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As exposure to psychosocial hazard at work represents a substantial risk factor for employee health in many modern occupations, being able to accurately assess how employees cope with their working environment is crucial. The workplace is generally accepted as being a dynamic environment, therefore, consideration should be given to the interaction between employees and the acute environmental characteristics of their workplace. The purpose of this paper is to investigate the effects of both acute demand and chronic work-related psychosocial hazard upon employees through ambulatory assessment of heart rate variability and blood pressure.

A within-subjects repeated measures design was used to investigate the relationship between exposure to work-related psychosocial hazard and ambulatory heart rate variability and blood pressure in a cohort of higher education employees. Additionally the effect of acute variation in perceived work-related demand was investigated.

Two dimensions of the Management Standards were found to demonstrate an association with heart rate variability; more hazardous levels of “demand” and “relationships” were associated with decreased standard deviation of the normal-to-normal interval. Significant changes in blood pressure and indices of heart rate variability were observed with increased acute demand.

This is the first attempt to combine the Health and Safety Management Standards Indicator Tool with physiological assessment of employees. The results provide evidence of associations between scores on the indicator tool and ambulatory heart rate variability as well as demonstrating that variation in acute perceived work-related demand is associated with alterations to autonomic and cardiovascular function. This has implications not only for employee health and workplace design but also for future studies employing ambulatory physiological monitoring.

The General Aggression Model (GAM) by Anderson & Bushman (2002) reveals the great depth of research on internal processes. Research on naturally occurring aggressive interaction episodes in specific material and social environments, however, is still largely lacking. How can information about environmental requirements and social processes relevant to aggression be acquired methodically? Based on an ambulatory assessment strategy, we discuss various apparatus‐based and direct observation strategies. Finally, we introduce an innovative methodology for recording in the field the environmental conditions in which aggressive behaviour arises, using the technical device of glasses with an inbuilt camera. Our investigations so far show that the camera‐glasses method is a promising new data collection technique that can be applied fruitfully in various fields of aggression research.

Experience sampling methods (ESM) have enabled researchers to capture intensive longitudinal data and how worker well-being changes over time. The conceptual advances in understanding the variability of well-being are discussed. These emerging forms in the literature include affective inertia, affective variability, affective reactivity, and density distributions. While most ESM research has relied on the active provision of data by participants (i.e., self-reports), technological advances have enabled different forms of passive sensing that are useful for assessing and tracking well-being and its contextual factors. These include accelerometer data, location data, and physiological data. The strengths and weaknesses of passively sensed data and future ways forward are discussed, where the use of both active and passive forms of ESM data in the assessment and promotion of worker well-being is expected.

This chapter analyzes the tourism industry from national and regional perspectives, in order to understand the past and current trends in Costa Rica’s positioning and branding attributes and strategies for tourism development. The intent here is not to provide an exhaustive comprehensive literature review of academic research on country branding; and so it is by all means a case study as it describes the evolution of the tourism industry in Costa Rica – including the transformative stages the country went through since the 1980s – as planned tourism national management programs evolved toward reaching the target of creating a nature-based tourism brand. The medical industry and then medical tourism industries are analyzed in a global basis and the US market is examined in detail because of its potential to develop a new complementary niche for Costa Rica’s tourism industry. The chapter intends to asses Costa Rica’s potential to become a country brand in medical tourism, leveraged on its natural tourism destination branding status quo.

This study intends to improve the quality of venous thromboembolism (VTE) prophylaxis practices including proper VTE risk assessment and the appropriate prophylaxis measures for surgical urology patients.

The authors applied the Six-Sigma define, measure, analyze, improve and control (DMAIC) improvement methodology in a pre–post interventional study that involved all adult patients above 18 years old indicated and scheduled for urology surgical interventions including endoscopic urological surgeries in a urology specialized 60-bed hospital. The pre-intervention sample included all patients meeting the inclusion criteria over a period of six months. Post-intervention sample included all patients meeting the inclusion criteria over a period of six months. The improvement areas included both the VTE risk assessment as well as the VTE prophylaxis prescription.

DMAIC methodology has achieved a substantial sustained improvement in surgical urology VTE prophylaxis practices with an average of 70% on both levels; VTE risk assessment practices and VTE prophylaxis prescribing practices were statistically significant. The post-intervention results also showed a statistically controlled process with no special cause variations. Based on the study results, the Six-Sigma DMAIC methodology can be considered of high value when applied in healthcare clinical practice improvement projects.

The project study includes some pitfalls that can be addressed as follows: 1. The lack of VTE rate incidence tracking. This limitation can be partly refuted when the authors conduct a literature review and explore that the VTE prophylaxis effectiveness had been proven with sufficient evidence to an extent that pushed several scientific societies to develop their own guidelines to support VTE prophylaxis. (Algattas et al., 2018). 2. Another limitation of this study can be that it handled only surgical patients and more specifically surgical urology patients. Of course, VTE prophylaxis is a crucial life-threatening problem not only for the surgical admitted patients but also for all the medical admitted patients either in hospital wards or ICUs. However, the prediction that surgical patients especially surgical urology patients are more prone to VTE development risk as they have -in several cases-two or three main additive risk factors which are age, procedure duration and malignancy in elderly men. (Tikkinen et al., 2014). So, the authors consider the study project to be a prototype that hopefully can be utilized for future study projects that will manage both other surgical specialty patients and medical patients on the national level and can track accurately and effectively report the VTE incidence rates.

Several recommendations can be extracted from the research project that is summarized in the following points: Paying focused attention to continuous healthcare quality improvement initiatives and projects as a main approach for healthcare improvement especially for the public health-related problems. This might be achieved through periodic region-specific or specialty-specific focus groups from which public health problems could be addressed and prioritized to be considered as a part of country healthcare campaigns regarding cost-utility and feasibility studies. The adoption of a system thinking approach in dealing with the improvement strategies; all efforts and resources are to be employed to achieve a common objective. This includes the generation of a national-wide electronic health information system that can aid in healthcare resource allocation and direct the healthcare efforts towards the most important, high-priority public health problems. Electronic national-wide health record is really an effort, and resources consuming activity, but actually, it's worth exerting efforts, and its valuable outcomes may be seen several years later. 3. Development of unified national specialized VTE prophylaxis pathways to standardize the patient-specific VTE prophylaxis plans. Standardization of healthcare pathways enables healthcare professionals to follow an evidence-based practice which will be reflected on the improvement of healthcare quality level, cost-effectiveness enhancement, and timely patient care on all levels especially in high critical areas like ER and ICU. 4. Incorporation of VTE prophylaxis costs in the universal health insurance diagnosis-related group (DRG) insurance packages and service pricing. Universal health insurance is a nationwide strategy that is aiming to cover all Egypt residents by the year 2030. Universal health insurance is being following the DRG reimbursement policy that is thought to control all the healthcare-associated costs so, the VTE prophylaxis costs shall be added as the main cost item to encourage all healthcare facilities to follow an evidence-based VTE prophylaxis pathway taking into consideration the high-risk patient categories who will definitely represent a high-cost burden on the long run if they suffer a VTE event.

DMAIC improvement methodology applications in healthcare are still relatively limited, especially on the clinical level. The study can be considered one of a kind in Egypt dealing with a comprehensive DMAIC methodology application on the clinical level.

This paper aims to stimulate the discussion in the fields of hospitality, tourism and leisure on what exactly constitutes “an experience” and how to measure it; the authors unpack the experience construct into its core constituent elements, namely, emotions.

The paper reviews insights from psychology and cognitive neuroscience that define experiences as a fine-grained temporal succession of emotions that occur during an experiential episode. Limitations of current methods for measuring experiences are discussed, after which biometric and neuroscientific methods are reviewed that are optimally geared toward measuring emotions, as they occur during an experience with fine temporal detail.

An overview is presented of the available studies within the fields of hospitality, tourism and leisure that use these methodologies. These studies show that using these methodologies provides a fruitful methodological approach to measuring experiences in real time.

Companies are constantly seeking to create memorable experiences for their customers. The proposed research methodologies allow companies to get a more fine-grained image of what impacts customers over the course of their experience and to actively integrate the use of emotions into creating experiences, as emotions are key to making them memorable.

The paper sketches the contours of a rapidly emerging framework that unpacks memorable experiences into their constituent element – emotions. It is proposed that this will contribute to a deeper understanding of how consumers experience offerings in the hospitality, tourism and leisure industry.

As social and nutritional conditions have improved over the last century, there has been a dramatic improvement in health. Communicable diseases have almost been eradicated and mortality rates in childhood have dropped. Consequently, people are now living longer and dying has become an experience of the elderly and often as a result of degenerative diseases such as cancer. The hospice movement was set up to care for patients, such as those with cancer, who could not realistically expect to be cured, and whose needs were primarly for comfort and relief for the remaining period of life. Wheatfields is a hospice in Leeds at which great care is taken over the patients' diets, as Linda Auty, BSc, SRD, senior lecturer at the Department of Dietetics, Leeds Polytechnic, Maire O'Donnell, SRN, ONC matron at Wheatfields and Jackie Evans, SRN, RCNT assistant matron explain.

The purpose of this paper is to explore customers’ emotions during a host–guest interaction at the reception desk of a hotel. Guests’ emotional responses are analyzed in real time to understand their link to behavior and levels of service and relationship quality.

To achieve this aim, 225 random customers experience six different types of interactions (scenarios) at a staged reception desk, representing a high/low service or relationship quality. The emotions provoked within guests are (video) recorded and analyzed with the help of SHORETM, a facial recognition software that processes four basic emotions derived from human muscular activity and calculates average emotional scores per scenario.

Results reveal that customers respond more positively to service than to relationship quality. Informal approaches to interacting with guests are mixed; they can both excite or irritate customers. As with existing evidence in service marketing research, the results found out through this study demonstrate that a good service recovery process seems to immediately generate more satisfied customers than do constant high-quality standards.

The main limitations are related to the semi-staged nature of social interactions, which might cause distortions in measuring emotions and limitations in the comparability of cases.

Practical implications are directed to service designers and managers in hospitality to improve service design and ensure effective service recoveries.

This paper introduces a novel approach for assessing host–guest interactions in tourism based on a real-time emotional assessment of service and relationship quality in hospitality. Technologically advanced observation techniques enable in-depth analyses of actions and emotional responses between hosts and guests across time. New insights concerning service design and service recovery management are gained for practitioners and for future research.

The most commonly described components of customer experience include cognitive and affective aspects. However, the subjective self-reported methods traditionally applied in tourism research cannot fully represent the instant, dynamic, and affective nature of customer experience. Therefore, there is a need for moment-based approaches and longitudinal methods in tourism research. The chapter provides a selective review of measures that can be used to assess the affective aspects of customer experience. Taking into account the advantages and limitations of each method, the integration of self-reported scales, moment-based psychophysiological techniques, and longitudinal methods should be considered as the best approach to measuring affective components of customer experience in tourism. This holistic interdisciplinary approach will help researchers and tourism practitioners understand the relationship between affective and cognitive components of tourists' pre-visit, onsite, and post-visit experience, as well as evaluate the effectiveness of marketing campaigns, identify weak points of tourists' customer journey, and maximize total travel experience.

The main objective of our study is to shed light on how perceived enjoyment influences the intricate relationship between value cocreation and consumer satisfaction, with a specific focus on the realms of tourist services.

To achieve the objective outlined in this research, an information survey was carried out on 400 consumers of tourist services who have participated in virtual cocreation processes through digital platforms. As a data analysis technique, the dynamic structural equation modeling (DSEM) analyzes the causal relationships between the elements under study.

Our extensive analysis draws upon the data collected through a survey spanning from 2018 to 2023, encompassing 400 participants who actively engaged in value cocreation processes in both physical and virtual settings. Our investigation considers two competing models to elucidate the role of perceived enjoyment. Our findings, established through DSEM illuminates that perceived enjoyment predominantly functions as a mediator, exerting a more pronounced influence on the connection between value cocreation and consumer satisfaction. Contrary to a moderating role, perceived enjoyment emerges as a significant mediator in our study.

The most significant addition is recognizing virtual value cocreation behaviors in tourist sector activities over time, primarily because it indicates the likelihood of negative repercussions of its usage. Furthermore, it must be capable of designing surroundings according to the characteristics of customers in terms of immersion and technology usage, preventing a rise in stress situations that might result in more negative consequences than planned. Another important insight is that virtual value cocreation initiatives have detrimental long-term implications, particularly in tourism.