Persistent post-surgical pain (PPSP) is a major clinical problem with significant individual, social and health care costs. The aim of this study was to examine the joint role of demographic, ...clinical and psychological risk factors in the development of moderate and severe PPSP after Total Knee and Hip Arthroplasty (TKA and THA, respectively). This was a prospective study wherein a consecutive sample of 92 patients were assessed 24 hours before (T1), 48 hours after (T2) and 4-6 months (T3) after surgery. Hierarchical logistic regression analyses were performed to identify predictors of moderate and severe levels of PPSP. Four to six months after TKA and THA, 54 patients (58.7%) reported none or mild pain (Numerical Rating Scale: NRS ≤ 3), whereas 38 (41.3%) reported moderate to severe pain (NRS >3). In the final multivariate hierarchical logistic regression analyses, illness representations concerning the condition leading to surgery (osteoarthritis), such as a chronic timeline perception of the disease, emerged as a significant predictor of PPSP. Additionally, post-surgical anxiety also showed a predictive role in the development of PPSP. Pre-surgical pain was the most significant clinical predictive factor and, as expected, undergoing TKA was associated with greater odds of PPSP development than THA. The findings on PPSP predictors after major joint arthroplasties can guide clinical practice in terms of considering cognitive and emotional factors, together with clinical factors, in planning acute pain management before and after surgery.
This study aims to offer some insights on the contribution of sensory diversity as perceived by tourists to memorable destination experiences and to explore the connection between long-term memory of ...sensory impressions and destination loyalty. The vital role of the sensory dimension of tourist experiences is stressed by current tourism research and supported by a multidisciplinary view on the role of the five external senses in human perception, memory, and behavior. While the marketing management approach highlights the importance of considering multisensory information in the process of facilitating positive and memorable destination experiences, there is a lack of empirical research to validate the theoretical literature. A two-step exploratory study was conducted in loco and six months after tourists' visits to Southwest Portugal. The findings suggest that perceived richer sensory tourist experiences may have a significant role in the long-term memory of individuals’ experiences, encouraging favorable tourist behavior towards destinations.
•Conducts a two-step study with a managerial perspective to facilitate positive destination experiences.•Suggests that diversified sensory impressions as perceived by tourists impact the long-term memory.•Diversified sensory impressions recalled in the post-visit phase enhance favorable tourist behavior towards destinations.•Reveals a link between richer sensory tourist experiences and destination loyalty.
This study proposes a model to investigate the relationship between residents’ perception of tourism’s impact on their quality of life (QoL) and their emotional solidarity toward tourists. The social ...exchange theory was used as a framework to explain the relationship, and structural equation modeling to assess the hypothesized model. Data for this study were obtained from survey responses of 407 residents in Macau, China, characterized by an intense tourism activity in a small territory. Results indicate that residents’ perception of tourism’s impact on four life domains (material, community, emotional, and health and safety) influences their satisfaction with the corresponding life domains. However, these domains only partially contribute to their overall satisfaction with QoL. Moreover, overall satisfaction with QoL revealed to be a significant predictor of residents’ emotional solidarity toward tourists. The findings indicate the importance of considering QoL in examining residents’ attitudes toward tourists. Implications and opportunities for further research are proposed.
Because existing instruments for assessing surgical fear seem either too general or too limited, the Surgical Fear Questionnaire (SFQ) was developed. The aim of this study is to assess the validity ...and reliability of the SFQ.
Based on existing literature and expert consultation the ten-item SFQ was composed. Data on the SFQ were obtained from 5 prospective studies (N = 3233) in inpatient or day surgery patients. These data were used for exploratory factor analysis (EFA), confirmatory factor analysis (CFA), reliability analysis and validity analysis.
EFA in Study 1 and 2 revealed a two-factor structure with one factor associated with fear of the short-term consequences of surgery (SFQ-s, item 1-4) and the other factor with fear of the long-term consequences of surgery (SFQ-l, item 5-10). However, in both studies two items of the SFQ-l had low factor loadings. Therefore in Study 3 and 4 the 2-factor structure was tested and confirmed by CFA in an eight-item version of the SFQ. Across all studies significant correlations of the SFQ with pain catastrophizing, state anxiety, and preoperative pain intensity indicated good convergent validity. Internal consistency (Cronbach's alpha) was between 0.765-0.920 (SFQ-total), 0.766-0.877 (SFQ-s), and 0.628-0.899 (SFQ-l). The SFQ proved to be sensitive to detect differences based on age, sex, education level, employment status and preoperative pain intensity.
The SFQ is a valid and reliable eight-item index of surgical fear consisting of two subscales: fear of the short-term consequences of surgery and fear of the long-term consequences.
People with haemophilia (PWH) experience acute pain during joint bleeds and might develop chronic pain due to joint degeneration. However, there is a lack of standardized measures to comprehensively ...assess pain in PWH. This study aimed to develop a multidimensional questionnaire for haemophilia-related pain, the Multidimensional Haemophilia Pain Questionnaire (MHPQ), and to present initial validation data among adults.The questionnaire distinguishes between acute/chronic pain and queries about pain locations, duration, frequency, triggering factors, intensity, interference, strategies, specialists for pain management and satisfaction with treatment. An initial version was tested with 16 patients to ensure item comprehensibility and face validity. The final version was answered by 104 adults, with 82 (78.8%) reporting haemophilia-related pain in the previous year (mean age = 43.17; SD = 13.00). The non-response analysis revealed good item acceptability. Exploratory and confirmatory factor analysis (EFA/CFA), reliability (internal consistency, test-retest, inter-item and item-total correlations) and convergent validity were analysed for the intensity and interference dimensions of the questionnaire. A combined EFA with these two constructs supported a 2-factor structure distinguishing intensity (α = 0.88) from interference items (α = 0.91). CFA was tested for the interference dimension, demonstrating suitability for this sample. Item-total correlations were >0.30 on both dimensions and most inter-item correlations were <0.70. Test-retest reliability (n = 42) was good for intensity (r = 0.88) and interference (r = 0.73), and convergent validity was confirmed for most hypotheses (r>0.30).This questionnaire is a comprehensible tool, achieving a thorough assessment of relevant pain dimensions. The MHPQ can help guide treatment recommendations by highlighting relevant topics and contributing to more effective, integrated treatments.
Drawing on the authentic happiness theory, the aims of this article are three-fold: first, to propose a refined measurement scale for tourists’ sense of well-being; second, to investigate the impact ...of four categories of tourist experience on tourists’ sense of well-being; and third, to explore the effect of the sense of well-being on tourists’ satisfaction and loyalty. Data were collected from tourists spending their holidays in the Algarve, Portugal. To address the lack of an integrated measurement scale for assessing tourists’ sense of well-being, an exploratory factor analysis was initially conducted. Subsequently, the data were analyzed using structural equation modeling in WarpPLS 8.0. The findings reveal a three-dimensional scale for tourists’ sense of well-being, consisting of meaningfulness, active pleasure, and release. The results also show a significant positive impact of the four realms of tourists’ experiences on the sense of well-being. Finally, positive relationships between well-being, tourist satisfaction and loyalty are confirmed. The theoretical and practical implications, limitations, and potential directions for future research are discussed.
Competition issues with food industry have recently boosted the exploration of alternative solutions capable of replacing starch in papermaking to a certain extent. Covalent grafting of quaternary ...ammonium groups onto LignoBoost® Eucalyptus kraft lignin has recently shown promise in this regard as the cationic products feature excellent water solubility across the entire pH scale. Considering these suitable properties, cationic kraft lignin was applied and evaluated, for the first time, in the perspective of partial substitution of cationic starch in papermaking, using bleached Eucalyptus kraft pulp. Based on an assessment of key paper properties, such as mechanical (tensile, bursting, and tearing indexes), structural (roughness, capillarity rise, air resistance, internal strength, and water contact angle), and optical ones (brightness, opacity, and relative color change), it is safe to conclude that the partial replacement of conventional cationic starch by cationic lignin does not compromise these features. The results also show that properties can be fine-tuned by varying the degree of lignin derivatization, providing paper-specific solutions for replacing starch by lignin potentially available at large-scale at the pulp and paper industry, closing the loop within the circular economy concept.
Destination social responsibility (DSR) is a contemporary construct related to social responsibility efforts at the level of destinations rather than corporations. While DSR has become a salient ...topic for destinations, research approaches are still fragmented. This work discusses existing conceptualisations, followed by a systematic review. Studies have supported positive outcomes of DSR, which can be favourable towards destinations at large. Although stakeholder theory is deemed foundational in conceptualizing DSR, findings reveal the construct has been studied from the perspective of tourists or residents, whereas other stakeholders are still absent from studies. The topic is biased towards quantitative methods and settings, and a comprehensive measurement instrument and definition of DSR are called for. This review aims to outline the contribution and progress of DSR in the context of responsible tourism, propose a unifying definition of DSR, and offer avenues for future research.
Across vertebrates, the numerous estrogenic functions are mainly mediated by nuclear and membrane receptors, including the G protein-coupled estrogen receptor (GPER) that has been mostly associated ...with rapid non-genomic responses. Although Gper-mediated signalling has been characterized in only few fish species, Gpers in fish appear to present more mechanistic functionalities as those of mammals due to additional gene duplicates. In this study, we ran a thorough investigation of the fish Gper evolutionary history in light of available genomes, we carried out the functional characterization of the two gper gene duplicates of European sea bass (Dicentrarchus labrax) using luciferase reporter gene transactivation assays, validated it with natural and synthetic estrogen agonists/antagonists and applied it to other chemicals of aquaculture and ecotoxicological interest. Phylogenetic and synteny analyses of fish gper1 and gper1-like genes suggest their duplication may have not resulted from the teleost-specific whole genome duplication. We confirmed that both sbsGper isoforms activate the cAMP signalling pathway and respond differentially to distinct estrogenic compounds. Therefore, as observed for nuclear estrogen receptors, both sbsGpers duplicates retain estrogenic activity although they differ in their specificity and potency (Gper1 being more potent and more specific than Gper1-like), suggesting a more conserved role for Gper1 than for Gper1-like. In addition, Gpers were able to respond to estrogenic environmental pollutants known to interfere with estrogen signalling, such as the phytoestrogen genistein and the anti-depressant fluoxetine, a point that can be taken into account in aquatic environment pollution screenings and chemical risk assessment, complementing previous assays for sea bass nuclear estrogen receptors.
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