Business Modelling of a Dementia Friendly Hotel

The dementia challenge has been recognised as one of the future trends for the hotel business in the Dementia Project by Okada, Igarashi, Nomura & Tokuda (2013) who refer to the need for travel and stay in hotels as a significant factor for wellbeing. The paper describes the Business Model generation process of a hotel business that is offering short term hospitality to customers suffering from Dementia and to their caregivers. The standard canvas of Osterwalder & Pigneux (2009) is being adopted for business model analysis. The model is analysed and evaluated according to possible alternative market scenarios. Conclusions provide some initial insights provided by international developments in the area, after discussions with 17 groups of business administration students who went through two dementia awareness lectures as part of groupwork on quality management requirements by businesses with dementia customers and interviews and group discussions with twelve caregivers that took place at the Entrepreneurship Living Lab of the TEI of Thessaly, Greece. Possible strategic decisions in the hotel business that relate to the selections and evaluations being analysed are identified

Challenges for hospitality management: the case of dementia patients and caregivers as customers

The rapidly increasing numbers of people suffering from dementia along with the significant changes in the relevant care business models open new opportunities for the hospitality industry. It is understood that dementia patients and their families and caregivers should not be isolated and they deserve to live a better life in better caring environments that will cater for their needs. The freedom to be able to travel and enjoy life is very important for all people and is top priority for dementia patients and caregivers. The current paper looks into some new challenges for the tourism and hospitality market because of the advanced requirements and processes needed for the dementia friendly business model to succeed. The research methodology is qualitative based on the selection and evaluation of secondary metadata content from webpages, open in depth interviews with caregivers along with focus group discussions of selected themes. Innovative solutions to the most important hospitality management challenges, ie customer relationship and channels in the business model canvas as described by Osterwalder & Pigneux (2009) are presented and documented along with conclusions for further research on the quality management improvements necessary for the successful adoption and operation of the expanded business model

Speedy Transactions in Multicore In-Memory Databases

Silo is a new in-memory database that achieves excellent performance and scalability on modern multicore machines. Silo was designed from the ground up to use system memory and caches efficiently. For instance, it avoids all centralized contention points, including that of centralized transaction ID assignment. Silo's key contribution is a commit protocol based on optimistic concurrency control that provides serializability while avoiding all shared-memory writes for records that were only read. Though this might seem to complicate the enforcement of a serial order, correct logging and recovery is provided by linking periodically-updated epochs with the commit protocol. Silo provides the same guarantees as any serializable database without unnecessary scalability bottlenecks or much additional latency. Silo achieves almost 700,000 transactions per second on a standard TPC-C workload mix on a 32-core machine, as well as near-linear scalability. Considered per core, this is several times higher than previously reported results.Engineering and Applied Science

Acceptability of HIV self-sampling kits (TINY vial) among people of black African ethnicity in the UK: a qualitative study

Background: Increasing routine HIV testing among key populations is a public health imperative, so improving access to acceptable testing options for those in need is a priority. Despite increasing targeted distribution and uptake of HIV self-sampling kits (SSKs) among men who have sex with men in the UK, little is known about why targeted SSK interventions for black African users are not as wide-spread or well-used. This paper addresses this key gap, offering insight into why some groups may be less likely than others to adopt certain types of SSK interventions in particular contexts. These data were collected during the development phase of a larger study to explore the feasibility and acceptability of targeted distribution of SSKs to black African people. Methods: We undertook 6 focus groups with members of the public who self-identified as black African (n = 48), 6 groups with specialists providing HIV and social services to black African people (n = 53), and interviews with HIV specialist consultants and policy-makers (n = 9). Framework analysis was undertaken, using inductive and deductive analysis to develop and check themes. Results: We found three valuable components of targeted SSK interventions for this population: the use of settings and technologies that increase choice and autonomy; targeted offers of HIV testing that preserve privacy and do not exacerbate HIV stigma; and ensuring that the specific kit being used (in this case, the TINY vial) is perceived as simple and reliable. Conclusions: This unique and rigorous research offers insights into participants’ views on SSK interventions, offering key considerations when targeting this population.. Given the plethora of HIV testing options, our work demonstrates that those commissioning and delivering SSK interventions will need to clarify (for users and providers) how each kit type and intervention design adds value. Most significantly, these findings demonstrate that without a strong locus of control over their own circumstances and personal information, black African people are less likely to feel that they can pursue an HIV test that is safe and secure. Thus, where profound social inequalities persist, so will inequalities in HIV testing uptake – by any means

Autoantibodies to αS1-Casein Are Induced by Breast-Feeding

BACKGROUND: The generation of antibodies is impaired in newborns due to an immature immune system and reduced exposure to pathogens due to maternally derived antibodies and placental functions. During nursing, the immune system of newborns is challenged with multiple milk-derived proteins. Amongst them, caseins are the main constituent. In particular, human αS1-casein (CSN1S1) was recently shown to possess immunomodulatory properties. We were thus interested to determine if auto-antibodies to CSN1S1 are induced by breast-feeding and may be sustained into adulthood. METHODS: 62 sera of healthy adult individuals who were (n = 37) or were not (n = 25) breast-fed against human CSN1S1 were investigated by a new SD (surface display)-ELISA. For cross-checking, these sera were tested for anti Epstein-Barr virus (EBV) antibodies by a commercial ELISA. RESULTS: IgG-antibodies were predominantly detected in individuals who had been nursed. At a cut-off value of 0.4, the SD-ELISA identified individuals with a history of having been breast-fed with a sensitivity of 80% and a specificity of 92%. Under these conditions, 35 out of 37 sera from healthy donors, who where breast-fed, reacted positively but only 5 sera of the 25 donors who were not breast-fed. The duration of breast-feeding was of no consequence to the antibody reaction as some healthy donors were only short term breast-fed (5 days minimum until 6 weeks maximum), but exhibited significant serum reaction against human CSN1S1 nonetheless. CONCLUSION: We postulate that human CSN1S1 is an autoantigen. The antigenicity is orally determined, caused by breast-feeding, and sustained into adulthood

Success or failure of critical steps in community case management of malaria with rapid diagnostic tests: a systematic review

Background: Malaria still causes high morbidity and mortality around the world, mainly in sub-Saharan Africa. Community case management of malaria (CCMm) by community health workers (CHWs) is one of the strategies to combat the disease by increasing access to malaria treatment. Currently, the World Health Organization recommends to treat only confirmed malaria cases, rather than to give presumptive treatment. Objectives. This systematic review aims to provide a comprehensive overview of the success or failure of critical steps in CCMm with rapid diagnostic tests (RDTs). Methods. The databases of Medline, Embase, the Cochrane Library, the library of the \u27Malaria in Pregnancy\u27 consortium, and Web of Science were used to find studies on CCMm with RDTs in SSA. Studies were selected according to inclusion and exclusion criteria, subsequently risk of bias was assessed and data extracted. Results: 27 articles were included. CHWs were able to correctly perform RDTs, although specificity levels were variable. CHWs showed high adherence to test results, but in some studies a substantial group of RDT negatives received treatment. High risk of bias was found for morbidity and mortality studies, therefore, effects on morbidity and mortality could not be estimated. Uptake and acceptance by the community was high, however negative-tested patients did not always follow up referral advice. Drug or RDT stock-outs and limited information on CHW motivation are bottlenecks for sustainable implementation. RDT-based CCMm was found to be cost effective for the correct treatment of malaria in areas with low to medium malaria prevalence, but study designs were not optimal. Discussion. Trained CHWs can deliver high quality care for malaria using RDTs. However, lower RDT specificity could lead to missed diagnoses of non-malarial causes of fever. Other threats for CCMm are non-adherence to negative test results and low referral completion. Integrated CCM may solve some of these issues. Unfortunately, morbidity and mortality are not adequately investigated. More information is needed about influencing sociocultural aspects, CHW motivation and stock supply. Conclusion: CCMm is generally well executed by CHWs, but there are several barriers for its success. Integrated CCM may overcome some of these barriers