This study aimed to explore optimal ways to promote all kinds of tourism during the phase of emergency response to the current outbreak of Omicron subvariants. A framework-based systematic literature review was conducted as the primary methodology, supported by the preferred reporting items for systematic reviews and meta-analyses checklist. Four analytical units were allocated to include United Nations agencies, governments, tour businesses, and local communities. Economic interest-based tourism promotion was examined to develop local temperature-based tourism promotion via the same four variables. The study found that the pursuit of economic interests was not a productive solution for tourism promotion any longer due to the matter of local weather. It concluded that the four stakeholders should work to replace economic interest-based tourism promotion with local temperature-based tourism promotion. Results of this study can guide the positive effects of warm temperatures, brand image, psychological impacts, digital marketing, and others.

Classifications of mental disorders change regularly. This fact requires analysis, taking into account changes in the epidemiological situation and changes in the organizational structure of mental health service, and development of its technical and human resources. The preliminary analysis of these changes presented in the article using the example of ICD-11 gives us reason to believe that they are almost unrelated to the diagnostic process improvement. On the contrary, each new classification is characterized by an increasing formalization and simplification of the criteria for separate clinical forms. The inevitable losses of clinical accuracy in psychopathological assessment of disorder are compensated for increasing opportunities to deliver care to a significantly greater number of patients.
Классификации психических расстройств меняются регулярно. Этот факт требует анализа с учетом изменений эпидемиологической ситуации и изменений организационной структуры психиатрической помощи, развития ее технических и кадровых ресурсов. Представленный в статье предварительный анализ этих изменений на примере ICD-11 дает основания считать, что они почти не связаны с совершенствованием диагностического процесса. Напротив, каждая новая классификация характеризуется все большей формализацией и упрощением критериев отдельных клинических форм. Неизбежные потери точности психопатологической оценки болезненного состояния компенсируются расширяющимися возможностями оказания помощи значительно большему числу больных.

The aim of this case series report is to provide a new topical view of styletubation (video intubating stylet technique) in obese patients undergoing bariatric surgeries. In contrast to various conventional direct laryngoscopes (DLs), videolaryngoscopes (VLs) have been applied in such obese populations with potentially difficult airway complications. The safety and effectiveness of VLs have been repeatedly studied, and the superiority of VLs has then been observed in and advocated for routine use. In this article, among our vast use experiences with styletubation (more than 54,998 patients since 2016) for first-line routine tracheal intubation, we present the unique experience to apply the styletubation technique in obese patients undergoing bariatric surgery. Consistent with the experiences applied in other patient populations, we found the styletubation technique itself to be swift (the time to intubate from 5 s to 24 s), smooth (first-attempt success rate: 100%), safe (no airway complications), and easy (high subjective satisfaction). The learning curve is steep, but competency can be enhanced if technical pitfalls can be avoided. We, therefore, propose that the styletubation technique can be feasibly and routinely applied as a first-line airway modality in obese patients undergoing bariatric surgery.

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This is an era of uncertainty, during which adaptability is a key capability to survival and future success. What has Singapore done to develop an education system that facilitates its young to learn in such an era? Firstly, Singapore enhances the adaptive capacity of its education system by increasing its diversity. In particular, it is developing more educational pathways, areas of learning and types of schools. Secondly, Singapore emphasizes lifelong learning. In particular, Singapore will be focusing on providing more learning opportunities for working adults and enhancing support for mid-career reskilling. In these educational changes, Singapore has been addressing both hardware (changing policies) and software (addressing culture), in order to develop an education system that can facilitate learners to learn in an era of uncertainty. What will help Singapore in further developing such a system? This paper suggests two software \"upgrades\", namely \"inspiration by design\" and \"readiness for paradigm shift\". Firstly, instead of a paradigm of competence, Singapore adopts a paradigm of inspiration. In this paradigm, the aim is for students to find their inspiration to learn, and such inspiration is provided through a systemic approach. This is \"inspiration by design\". Secondly, Singapore nurtures the spirit of readiness for paradigm shifts in education. An example of a paradigm shift is to be ready for the advent of artificial intelligence in education. Such readiness is about reflecting on fundamentals so that the use of artificial intelligence enhances the development of real human intelligence.

Groundwater Charge was introduced in 2005 as one of the sustainable resource management measures in South Korea. The implementation rate, however, stagnated around 37 %, indicating that most local governments chose not to adopt this \'optional\' regulation. While previous Stakeholder Analysis studies mainly blamed exclusion - or limited involvement - of stakeholders in the designing and structuring stage of policy-making process for policy failures, this study focused on the interest conflicts and dynamics hindered implementation process. This is because the issue with the subject policy, i.e., Groundwater Charge in South Korea, is low \'implementation rate\' not the \'collection rate\' or \'tax deficit.\' If it was simply design or structural issue, the Charge should suffer from tax deficit problem due to lower tax income than operational costs. Thus, in order to investigate the reasons of low Charge adoption rate at the local government level, the Stakeholder Analysis Theory was applied to examine each stakeholder of the Charge to distinguish the interaction among supportive and opposing groups. The analysis revealed that there are only strong opponents of the policy without clearly identifiable supporters. Having agricultural & fishery industry and small independent businesses in spas, hotels, and swimming pool as strong Players, the Context setters (local governments) are not motivated to enforce Groundwater charge. Furthermore, today\'s social norm governed by economic efficiency is preventing the environmentalists and other Subjects to counteract Players. Under these circumstances, this study recommends the Subject to transform the Crowds (general public) into policy supporters through education. Environmental education is the only viable means to encourage necessary paradigm shift to enable effective implementation of environmental policies like Groundwater charge.

A key challenge of implementing advance care planning lies in the fact that decisions made in advance require patients and their family members to imagine what their clinical picture will look like rather than knowing or experiencing the clinical circumstances as they unfold. Even more important is the acknowledgment of the unpredictability of a given clinical course. This type of situation requires adaptiveness and flexibility in decision-making that frequently occurs in the moment(s) triggered by changes in health state(s). We describe an alternative frameshifting approach called \"Adaptive Care Planning (AdaptCP),\" which features an evolving communication between physicians and patients/families with ongoing incorporation of the patient\'s/family\'s perspective. This process continues iteratively until each decision can be reached in a way that is both harmonious with the patient\'s/family\'s perspective and is consistent with medical treatment options that are actionable for the healthcare team. We include a table of tools drawn from the literature that can help clinicians when implementing AdaptCP.

Forensic science is undergoing an evolution in which a long-standing \"trust the examiner\" focus is being replaced by a \"trust the scientific method\" focus. This shift, which is in progress and still partial, is critical to ensure that the legal system uses forensic information in an accurate and valid way. In this Perspective, we discuss the ways in which the move to a more empirically grounded scientific culture for the forensic sciences impacts testing, error rate analyses, procedural safeguards, and the reporting of forensic results. However, we caution that the ultimate success of this scientific reinvention likely depends on whether the courts begin to engage with forensic science claims in a more rigorous way.

In June 2023, the UK began official hearings for its independent investigation into pandemic preparedness. Thus far, the inquiry has been told that planning has been wholly inadequate and that a future outbreak is inevitable. We present here four key problems that contributed to significant morbidity and mortality during the Coronavirus 2019 (COVID-19) pandemic over the past 3 years in the UK - and which will contribute to excess morbidity and mortality in the next outbreak. First, there was misunderstanding about what procedures were deemed as aerosol generating. Aerosol transmission has always been a component of respiratory viruses; however, no specific aerosol-generating procedures are required to transmit any respiratory pathogens over long distances. Second, policy-makers were too binary in their answers to the public in terms of questions about severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2). This meant that, as evidence evolved and different conclusions were drawn, the public lost faith in both the UK Government and science. Third, public health guidance did not take into account that certain groups would be impacted differentially by public health guidelines and instead used a one-size-fits-all approach to non-pharmaceutical interventions. Finally, there was worsening of existing inequalities, especially in ethnic minority groups, that resulted in excessive numbers within certain cohorts becoming infected.

In Mexico, the kidneys of individuals in poor and marginalized communities are failing with little warning and no explanation. Commonly referred to as chronic kidney disease of non-traditional origin (CKDnt), this new variant of kidney disease cannot be accounted for by conventional or discrete etiological explanations, but is instead understood to be a consequence of economic development, environmental degradation and precarious working and living conditions. Drawing on two interconnected ethnographic studies, and the intertwining problems of causation and care, this paper will (1) document the social conditions of disease emergence around Lake Chapala, Central Mexico, and (2) follow the haphazard routes kidney patients take to access resource-intensive biotechnical treatments. Its aim is to both challenge and reconceptualize social determinants as social relations in order to fully account for the profoundly contextual, temporal, and dynamic character of this condition, and to rethink opportunities for care and intervention.