm and hand function (11.5%). Sexual function (5.7%), bladder and bowel (3.7%) and trunk function (3.5%) were chosen less frequently. When considering the average ranking of symptoms, while pain remained the priority (2.6±2.0), this was closely followed by walking (2.9±1.7) and arm/hand function (3.0±1.4). Sensation ranked lower (4.3±2.1). With respect to disease characteristics, overall pain remained the recovery priority, with the exception of patients with greater walking impairment (p<0.005) who prioritised walking, even among patients with lower pain scores. CONCLUSIONS: This is the first study investigating patient priorities in DCM. The patient priorities reported provide an important framework for future research and will help to ensure that it is aligned with patient needs.NIHR Welcome Trus

The human resources management contribution to social responsibility and environmental sustainability: explorations from Ibero-America

[EN] In this paper we aim to advance the discussion on HRM¿s quest to create value around social responsibility and environmental sustainability. We explore the perceptions reported by Human Resource managers in three Ibero-American countries (Spain, the Dominican Republic and Costa Rica). We focus on the hospitality sector, one of particular relevancy for these countries and with significant sustainability challenges. Relying on in-depth interviews in twenty-eight organizations and a mixed-methods approach, we examine HR managers¿ underlying notions around social and environmental issues, stakeholder collaboration, HRM practices, roles and internal organization. Analysis of the interviews suggests varying views on those dimensions, as well as identifies Active and Advanced firms, the latter showing more commitment to sustainability (as part of the organizational culture), usage of HRM practices and engagement with multiple stakeholders. From this empirical exploration and relying on current sustainability developments, we contribute to the literature by outlining an externally-oriented model (centred on corporate priorities, communities¿ flourishing and ecosystems¿ resilience) aiming to advance HRM¿s engagement with sustainability-driven agendas.Alcaraz, JM.; Susaeta-Erburu, L.; Suárez-Ruz, ME.; Colón, C.; Gutierrez, I.; Cunha, R.; Leguizamon, F.... (2017). The human resources management contribution to social responsibility and environmental sustainability: explorations from Ibero-America. The International Journal of Human Resource Management. https://doi.org/10.1080/09585192.2017.1350732

Russian Artistic Gymnastics as a Sports Tourism Product: Some Observations and a Research Agenda

Tourism and its importance to the Russian Federation are very much in the headlines at present. Considering the huge investment made in facilities for the Winter Olympics, the building of new sports facilities for such mega events as the Football World Cup, and the status of St Petersburg as a candidate city for the 2028 Olympics, it is clear that Russia has long term plans to attract visitors to their sporting events. The purpose of this paper is to develop a research agenda to explore the potential of artistic gymnastics, a sport in which the Russian Federation has excelled for many years, as an agent of tourism development. The paper will take a case study approach, considering the nature of fandom and identifying features of artistic gymnastics as cultural heritage and sports tourism product. The national and international environment within which it is set are examined, prior to the development of a research agenda. A detailed review of literature on the historic, current and emerging trends in Russian artistic gymnastics; the place of artistic gymnastics in tourism development and sports tourism in Russia will be carried out. The paper’s findings will include considerations of: • The nature of gymnastics fandom, both in Russia and internationally • The nature of sports tourism development in the Russian Federation • The nature of gymnastics as a sport and its competition cycle • Artistic gymnastics as cultural heritage, and its potential as an autonomous means of promoting Russian national identity • The relationship between Russia’s sometimes fading gymnastics competition results, and its potential to leverage the sport for tourism interest • The potential for tourism product development linked to artistic gymnastics in the Russian Federation. The paper contributes to the literature on the nature of sports tourism as it relates to artistic gymnastics in the Russian Federation in particular

Divided we stand: institutional collaboration in tourism planning and development in the Central Region of Ghana

This research is an exploratory study that examines collaboration at the institutional level in the tourism sector of the Central Region, Ghana. The research begins with a review of the key issues related to collaboration in tourism planning and development followed by an extensive exploration of three main issues related to institutional collaboration in tourism in the Central Region. The three main issues are the vision of tourism development shared among stakeholders, collaboration and coordination within the public sector and between the public and private sectors and the factors that constrain and facilitate collaboration and coordination. Using extensive interviews with key stakeholders and reviewing policy documents, the research indicates low levels of collaboration between tourism institutions both within the public sector and across the public?private sectors. This is notwithstanding a shared awareness of the benefits of collaboration among all actors. The research thus contributes interesting insights into the politics of collaboration in tourism destinations. Given tourism's contribution to the Ghanaian economy, it is imperative that efforts are made towards improving the levels of collaboration and coordination between tourism agencies and institutions

Targeting patient recovery priorities in degenerative cervical myelopathy:design and rationale for the RECEDE-Myelopathy trial-study protocol

Introduction: Degenerative cervical myelopathy (DCM) is a common and disabling condition of symptomatic cervical spinal cord compression secondary to degenerative changes in spinal structures leading to a mechanical stress injury of the spinal cord. RECEDE-Myelopathy aims to test the disease-modulating activity of the phosphodiesterase 3/phosphodiesterase 4 inhibitor Ibudilast as an adjuvant to surgical decompression in DCM. Methods and analysis: RECEDE-Myelopathy is a multicentre, double-blind, randomised, placebo-controlled trial. Participants will be randomised to receive either 60-100 mg Ibudilast or placebo starting within 10 weeks prior to surgery and continuing for 24 weeks after surgery for a maximum of 34 weeks. Adults with DCM, who have a modified Japanese Orthopaedic Association (mJOA) score 8-14 inclusive and are scheduled for their first decompressive surgery are eligible for inclusion. The coprimary endpoints are pain measured on a visual analogue scale and physical function measured by the mJOA score at 6 months after surgery. Clinical assessments will be undertaken preoperatively, postoperatively and 3, 6 and 12 months after surgery. We hypothesise that adjuvant therapy with Ibudilast leads to a meaningful and additional improvement in either pain or function, as compared with standard routine care. Study design: Clinical trial protocol V.2.2 October 2020. Ethics and dissemination: Ethical approval has been obtained from HRA - Wales. The results will be presented at an international and national scientific conferences and in a peer-reviewed journals.Trial registration number: ISRCTN Number: ISRCTN16682024.</p

Gathering Global Perspectives to Establish the Research Priorities and Minimum Data Sets for Degenerative Cervical Myelopathy:Sampling Strategy of the First Round Consensus Surveys of AO Spine RECODE-DCM

STUDY DESIGN: Survey.INTRODUCTION: AO Spine Research Objectives and Common Data Elements for Degenerative Cervical Myelopathy (AO Spine RECODE-DCM) is an international initiative that aims to accelerate knowledge discovery and improve outcomes by developing a consensus framework for research. This includes defining the top research priorities, an index term and a minimum data set (core outcome set and core data elements set - core outcome set (COS)/core data elements (CDE)).OBJECTIVE: To describe how perspectives were gathered and report the detailed sampling characteristics.METHODS: A two-stage, electronic survey was used to gather and seek initial consensus. Perspectives were sought from spinal surgeons, other healthcare professionals and people with degenerative cervical myelopathy (DCM). Participants were allocated to one of two parallel streams: (1) priority setting or (2) minimum dataset. An email campaign was developed to advertise the survey to relevant global stakeholder individuals and organisations. People with DCM were recruited using the international DCM charity Myelopathy.org and its social media channels. A network of global partners was recruited to act as project ambassadors. Data from Google Analytics, MailChimp and Calibrum helped optimise survey dissemination.RESULTS: Survey engagement was high amongst the three stakeholder groups: 208 people with DCM, 389 spinal surgeons and 157 other healthcare professionals. Individuals from 76 different countries participated; the United States, United Kingdom and Canada were the most common countries of participants.CONCLUSION: AO Spine RECODE-DCM recruited a diverse and sufficient number of participants for an international PSP and COS/CDE process. Whilst PSP and COS/CDE have been undertaken in other fields, to our knowledge, this is the first time they have been combined in one process.</p

Films and critical pedagogy in management education: A tourism studies context

This article examines and critically assesses the role of films in the practice of critical pedagogy in undergraduate management education, using tourism studies as a context. Utilising online focus groups, it aims to gain an in-depth knowledge and understanding of the role of films as an effective pedagogical medium in enhancing experiential approaches to learning. It argues that films play an important role in facilitating critical analyses of the studied phenomenon, illustrating and problematising abstract concepts and ideas, as well as in facilitating students’ ability to discern multiple and alternative discourses about management. The findings highlight the role of films in context-specific critical engagement with the studied content and in stimulating emotionality in learning development, thereby enhancing deep approaches to learning. Emotional responses, even negative ones, prove to be critical in engaging with intellectual and critical reflection after watching films. The findings yield new and empirical insights into the pedagogic use of films in management education, thereby contributing to some of the goals of critical management studies

Tourism and water inequity in Bali: A social-ecological systems analysis

This paper is a social-ecological systems (SES) analysis of tourism and water inequity in Bali. It uses Elinor Ostrom’s SES model to look at the particular niche of Bali’s tourism and water nexus. Re-analysis of previous qualitative research revealed that the vulnerability of the SES was due to numerous characteristics. In particular, user groups are highly diverse, transient and stratified, thereby inhibiting communication and knowledge sharing. This, in combination with weak governance systems and the economic power of the tourism industry, interact to affect declining water resources and the iniquitous impact of this. Whilst there are obvious indications that Bali’s water resources are over stretched, there is no feedback loop to the institutional structures that would help enable appropriate responses from the user groups or governance system

Charting the course for a Blue Economy in Peru: A Research Agenda

Ocean- and coastal-based economic activities are increasingly recognised as key drivers for supporting global economies. This move towards the “blue economy” is becoming globally widespread, with the recognition that if ocean-based activities are to be sustainable, they will need to move beyond solely extractive and exploitative endeavours, aligning more closely with marine conservation and effective marine spatial planning. In this paper we define the “blue economy” as a “platform for strategic, integrated and participatory coastal and ocean development and protection that incorporates a low carbon economy, the ecosystem approach and human well-being through advancing regional industries, services and activities”. In Peru, while the seas contribute greatly to the national economy, the full potential of the blue economy has yet to be realised. This paper presents the findings of an early career scientist workshop in Lima, Peru, in March 2016. The workshop “Advancing Green Growth in Peru” brought together researchers to identify challenges and opportunities for green growth across three Peruvian economic sectors—tourism, transport and the blue economy with this paper exploring in detail the priorities generated from the “blue economy” stream. These priorities include themes such as marine spatial planning, detailed evaluations of existing maritime industries (e.g. guano collection and fisheries), development of an effective MPA network, support for sustainable coastal tourism, and better inclusion of social science disciplines in understanding societal and political support for a Peruvian blue economy. In addition, the paper discusses the research requirements associated with these priorities. While not a comprehensive list, these priorities provide a starting point for future dialogue on a co-ordinated scientific platform supporting the blue growth agenda in Peru, and in other regions working towards a successful “blue economy”