Suchergebnisse

2014 Summer. ; Includes bibliographical references. ; Background: The merging of the former U.S. Army Veterinary Command (VETCOM) with the former U.S. Army Center for Health Promotion and Preventive Medicine (USACHPPM) into the U.S. Army Public Health Command (USAPHC) in 2011 created an opportunity for the military to fully embrace the One Health concept. That same year, the USAPHC began work on a Zoonotic Disease Report (ZDR) aimed at supporting critical zoonotic disease risk assessments by combining zoonotic disease data from human, entomological, laboratory, and animal data sources. The purpose of this dissertation is to facilitate the creation of a military Zoonotic Disease Surveillance program that combines disease data from both military human and animal sources. Methods: Five of the most commonly used human military medical data systems were systematically reviewed using a standardized template based on Centers for Disease Control and Preventive Medicine (CDC) guidelines. The systems were then compared to each other in order to recommend the one(s) best suited for use in the USAPHC ZDR. The first stage of the comparison focused on each system's ability to meet the specific goals and objectives of the ZDR, whereas the second stage applied capture-recapture methodology to data system queries in order to evaluate each system's data quality (completeness). A pilot study was conducted using Lyme borreliosis to investigate the utility of military pet dogs as sentinel surveillance for zoonotic disease in military populations. Canine data came from 3996 surveys collected from 15 military veterinary facilities from 1 November 2012 through 31 October 2013. Surveys simultaneously collected Borrelia burgdorferi (Bb) seroprevalence and canine risk factor data for each participating pet dog. Human data were obtained by querying the Defense Medical Surveillance System for the same 15 military locations and the same time period. The correlation of military pet dog Bb seroprevalence and military human Lyme disease (borreliosis) data was estimated using the Spearman Rank Correlation. The difference between military pet dog data and civilian pet dog data was examined through the use of the chi-squared test for proportions. Multivariable logistic regression was then used to investigate the potential for identified risk factors to impact the observed association. Results: The comparison of human military medical data systems found the Military Health System Management Analysis and Reporting Tool (M2) data system most completely met the specific goals and objects of the ZDR. In addition, completeness calculation showed the M2 data source to be the most complete source of human data; 55% of total captured cases coming from the M2 system alone. The pilot study found a strong positive correlation between military human borreliosis data and military pet dog Bb seroprevalence data by location (rs = 0.821). The study showed reassuring similarities in pet dog seroprevalence by location for the majority of sites, but also showed meaningful differences between two locations, potentially indicating military pet dogs as more appropriate indicators of Lyme disease risk for military populations than civilian pet dog data. Unfortunately, whether canine Bb seroprevalence is influenced by the distribution of identified risk factors could not be determined due to limited study power. Conclusions: Based on this study M2 was recommended as the primary source of military human medical data for use in the Public Health Command Zoonotic Disease Report. In addition, it was recommended that Service member pet dog data be incorporated as a sensitive and convenient measure of zoonotic disease risk in human military populations. The validity of the data, however, should be evaluated further with either larger sample sizes and/or a zoonotic disease with higher prevalence.

This study compares destination managers reactions towards the use of shock advertising in the European tourism sectors and develops the knowledge of how shock advertising can be an effective tool in managing annoying tourists' behaviours. Impactful communication has often been found to be effective in changing behaviour. Governments and other public bodies use communication, including advertising to educate the public, create awareness and change behaviours (GCS, 2014). The tourism industry is one of the sectors where various forms of advertising are important tools of communication. For example, a good way to reach tourists is to advertise in in-flight magazines, or to offer advertising at the hotel check-in at the destination, or as in-room literature. Some destinations use incentives alongside communication to influence tourist behaviour. For instance, tourists in Venice are fined for several annoying behaviours. The campaign, #EnjoyRespectVenezia utilized social media, website, posters around the town and flyers at important locations such as train stations to warn tourists of the impact of their irresponsible behaviour on the local community and environment. Tourists could be fined for littering, damaging the trees, benches or any other property in town, or for going shirtless (Buckley, 2017). Such campaigns may become more important as the number of tourists and the importance of tourism to local economies have been rising (WTO, 2018). Shock advertising can act as a powerful strategy to persuade individuals to change behaviours and attitudes (Mehta, 2000). Such communication can take many forms, including the use of shocking images, text, voiceover, or any combination of these to elicit attention and behavioural change (Dahl et al., 2003). The effectiveness of such advertisements has been well-researched except for the area of tourist behaviour. Tourists constitute an important segment of the global market (WTO, 2018), and are found to have important positive and negative influence on local communities. This influence, especially tourists' irresponsible and 'annoying' behaviours often has negative consequences for the local communities, the places' image and the involved service providers. Hughes et al., (2011) studied tourists' behaviours in various holiday destinations across Europe such as the Balearic Islands (Spain), Algarve (Portugal), Venice (Italy), Crete (Greece) and Cyprus, and found that the abuse of alcoholic drinks and drugs was positively related with the reported increase in violence, crime rates, risky sexual encounters and anti-social behaviour in these destinations. Much of these anti-social behaviours are a result of binge drinking, drugs abuse, the portrayal of the holiday destinations as an environment where individuals feel that "anything goes", cheap pricing of alcohol, and unawareness of local customs. To support tourism and continue its contribution to the economy, it is important to find ways of encouraging tourists to behave in respectful ways so that they do not alienate local tourist providers, other tourists, and do not contribute to creating negative place perceptions and negative image. One way of doing that may be the use of shocking advertising which has been found effective in deterring harmful behaviours in other industries but has not been very popular in the tourism industry. One of the obstacles to using shocking adverts are those decision makers who decide what creative strategies are employed in destination promotion and tourist behaviour management. In context of tourism, destination managers (DMs) are important decision makers in this process. DMs are part of the culture production system and they influence not only the image of the destination but may have an impact on tourist behaviour through tourist management systems and policies. Hence it is important to explore their attitudes towards the use of one possible creative strategy that may be effective in influencing behaviour of tourists, which is shocking advertising.

This article discusses evidence on the importance of large-scale environmental risk factors for onset of tobacco, alcohol, and other drug use. It is suggested that smoking onset occurs through a process in which some individuals change from nonsmoking to susceptibility, experimentation, and adoption of regular use. A distinction is made between distal and proximal risk factors, and a model is outlined that encompasses both levels. We consider evidence on large-scale variables including socioeconomic status, ethnicity, and media advertising as factors in onset and discuss how the effects of these large-scale variables are mediated. Recommendations for research and program development are made.