Tourism as connectedness.

Late modernity in developed nations is characterized by changing social and psychological conditions, including individualization, processes of competition and loneliness. Remaining socially connected is becoming increasingly important. In this situation, travel provides meaning through physical encounters, inclusion in traveller Gemeinschaft based on shared norms, beliefs and interests, and social status in societies increasingly defined by mobilities. As relationships are forged and found in mobility, travel is no longer an option, rather a necessity for sociality, identity construction, affirmation or alteration. Social contexts and the underlying motivations for tourism have changed fundamentally in late modernity: non-tourism has become a threat to self-conceptions. By integrating social and psychological perspectives, this paper expands and deepens existing travel and mobilities discussions to advance the understanding of tourism as a mechanism of social connectedness, and points to implications for future tourism research

Transcultural Brokerage: The Role of Cosmopolitans in Bridging Structural and Cultural Holes

The growth and proliferation of global systems and transnational cultures have generated larger and more diverse types of cosmopolitans, all of whom span conventional social boundaries. Understanding this diversity is increasingly important because cosmopolitans often bridge across a wide range of transnational and global networks within and across global organizations. Drawing on multiple disciplines, we conceptualize cosmopolitanism as an embodied disposition characterized by high levels of cultural transcendence and openness that are manifested in and enacted along varied trajectories of cultural embeddedness in one’s own culture and cultural engagement with the cultural Other. We then propose an analytical framework for the influence of cosmopolitan disposition on transcultural brokerage processes, specifically on bridging structural and cultural holes. Finally, we present a typology of cosmopolitan brokers and their corresponding practices and activities as they engage in transcultural brokerage. By recognizing the diversity of cosmopolitans and their respective dispositions, we significantly expand the pool of “global talent” beyond the traditional focus on expatriates, and we challenge the conventional wisdom on who counts as talent in an interconnected world

Development and Validation of a Risk Score for Chronic Kidney Disease in HIV Infection Using Prospective Cohort Data from the D:A:D Study

Ristola M. on työryhmien DAD Study Grp ; Royal Free Hosp Clin Cohort ; INSIGHT Study Grp ; SMART Study Grp ; ESPRIT Study Grp jäsen.Background Chronic kidney disease (CKD) is a major health issue for HIV-positive individuals, associated with increased morbidity and mortality. Development and implementation of a risk score model for CKD would allow comparison of the risks and benefits of adding potentially nephrotoxic antiretrovirals to a treatment regimen and would identify those at greatest risk of CKD. The aims of this study were to develop a simple, externally validated, and widely applicable long-term risk score model for CKD in HIV-positive individuals that can guide decision making in clinical practice. Methods and Findings A total of 17,954 HIV-positive individuals from the Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) study with >= 3 estimated glomerular filtration rate (eGFR) values after 1 January 2004 were included. Baseline was defined as the first eGFR > 60 ml/min/1.73 m2 after 1 January 2004; individuals with exposure to tenofovir, atazanavir, atazanavir/ritonavir, lopinavir/ritonavir, other boosted protease inhibitors before baseline were excluded. CKD was defined as confirmed (>3 mo apart) eGFR In the D:A:D study, 641 individuals developed CKD during 103,185 person-years of follow-up (PYFU; incidence 6.2/1,000 PYFU, 95% CI 5.7-6.7; median follow-up 6.1 y, range 0.3-9.1 y). Older age, intravenous drug use, hepatitis C coinfection, lower baseline eGFR, female gender, lower CD4 count nadir, hypertension, diabetes, and cardiovascular disease (CVD) predicted CKD. The adjusted incidence rate ratios of these nine categorical variables were scaled and summed to create the risk score. The median risk score at baseline was -2 (interquartile range -4 to 2). There was a 1: 393 chance of developing CKD in the next 5 y in the low risk group (risk score = 5, 505 events), respectively. Number needed to harm (NNTH) at 5 y when starting unboosted atazanavir or lopinavir/ritonavir among those with a low risk score was 1,702 (95% CI 1,166-3,367); NNTH was 202 (95% CI 159-278) and 21 (95% CI 19-23), respectively, for those with a medium and high risk score. NNTH was 739 (95% CI 506-1462), 88 (95% CI 69-121), and 9 (95% CI 8-10) for those with a low, medium, and high risk score, respectively, starting tenofovir, atazanavir/ritonavir, or another boosted protease inhibitor. The Royal Free Hospital Clinic Cohort included 2,548 individuals, of whom 94 individuals developed CKD (3.7%) during 18,376 PYFU (median follow-up 7.4 y, range 0.3-12.7 y). Of 2,013 individuals included from the SMART/ESPRIT control arms, 32 individuals developed CKD (1.6%) during 8,452 PYFU (median follow-up 4.1 y, range 0.6-8.1 y). External validation showed that the risk score predicted well in these cohorts. Limitations of this study included limited data on race and no information on proteinuria. Conclusions Both traditional and HIV-related risk factors were predictive of CKD. These factors were used to develop a risk score for CKD in HIV infection, externally validated, that has direct clinical relevance for patients and clinicians to weigh the benefits of certain antiretrovirals against the risk of CKD and to identify those at greatest risk of CKD.Peer reviewe

Neglect and motion stimuli – insights from a touchscreen-based cancellation task

BACKGROUND AND PURPOSE: In stroke patients, neglect diagnostic is often performed by means of paper-pencil cancellation tasks. These tasks entail static stimuli, and provide no information concerning possible changes in the severity of neglect symptoms when patients are confronted with motion. We therefore aimed to directly contrast the cancellation behaviour of neglect patients under static and dynamic conditions. Since visual field deficits often occur in neglect patients, we analysed whether the integrity of the optic radiation would influence cancellation behaviour. METHODS: Twenty-five patients with left spatial neglect after right-hemispheric stroke were tested with a touchscreen cancellation task, once when the evenly distributed targets were stationary, and once when the identic targets moved with constant speed on a random path. The integrity of the right optic radiation was analysed by means of a hodologic probabilistic approach. RESULTS: Motion influenced the cancellation behaviour of neglect patients, and the direction of this influence (i.e., an increase or decrease of neglect severity) was modulated by the integrity of the right optic radiation. In patients with an intact optic radiation, the severity of neglect significantly decreased in the dynamic condition. Conversely, in patients with damage to the optic radiation, the severity of neglect significantly increased in the dynamic condition. CONCLUSION: Motion may influence neglect in stroke patients. The integrity of the optic radiation may be a predictor of whether motion increases or decreases the severity of neglect symptoms

Global value chains in international knowledge work: networks, stratifications and labour markets

Hollinshead G. Global value chains in international knowledge work: networks, stratifications and labour markets. Global Networks. A Journal of Transnational Affairs . 2019: glob.12253.In this article, I aim to cast light on the arguably indeterminate phenomenon of the global labour market (GLM) by placing the focus on an industry that has sometimes been perceived as epitomizing homogeneity and 'world flatness' in its deployment of geographically dispersed knowledge workers, that of international software development. Engaging in a sanguine analysis of this industry with reference to an empirical study of outsourcing to Ukraine it is revealed that labour markets servicing ICT (Information and communication technology) are subject to deep, if fluctuating, social stratifications. With reference to the notion of the global value chain (GVC), the significance of factors such as knowledge, language, citizenship and age as labour market differentiators for knowledge work is brought to the fore