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The purpose of this paper is to examine the relevance of Cuba’s medical system, its health tourism and related diplomacy in the context of the recent COVID-19 pandemic for the global response to disease outbreaks. In addition to Cuba being a destination for leisure tourists in the Caribbean, the renowned Cuban medical system attracts thousands of health tourists seeking low-cost but high-quality treatment. This paper demonstrates how Cuba’s unique response to the pandemic, which included sending thousands of medical staff abroad, can inform structural and global issues and contribute to a more sustainable future.

The research in this study is primarily drawn from published academic and media sources that address Cuba’s medical system, its health tourism and the government’s response to the recent pandemic. The author, a political scientist and an author of many publications on Cuba, and the PI of a study focused on Cuban tourism, will also draw on her expertise.

This paper addresses the Cuban Government’s ongoing response to the COVID-19 pandemic and places this response in the context of Cuba’s medical system, its health tourism and related diplomacy. It reveals key lessons from Cuba’s response for other tourist destination states and, more broadly, for the worldwide response to global outbreaks and the management of health systems. The findings will further research in diplomacy and tourism as well as inform policy and practice.

This paper explores an ongoing topic and thus further research will be required following the pandemic.

This research note offers important implications for practice including providing accurate, research-based information that challenges misinformation about Cuba’s health system, its medical diplomacy program, health tourism and its response to COVID-19. It offers valuable lessons for public health authorities including the importance of preventative health measures, community medicine and the benefits of working globally to combat outbreaks through the sharing of medical staff and resources.

This research note reveals the health, political and social implications of Cuba’s response in this time of crisis. It shows the benefits of a robust but low-cost community-based medicine program, medical diplomacy and how a state’s response during crisis can moderate the global inequities and injustices such as unequal access to care that often accompany disease outbreaks such as COVID-19.

This research note is an early analysis of a response by an important tourist destination country to the pandemic. The author anticipates that the information provided to the international community via this open access journal will offer practical implications for the ongoing global efforts to manage this crisis and contribute to the research on tourism, diplomacy, justice and health policy.

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.

The purpose of this paper is to review studies on the use of virtual reality (VR) and gamification to engage students in higher education for marketing issues to identify the research topics, the research gaps and to prepare a future research agenda.

A literature review is performed based on two search terms applied to Web of Science, resulting in a final pool of 115 articles. A text-mining approach is used to conduct a full-text analysis of papers related to VR and gamification in higher education. The authors also compare the salient characteristics presented in the articles.

From this analysis, five major research topics are found and analysed, namely, teaching methodologies and education, experience and motivation, student engagement, applied theories in VR and gamification. Based on this and following the theory concept characteristics methodology framework, the paper provides directions for future research.

There is no comprehensive review exploring the topics, theories, constructs and methods used in prior studies concerning VR and gamification applied to higher education services based on all the articles published in well-regarded academic journals. This review seeks to provide deeper insights, to help scholars contribute to the development of this research field.

En este documento se revisan los estudios sobre el uso de la realidad virtual (RV) y la Gamificación para involucrar a los estudiantes en la educación superior en marketing, se identifican los principales temas de investigación tratados, las lagunas de investigación y se sugiere una agenda futura de investigación.

Una revisión de la literatura basada en dos búsquedas en Web of Science (WOS) permitió identificar 115 artículos. La minería de textos se utilizó para realizar un análisis de texto completo de los artículos relacionados con RV y gamificación en la educación superior. Los autores también compararon las características más destacadas de los artículos.

A partir de este análisis, se encuentran y analizan cinco grandes temas de investigación: metodologías de enseñanza y educación, experiencia y motivación, compromiso de los estudiantes, aplicadas a la RV y la gamificación. Basándose en esto y siguiendo el marco del TCCM, el artículo proporciona una agenda futura de investigación.

No hay una revisión exhaustiva que explore los temas, las teorías, construcciones y métodos utilizados en estudios anteriores relativos a RV y gamificación aplicados a servicios de educación superior basados en todos los artículos publicados en revistas académicas. Esta revisión proporciona una panorámica más detallada y sugiere a los académicos nuevas líneas de trabajo para seguir desarrollando este campo de investigación.

本文的目的是回顾为了提高学生参与高等教育而使用虚拟现实(VR)和游戏化的营销方面的研究，以确定它们的研究主题，研究差距，并以此准备未来的研究议程。

本文的文献综述是基于Web of Science的两个搜索词进行的，最终搜索出115篇文章。本文采用文本挖掘方法，对与高等教育中的虚拟现实和游戏化相关的论文进行全文分析。作者还比较了这些文章中呈现的显著特征。

从这一调查中，我们发现并分析了五大研究主题，即教学方法与教育、体验与动机、学生参与、虚拟现实应用理论和游戏化。在此基础上，遵循理论概念、特征、方法论框架，为今后的研究提供了方向。

目前，在权威学术期刊上发表的所有文章，都没有对以往关于虚拟现实和游戏化应用于高等教育服务的研究的主题、理论、结构和方法进行全面的综述。本文旨在提供更深刻的见解，以帮助学者们为这一研究领域的发展做出贡献。

The estimation of the burden of a disease is one of the tasks with the longest tradition in health economics, which allows us to know the volume of resources that a country allocates to a specific health problem, and to compare countries and diseases. Although the fundamental objective of health systems is not to reduce the cost of the disease, but to improve the health of the population, the studies of burden of disease establish the economic seriousness of the problem, orienting the priorities of action.

Government-funded medical expenditure in Uruguay for the last ten years has tripled in US dollars. The increase in the prevalence of overweight and obesity has contributed to this growth. According to the World Health Organization, Uruguay has the highest growing trend in the prevalence of both overweight and obesity in South America. We have previously estimated that economic burden linked to obesity will be more than US$500 million by 2020, a figure close to 1% of the country’s GDP.

In this study, we tried to generate a measure of value to ascertain the cost of inaction in the fight against obesity and its consequences linked to several non-communicable diseases. The cost of inaction is not defined as the cost of not doing, but as the cost of not implementing the right policies (in this case health prevention policies) at the right time.