ABSTRACT
The COVID-19 pandemic halted tourism leading to job losses, loss of livelihoods and revenue losses at national and international levels. The pandemic has reinforced the need to develop strong domestic tourism bases. The overall aim of this study is to estimate domestic tourists' willingness to pay for domestic tourism packages during and post the COVID-19 pandemic. To achieve the overall aim, this study seeks to estimate the residents' willingness to pay (WTP) for a standard two-day domestic nature-based tourism package and analyse factors influencing residents' WTP for domestic nature-based tourism. The study relied on primary data sourced from an online questionnaire administered randomly to residents aged 18 years and older. The contingent valuation method (CVM) was used to analyse the average level of the residents' WTP for domestic tourism. On average, the respondents were willing to pay for a standard two-day domestic nature-based tourism experience package valued at BWP3 340.66 per person sharing. Some camps charge as high as BWP72 097.62 for a similar package. There is a need to develop plans that promote pricing and product offerings that accommodate domestic tourists without having an impact on the sustainability of natural resources and the integrity of the natural environment © 2023 AJHTL /Author(s)
ABSTRACT
Introduction: Anxiety is a significant mental health problem among older adults and is commonly comorbid with personality disorders (PD). However, specific relationships between personality functioning (a proposed feature of PDs) and late-life anxiety remain unclear. This study examined relationships between two models of personality functioning with late life clinical anxiety and COVID-19 anxiety. Method: Older adults (n = 222) completed the Geriatric Anxiety Scale (GAS), Coronavirus Anxiety Scale (CAS), Levels of Personality Functioning Scale-Self-Report (LPFS-SR), and Severity Indices of Personality Problems-Short Form (SIPP-SF). Results: The GAS and CAS were significantly correlated to all LPFS-SR and SIPP-SF domains with large effect sizes (> .78);higher clinical and COVID-19 anxiety was associated with increased personality dysfunction. In regressions, the LPFS-SR domains significantly accounted for 65% of variance in the GAS and 59% of variance in the CAS. Identity and Self-Direction were the strongest predictors of each anxiety scale, with Empathy also significantly related to coronavirus anxiety. The SIPP-SF domains significantly accounted for 65% of variance in the GAS and 58% of variance in the CAS. Responsibility and Social Concordance were the strongest predictors of each anxiety scale, with Self-Control also significantly related to clinical anxiety. Discussion: Results indicate theoretically-supported and meaningful overlap between clinical and COVID-19 anxiety with personality dysfunction according to two different models. This extensive overlap questions the extent to which personality functioning differentiates from affective distress. The two personality dysfunction models also differed somewhat in their relationships to anxiety, suggesting the need for further research especially among older adults.
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Background: Sjögren Europe was founded on 23 February 2019 by several European patient organisations representing Sjögren's patient to help to address the lack of visibility, attention, and solutions for Sjögren's. Objectives: To show the frst achievements and contributions of the federation. Methods: Sjögren Europe's purpose is to promote the advancement of knowledge, research, information, treatment, and care, to foster patient involvement and participation in research and any other relevant area, to increase awareness, identify the different unmet needs and articulate patient voices throughout Europe. Results: Finding one's bearings and the right rhythm during the frst years of an organisation's life is a challenge in itself. The Covid-19 pandemic has made this process even more difficult. Our frst goal was to organise a frst face-to-face European patient conference. This meeting had to be postponed. However, we were able to adapt and develop a range of activities. We organised a series of informative webinars on different topics by leading European experts for patients and others interested in the subject. We have organised various awareness campaigns such as a campaign for Sjögren Awareness Month in 2021 for which we have created 2 awareness videos and published several testimonials. We also created a 3-axis campaign about fatigue for World Sjögren's Day 2021 which won the Best Practice Award at the 2021 PARE Conference, and during which we shared the patients' perspective on fatigue in publications in 13 languages on social media. We published a booklet about fatigue developed by a specialist and produced 3 informative leafets for patients. We also subtitled 2 videos made by one of our members in 10 European languages to disseminate quality information that many patients miss. We have been involved in various research projects, working groups and patient panels and have been able to bring the patient perspective to various stakeholders on many occasions. Conclusion: Despite the limited contacts, we were able to create strong links and rich discussions that stimulated our creativity. Sjögren Europe has become a privileged partner, recognised, and appreciated by the various stakeholders. Patients with Sjögren's are better represented at the supranational level. It is our members, the national patient organisations, who by their trust give us our legitimacy. In return, Sjögren Europe has been able to inject a new energy and dynamism that can be felt at the different national levels and that opens up many perspectives and opportunities. We have been able to strengthen our presence and visibility with patients on social networks, where our audience is constantly growing, as well as in the rheumatology feld with researchers, clinicians, industry, and associations such as EULAR. The resumption of face-to-face contacts is eagerly awaited to consolidate the links already created and to feed the richness, relevance, originality and diversity of our discussions and activities.
ABSTRACT
COVID-19 poses a huge threat to the tourism industry. Not only is COVID-19 a health challenge, but it is also a socio-economic and ecological emergency. The UNWTO anticipates a 20-30% decline in tourist arrivals, a huge blow for sub-Saharan countries whose economies depend on nature-based tourism. Using qualitative document analysis, this paper presents an analysis of the interlinkages between COVID-19 and nature-based tourism, resultant impacts and implications for the future of tourism in Botswana. Results show that the disease spread in Botswana has resulted in far reaching socio-economic and environmental repercussions. These include revenue losses, business closures, retrenchments, and loss of opportunities for financing community development projects;wildlife straying beyond their normal ranges posing a threat to life and increasing chances of poaching. Lessons learnt for the future transformational agenda include the need to intensify domestic tourism;virtual operations and strategies for human-wildlife co-existence.
ABSTRACT
Purpose : The coronavirus pandemic has prompted unprecedented delays to treatment with anti-VEGF intra-vitreal injections due to the need to reduce hospital attendances and prioritize the patients at highest risk of vision loss. This study aims to quantify the effect of these delays on visual acuity (VA) outcomes and optical coherence tomography (OCT) features for retinal vein occlusion (RVO) and diabetic macular oedema (DMO) patients. Methods : A retrospective data analysis of an electronic medical record was performed on a random sample of eyes receiving anti-VEGF injections for RVO and DMO between 1 January and 23 March 2020. Patients with RVO and DMO were identified and data collected included whether the review was delayed (defined as delayed by 8 weeks or more from planned) and VA at baseline and follow up. For those patients not delayed, a VA at 20 weeks was recorded to provide a control group as this was the mean number of weeks until the delayed group were seen. For the delayed group, the OCT features at follow up were also noted. Results : 300 eyes were analysed, of which 176 had RVO and 124 had DMO. 65 out of 176 eyes (36.9%) with RVO and 39 out of 124 eyes (31.5%) with DMO had their review delayed by 8 weeks or more. The mean number of weeks delay was 13.3 and 13.7 weeks for RVO and DMO respectively. Mean change in VA for eyes with RVO where their appointment was delayed was worse compared to those not delayed. For delayed RVO eyes, VA changed from 59.7 to 54.5 (-5.2) letters and for non-delayed RVO eyes VA changed from 63.5 to 61.6 (-1.9) letters (P=0.363). Mean change in VA for eyes with DMO was comparable between delayed (63.0 to 61.1 letters, -1.9) and non-delayed groups (63.7 to 61.0 letters, -2.7). For the delayed group, mean CMT (μm) changed from 374 to 451 (+77) in RVO eyes and 395 to 387 (-8) in DMO eyes. By November 2020, 23.1% of eyes with RVO and 8.6% of eyes with DMO had not returned to within 5 letters of their baseline vision. Conclusions : Delayed appointments due to COVID-19 affected a significant proportion of RVO and DMO patients receiving intra-vitreal injections. Delayed reviews in RVO eyes had a greater impact than for DMO eyes, with a higher proportion losing vision both in the short and long term. VA loss was associated with worsening of OCT features in RVO patients.
ABSTRACT
Purpose : The coronavirus pandemic has prompted unprecedented delays to treatment with anti-VEGF intra-vitreal injections due to the need to reduce hospital attendances and prioritize the patients at highest risk of vision loss. This study aims to quantify the effect of these delays on visual acuity (VA) outcomes and optical coherence tomography (OCT) features for patients receiving treatment for neovascular age-related macular degeneration (nAMD). Methods : A retrospective data analysis of an electronic medical record was performed on a random sample of 681 eyes receiving anti-VEGF injections between 1 January and 23 March 2020 for nAMD. Data collected included whether the review was delayed (defined as delayed by 8 weeks or more from planned) and the VA at baseline and follow up. For those eyes not delayed, a VA at 20 weeks was recorded to provide a control group, as this was the mean number of weeks until the delayed group was seen. For the delayed group, the OCT features at follow up were also noted. Results : The sample of 681 eyes was analysed, of which 194 (28.5%) had been delayed by 8 weeks or more. The mean number of weeks delay was 12.7. Mean change in VA for eyes in the delayed group was significantly worse compared to those not delayed. VA change in the delayed group was 60.1 to 55.2 (-4.9) letters and VA change in the non-delayed group was 61.4 to 59.9 (-1.5) letters (p = 0.001). 161 eyes that were delayed had a repeat OCT at their delayed review;mean CMT (μm) had increased from 311 to 342 and 118 eyes (73.3%) showed evidence of intraretinal and/or subretinal fluid. By November 2020, 25.1% of eyes had not returned to within 5 letters of their baseline vision. Conclusions : Delayed appointments due to COVID-19 affected a significant proportion of nAMD patients receiving intra-vitreal injections. nAMD eyes which were delayed experienced significant visual loss compared to those who were not delayed. This was associated with worsening of disease activity on OCT.
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OBJECTIVE: We aimed at explaining the mechanism of therapeutic effect of Umbilical Cord Mesenchymal Stem Cells (UC-MSC) in subjects with COVID-19 Acute Respiratory Distress Syndrome (ARDS). Patients with COVID-19 ARDS present with a hyperinflammatory response characterized by high levels of circulating pro-inflammatory mediators, including tumor necrosis factor α and ß (TNFα and TNFß). Inflammatory functions of these TNFs can be inhibited by soluble TNF Receptor 2 (sTNFR2). In patients with COVID-19 ARDS, UC-MSC appear to impart a robust anti-inflammatory effect, and treatment is associated with remarkable clinical improvements. We investigated the levels of TNFα, TNFß and sTNFR2 in blood plasma samples collected from subjects with COVID-19 ARDS enrolled in our trial of UC-MSC treatment. PATIENTS AND METHODS: We analyzed plasma samples from subjects with COVID-19 ARDS (n=24) enrolled in a Phase 1/2a randomized controlled trial of UC-MSC treatment. Plasma samples were obtained at Day 0 (baseline, before UC-MSC or control infusion), and Day 6 post infusion. Plasma concentrations of sTNFR2, TNFα, and TNFß were evaluated using a quantitative multiplex protein array. RESULTS: Our data indicate that at Day 6 after infusion, UC-MSC recipients develop significantly increased levels of plasma sTNFR2 and significantly decreased levels of TNFα and TNFß, compared to controls. CONCLUSIONS: These observations suggest that sTNFR2 plays a mechanistic role in mediating UC-MSC effect on TNFα and TNFß plasma levels, determining a decrease in inflammation in COVID-19 ARDS.
Subject(s)
COVID-19/blood , Lymphotoxin-alpha/blood , Mesenchymal Stem Cell Transplantation/methods , Receptors, Tumor Necrosis Factor, Type II/blood , Respiratory Distress Syndrome/blood , Tumor Necrosis Factor-alpha/blood , Umbilical Cord/transplantation , Biomarkers/blood , COVID-19/therapy , Double-Blind Method , Humans , Respiratory Distress Syndrome/therapy , Umbilical Cord/cytologyABSTRACT
COVID-19 has had significant impacts on industries and individuals globally. Due to restrictions put in place to reduce the spread of the disease, it has affected the travel and tourism industry. Using the concepts of ecotourism and sustainable tourism, a systematic qualitative document analysis of available literature was carried out to determine the impacts of the COVID-19 pandemic on nature-based tourism and its implications on community development, using Botswana as a case study. Results indicate that due to the unsustainable and predominant dependence on the international market, the tourism sector in Botswana has come to a standstill. Furthermore, the promotion of domestic tourism to nature-based attractions may lead to conservation issues. COVID-19 has also had an impact on community development through abrupt losses of employment and income. However, several positive environmental impacts have also been experienced. This article calls for a transformation of the tourism sector to make it more resilient. As a response measure, it is necessary to assess whether there is a need to call for a change in policy from high-value low-volume to low-cost high-volume, which may have negative impacts on conservation. However, as an adaptive response, we assert the need to diversify tourism products to consider the needs of both domestic and regional markets so that the focus is not just on nature-based tourism and international clientele. © 2021. All Rights Reserved.