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Exposure therapy is a widely used treatment for patients with post-traumatic stress dis -order. It involves reduction of fear through progressive exposure to frightening stimuli in a therapeutic environment. Here we propose a new method designed to improve the effectiveness of exposure therapy. We hypothesized that device-guided breathing during exposure therapy can increase the capability of the patient to undergo effective exposure. The successful application of the method is described for a single patient. Using a device to slow and regularize breathing, the patient was calmed and experienced a greater sense of control and a profound effect of the exposure. The use of the breathing-guiding device is believed to reduce arousal level and excitability of sympathetic “fight-flight” behaviors. The present study suggests that device-guided breathing integrated with exposure therapy may provide a practically feasible and potentially promising non-pharmacological treatment after trauma.

This article analyzes the concepts of experience economy and promotion of authenticity at The Venetian Hotel and Casino in Las Vegas by exploring the resort's tangible and intangible heritage use in design and marketing strategies.

This qualitative study conducts a content analysis of marketing material, historical documents, and site observations.

Visitors' active involvement, combined with The Venetian's use of tangible and intangible heritage, is used in creating an authentic themed experience. In addition, our study suggests that authenticity constitutes a key concept for today's hospitality industry.

This study centers on a single case study, and requires adjustments in order to be replicated. However, The Venetian represents one of the most prominent models followed by the hospitality industry worldwide.

This analysis provides a baseline for comparison among resorts that have theming but do not integrate it in the same way, or in general, to other professionals and academics considering themed experiences.

The manuscript centers on several aspects that are being debated in numerous fields, from business to sociology, such as customers' desire for authentic experiences through the creation of themed attractions.

This research fills a gap in hospitality marketing research into authenticity and themed experience by investigating how The Venetian Hotel and Casino uses the heritage of another, tourism-focused city (Venice) to promote itself. The investigation uncovers how themed attractions in hospitality create an experience-based involvement that centers on the authenticity of the theme (in our case cultural heritage) they replicate.

This paper aims to understand the most efficient hotel system and why efficiency varies across years and between the two differing types of hotel businesses in Turkey.

A data envelopment analysis (DEA) analysis was used to characterise the efficiency of all-inclusive (AI) and bed and breakfast (B&B) hotel businesses with one output (total revenue) and three inputs (labour, food and capital costs). The Malmquist approach is then used to discern changes in total efficiency (TTE) and intertemporal shifts in the efficiency frontier (technological change (Tch)).

The results reveal that the AI hotel operates at 100% efficiency in the summer and year-round. The B&B hotel business operates at 89.6% with variable constant returns to scale during the summer and with 100% efficiency. The results of the Malmquist approach indicate that the total factor productivity grew in the years 2015, 2016, 2018 and 2019, while the other years were marked by inefficiency. Such increases were due to technical efficiency change (TEch) and Tch, which means that managerial and allocative efficiency (AE) were barely achieved. Slight differences were noted in the two time periods (all year and summer), suggesting that the scale of hotel businesses is prepared to operate all year round, and this calls for strategies to mitigate seasonality.

As to avenues for future research, the limitations of this study are threefold. First, the hotel businesses are not parallel in terms of the duration of their service offerings. Future research may consider including an AI hotel business that is in operation for the whole year. Second, businesses in Turkey are sceptical about sharing their data as it is considered confidential. However, to better generalise the results and encourage hoteliers to consider the positive outcomes of such analysis, the number of observations could be increased by considering more hotel businesses in both categories. Third, a mixture of data representing businesses operating in various countries may reflect if the efficiency scores vary internationally.

Overall, AI hotel businesses are more attractive but less efficient than B&B. Furthermore, the external crisis impacts the efficiency of hotel businesses meaning that hotel managers could keep on exploring AI, perhaps educating their hosts not to waste or not offer huge quantities. Hotel managers may also need to enlarge their seasonal activities to ensure more efficiency.

Despite the intentions of AI hotel businesses to increase their profitability with a lower level of service quality, this study shows that the AI hotel business is very attractive but not so efficient due to the higher propensity of guests to consume food and beverages in excess that compromises the definition of efficiency as zero waste. AI is very attractive for family groups or those seeking the pleasure of relaxation at seaside resorts and is also very popular in Turkey. On the other hand, the B&B hotel business is more efficient but less attractive.

The contributions of this paper are threefold. First, the authors analysed the efficiency and inefficiency of hotel businesses within nine years of operations. During this period, Turkey experienced first a tourism boom (2011–2014) followed by stagnation and subsequently a sharp decline due to political instability resulting in an (in)direct impact on tourism (2015–2019). Second, the authors compared the efficiency and inefficiency of AI and B&B hotel businesses. Third, the authors examined the effects of hotel management factors to ensure efficiency.

This paper aims to review the known and anticipated medical geology problems in Ghana, to highlight the impact of some trace elements on human health and to reveal some essential aspects of medical geology on health.

Literature and empirical studies relating to medical geological issues in Ghana were reviewed. Secondary data were used in the present study such as case studies, reports, geological bulletins and published research studies.

High levels of heavy metals including arsenic, cadmium and mercury in gold extraction processes through artisanal small-scale mining have contributed to high concentrations of toxic elements in the environment. The distribution and availability of these elements in the environment are facilitated by the geological, chemical and local environmental activities that are irregularly spread exposing people mining areas to pollutions. Exposures to these elements in above and below baseline levels contributed to health implications including fluorosis, intellectual or developmental disability and death in some regions of Ghana. Cardiovascular and cerebrovascular diseases linked to mining activities were also presented in this study. Similarly, non-communicable diseases can affect many people if correct measures are not considered. Following the geometric increase in mining activities, it is anticipated that deleterious environmental and health impacts associated with mining may persist in mining areas in Ghana. Reported implications and continuous contamination of water bodies in mining areas could result in high pollution levels beyond treatment for human use or destroy aquatic habitats and aquatic lives through acid drainage. Above-threshold concentrations of heavy metals in soils could bio-accumulate in crops, and this could pose deleterious public health implications on consumers. Continuous effects posed on the environment and public health may prompt communities, regulatory institutions and government to reduce or ban mineral development.

This review has significantly revealed potential public health issues from the impact on the natural environment and recommends that medical geologists work together with medical workers to devise preventive and therapeutic techniques to address many geology-related-health issues in Ghana.

The paper aims at addressing the following research questions: does institutional quality improve countries' environmental efficiency? And which pillars of institutional quality improve countries' environmental efficiency?

By specifying a directional distance function in the context of stochastic frontier method where GHG emissions are considered as the bad output and the GDP is referred as the desirable one, the work computes the environmental efficiency into the appraisal of a production function for the European countries over three decades.

According to the countries' performance, the findings confirm that high and upper middle-income countries have higher environmental efficiency compared to low middle-income countries. In this environmental context, the role of institutional quality turns out to be really important in improving the environmental efficiency for high income countries.

This article attempts to analyze the role of different dimensions of institutional quality in different European countries' performance – in terms of mitigating GHGs (undesirable output) – while trying to raise their economic performance through their GDP (desirable output).

1. The paper aims at addressing the following research question: does institutional quality improve countries' environmental efficiency?

2. We adopt a directional distance function in the context of stochastic frontier method, considering 40 European economies over a 30-year time interval.

3. The findings confirm that high and upper middle-income countries have higher environmental efficiency compared to low middle-income countries.

4. The role of institutional quality turns out to be really important in improving the environmental efficiency for high income countries, while the performance decreases for the low middle-income countries.

The paper aims at addressing the following research question: does institutional quality improve countries' environmental efficiency?

We adopt a directional distance function in the context of stochastic frontier method, considering 40 European economies over a 30-year time interval.

The findings confirm that high and upper middle-income countries have higher environmental efficiency compared to low middle-income countries.

The role of institutional quality turns out to be really important in improving the environmental efficiency for high income countries, while the performance decreases for the low middle-income countries.

This paper aims to evaluate the relation between governance and financial efficiency of credit unions in Brazil. The study shows how poor financial efficiency in credit unions may result from undesirable configurations in executive management and other variables related to governance.

The study develops an innovative methodology to classify credit unions according to the level of governance using indicators of representativeness and participation, leadership, management and supervision. This methodology integrates the use of multiple correspondence and cluster analysis. The study then applies stochastic frontier models to analyze how governance affects the indicators of financial efficiency.

The results highlight that better governance substantially increases the efficiency of credit unions in terms of a higher level of credit operations per institution.

The paper uses a pioneering survey applied by the Central Bank to almost the total population of credit unions in Brazil. The results highlight how to operationalize a subjective and broad concept related to cooperative governance to identify the remarkable impacts of good governance practices on the financial efficiency of credit unions.

Total factor productivity (TFP) has become a prominent concept in agriculture economics and policy over the last three decades. The main aim of this paper is to obtain a detailed picture of the field via bibliometric analysis to identify research streams and future research agenda.

The data sample consists of 472 papers in several bibliometric exercises. Citation and collaboration structure analyses are employed to identify most important authors and journals and track the interconnections between main authors and institutions. Next, content analysis based on bibliographic coupling is conducted to identify main research streams in TFP.

Three research streams in agricultural TFP research were distinguished: TFP growth in developing countries in the context of policy reforms (1), TFP in the context of new challenges in agriculture (2) and finally, non-parametric TFP decomposition based on secondary data (3).

This research indicates agenda of future TFP research, in particular broadening the concept of TFP to the problems of policy, environment and technology in emerging countries. It provides description of the current state of the art in the agricultural TFP literature and can serve as a “guide” to the field.

The main objective of the study is to investigate the effect of COVID-19 on accounting education in the higher education (public and private universities) in the Gulf Cooperation Council (GCC).

The study is explorative in nature conducted with quantitative survey approach and using purposive techniques in collecting data. The sample focuses on the teaching staff at public and private universities in (GCC), Kingdom of Saudi Arabia, United Arab Emirates, Bahrain, Kuwait, Oman and Qatar during the COVID-19.

This study presumed to highlight some of the emergent issues faced during the pandemic pertaining the aspects of the COVID-19 and digitizing accounting education and its effect on future direction of digital education.

To the best of the authors’ knowledge, this study is the first academic paper to study the effect of COVID-19 on accounting education in the higher education in the GCC.

The purpose of this paper is to examine the marketization of domiciliary care, its consequences for employment practice, specifically fragmented time, and the implications for care quality.

Focus groups and face-to-face or telephone interviews were conducted with care commissioners, service providers and care workers across Wales. There were 113 participants in total.

These demonstrate fragmented time’s negative consequences for service providers, care workers and, ultimately, care quality.

No care recipients were interviewed and care quality was explored through the perceptions of other stakeholders.

For policy makers, tensions are evidenced between aspirations for high-quality care and commissioning practice that mitigates against it. Current care commissioning practices need urgent review.

The research extends the definition of fragmented time and integrates with a model of care quality to demonstrate its negative consequences. Links between employment practice and care quality have only previously been hinted at.