Effect of guideline implementation on costs of hand hygiene

Hands of health care personnel frequently serve as vectors for the transmission of organisms between patients and are also a major reservoir for pathogens with antimicrobial resistance. Hand hygiene is one effective strategy to reduce health care associated infections. The purposes of this study were to (a) compare the costs of hand hygiene in hospitals with high and low hand hygiene compliance as well as high and low frequency of alcohol hand rub use; and (b) examine associations between hospital characteristics and hand hygiene compliance as well as frequency of alcohol hand rub use. Nursing and health care policy leaders should look for ways to promote sustained adherence to hand hygiene recommendations.     

Vulnerable consumers in the ‘fourth age’: theoretical reflections upon the case of Sandra Bem

ABSTRACT

This commentary reflects upon consumer vulnerability in the ‘fourth age’ through a consideration of the case of Sandra Bem. In doing so, we focus on how Alzheimer’s disease affected Bem’s ability to make decisions and navigate the market to commit suicide. Subsequently, this article reflects upon terror management theory, ‘fourth age’ consumption and self-consciousness to suggest that future studies of degenerative illness are likely to breathe further life into the study of vulnerable consumers.     

Protected areas,wildlife-based community tourism and community livelihoods dynamics: spiraling up and down of community capitals

Participation in wildlife-based community tourism within and around protected areas is seen as a tool to link biodiversity conservation and community livelihoods improvement. However, there is a deficiency of frameworks currently used to understand complex and dynamic relationships that exist among conservation, tourism and development. The community capitals framework is adopted to assess these linkages from a systems-thinking perspective in which community capitals’ stock and flow, explained by a community's participation in tourism determines the direction of change. Results of the Chobe Enclave Conservation Trust in Botswana indicate that all community capitals are interdependent and play a dynamic role in shaping the spiraling of community livelihoods. Participation in tourism led to both the spiraling up and down of community capitals. The spiraling up of community capitals is explained by increased livelihoods and diversification options facilitated by increased tourism income. The spiraling down is explained by the heightened human–wildlife conflicts and fragile wildlife–livestock co-existence, which led to livestock diseases, loss of beef market and the ecosystems’ fragmentation through the introduction of veterinary fences. Thus, the spiraling of community capitals is explained by the transformation of one stock of community capital to another in a systems-thinking dynamics fashion.     

Farmer knowledge across the commodification spectrum: Rice,cotton, and vegetables in Telangana,India

Crop seeds are a factor of production that can be produced on farm or bought, commodified in varying ways and degrees, and that can change slowly or rapidly—all of which directly impact the crucial process of farmer “skilling.” Seed choices also offer a unique empirical window through which farmer knowledge may be studied. Although other studies have examined the differences between cash and food crops, this research provides new insights into varyingly commodified crops within the same agrarian system. When planting rice, genetically modified hybrid cotton seeds, and garden vegetables, farmers in Telangana, India, face different constraints and opportunities to learn about their seeds and practice that knowledge in the field. These differences arise from agronomic properties of the seeds themselves as well as from the sociocultural meaning that structures the context in which farmers buy, grow, and save them. This measurable discrepancy in farmer knowledge and experience presents an opportunity to examine the variable impact of seed commodification as it is experienced by the same group of farmers across several different crops. Building on theories of commodification and agricultural knowledge, we propose that the different ways in which farmer knowledge operates in these crops reflect a spectrum on which knowledge and commodification are inversely related.     

Protected areas,tourism and community livelihoods linkages: a comprehensive analysis approach

This study explores the linkages among protected areas, tourism and community livelihoods in a rural setting. The Chobe National Park and Chobe Enclave Community Trust, Botswana, provide the context for this study. Data were collected through a community asset mapping exercise, semi-structured interviews, and published and unpublished data sources. Data were analyzed and interpreted using the community capital framework (CCF) that provided a comprehensive approach. The study identified that protected areas, tourism and community livelihoods linkages have many inter-dependent community capitals relationships. The enhancement of community capitals was facilitated by a shift from government-controlled to multi-level governance arrangements that recognize community wildlife-based tourism potential co-exist with protected areas, have influence on community livelihoods and nurture positive linkages. Results also indicate that linkages are dependent on community capitals transformation or lack thereof; the linkages have an influential effect on the whole ecosystem on which protected areas, tourism and community livelihoods operate. The study provides a new methodological approach in understanding the changing relationships among tourism, conservation and community development by expanding community capitals framework. This study's findings also inform planners, managers, and policy makers to critically evaluate the processes of change and devise interventions accordingly.     

Teaching for critical thinking: preparing hospitality and tourism students for careers in the twenty-first century

Twenty-first century tourism educators and career-seeking graduates are faced with a host of novel challenges. Given the dynamic, complex nature of the contemporary tourism industry, students must be equipped with relevant twenty-first century skills. To address this need, critical thinking is currently being promoted, via university initiatives, as an employable skill. This study assesses the extent to which critical thinking is being transmitted to tourism students at a large southeastern university in the United States. Precourse and postcourse data were collected from students (n = 85) who participated in a tourism management class, that emphasized case study learning, during the fall 2014, spring 2015, and spring 2016 semesters. Uncorrected results indicate significant positive increases in overall critical thinking and two of five sub-domains – inference and deduction; however, in the conservative, corrected results there are no significant effects. Recommendations for improving critical thinking and three sub-domains – analysis, evaluation, and induction – are discussed.     

The shock of COVID-19 and the shock of rapid vaccine development on the value of senior life settlement contracts

In this paper, we develop a model that can capture how COVID-19 and the subsequent rapid vaccine development against COVID-19 impacts the value of pools of senior life settlements. The pandemic unexpectedly boosted the mortality rates of senior citizens who had prior diagnoses of certain health conditions. Our model accounts for the existence and concentration of these COVID-19 comorbidities in portfolios of senior life settlements. It is the concentration of assets linked to the mortality rates of a group who is at elevated risk to COVID-19 and who is also the primary beneficiaries of the COVID-19 vaccine that we examine. We illustrate how the shock of the pandemic increases the value of senior life settlements and how the accelerated development and distribution of COVID-19 vaccines moderated this increase. Our model is general enough to simulate the impact on other financial contracts that are linked to individual mortality rates. These would include life insurance contracts, annuities, and health insurance policies.