The Influence of Muslim and Christian Destinations on Tourists' Behavioural Intentions and Risk Perceptions

This paper studies the factors that influence tourists' risk perceptions of various destinations with different attributes and sociocultural profiles. Factor analysis is utilised to investigate the determinants of risk perceptions, finding that they are influenced both by the type of risk (delinquency, health, accident, environment and catastrophe) and by the characteristics of the destination regarding the management of risk. Structural equations modelling is conducted to study the relationships between risk perceptions, destination image and visiting intentions across destinations. Multi-group analysis across different destinations proves that tourists' risk perceptions have different influences on destination image and visiting intentions. The results show that there are significant differences according to the predominant religion at the destinations, i.e., Muslin and Christian. The implication is that different dimensions of perceived risks and destination socio-culture contexts have different influences on the behaviour of tourists.

Emotions and decision rules in discrete choice experiments for valuing health care programmes for the elderly

The evaluation of health care programmes is commonly approached with stated preference methods such as contingent valuation or discrete choice experiments. These methods provide useful information for policy decisions involving health regulations and infrastructures for health care. However, econometric modelling of these data usually relies on a number of maintained assumptions, such as the use of the compensatory or random utility maximization rule. On the other hand, health policy issues can raise emotional concerns among individuals, which might induce other types of choice behaviour. In this paper we consider potential deviations from the general compensatory rule, and how these deviations might be explained by the emotional state of the subject. We utilized a mixture econometric model which allows for various potential decisions rules within the sample, such as the complete ignorance, conjunctive rule and satisfactory rules. The results show that deviations from the full linear compensatory decision rule are predominant, but they are significantly less observed for those subjects with a medium emotional state about the issue of caring for the health state of the elderly. The implication is that the emotional impact of health policy issues should be taken into account when making assumptions of individual choice behaviour in health valuation methods.

Economic evaluation of health effects with preference imprecision

The estimation of economic benefits of health effects through direct methods, such as contingent valuation, presents the problem of preference imprecision. This paper deals with this problem by proposing an elicitation method that allows the subject to state an interval for willingness to pay, without inducing any specific amount as a response. The paper also analyzes the effects of the context where changes in health occur on the associated imprecision level and the estimates, by comparing a situation without context with another in which effects are due to atmospheric pollution. The econometric modelling develops a Bayesian estimation method for censored intervals, which models the existing uncertainty between the lower and upper limits derived from the elicitation process. Results prove that data dispersion is significantly higher for the non-contextual scenario, and increases for the most severe symptoms.

The effect of medical experience on the economic evaluation of health policies. A discrete choice experiment

In this paper we present results on the effect of medical experience on the economic evaluation of health policies utilizing the method of discrete choice experiments. Subjects in two split samples were asked about choice situations involving alternative profiles defined by the attributes of an innovative program for cervical cancer screening. The first sample was formed by expert medical practitioners who were familiar with the illness and its potential treatments. A second sample was formed by young undergraduate students in social sciences who were not familiar with the illness or with the potential benefits of screening programmes. The statistical comparison between both subsamples utilizes a robust method for discrete choice models which shows that there are no significant differences in the structural models and the parameter estimates. The main implication is that background medical information and familiarity with the process of illness might not have a relevant impact on the valuation of health policies with discrete choice experiments.

Use of a polytetrafluoroethylene tube and patch in the repair of a difficult duodenal stump

In the cases where a primary anastomosis is unable after a duodenal resection, special care must be taken to avoid any complication in the duodenal stump such as suture dehiscence. Wall inflammation is an important factor in the development of this complication. We report a case of a 35-year-old woman who had previously undergone to pyloric exclusion due to a wall defect occurred after a bilio-digestive anastomosis, which complicated with a posterior duodenal stump dehiscence. The acute edema of the stump walls that resulted after it because exposure to bile conducted to heroic measures for its closure: first, the use of a polytetrafluoroethylene tube as duodenostomy and posteriorly a patch of the same material for its final closure. Both gave successful results in the repair of a refractory duodenal stump dehiscence.

Willingness to pay for health risk reduction in the context of altruism

This paper presents results on the valuation of health risks in the presence of altruism. The contingent valuation method is utilised in a split sample experiment for estimating the private and public values in reducing the risk of flu. Data modelling for the dichotomous choice method follows a Bayesian approach, which accounts for zero responses and is adequate for the comparison of small sample results. The results of the experiment suggest that altruism is a positive component in the value of reducing the probability of flu, which depends positively on the number of days involved, the health status and the personal income of the subject. The marginal value of risk is found to be a decreasing function of the reduction in the probability of becoming ill.

[Use of spasmolytic agent otilonium bromide (spasmomen) in digestive endoscopy: a prospective study in 63 patients]

Otilonium bromide is a calcium antagonist with a direct myolytic effect, that is indicated in spastic conditions and functional dyskinesias of the gastroenteric apparatus (irritable bowel syndrome) and as a premedication for gastrointestinal endoscopic procedures. The present study assessed otilonium bromide 40 mg PO the night before and 40 mg PO the morning in 49 upper and 14 lower flexible endoscopies in 63 patients, to determine the presence or absence of peristalsis and relaxation of the pylorus. No side effects were observed due to the medication. In 46 (93.8%) upper endoscopies marked relaxation of the gastrointestinal tract and also pylorus relaxation were observed. In 13 (92.8%) lower endoscopies, marked relaxation of the colonic tract was also seen. All patients tolerated well the endoscopies. Otilonium bromide was useful as premedication in order to enable upper and lower endoscopic explorations, because of its spasmolytic effect.

Syphilitic rectal ulcer associated with perforation of the hard palate: case report

We report a case of a patient that presented with a perforated hard palate as a late complication due to an unsuspected syphilis. This disease first presented as a rectal ulcer which was misdiagnosed as an amebic proctitis. The patient received antiamebic treatment with a satisfactory outcome. He did not return for late control of the latter treatment and returned seeking medical advice six years later with the former complication. He tested positive for syphilis and appropriate treatment was performed. In addition, the ORL department recommended a palate prosthesis.