A systematic literature review and lexicometric analysis on overtourism: Towards an ambidextrous perspective

While overtourism is a relatively recent term, it has nevertheless triggered a large number of publications because of its human, environmental and social challenges. This systematic review therefore aims to take stock of the literature on overtourism. A lexicometric analysis based on 236 articles reveals that research on overtourism is highly concentrated and articulated around three main themes: the management, the experience, and the context of overtourism. The findings also suggest that academic research has so far focused on the negative impacts of overtourism. Subsequently, this study is calling for an ambidextrous approach, taking into account both the negative effects of overtourism, while also considering it as an opportunity in addressing the problem.

COVID-19 vaccines and anti-consumption: Understanding anti-vaxxers hesitancy

Anti-vaccination sentiment and vaccine hesitancy are on the rise. This is unfortunate given the world's coronavirus disease 2019 (COVID-19) pandemic response plan relies on a global vaccination program the likes of which has never been attempted. Using an anti-consumption lens, this study utilizes a qualitative approach and 53 interviews revolving around people's attitudes towards the COVID-19 vaccination plan. The findings reveal that COVID-19 vaccination hesitancy comes from two major factors: stable factors and contextual factors. Stable factors refer to factors that are consistently found in anti-vaccination movements and include political and philosophical opposition. Contextual factors refer to factors that are highly dependent on the COVID-19 situation and relates to a negative benefit to risk ratio informed by information overload and the influence of marketing phenomena such as branding and country of origin effects. Finally, theoretical and managerial contributions are offered for public policymakers and social marketers.

Global perspectives on the provision of diabetic retinopathy screening and treatment: Survey of health care professionals in 41 countries

AIM

To assess the level of awareness and provision of screening and treatment for Diabetic Eye Disease (DED) comprising Diabetic Retinopathy (DR) and Diabetic Macular Edema (DME) among health care professionals.

METHODS

The study was conducted in two phases. The first phase consisted of a qualitative study, based on semi-structured face-to-face and telephone interviews in 8 countries. The second phase used a quantitative approach utilising online surveys in 41 countries. The survey for health care professionals comprised of 43 questions covering provider information, practice characteristics, management of adults with diabetes and specific information from ophthalmologists on screening and treatments for DR.

RESULTS

There were 2329 health care professionals who participated in the online survey. More than one third of diabetes specialists surveyed reported that they did not discuss eye care with their diabetes patients. Nearly two-thirds of all health care professionals surveyed reported that they had written information about diabetes for patients available in their practice. Only one in five (22%, n = 58) primary care providers reported they had material that contained sufficient information on eye complications, and 37% (n = 252) of ophthalmologists reported that they had sufficient information on eye complications. Sixty-five percent (n = 378) of ophthalmologists reported that most of their patients presented when visual problems had already occurred. Six percent (n = 36) stated that most of their patients presented when it was already too late for effective treatment. The most substantial barriers to eye health mentioned by health care professionals responding to the survey were: a patients' lack of knowledge and/or awareness about eye complications (43%), followed by lack of importance given to eye examinations by patients (33%), and the high cost of care (32%). Ophthalmologists also reported late screening (66%), and lack of patient education materials (55%) as obstacles for improving eye health outcomes.

CONCLUSION

Health care professionals need to be appropriately supported and trained so they can provide adults with diabetes with information about the risks of DR, support them in reducing their risk, and advocate for the provision of affordable DR screening and treatment as required.

Sustaining diabetes prevention and care interventions: A multiple case study of translational research projects

BACKGROUND

This study identifies the barriers and enablers for sustainability of interventions in primary and secondary prevention of diabetes. In the context of translational research, sustainability is defined as the continued use of program components and activities for the continued achievement of desirable program and population outcomes.

METHODS

In this study, eleven translational research projects, supported by the BRIDGES program of the International Diabetes Federation, were investigated. By theoretically-informed semi-structured interviews and analyses of project reports, qualitative data was collected on the sustainability outcomes and the barriers and enablers.

RESULTS

The sustainability outcomes can be grouped in three main areas: (1) sustainability at the intervention site(s); (2) diffusion to the wider community; and (3) replication of the intervention at other site(s). Each of the outcomes has their own set of enablers and barriers, and thus requires consideration for a different sustainability strategy.

CONCLUSIONS

This study is the first international study that relates the sustainability outcomes of translational research project to specific barriers and enablers, and develops an evidence-based framework which provides practical advice on how to ensure the sustainability of health interventions.

The Diabetic Retinopathy Barometer Study: Global perspectives on access to and experiences of diabetic retinopathy screening and treatment

AIM

To assess the level of awareness, prevention and treatment of Diabetic Eye Disease (DED) comprising Diabetic Retinopathy (DR) and Diabetic Macula Edema (DME) retinopathy among adults with diabetes and health professionals.

METHODS

The Diabetic Retinopathy Barometer Study consisted of a qualitative study, which consisted of semi-structured interviews, and a quantitative study using online surveys for adults with diabetes and for health professionals.

RESULTS

A total of 4340 adults with diabetes and 2329 health professionals participated in the surveys. Diabetic eye disease (DED) without macular edema (DME) was reported by 19.5% of adults with diabetes and a further 7.6% reported that they had DME. Although 94% of adults with diabetes saw a health care professional for their diabetes, only 79% had ever had an eye examination for DED, and 23% had not had an eye examination in the last year. Moreover, 65% of the ophthalmologists surveyed reported that most patients presented when visual problems had already occurred. Overall, 62% of people with DED had received treatment. Of these, 74% had laser therapy, 29% surgery and 24% anti-VEGF therapy.

CONCLUSION

Strategic investment is required to enhance patient education and professional training on the importance of regular eye examinations; and in providing accessible DR screening programmes and proactive treatments.

Reasons why patients referred to diabetes education programmes choose not to attend: a systematic review

AIMS

To identify the reasons why those offered a place on diabetes education programmes declined the opportunity.

BACKGROUND

It is well established that diabetes education is critical to optimum diabetes care; it improves metabolic control, prevents complications, improves quality of life and empowers people to make informed choices to manage their condition. Despite the significant clinical and personal rewards offered by diabetes education, programmes are underused, with a significant proportion of patients choosing not to attend.

METHODS

A systematic search of the following databases was conducted for the period from 2005-2015: Medline; EMBASE; Scopus; CINAHL; and PsycINFO. Studies that met the inclusion criteria focusing on patient-reported reasons for non-attendance at structured diabetes education were selected.

RESULTS

A total of 12 studies spanning quantitative and qualitative methodologies were included. The selected studies were published in Europe, USA, Pakistan, Canada and India, with a total sample size of 2260 people. Two broad categories of non-attender were identified: 1) those who could not attend for logistical, medical or financial reasons (e.g. timing, costs or existing comorbidities) and 2) those who would not attend because they perceived no benefit from doing so, felt they had sufficient knowledge already or had emotional and cultural reasons (e.g. no perceived problem, denial or negative feelings towards education). Diabetes education was declined for many reasons, and the range of expressed reasons was more diverse and complex than anticipated.

CONCLUSION

New and innovative methods of delivering diabetes education are required which address the needs of people with diabetes whilst maintaining quality and efficiency.

Chemotherapy dosing in achondroplastic dwarfism: a case report and review of literature

WHAT IS KNOWN AND OBJECTIVE

CASE DESCRIPTION: A 74-year-old female with achondroplastic dwarfism was diagnosed with ER-, BR- and HER2- breast cancer. No guideline currently exists to direct chemotherapy dosing in this population. She received neoadjuvant chemotherapy based on body surface area utilizing actual height and weight with dose-dense doxorubicin and cyclophosphamide followed by paclitaxel with the use of granulocyte colony-stimulating factor. Satisfactory clinical response and remission were achieved, and treatment proceeded without any significant toxicity or delays.

WHAT IS NEW AND CONCLUSION

In the absence of guideline recommendations, dosing chemotherapy based on actual height and weight in patients with achondroplastic dwarfism may be safe and appropriate.

Managing high-density commercial scale wine fermentations

AIMS

To investigate the effects of grape juice dilution and different temperature/nitrogen addition regimes on commercial-scale, high-density Shiraz and Chardonnay fermentations.

METHODS AND RESULTS

Duplicated fermentations (30 hl) were conducted at two temperatures for Shiraz and for Chardonnay. Two additional tanks of Chardonnay and Shiraz were diluted. Nitrogen was added once at inoculation or in aliquots over several days. Yeast concentration and viability was determined by flow cytometry. Fermentation chemistry was monitored by Fourier transform infrared spectroscopy. Fermentations arrested in both of the undiluted, higher temperature duplicate tanks of Shiraz. Different fermentation temperature resulted in sensorially different Shiraz, but not Chardonnay, wines made from undiluted musts. The converse was observed for wines made from diluted musts.

CONCLUSIONS

High-density musts can be fermented completely using reduced fermentation temperature coupled with incremental nitrogen addition.

SIGNIFICANCE AND IMPACT OF THE STUDY

This is the first study in duplicated, commercial-scale, high-density grape juice fermentations to address temperature, nitrogen addition, and juice dilution effects on stuck fermentation potential and wine sensory properties.