Search

Despite luxury brands’ efforts to incorporate sustainable development into their branding and product design, studies have shown inconclusive evidence about consumers’ reaction towards such efforts. This study investigates how consumption values (i.e. the need for exclusivity, conformity, and hedonism) affect consumers’ acceptance of luxury brands’ sustainable efforts. It adopts a cross-cultural framework by analysing two countries, namely China and the UK, which differ substantially in some of Hofstede’s cultural dimensions, namely power distance, individualism, and indulgence. Using the structural equation modelling in analysing 677 survey responses from actual luxury goods’ consumers in the two countries, we suggest that hedonic needs drive consumers’ purchase intentions in China and the UK. We find that the need for exclusivity in sustainable luxury items is negatively related to consumers’ purchase intentions in China, while the need for conformity is positively related. In contrast, these effects are reversed in the UK. Our study implies the need to align the marketing of sustainable luxury with consumption values of consumers to reflect the cultural differences. In theorizing sustainable luxury research, this study provides a deeper understanding of value perceptions pertaining to luxury product consumption and sustainability. Supplementary Information The online version contains supplementary material available at 10.1057/s41262-020-00228-0.

This paper attempts to investigate the potential of courtyards in optimizing natural ventilation and improving comfort levels in the learning spaces of a naturally ventilated educational institution with courtyards in the warm-humid climatic region of Madurai. Field measurements and experimental studies were carried out to predict the indoor and outdoor environmental conditions. The numerical study was carried out using computational fluid dynamics-based simulations using Ansys Fluent as the solver. The main aim of the simulation is to understand the airflow pattern and air velocity fields inside the classrooms surrounding the courtyards for different wind directions. The computational fluid dynamics results were validated by comparing it with the experimental results obtained in the current study and numerical results from other studies. The major findings of the current study suggest that courtyards with an aspect ratio of 1:2, orientations of openings at an angle of 0–20° to the predominant wind directions and the overall percentage of openings between 15 and 30% in buildings in Madurai region can enhance natural ventilation and thus improve thermal comfort of the occupants.Practical application: Naturally ventilated buildings in warm-humid climates have difficulty in providing thermal comfort to the occupants. CFD tools have been used to predict the ventilation performance of a naturally ventilated educational building with courtyards. The CFD results were helpful in identifying the implication of building design on the indoor air flow pattern. The recommendations given in this paper are applicable to any building type which relies on natural ventilation for thermal comfort provided they have similar building configurations, boundary conditions and weather conditions. The study is intended to help architects and building designers in the effective design of naturally ventilated buildings with respect to its climatic conditions.

This paper presents two vignettes that might interest tourism scholars in their future research endeavours. Firstly, a journey in multidisciplinary research is described to expound on the successful collaboration between scholars of different background premised on being open to ideas from non-tourism perspectives and learning how to hybridize an explanation or method is helpful to the scientific goals. Secondly, we review sequential exploratory mixed methods and scale development as a contribution to the tourism discipline. Utilizing the qualitative and quantitative data collection and analysis in a sequence of phases, the project aimed to develop the scale to measure travel suppliers’ readiness to provide transformational tourism Services. The significance of this work rests on sharing insights to working in a multidisciplinary team and propose a conceptual framework to crafting and validating findings using scaling and sequential phases combined with qualitative methods all with the aid of existing data reading software.

Today, customer satisfaction alone is not enough anymore in the tourism and hospitality industry in order to win the loyalty of guests. Instead, the industry need to achieve service excellence by delighting their guests with a set of drivers of excellence. Despite the relevance of the topic to the Asian tourism industry, the extant literature is scarce and fragmented. The 12 chapters in this book derive from a call for papers as well as from a study tour of Singapore and Malaysia. Papers went through a double-blind peer review procedure. They comprise both conceptual and—in most cases—empirical papers, drawing on recent research in the Asian tourism and hospitality industry. This edited book sets out to examine what and how companies in the tourism and hospitality industry do to deliver a high level of service excellence. They span aspects including the design of services, managing customer-oriented operations, leveraging digital technology and managing resources.

This paper reviews the potential benefits of Lean Six Sigma for service providers in the tourism and hospitality industry. The fact that Lean Six Sigma was designed and mainly used by the manufacturing industry makes it seem unattractive for service providers. The goal is to provide scientific information on the advantages and difficulties associated with implementing Lean Six Sigma in a tourism and hospitality operation, with a focus on Asia. In order to gather information for this paper, a literature review and field research were conducted in several South East Asian touristic attractions. The discussion entails the extent to which two selected attractions can employ Lean Six Sigma, and what benefits could result from using them. Overall, Lean Six Sigma has high potential in the tourism and hospitality industry, but has yet to be more frequently used by businesses operating in this sector.

Whilst the Asian region is experiencing a growth in tourist arrivals, it becomes increasingly important for businesses in its tourism and hospitality industry to find ways to sustain the growth momentum into the future. This edited book posits that going beyond just customer satisfaction to achieve customer delight may be the solution. For long-term competitiveness, with a better understanding of customer needs, businesses can develop their operational capabilities and competencies in meeting these needs, not only to satisfy, but also to delight their customers. Some key takeaways from the broad array of practices and challenges discussed in the 12 chapters in this book include the influence of cultures on how and what businesses in the Asian tourism and hospitality industry do in their quest for service excellence, as well as how adding a personal touch can make a key difference on the whole customer experience.

Entrepreneurs in tourism constantly find business a challenge, especially when competing with well-established players in the industry who have huge capital and large market shares. More often than not, these entrepreneurs must constantly innovate and come up with new ideas on travel booking and new ways to enhance travel experiences. Focusing on entrepreneurs in Asia, very few countries proactively fund aspiring entrepreneurs who often struggle like their American counterparts with credit card debts and huge loans. This chapter reviews Asian entrepreneurs in tourism, with a focus on accessibility to state support and funds, identifying research areas for future studies. Using systematic literature review and country-specific profiling of India, Singapore, Thailand, and Vietnam, the study examines the extent governments support entrepreneurs and the sustainability of their business. This research is intended to trigger insights for both industry practitioners and policymakers and to form an awareness to create a sustainable environment for budding entrepreneurs in tourism.

This paper proposes a gamified approach to promote tourism attractions based on users' interaction with a virtual pet in the context of an AR mobile application. Technology Acceptance Model, 6–11 Framework and Persuasive Systems Design are combined, to extract factors influencing the intention to travel with the virtual pet. A survey questionnaire was developed and administered online to 539 participants. Outcomes of this study highlight the significant role of emotional attachment and rewarding experience towards intention to travel with a virtual pet. The outcomes also helped us to develop a new ‘Intention to Travel’ (I2T) model. To interest and excite prospective visitors, a design of a mobile game with Augmented Reality (AR) features is proposed which will involve engaging interactions with virtual pets to attract visitors to desired location(s). Practitioners such as game developers and tourism policy makers may consider the virtual pets as a vehicle to impact tourists' behavior.

The luxury tourism industry immediately conjures up thoughts of exclusivity, with access to it confined to a small and elite group of travelers often located within their own social bubble. Our systematic literature review seeks to understand how tourism scholarship has addressed the issue of luxury travel based on social media pronouncements and the areas of concentration in which earlier studies have been conducted. Literature was sourced using the following key terms “luxury tourism”, “elite travel”, “social media”, and “sustainability” in various combinations using the OneSearch online platform, the Proquest Database, and Google Scholar. Only peer-reviewed journals were used for the critical analysis. Three main thematic areas were identified and reviewed: (1) the role of social media in luxury tourism; (2) the behavioral attributes of luxury travelers’ when using social media; and (3) the methodologies employed in the extant literature, given the limitations of accessing specific data for the luxury tourism market. The selected period for the journals and articles reviewed was the last ten years, from March 2010 to March 2020. NVivo version 12 was used to decipher the themes and focus areas as well as quantify the significance of social media to luxury tourism. Drawing from these literature review outcomes, the study explores future research areas and issues that require new theoretical and methodological frameworks to further our understanding of the intersection between social media and the luxury tourism business.

Approximately US$3.5 billion is spent annually as a result of adverse drug events (ADEs) [1], responsible for approximately a third of rehospitalizations and resulting in more than 700,000 annual emergency department visits by Medicare patients [2]. A substantial opportunity exists to reduce these iatrogenic events by taking a comprehensive and, when warranted, pharmacogenetics-guided approach to medication management based on the use of sophisticated clinical decision support (CDS) tools.

The idea of destination development often emphasizes transport connectivity, hospitality services, infrastructure building, attractions facilities and promotions with an indicative measure of visitor arrivals. In contrast, we underline the importance of souvenirs corollary to tourism development if it is related to traditional crafts especially in emerging destinations. Souvenirs in tourism are a useful tool in promoting a tourist destination's image. However, in Vietnam's tourism landscape, souvenir development has not played a corresponding role of image creation and commercial enterprise. We examine the problems of adapting Vietnamese souvenirs for tourism using stakeholder analysis. Attention to souvenirs in Vietnam provides an opportunity to illustrate the nexus between tourism development trajectories, image-making and the intricacies involved in national representation.

The beach is one of the idyllic tropical attractions requiring and receiving attention from all those who partake in it. As a tourism resource, the issue of preserving its awe and beauty proves challenging for stakeholders in the tropics. Existing academic frameworks of sustainability primarily focus on the triple bottom line, community-based tourism and tourist management strategies to mitigate tourist activities that are detrimental to the beach as a generational resource. This paper proposes a marketing-activities approach to offer policy options when promoting beaches in the tropics. In this approach, we analyse ways natural settings and accompanying activities produce sustainable results if the marketing programmes are in sync with activities at the beach as a perceived valuable resource. The model attempts to understand the beach as a marketable resource commensurate with escalation of activities. A comparative descriptive study was conducted on Singapore’s Sentosa Island, Thailand’s Phuket and India’s Goa beaches to draw a conceptual framework. This framework presents principal stakeholders practical management strategies vis-a-vis marketing and beach activities. Tropical destinations are limited natural resources and face increasing development pressures. A marketing-activities approach can address issues of sustainability alongside experiences of quintessential tropical vacations for tourists.

This manuscript provides nomenclature recommendations developed by an international workgroup to increase transparency and standardization of pharmacogenetic (PGx) result reporting. Presently, sequence variants identified by PGx tests are described using different nomenclature systems. In addition, PGx analysis may detect different sets of variants for each gene, which can affect interpretation of results. This practice has caused confusion and may thereby impede the adoption of clinical PGx testing. Standardization is critical to move PGx forward.

The 2015 year-end will mark a new era for the Association of Southeast Asian Nations that seeks to transform from a loosely held cooperating nations to a more closely knit “ASEAN Economic Community” (AEC) of over 600 million people. Greater economic cooperation is predicted to accelerate intra-ASEAN mobility. The AEC is expected to be characterized by the removal of tariffs and non-tariff barriers to trade, common external tariffs, and free movement of capital, goods, labor, and people. In all of ASEAN, tourism is a key economic sector that has implications for societies and cultures. This chapter evaluates the integrating elements that affect the tourism sector in member states. Building on earlier research and current tourism industry practices in ASEAN, three key areas are examined: employment and inbound and intra-ASEAN travel strategies. The implementation of the mutual recognition agreement and managed mobility of skilled labor opens up new economic vistas for people in the region seeking opportunities beyond national boundaries.

Background In polypharmacy patients under home health management, pharmacogenetic testing coupled with guidance from a clinical decision support tool (CDST) on reducing drug, gene, and cumulative interaction risk may provide valuable insights in prescription drug treatment, reducing re-hospitalization and emergency department (ED) visits. We assessed the clinical impact of pharmacogenetic profiling integrating binary and cumulative drug and gene interaction warnings on home health polypharmacy patients. Methods and findings This prospective, open-label, randomized controlled trial was conducted at one hospital-based home health agency between February 2015 and February 2016. Recruitment came from patient referrals to home health at hospital discharge. Eligible patients were aged 50 years and older and taking or initiating treatment with medications with potential or significant drug-gene-based interactions. Subjects (n = 110) were randomized to pharmacogenetic profiling (n = 57). The study pharmacist reviewed drug-drug, drug-gene, and cumulative drug and/or gene interactions using the YouScript® CDST to provide drug therapy recommendations to clinicians. The control group (n = 53) received treatment as usual including pharmacist guided medication management using a standard drug information resource. The primary outcome measure was the number of re-hospitalizations and ED visits at 30 and 60 days after discharge from the hospital. The mean number of re-hospitalizations per patient in the tested vs. untested group was 0.25 vs. 0.38 at 30 days (relative risk (RR), 0.65; 95% confidence interval (CI), 0.32–1.28; P = 0.21) and 0.33 vs. 0.70 at 60 days following enrollment (RR, 0.48; 95% CI, 0.27–0.82; P = 0.007). The mean number of ED visits per patient in the tested vs. untested group was 0.25 vs. 0.40 at 30 days (RR, 0.62; 95% CI, 0.31–1.21; P = 0.16) and 0.39 vs. 0.66 at 60 days (RR, 0.58; 95% CI, 0.34–0.99; P = 0.045). Differences in composite outcomes at 60 days (exploratory endpoints) were also found. Of the total 124 drug therapy recommendations passed on to clinicians, 96 (77%) were followed. These findings should be verified with additional prospective confirmatory studies involving real-world applications in larger populations to broaden acceptance in routine clinical practice. Conclusions Pharmacogenetic testing of polypharmacy patients aged 50 and older, supported by an appropriate CDST, considerably reduced re-hospitalizations and ED visits at 60 days following enrollment resulting in potential health resource utilization savings and improved healthcare. Trial registration ClinicalTrials.gov NCT02378220

The study of vandalism, particularly graffiti at tourist attractions is dispersed across several academic disciplines; within the field of tourism itself, vandalism has received limited attention. This paper examines vandalism prevention methods employed at the Borobudur Temple in Indonesia to suggest alternative approaches to heritage management that takes into account tourists’ desires to deface attractions through graffiti. Drawing on fieldwork observations and examples of graffiti deterrence found in North America and Asia, this study suggests that managing attractions in Asia has to consider tourists desires as much as placing emphasis on traditional punitive actions and preventative measures.

A 19-base pair germline deletion in exon 2 of the CDKN2A (cyclin-dependent kinase inhibitor 2A) gene (Leiden mutation) has been detected in Dutch families with familial melanomas. The penetrance of CDKN2A mutations varies widely and is influenced by environmental and unrelated genetic factors such as variants in the MC1R gene.We describe a 25-year-old German woman who developed 8 invasive melanomas and 6 in situ melanomas after radiation therapy and polychemotherapy for Hodgkin lymphoma. Genetic testing revealed a constitutional CDKN2A Leiden mutation in the proband and her sister, mother, and mother's sister. The proband also carried high-risk MC1R variant alleles R151C and R160W, which she had inherited from her father and her mother, respectively. The less affected mutation carrier sister did not have high-risk MC1R variant alleles. Analysis of DNA from paraffin-embedded tissues showed loss of heterozygosity at CDKN2A loci in all 3 melanomas studied but not in Hodgkin lymphoma. The pedigree revealed several types of cancers on both sides of the family, but no Dutch ancestors were found. No mutations in the CDK4, B-raf, and N-ras genes were detected either in the germline or in tumors from the patient.This study shows the variability of the penetrance of the CDKN2A Leiden mutation within the same family, which could be due to genetic or exogenous factors.

Summary This case–control study examines the association between lung cancer and genetic polymorphisms in two base excision repair (BER) genes, XRCC1 and APEX1 and two genes involved in homologous recombination repair (HR), XRCC3 and NBS1. Never-smoking lung cancer patients were recruited, and also the next diagnosed ever-smoking case of the same gender and age group. Controls were recruited from the regional population register, frequency matched to cases by hospital catchment area, gender, age group and smoking category. As a result more than 70% of the study population were women. A total of 331 individuals were analysed. Presence of the XRCC1 399Gln allele was associated with a significantly decreased risk for lung cancer among non-smoking women (odds ratio (OR) 0.4, 95% confidence interval (CI) 0.2–0.9). No significant effect was seen with the APEX1 polymorphism. Women smokers carrying the XRCC3 241Met allele showed a significantly decreased risk for lung cancer (OR 0.3, CI 0.2–0.7). The NBS1 185Gln allele was significantly associated with an increased risk for lung cancer among non-smoking women (OR 2.2, CI 1.0–4.8) and low-dose smoking women (OR 4.8, CI 1.5–15.7). The protective effect of the variant XRCC3 241Met allele was strengthened when combined with the low-risk Glu185 allele of the NBS1 gene. Smokers (OR 0.38, CI 0.16–0.90) and women (OR 0.42, CI 0.21–0.85) with at least three low-risk alleles in these two HR genes showed a significantly decreased risk for lung cancer. Thus, in spite of a relatively small study population, this study, including a comparatively large number of never-smokers and women, presents several novel aspects on genetic susceptibility to lung cancer. Our results show that the genetic variation in XRCC1, XRCC3 and NBS1 influence lung cancer susceptibility among women, and that combinations of risk alleles in the two HR genes can enhance the effects.

The endothelin signaling pathway plays a crucial role in melanocyte differentiation and migration. In this study, we investigated whether germline mutations of endothelin receptor B (EDNRB), a gene involved in Hirschsprung disease (HSCR), could also predispose for malignant melanoma (MM). The coding region of EDNRB was sequenced in 137 MM patients and in 130 ethnically matched Caucasian control subjects. Six nonsynonymous EDNRB variants were found in 15 patients (11%), but only two were found in four control subjects (3%, odds ratio [OR] = 3.87, 95% confidence interval [CI] = 1.25 to 12; P = .012). Overall, 14 out of 15 MM patients carried EDNRB mutations reported in HSCR, some of which had previously been shown to lead to loss of function. In multivariable logistic regression analysis including skin type, eye and hair color, number of nevi, and dorsal lentigines (freckles), the association between EDNRB mutations and MM risk remained statistically significant (OR = 19.9, 95% CI = 1.34 to 296.2; P = .03). Our data strongly suggest that EDNRB is involved in predisposition for two different multigenic disorders, HSCR and melanoma.

In a recent report on the role of the 5,10-methylenetetrahydrofolate reductase (MTHFR) genetic polymorphisms in childhood acute lymphoblastic leukemia (ALL), Krajinovic et al reported a reduced risk associated with a combination of genotypes.[1][1] On stratification of patients into those born