Search results for: elderly tourists

Authors: D. Furuya, H. Ryujin, S. Takahira, Y. Sekine, Y. Oya, K. Sonoda, H. Ogawa, Y. Nomura, R. Maruyama, H. Kim, T. Kudo, A. Nakano, T. Saruta, S. Sugita, M. Nemoto, N. Tanahashi

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Purpose: To study the clinical characteristics of hypoglycemic coma in adult patients with type 1 or type 2 diabetes mellitus (DM). Methods: Participants in this retrospective study comprised 91 patients (54 men, 37 women; mean age ± standard deviation, 71.5 ± 12.6 years; range, 42-97 years) brought to our emergency department by ambulance with disturbance of consciousness in the 7 years from April 2007 to March 2014. Patients with hypoglycemia caused by alcoholic ketoacidosis, nutrition disorder, malignancies and psychological disorder were excluded. Results: Patients with type 1 (8 of 91) or type 2 DM (83 of 91) were analyzed. Mean blood sugar level was 31.6 ± 10.4 in all patients. A sulfonylurea (SU) was more commonly used in elderly (>75 years old; n=44)(70.5%) than in younger patients (36.2%, p < 0.05). Cases showing prolonged unconsciousness (range, 1 hour to 21 days; n=30) included many (p < 0.05) patients with dementia (13.3%; 0.5% without dementia) and fewer (p < 0.05) patients with type 1 DM (0%; 13.1% in type 2 DM). Specialists for DM (n=33) used SU less often (24.2%) than general physicians (69.0%, p < 0.05). Conclusion: In cases of hypoglycemic coma, SU was frequently used in elderly patients with DM.

Keywords: hypoglycemic coma, Diabetes mellitus, unconsciousness, elderly patients

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Authors: Chun-Lin Zhang, Min Wan

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With the upgrade development of the tourism industry from the simple sightseeing tour to the leisure and vacation, people's travel idea has undergone a fundamental change. More and more people begin to pursue liberal and personal tourism, so self-driving tourism has become the main form of current tourism activities. With the self-driving tourism representing the general trend, the importance of convenient tourism transportation and perfect road traffic signs have become more and more prominent. A clear urban road traffic signs can help visitors quickly identify the direction and distance to the tourism destination. The purpose of this article is analyzing the planning of urban road traffic signs which can bring positive impact on the participation in the recreation involved of self-driving tourists. The content of this article is divided into three parts. Based on the literature review and theoretical analysis, the first part constructs a structural variance model. The model is from three dimensions: the attention of the self-driving tourists to the urban traffic signs along the road, the perception of the self-driving tourists to the road traffic signs itself, the perceptions of the self-driving tourists to the tourism destination information on the traffic signs. Through this model, the paper aims to explore the influence of the urban road traffic signs to the leisure psychological involvement and leisure behavior involvement of the self-driving tourists. The second part aims to verify through the hypothesis model the questionnaire survey and come to preliminary conclusions. The preliminary conclusions are as follows: firstly, the color, shape, size, setting mode and occurrence frequency of urban road traffic sign have significant influence on the leisure psychological involvement and leisure behavior involvement of the self-driving tourists. Secondly, the influence on the leisure behavior involvement is obviously higher than the influence on the leisure psychological involvement. Thirdly, the information about the tourism destination marked on the urban road traffic signs has not obviously influence on the leisure psychological involvement, but it has distinct influence on the leisure behavior involvement of self-driving tourists. The third part puts forward that the planning of urban road traffic signs should focus on the angle of the impact of road traffic signs on people's psychology and behavior. On the basis of the above conclusions, the paper researches the color, shape, size, setting mode and information labeling of urban road traffic signs so that they can preferably satisfy the demand of the leisure involvement of self-driving tourists.

Keywords: leisure involvement, self-driving tourism, structural equation, urban road traffic signs

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Authors: Obinna Benedict Duru

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This study focuses on the elderly and the challenges that confront them. The elderly are that particular segment of our population who by virtue of the aging process have attained the stage in most cases where they are confronted with the challenges of economic dependency and social marginality. These challenges are as a result of the physical and biological decline occasioned by social myths and realities which portray the elderly as a dependent population whose members could not and should not work and who need social assistance that the younger population is obliged to provide. From the moment of birth to the moment of death, our bodies are constantly changing. We are all enmeshed in the process of growing old, a transition from youthfulness to elderliness. In youth-oriented modern societies like ours, we tend to attach positive importance and significance to the biological changes that occur early in life and define later physical changes in negative terms. Children growing up and young adults receive more attention, greater responsibilities and more legal rights to reward them on their way. But few people are congratulated on getting old. We commiserate with people who are getting old and make jokes about their supposedly physical, mental and biological decline. Wrinkles, loss of weight and vitality are all parts of the aging process. In almost all parts of the world, earlier researches have shown that about fifty percent of the elderly who suffer from stroke, arthritis, senility and other age related diseases are the disengaged and neglected elderly. Rapid technological changes render the knowledge and skills of the elderly obsolete; education is geared toward the young and the generational competition for jobs leads to pressures on the elderly to retire. Control of initial resources are shifted to the middle-aged and older workers are pushed into positions of economic dependency. This study therefore, among other things tend to discover how some government policies have affected the elderly particularly in Africa. To discover the prospects and possibilities of the elderly for a better living. To make a comparison of the advances in healthcare giving made in the advanced western societies to the practice in Sub Saharan Africa etc. The hypotheses of this study include: that the elderly in Sub Saharan Africa are more vulnerable than their counterparts in Europe and America. The elderly are more prone to social isolation, and that the elderly are mostly affected by age-related sickness etc. With a survey method as the research design, and sample size of about 500 respondents,probability sampling technique was used. Data which were analyzed using chi-square and tables were collected through primary and secondary sources. The findings made include: that the elderly suffer pains of old age especially when disengaged from work or social activity. That loss of income condemn the elderly to a life of vegetable existence, and that those who do not have other means of re-integration usually see old age with regret and despair. It is therefore, recommended among other things that social welfare scheme and the process of re-integration at old age be introduced for the non pensionable elderly in Africa.

Keywords: elderly, social isolation, dependency, re-integration

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Authors: Hennie Boeije, Renate Verkaik, Joke Korevaar

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In Dutch national policy, it is promoted that the elderly remain living at home longer. They are less often admitted to a nursing home or only later in life. While living at home, it is important that they experience a good quality of life. Care providers in primary care support this. In this study, it was investigated what quality of life means for the elderly and which characteristics care should have that supports living at home longer with quality of life. To explore this topic, a qualitative methodology was used. Four focus groups were conducted: two with elderly people who live at home and their family caregivers, one with district nurses employed in-home care services and one with elderly care physicians working in primary care. Next to this individual interviews were employed with general practitioners (GPs). In total 32 participants took part in the study. The data were thematically analysed with MaxQDA software for qualitative analysis and reported. Quality of life is a multi-faceted term for elderly. The essence of their description is that they can still undertake activities that matter to them. Good physical health, mental well-being and social connections enable them to do this. Own control over their life is important for some. They are of opinion that how they experience life and manage old age is related to their resilience and coping. Key terms in the definitions of quality of life by GPs are also physical and mental health and social contacts. These are the three pillars. Next, to this elderly care, physicians mention security and safety and district nurses add control over their own life and meaningful daily activities. They agree that with frail elderly people, the balance is delicate and a change in one of the three pillars can cause it to collapse like a house of cards. When discussing what support is needed, professionals agree on access to care with a low threshold, prevention, and life course planning. When care is provided in a timely manner, a worsening of the situation can be prevented. They agree that hospital care often is not needed since most of the problems with the elderly have to do with care and security rather than with a cure per se. GPs can consult elderly care physicians to lower their workload and to bring in specific knowledge. District nurses often signal changes in the situation of the elderly. According to them, the elderly predominantly need someone to watch over them and provide them with a feeling of security. Life course planning and advance care planning can contribute to uniform treatment in line with older adults’ wishes. In conclusion, all stakeholders, including elderly persons, agree on what entails quality of life and the quality of care that is needed to support that. A future challenge is to shape conditions for the right skill mix of professionals, cooperation between the professions and breaking down differences in financing and supply. For the elderly, the challenge is preparing for aging.

Keywords: elderly living at home, quality of life, quality of care, professional cooperation, life course planning, advance care planning

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Authors: Ghassen Kharroubi, Ines Cherif, Leila Bouabid, Adel Gharbi, Aicha Boukthir, Margaret McCarron, Nissaf Ben Alaya, Afif Ben Salah, Jihene Bettaieb

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Influenza vaccination (IV) is recommended for elderly persons, especially those with underlying conditions. In countries where IV rates in the elderly remain unsatisfactory, exploring attitudes of older persons toward the flu vaccine could be useful to identify barriers and facilitators to IV. The aim of this study was to determine the reasons for IV acceptance or decline in the Tunisian elderly. A national cross-sectional study was conducted in 2019, among persons aged 60 years and over with chronic disease. Data were collected using a standard administered questionnaire. Of the 1191 older persons included, 19.4% received the influenza vaccine in the 2018-2019 flu season. The two main reasons that may lead to refusal of vaccination were concerns that the vaccine could cause side effects (71.5%) and a belief that the vaccine was ineffective (33.9%). The main reason that may lead to accepting vaccination was a doctor’s recommendation (41.1%). Doctors were by far the most trusted source for information regarding influenza vaccine (91.5%) followed by pharmacists (17.6%). Our results highlighted the important role that doctors could play in promoting IV among the Tunisian elderly. Physicians should correct misconceptions about adverse events and the efficiency of the vaccine. In fact, influenza vaccines are generally effective and safe among older persons.

Keywords: attitudes, influenza vaccination, older persons, Tunisia

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Authors: Aarti Suryawanshi

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Royal Tourism has always been a popular niche activity for many tourists around the world. The United Kingdom being at the heart of it, has been a pioneering nation for Royal tourists. Though many other countries with monarchies such as India, Thailand, Japan, Spain, Netherlands, and many more have attracted tourists with the motivation to see and experience the royalty to their nations, the Middle Eastern countries have never really been the attraction for Royal tourists. Royalty in the middle east is fast emerging as a tourist product and also paving way to marketing opportunity that may lead to the increased popularity of the Royal Houses of the region. Dubai has been garnering the centre stage for futuristic developments, economic growth initiatives, and continuous efforts towards urbanisation which has brought the lime light on the Royal house of the Al Maktoum globally, along with the younger royal members being extensively recognised and appreciated for their public and private adventures which are shared through various social media platforms. The objective of this paper is to analyse the popularity of His Highness Sheikh Hamdan Bin Mohammed Bin Rashid Al Maktoum through social media platforms and the possibility of inducing Royal Tourism in Dubai. An empirical study has been performed to describe the automated repositioning of the city of Dubai as a royal tourism hub.

Keywords: royalty, royal tourism, monarchy, marketing strategy, repositioning

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Authors: Veruska C. Dutra, Mary L. G. S. Senna, Felipe S. Spindler

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The State Park Jalapao - PEJ proved to be one of the protected areas that has attracted tourists from all over the world with its unique scenic landscapes. Although the region already has a considerable tourist flow, to our knowledge there is a lack of continuity of studies in the region capable of drawing a plan of activities, such as the profile of the tourist and analysis of their experiences in the region, carried out from 2006-2007. Therefore, this study was proposed to know the profile and experiences of tourists visiting the park today, making a connection with the earlier study, in order to generate subsidies to trace improvement actions. We conducted interviews with tourists in the main tourism season 2015. The results show that after eight years of carrying out the first study, there were no changes, highlighting the lack of a tourism plan for the park.

Keywords: Jalapao, profile tourist, level, satisfaction

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Authors: Wan-Yu Liu, Tiffany April Lin, Yu-Chieh Tang, Yi-Lin Wang, Chieh-Hui Li

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As the national income in Taiwan has been raised, the life style of the public has also been changed, so that the tourism industry gradually moves from a service industry to an experience economy. The Lihpaoland is one of the most popular theme parks in Taiwan. However, the related works on performance of service quality of the park have been lacking since its re-operation in 2012. Therefore, this study investigates the quality of software/hardware facilities and services of the Lihpaoland, and aims to achieve the following three goals: 1) analyzing how various sample data of tourists leads to different results for service quality of LihpaoLand; 2) analyzing how tourists respond to the service tangibility, service reliability, service responsiveness, service guarantee, and service empathy of LihpaoLand; 3) according to the theoretical and empirical results, proposing how to improve the overall facilities and services of LihpaoLand, and hoping to provide suggestions to the LihpaoLand or other related businesses to make decision. The survey was conducted on the tourists to the LihpaoLand using convenience sampling, and 400 questionnaires were collected successfully. Analysis results show that tourists paid much attention to maintenance of amusement facilities and safety of the park, and were satisfied with them, which are great advantages of the park. However, transportation around the LihpaoLand was inadequate, and the price of the Fullon hotel (which is the hotel closest to the LihpaoLand) were not accepted by tourists – more promotion events are recommended. Additionally, the shows are not diversified, and should be improved with the highest priority. Tourists did not pay attention to service personnel’s clothing and the ticket price, but they were not satisfied with them. Hence, this study recommends to design more distinctive costumes and conduct ticket promotions. Accordingly, the suggestions made in this study for LihpaoLand are stated as follows: 1) Diversified amusement facilities should be provided to satisfy the needs at different ages. 2) Cheep but tasty catering and more distinctive souvenirs should be offered. 3) Diversified propaganda schemes should be strengthened to increase number of tourists. 4) Quality and professional of the service staff should be enhanced to acquire public praise and tourists revisiting. 5) Ticket promotions in peak seasons, low seasons, and special events should be conducted. 6) Proper traffic flows should be planned and combined with technologies to reduce waiting time of tourists. 7) The features of theme landscape in LihpaoLand should be strengthened to increase willingness of the tourists with special preferences to visit the park. 8) Ticket discounts or premier points card promotions should be adopted to reward the tourists with high loyalty.

Keywords: service quality, customers’ satisfaction, theme park, Taiwan

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Authors: Siri-orn Champatong

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The purpose of this research was to study factors that were related with travel behaviors of Thai tourists at the Ayothaya Floating Market, Phra Nakhon Sri Ayutthaya. The quantitative research was conducted with 400 samples of Thai tourists traveling to the Ayothaya Floating Market. The Questionnaire was a tool used to collect data, and the statistics used for data analysis were mean and Pearson product moment correlation coefficient. The results found that Thai tourists focused on attraction, easy access and facilities of the tourist spot at a high level. In addition, they gave priority to the marketing mix in the dimension of products, price, and distribution channels at a high level as well. For marketing promotion, it was at the moderate level. The results of hypothesis testing revealed that factors related to the attractions of the tourist destination, easy access to the tourist destination, the facilities of the tourist spot, and product and price of the marketing mix were associated with travel behaviors in the aspect of the number of visits used and the budget on tourism.

Keywords: floating market, marketing mix, tourism attractions, travelling behavior

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Authors: Chisakan Papapankiad

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The purpose of this research was to study the level of satisfaction from the perspective of inbound tourists who visited Bangkok, Thailand during January to March of 2014. While the independent variables included gender, age, levels of education, occupation, and income, the dependent variables were ten reasons for their visiting Thailand. A quota sampling method was utilized to get 200 respondents with 50 percent male and 50 percent female respondents. The majority of respondents were between 30-40 years old. Most were married and had an undergraduate degree. The average income of the respondents was between $30,000-50,000 per year. The findings revealed the ranking levels of satisfaction by highest mean to lowest mean as follows: Thai food and beverage, nature-beach-mountain, spa-massage-beauty, malls-shopping places, souvenir and handcraft, festivals and activities, tradition markets, museum-art-history, night entertainment, and conference-expo. In addition, the overall means is 4.19 with 0.790 SD.

Keywords: inbound tourists, satisfaction, visiting, Thailand

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Authors: Frezer Okubay Weldegebriel

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The tourism sector in Ethiopia plays a significant role in the national economy. The government is granting its pledge and readiness to develop this sector through various initiatives since to eradicate poverty and encourage economic development of the country is one of the Millennium Development plans. The tourism sector has been identified as one of the priority economic sectors by many countries, and the Government of Ethiopia has planned to make Ethiopia among the top five African destinations by 2020. Nevertheless, the international tourism demand for Ethiopia currently lags behind other African countries such as South Africa, Egypt, Morocco, Tanzania, and Kenya. Meanwhile, the number of international tourists’ arrival in Ethiopia is recently increasing even if it cannot be competitive with other African countries. Therefore, to offer demand-driven tourism products, the Ethiopian government, Tourism planners, Tour & Travel operators need to understand the important factors, which affect international tourists’ decision to visit Ethiopian destinations. This study was intended to analyze Italian Tourists Demand towards Ethiopian destination. The researcher aimed to identify the demand for Italian tourists’ preference to Ethiopian destinations comparing to the top East African countries. This study uses both qualitative and quantitative research methodology, and the data is manipulating through primary data collection method using questionnaires, interviews, and secondary data by reviewing books, journals, magazines, past researches, and websites. An active and potential Italian tourist cohort, five well-functioning tour operators based in Ethiopia for Italian tourists and professionals from Ethiopian Ministry of Tourism and Culture participated. Based on the analysis of the data collected through the questionnaire, interviews, and reviews of different materials, the study disclosed that the majority of Italian tourists have a high demand on Ethiopian Tourist destination. Historical and cultural interest, safety and security, the hospitality of the people and affordable accommodation coast are the main reason for them. However, some Italian tourists prefer to visit Kenya, Tanzania, and Uganda due to the fact that they are fascinated by adventure, safari and beaches, while Ethiopia cannot provide these attractions. Most Italian tourists have little information and practical experiences on Ethiopian tourism possibilities via a tour and travel companies. Moreover, the insufficient marketing campaign and promotion by Ethiopian Government and Ministry of Tourism could also contribute to the failure of Ethiopian tourism.

Keywords: The demand of Italian tourists, Ethiopia economy, Ethiopia tourism destination, promoting Ethiopia tourism

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Authors: Natchaphon Auampradit, Patama Vapattanawong, Sureeporn Punpuing, Malee Sunpuwan, Tawanchai Jirapramukpitak

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Longitudinal studies related to cognitive impairment in elderly are necessary for health promotion and development. The purposes of this study were (1) to examine changes in cognition of elderly over time and (2) to examine the impacts of changes in social determinants of health (SDH) toward changes in cognition of elderly by using the secondary data derived from the Kanchanaburi Demographic Surveillance System (KDSS) by the Institute for Population and Social Research (IPSR) which contained longitudinal data on individuals, households, and villages. Two selected projects included the Health and Social Support for Elderly in KDSS in 2007 and the Population, Economic, Social, Cultural, and Long-term Care Surveillance for Thai Elderly People’s Health Promotion in 2011. The samples were 586 elderly participated in both projects. SDH included living arrangement, social relationships with children, relatives, and friends, household asset-based wealth index, household monthly income, loans for livings, loans for investment, and working status. Cognitive impairment was measured by category fluency and delayed recall. This study employed Generalized Estimating Equation (GEE) model to investigate changes in cognition by taking SDH and other variables such as age, gender, marital status, education, and depression into the model. The unstructured correlation structure was selected to use for analysis. The results revealed that 24 percent of elderly had cognitive impairment at baseline. About 13 percent of elderly still had cognitive impairment during 2007 until 2011. About 21 percent and 11 percent of elderly had cognitive decline and cognitive improvement, respectively. The cross-sectional analysis showed that household asset-based wealth index, social relationship with friends, working status, age, marital status, education, and depression were significantly associated with cognitive impairment. The GEE model revealed longitudinal effects of household asset-based wealth index and working status against cognition during 2007 until 2011. There was no longitudinal effect of social conditions against cognition. Elderly living with richer household asset-based wealth index, still being employed, and being younger were less likely to have cognitive impairment. The results strongly suggested that poorer household asset-based wealth index and being unemployed were served as a risk factor for cognitive impairment over time. Increasing age was still the major risk for cognitive impairment as well.

Keywords: changes in cognition, cognitive impairment, elderly, KDSS, longitudinal study

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Authors: C. Caçador, M. J. Reis Lima, J. Oliveira, M. J. Veiga, M. Teixeira Veríssimo, F. Ramos, M. C. Castilho, E. Teixeira-Lemos

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In the present study we evaluated the nutritional status of 214 institutionalized elderly residents of both genders, aged 65 years and older of 11 care homes located in the district of Viseu (center of Portugal). The evaluation was based on anthropometric measurements and the Mini Nutritional Assessment (MNA) score. The mean age of the subjects was 82.3 ± 6.1 years-old. Most of the elderly residents were female (72.0%). The majority had 4 years of formal education (51.9%) and was widowed (74.3%) or married (14.0%). Men presented a mean age of 81.2±8.5 years-old, weight 69.3±14.5 kg and BMI 25.33±6.5 kg/m2. In women, the mean age was 84.5±8.2 years-old, weight 61.2±14.7 kg and BMI 27.43±5.6 kg/m2. The evaluation of the nutritional status using the MNA score showed that 24.0% of the residents show a risk of undernutrition and 76.0% of them were well nourished. There was a high prevalence of obese (24.8%) and overweight residents (33.2%) according to the BMI. 7.5% were considered underweight. We also found that according to their waist circumference measurements 88.3% of the residents were at risk for cardiovascular disease (CVD) and 64.0% of them presented very high risk for CVD (WC≥88 cm for women and WC ≥102 cm for men). The present study revealed the coexistence of a dual form of malnutrition (undernourished and overweight) among the institutionalized Portuguese concomitantly with an excess of abdominal adiposity. The high prevalence of residents at high risk for CVD should not be overlooked. Given the vulnerability of the group of institutionalized elderly, our study highlights the importance of the classification of nutritional status based on both instruments: the BMI and the MNA.

Keywords: nutritional satus, MNA, BMI, elderly

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Authors: Lovro Štefan

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The main purpose of the study was to explore if a higher level of Elderly Dietary index score was correlated with lower peak plantar pressures. One-hundred and twenty older adults aged ≥60 years participated in this cross-sectional study. To assess the level of adherence to nutritional recommendations for older adults, we used Elderly Dietary Index score. Plantar pressures beneath the forefoot, midfootandhindfootregions of the foot were determined by pressure platform. Pearson’s coefficient of correlations and partial correlations were used to calculate the relationships. In the unadjusted model, higher Elderly Dietary Index was significantly correlated with lower peak plantar pressure beneath the forefoot (r = -0.45, p<0.001) and hindfoot (r = -0.37, p<0.001) the region, while no significant correlation with peak plantar pressure beneath the (r = -0.15, p=0.113) was observed. When we adjusted for age, body-mass index and gait velocity, higher Elderly Dietary Index remained significantly correlated with lower peak plantar pressure beneath the forefoot (r = -0.41, p<0.001) and hintfoot (r = -0.32, p<0.001) region. This study shows that higher adherence to nutritional recommendations is significantly correlated with lower forefoot and hindfoot peak plantar pressures in older women.

Keywords: elderly, biomechanics, nutrition, associations, force

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Authors: Mobarok Hossain Bhuyain

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Video surveillance processing has attracted various security fields transforming it into one of the leading research fields. Today's demand for detection and tracking of human mobility for security is very useful for human security, such as in crowded areas. Accordingly, video surveillance technology has seen a rapid advancement in recent years, with algorithms analyzing the behavior of people under surveillance automatically. The main motivation of this research focuses on the detection and tracking of the elderly and socially vulnerable people in crowded areas. Degenerate people are a major health concern, especially for elderly people and socially vulnerable people. One major disadvantage of video surveillance is the need for continuous monitoring, especially in crowded areas. To assist the security monitoring live surveillance video, image processing, and artificial intelligence methods can be used to automatically send warning signals to the monitoring officers about elderly people and socially vulnerable people.

Keywords: human detection, target tracking, neural network, particle filter

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Authors: Faizan Rathore, Naveed Sultan, Humphrey O. Connor

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This study was carried out from Jan '12-Dec'12 to assess current practice in Kerry General Hospital against the age-related indicators for colonoscopies. A total of 1474 colonoscopies were performed,1177(79.9%) were diagnostic and 297 (20.1%) were therapeutic, patients were divided into 4 age groups under 75, 75-80, 81-85, 86+. The trend analysis revealed an increase in diagnostic colonoscopies and decrease in therapeutic colonoscopies with age. 664(45.04%) of colonoscopies were reported normal which made up the majority of the total diagnoses, 1330 (90.2%) of colonoscopies occurred without any complications. Main complications were patient discomfort being the highest, present in 112(7.6%) of patients, and lowest being urticaria around the IV site present in 1 (0.1%) of the cases. Patient discomfort was higher in younger patients as evidenced by 98 cases aged <75 , followed by 11 cases aged 75-80, 2 cases aged 81-85 and 1 case aged >86. Highest percentage of poor tolerance was found in 14 (1.1%) of total patients <75, 1 (0.8%) of total patients aged 75-80, 1(1.7%) of total patients in age group 81-85 and none (0%) in age group >86. We have established the safety of colonoscopy, low rate of complications and a better tolerance in the elderly from this study, however, its utility, especially in the presence of other comorbidities in elderly is questionable.

Keywords: colonoscopy, elderly patients, utility, tolerance

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Authors: Pelin Kinay, Andy P. Morse, Elmer V. Villanueva, Karyn Morrissey, Philip L Staddon, Shanzheng Zhang, Jingjing Liu

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The present study aims to evaluate the climate change and health related knowledge, attitudes and practices (KAP) of the elderly population (60 years plus) in Hefei and Suzhou cities of China (n=300). This cross-sectional study includes 150 participants in each city. Data regarding demographic characteristics, KAP, and climate change perceptions were collected using a semi-structured questionnaire. When asked about the potential impacts of climate change over 79% of participants stated that climate change affected their lifestyle. Participants were most concerned about storms (51.7%), food shortage (33.3%) and drought (26%). The main health risks cited included water contamination (32%), air pollution related diseases (38.3%) and lung disease (43%). Finally, a majority (68.3%) did not report receiving government assistance on climate change issues. Logistic regression models were used to analyse the data in order to understand the links between socio-demographical factors and KAP of the participants. These findings provide insights for potential adaptation strategies targeting the elderly. It is recommended that government should take responsibility in creating awareness strategies to improve the coping capacity of elderly in China to climate change and its health impacts and develop climate change adaptation strategies.

Keywords: China, climate change, elderly, KAP

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Authors: Odete Paiva, Cláudia Seabra, José Luís Abrantes, Fernanda Cravidão

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There is a clear ‘cult of authenticity’, at least in modern Western society. So, there is a need to analyze the tourist perception of authenticity, bearing in mind the destination, its attractions, motivations, cultural distance, and contact with other tourists. Our study seeks to investigate the relationship among cultural values, image, sense of place, perception of authenticity and behavior intentions at World Heritage Historic Centers. From a theoretical perspective, few researches focus on the impact of cultural values, image and sense of place on authenticity and intentions behavior in tourists. The intention of this study is to help close this gap. A survey was applied to collect data from tourists visiting two World Heritage Historic Centers – Guimarães in Portugal and Cordoba in Spain. Data was analyzed in order to establish a structural equation model (SEM). Discussion centers on the implications of model to theory and managerial development of tourism strategies. Recommendations for destinations managers and promoters and tourist organizations administrators are addressed.

Keywords: authenticity perception, behavior intentions, cultural tourism, cultural values, world heritage historic centers

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Authors: Hui-Yen Lee, Hsiu-Yun Wei, Guey-Jen Lin, Pi-Yueh Lee Lee

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Background: Unplanned hospital readmissions increase healthcare costs and have been considered a marker of poor healthcare performance. The elderly face a higher risk of unplanned readmission due to elderly-specific characteristics such as deteriorating body functions and the relatively high incidence of complications after treatment of acute diseases. Purpose: The aim of this study was exploring the factors that relate to the unplanned readmission of elderly within 14 days of discharge at our hospital in southern Taiwan. Methods: We retrospectively reviewed the medical records of patients aged ≥65 years who had been re-admitted between January 2018 and December 2018.The Charlson Comorbidity score was calculated using previous used method. Related factors that affected the rate of unplanned readmission within 14 days of discharge were screened and analyzed using the chi-squared test and logistic regression analysis. Results: This study enrolled 829 subjects aged more than 65 years. The numbers of unplanned readmission patients within 14 days were 318 cases, while those did not belong to the unplanned readmission were 511 cases. In 2018, the rate of elderly patients in unplanned 14 days readmissions was 38.4%. The majority patients were females (166 cases, 52.2%), with an average age of 77.6 ± 7.90 years (65-98). The average value of Charlson Comorbidity score was 4.42±2.76. Using logistic regression analysis, we found that the gastric or peptic ulcer (OR=1.917 , P< 0.002), diabetes (OR= 0.722, P< 0.043), hemiplegia (OR= 2.292, P< 0.015), metastatic solid tumor (OR= 2.204, P< 0.025), hypertension (OR= 0.696, P< 0.044), and skin ulcer/cellulitis (OR= 2.747, P< 0.022) have significantly higher risk of 14-day readmissions. Conclusion: The results of the present study may assist the healthcare teams to understand the factors that may affect unplanned readmission in the elderly. We recommend that these teams give efficient approach in their medical practice, provide timely health education for elderly, and integrative healthcare for chronic diseases in order to reduce unplanned readmissions.

Keywords: unplanning readmission, elderly, Charlson comorbidity score, logistic regression analysis

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Authors: Sudawan Somjai

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The purposes of this research were to investigate the five important perceptions of service quality from inbound tourists who visited Bangkok, Thailand in the first quarter of 2014. Data were collected from over 10 important tourist destinations in Bangkok. The independent variables of this study included gender, age, levels of education, occupation, income, and country of origin while the dependent variables included their experience, opinion, and comment on the service received during visited tourist destinations. A simple random sampling method was performed to obtain 400 respondents. The respondents were both male and female in the same proportion. However, the majority were between 31-40 years old. Most were married with an undergraduate degree. Most were considered themselves as middle income with an average income of the respondents was between $30,001-40,000 per year. The findings revealed that the majority of respondents came to Bangkok because of low cost and high quality of tourism. The majority came to Bangkok for the first time and spent about 10 days in Thailand. The five important service perceptions that were observed by the inbound tourists in descending order according to mean were reliable of service provider, proper time of service provider, competency of service provider, neat and clean of service provider, and politeness of service provider.

Keywords: experience, inbound tourists, perception, service quality

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Authors: Ketwadee Madden

Abstract:

Product or service image is among the vital factors that predict individuals’ choice of buying a product or services, goes to a place or attached to a person. Similarly, in the context of tourism, the destination image is a very important factor to which tourist considers before making their tour destination decisions. In light of this, the objective of this study is to conceptually investigate among French tourists, the determinants of Thailand’s tourism destination image. For this objective to be achieved, prior studies were reviewed, leading to the development of conceptual framework highlighting the determinants of destination image. In addition, this study develops some hypotheses that are to be empirically investigated. Aside these, based on the conceptual findings, suggestions on how to motivate European tourists to chose Thailand as their preferred tourism destination were made.

Keywords: cognitive destination image, affective destination image, motivations, risk perception, word of mouth

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Authors: Sha Fan, Renuka Mahadevan

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In recent years, the subject of how retirement influences consumption behaviours has garnered attention in economic research. However, a significant gap persists in our understanding of how retirement precisely impacts tourism consumption patterns among the elderly demographic. To address this gap, this research conducts an in-depth exploration into the multifaceted relationship between retirement and elderly tourism consumption.To achieve this, the study employs regression discontinuity design, using three waves of panel data from China covering a span of six years. This approach aims to identify the causality between retirement and tourism consumption. Furthermore, the study scrutinizes the pathways through which retirement's impact on tourism consumption unfolds. It adopts a dual-pronged perspective, examining the roles played by economic status and the availability of leisure time. The economic dimension underscores the financial adjustments that retirees make as they transition into a new phase of life, impacting their propensity to allocate resources towards tourism activities. Meanwhile, considering leisure time recognizes that retirement often heralds an era of newfound freedom, allowing retirees the luxury to engage in leisurely pursuits like tourism.

Keywords: tourism consumption, retirement, the elderly, regression discontinuity design

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Authors: Kuei-Yu Chien, Hsiu-Yu Chiu, Chia-Nan Chen, Shu-Chen Chen

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Background: Frailty is associated with decreased physical performances that affect mobility of the elderly. Time up and go test (TUG) was the common method to evaluate mobility in the community. The purpose of this study was to compare the parameters in different stages of Time up and go test (TUG) and physical performance between pre-frail elderly (PFE) and non-frail elderly (NFE). We also investigated the relationship between TUG parameters and physical performance. Methods: Ninety-two community-dwelling older adults were as participants in this study. Based on Canadian Study of Health and Aging Clinical Frailty Scale, 22 older adults were classified as PFE (71.77 ± 6.05 yrs.) and 70 were classified as NFE (71.2 ± 5.02 yrs.). We performed body composition and physical performance, including balance, muscular strength/endurance, mobility, cardiorespiratory endurance, and flexibility. Results: Pre-frail elderly took significantly longer time than NFE in TUG test (p=.004). Pre-frail elderly had lower turning average angular velocity (p = .017), turning peak angular velocity (p = .041) and turning-stand to sit peak angular velocity (p = .037) than NFE. The turning related parameters related to open-eye stand on right foot, 30-second chair stand test, back scratch, and 2-min step tests. Conclusions: Turning average angular velocity, turning peak angular velocity and turning-stand to sit peak angular velocity mainly affected the TUG performance. We suggested that static/dynamic balance, agility, flexibility, and muscle strengthening of lower limbs exercise were important to PFE.

Keywords: mobility, aglity, active ageing, functional fitness

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Authors: Girish Prayag, Wantanee Suntikul, Elizabeth Agyeiwaah

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Current research on dark tourism largely follows residents’ perspectives with limited evaluations of tourists’ experiences. Unravelling the case of a dark heritage site in Elmina, Ghana, this paper develops a theoretical model to understand the relationships among four constructs namely, motivation, tourism impacts, place attachment, and satisfaction. Based on a sample of 414 domestic tourists, PLS-SEM confirmed several relationships and inter-relationships among the four constructs. For example, motivation had a positive relationship with perceptions of positive and negative tourism impacts suggesting that the more tourists were motivated to visit the site for cultural/learning experiences, the more positive and negative tourism impacts they perceived. Implications for dark tourism and heritage site management are offered.

Keywords: dark tourism, motivation, place attachment, tourism impacts

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Authors: E. Vazquez-Santacruz, M. Gamboa-Zuniga

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In this paper, we show a methodology for bodies classification in lying state using HOG descriptors and pressures sensors positioned in a matrix form (14 x 32 sensors) on the surface where bodies lie down. it will be done in real time. Our system is embedded in a care robot that can assist the elderly patient and medical staff around to get a better quality of life in and out of hospitals. Due to current technology a limited number of sensors is used, wich results in low-resolution data array, that will be used as image of 14 x 32 pixels. Our work considers the problem of human posture classification with few information (sensors), applying digital process to expand the original data of the sensors and so get more significant data for the classification, however, this is done with low-cost algorithms to ensure the real-time execution.

Keywords: real-time classification, sensors, robots, health care, elderly patients, artificial intelligence

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Authors: Wen-Yu Chen, Chia-Yuan Hsu, Sasinee Vongsrikul

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The present study is to explore the perception of Taiwanese females towards medical tourism in Thailand for the development of applicable marketing strategy, integrating travel motivation and cosmetic surgery trend to attract potential medical tourists from Taiwan. Since previous studies relevant to this research issue are limited, qualitative study is firstly employed by using one focus group interview and in-depth interviews with Taiwanese females. Moreover, the present research collected questionnaires from 290 Taiwanese females to provide greater understanding of research results. The top three factors that affect Taiwanese females’ decision for not going to Thailand for medical tourism are “physicians and nurses cannot speak Chinese”, “low quality of the cosmetic surgery product that I want to do”, and “the county does not have laws to protect medical tourists’ right”. The finding of the empirical part would suggest the area in medical tourism industry which Thailand should promote and emphasizes in order to increase its presence as a hub for cosmetic surgery and attract Taiwanese female market. Therefore, the study contributes to the potential development of marketing strategy for medical tourism, specifically in the area of cosmetic surgery in Thailand while targeting Taiwan market.

Keywords: Thailand, Taiwanese female tourists, medical tourism, cosmetic surgery

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Authors: Jui-Chen Huang

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This research used artificial intelligence method to explore elderly’s opinions on the reuse of telecare, its effect on their service quality, satisfaction and the relationship between customer perceived value and intention to reuse. This study conducted a questionnaire survey on the elderly. A total of 124 valid copies of a questionnaire were obtained. It adopted Backpropagation Network (BPN) to propose an effective and feasible analysis method, which is different from the traditional method. Two third of the total samples (82 samples) were taken as the training data, and the one third of the samples (42 samples) were taken as the testing data. The training and testing data RMSE (root mean square error) are 0.022 and 0.009 in the BPN, respectively. As shown, the errors are acceptable. On the other hand, the training and testing data RMSE are 0.100 and 0.099 in the regression model, respectively. In addition, the results showed the service quality has the greatest effects on the intention to reuse, followed by the satisfaction, and perceived value. This result of the Backpropagation Network method is better than the regression analysis. This result can be used as a reference for future research.

Keywords: artificial intelligence, backpropagation network (BPN), elderly, reuse, telecare

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Authors: Ha Van Trung, Suchint Simaraks

Abstract:

Agro-tourism is a form of rural tourism that has actively developed in recent years. Tra Que vegetable village has developed this type of tourism to meet the needs of visitors to visit and experience. However, in the process of agricultural tourism development, Tra Que village is facing many issues related to the agricultural way of life, affecting the attraction of tourists. The purpose of this study is to find those issues. The survey questionnaire of 71 households and a semi-structured group interview of 30 households has been applied for the data collection. Research results show that there is a shortage of young workers, lack of training in tourism and agricultural production, and households only exploit a few agricultural activities for tourism. The number of households receiving tourists tends to decrease, and the number of households selling products to tourists at farms accounts for a small proportion. These will affect sustainable agro-tourism development in the future. Focusing on training local households in tourism and agricultural production, encourage young generation to preserve the agricultural way of life, upgrade infrastructure and public services, develop agro-products and tourism services will contribute to the sustainable development of agro-tourism in Tra Que vegetable village in the future.

Keywords: agro-tourism, way of life, Vietnamese tourists, Tra Que vegetable village

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Authors: Song Qingfeng

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This research aims to seek the relationship between social media usage and overtourism from the perspective of tourists based on the theory of Maslow’s hierarchy needs. A questionnaire is formulated to collect data from 400 tourists who have visited the Hangzhou city in China in the last 12 months. Structural Equation Model (SEM) is employed to analysis data. The finding is that social media usage aggravates overtourism. Specifically, social media is used by tourists to information-seeking, entertainment, self-presentation, and socialization for traveling. These roles of social media would evoke the traveling intention to a specific destination at a certain time, which further influences the tourist flow. When the tourist flow concentrate, the overtourism would be aggravated. This study contributes to the destination managers to deep-understand the cause-effect relationship between social media and overtourism in order to address this problem.

Keywords: social media, overtourism, tourist flow, SEM, Maslow’s hierarchy of needs, Hangzhou

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Authors: Ammar Alobaidy, Lamees Alsawafi, Malak Almawali, Balqees Alabri, Hajer Alhamrashdi

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Background: There is scarce data in the literature concerning the use of Arabic version neuron psychological cognitive tests in the geriatric age group of the Omani population. Objectives: Our aim is to obtain norms for normal elderly Omanis assessed by The Consortium to Establish a Registry for Alzheimer's disease (CERAD) neuro psychological battery and to compare these norms with other studies in the literature. Methods: 84 attendants and visitors of in-patients at Sultan Qaboos University Hospital, elder than 55 years, were interviewed. All participants were assessed by Dementia Rating Scale & Geriatric Depression Scale to ensure the integrity of their activities of daily living and the absence of depression, respectively. The performance of all participants in the CERAD battery was rated by a single rater to optimize the inter-rater reliability. Results: The cut-point for average performance in CERAD battery is dependent on the age, sex, and level of education and cannot be set as a single cut-point for all elderly Omanis. Conclusion: This study has shown the effect of age, sex, and level of education on the cognitive performance of normal elderly Omanis. The normative data obtained from this study can be utilized to differentiate between the cognitive decline of normal aging and the cognitive impairment due to various neuro cognitive disorders in the elderly Omanis, and probably culturally similar Arabic speaking communities.

Keywords: CERAD, neuropsychological battery, normal aging, elderly Omanis

Procedia PDF Downloads 367