Understanding preferences for nature based and sustainable tourism. The role of personal values and general and specific environmental attitudes

This paper reports the results of a study which investigated the social psychological correlates of people’s preferences for sustainable and unsustainable tourism activities. Two-hundred-eighty-two participants from two Italian cities responded to a questionnaire which recorded their tourism preferences, their general pro-environmental attitudes and values, and their specific attitudes towards sustainable tourism. Results showed positive correlations among the constructs considered. Groups of participants differing in their tourism preferences were also identified and the paper discusses the way in which the social psychological variables considered here may be used to plan adequate strategies and management instruments able to address crucial issues of sustainability in tourism, including, for example, tourists’ ecological behaviors “on site” and their educational needs

The impact of Mirabegron on sexual function in women with idiopathic overactive bladder

Background: Overactive bladder (OAB) can frequently exert a negative effect on female sexual function. Mirabegron, a beta 3 receptor agonist, improves OAB symptoms, but there are very few information about its role on female sexual dysfunction (FSD). Aim of the study was to assess the impact of Mirabegron on FSD in women affected by OAB.Fifty sexually active women suffering from idiopathic OAB were included in the study. Patients were assessed by means of a urogynecologic physical examination and were asked to complete the 3-day voiding diary, the International Consultation on Incontinence Questionnaire- Short Form (ICIQ-SF), the Female Sexual Function Index (FSFI) questionnaire and VAS, before and 12 weeks after treatment with Mirabegron. In addition, at the same time points, patients underwent uroflowmetry with the measurement of post- void residual volume (PVR).At baseline all patients were affected by OAB symptoms, with 49/50 patients (98%) presenting with FSD. At 12- weeks follow- up, OAB symptoms improved significantly in all patients, with 59.5% of subjects achieving a complete urinary continence. FSFI Total Score significantly improved in 42/50 patients (84%) from 18.9 +/- 4.3 to 21.8 +/- 4.5 (p < 0.0001). Sixteen cases (32%) presented with no FSD. Also mean +/- SD scores of ICIQ-SF and VAS significantly improved (from 17.1 +/- 5 to 7.9 +/- 4.8 and from 3.9 +/- 1.2 to 6.9 +/- 1.2 respectively, p < 0.000).Mirabegron not only is able to control urinary symptoms in women with OAB, but also induces a significant improvement in their sexual life

Intradetrusorial botulinum toxin in patients with multiple sclerosis: A neurophysiological study

Patients with multiple sclerosis (MS) often complain of urinary disturbances characterized by overactive bladder syndrome and difficulties in bladder emptying. The aim of the study was to investigate the pathophysiology of bladder dysfunction and the neurophysiological effects of intradetrusorial incobotulinum toxin A (BoNT/A) in patients with MS having both brain and spinal MS-related lesions. Twenty-five MS patients with neurogenic detrusor overactivity (NDO) underwent clinical evaluation and soleus Hoffmann reflex (H reflex) study during urodynamics. Of the 25 patients, 14 underwent a further session one month after intradetrusorial BoNT/A injection. Eighteen healthy subjects acted as the control. In healthy subjects, the H reflex size significantly decreased at maximum cystometric capacity (MCC), whereas in MS patients with NDO, the H reflex remained unchanged. In the patients who received intradetrusorial BoNT/A, clinical and urodynamic investigations showed that NDO improved significantly. Volumes at the first, normal and strong desire to void and MCC increased significantly. Despite its efficacy in improving bladder symptoms and in increasing volumes for first desire, normal and strong desire to void, BoNT/A left the H reflex modulation during bladder filling unchanged. In the MS patients we studied having both brain and spinal MS-related lesions, the H reflex size remained unchanged at maximum bladder filling. Since this neurophysiological pattern has been previously found in patients with spinal cord injury, we suggest that bladder dysfunction arises from the MS-related spinal lesions. BoNT/A improves bladder dysfunction by changing bladder afferent input, as shown by urodynamic findings on bladder filling sensations, but its effects on H reflex modulation remain undetectable