The Tourism Demarketing Mix: Working to Reduce Revisits to Egyptian Nature Reserves

This study tests the impact of the tourism demarketing mix (product, price, place, promotion) on tourists’ intention to reduce revisits to nature reserves in Egypt. In particular, this work focuses on the moderating role of switching cost. Data were collected from 401 tourists of the Wadi Degla and Petrified Forest nature reserves in Egypt. Path analysis is employed to test the research hypotheses using WarpPLS 6. Findings confirm that the tourism demarketing mix significantly affects tourists’ perception and intention to reduce revisits to the nature reserves. Lower switching cost partially enhanced the relationship between the tourism demarketing mix and tourists’ intention to reduce revisits. Regarding implications, managers can use findings from this study to design marketing plans that contribute to sustainable stewardship of destinations and protect nature reserves. Limitations and conclusions were also provided

Assessment of Some Heavy Metals Pollution and Bioavailability in Roadside Soil of Alexandria-Marsa Matruh Highway, Egypt

To assess the roadside soils contamination with Pb, Cd, and Zn, 34 soil samples were collected along Alexandria-Marsa Matruh highway, Egypt, and analyzed by using the atomic absorption. The contamination with these metals was evaluated by applying index of geoaccumulation ( geo ), contamination factor (CF), pollution load index (PLI), the single ecological risk index ( ), and the potential ecological risk index (PERI). The average concentrations of Pb, Cd, and Zn were 38.2, 2.3, and 43.4 g/g, respectively. geo indicates the pollution of soil with Pb and Cd as opposed to Zn. shows that the roadside soils had low risk from Pb and Zn and had considerable to high risk from Cd. Most of the samples (62%) present low PERI risk associated with metal exposure and the rest of the samples (38%) are of moderate PERI. The bioavailable fraction (EDTA-Extract) was 72.5 and 37.5% for Pb and Cd contents, respectively. These results indicate the remarkable effect of vehicular and agricultural activities on Pb and Cd contents in soil

The use of watershed geomorphic data in flash flood susceptibility zoning: a case study of the Karnaphuli and Sangu river basins of Bangladesh

The occurrence of heavy rainfall in the south-eastern hilly region of Bangladesh makes this area highly susceptible to recurrent flash flooding. As the region is the commercial capital of Bangladesh, these flash floods pose a significant threat to the national economy. Predicting this type of flooding is a complex task which requires a detailed understanding of the river basin characteristics. This study evaluated the susceptibility of the region to flash floods emanating from within the Karnaphuli and Sangu river basins. Twenty-two morphometric parameters were used. The occurrence and impact of flash floods within these basins are mainly associated with the volume of runoff, runoff velocity, and the surface infiltration capacity of the various watersheds. Analysis showed that major parts of the basin were susceptible to flash flooding events of a ‘moderate’-to-‘very high’ level of severity. The degree of susceptibility of ten of the watersheds was rated as ‘high’, and one was ‘very high’. The flash flood susceptibility map drawn from the analysis was used at the sub-district level to identify populated areas at risk. More than 80% of the total area of the 16 sub-districts were determined to have a ‘high’-to-‘very-high’-level flood susceptibility. The analysis noted that around 3.4 million people reside in flash flood-prone areas, therefore indicating the potential for loss of life and property. The study identified significant flash flood potential zones within a region of national importance, and exposure of the population to these events. Detailed analysis and display of flash flood susceptibility data at the sub-district level can enable the relevant organizations to improve watershed management practices and, as a consequence, alleviate future flood risk

Lithium side effects and toxicity: prevalence and management strategies

Despite its virtually universal acceptance as the gold standard in treating bipolar disorder, prescription rates for lithium have been decreasing recently. Although this observation is multifactorial, one obvious potential contributor is the side effect and toxicity burden associated with lithium. Additionally, side effect concerns assuredly play some role in lithium nonadherence. This paper summarizes the knowledge base on side effects and toxicity and suggests optimal management of these problems. Thirst and excessive urination, nausea and diarrhea and tremor are rather common side effects that are typically no more than annoying even though they are rather prevalent. A simple set of management strategies that involve the timing of the lithium dose, minimizing lithium levels within the therapeutic range and, in some situations, the prescription of side effect antidotes will minimize the side effect burden for patients. In contrast, weight gain and cognitive impairment from lithium tend to be more distressing to patients, more difficult to manage and more likely to be associated with lithium nonadherence. Lithium has adverse effects on the kidneys, thyroid gland and parathyroid glands, necessitating monitoring of these organ functions through periodic blood tests. In most cases, lithium-associated renal effects are relatively mild. A small but measurable percentage of lithium-treated patients will show progressive renal impairment. Infrequently, lithium will need to be discontinued because of the progressive renal insufficiency. Lithium-induced hypothyroidism is relatively common but easily diagnosed and treated. Hyperparathyroidism from lithium is a relatively more recently recognized phenomenon

Sexual functioning in patients with anxiety disorders: an investigation of the potential influence of neuroinflammatory and endocrine factors

Previous studies have revealed complex associations between sexual dysfunction, depressive symptoms, and treatment with antidepressant drugs, and provide evidence linking depression, neuroinflammation and hypothalamo-pituitary-axis (HPA) dysregulation. However, little is known about the prevalence of sexual dysfunction or incidence of treatment-emergent sexual dysfunction in patients with anxiety disorders. Published studies have found contrasting evidence of the association between anxiety symptoms and disrupted levels of inflammatory markers, and investigations of HPA function in anxiety disorders have produced inconsistent findings. Augmentation with COX-2 inhibitors in patients with depression can reduce depressive symptoms and improve quality of life, but the potential therapeutic benefit of COX-2 inhibitors in patients with anxiety disorders is uncertain. This thesis includes a systematic review of the utility of the Arizona Sexual Experiences scale (ASEX) and a series of investigations in patients with anxiety disorders (n=35), with exploration of sexual function, anxiety symptoms, neuroinflammation and HPA dysregulation, at baseline, after six weeks of treatment, and after six weeks of augmentation with the COX-2 inhibitor celecoxib. The ASEX appears reliable, valid, and sensitive to change, and acceptable in a broad range of clinical settings. Cross-sectional findings indicate a point prevalence of sexual dysfunction of 57.1% at Baseline, 75.1% at Week 6 and 39.3% at Week 12. Sexual dysfunction was significantly positively correlated with the severity of anxiety symptoms, and significantly negatively correlated with mental wellbeing at Baseline, Week 6 and Week 12. There were low levels of IL-12p70 and low IL-2 but a high level of TNF-α at Week 6. At Week 12, there were low levels of IL-1β, low IL-12p70 and IL-13, a high level of TNF-α (regardless of augmentation with celecoxib) but low IL-2 levels in the nonaugmentation group. At Baseline, patients with panic disorders with agoraphobia had a high hair cortisol concentration (HCC). Longitudinal analysis found worsening of sexual function at Week 6, but significant improvement in anxiety symptoms, wellbeing and sexual function at Week 12 in the celecoxib augmentation group. There was a significant reduction in IL-2 level from Week 6 to Week 12 in the augmentation group, a reduction of HCC from Baseline to Week 6, and a slight elevation at Week 12, although changes in HCC were not statistically significant. Investigating sexual dysfunction as part of the clinical assessment of patients with anxiety disorders, is important to facilitate better management and well-being. Augmentation with celecoxib can improve clinical outcomes, yet further research is needed to retest this. More research is needed to explore HCC in anxiety disorders in larger clinical samples

Treatment with citalopram, but not with agomelatine, adversely affects sperm parameters: a case report and translational review

BACKGROUND: Adverse effects of antidepressant drug treatmenton sexual function are well documented but the effects of antidepressants on sperm production have not been researched extensively.METHODS: A narrative of an interventional case report of sperm parameters in a 30-year-old Caucasian man with a diagnosis of mixed depressive and anxiety disorder, who underwent citalopram treatment, followed by agomelatine treatment. Clinical observations prompted a review of the pre-clinical and clinical literature on the effects of antidepressant administration or treatment on sperm production and parameters. Findings from the review are discussed to suggest potential underlying mechanisms.RESULTS: Abnormal sperm parameters were associated with treatment with the SSRI citalopram. There was an improvement in sperm concentration, motility, progressive motility and sperm morphology following its withdrawal. There was no similar association during subsequent treatment with agomelatine. The clinical observations reflect findings from animal studies, which indicate that antidepressants can have untoward effects on spermatogenesis.CONCLUSIONS: SSRI treatment can be associated with impaired semen quality. Potential underlying mechanisms include changes in sperm DNA integrity, activation of IDO and shifting tryptophan metabolism. Further studies of the effects of antidepressants on spermatogenesis might benefit from including investigation of changes in IDO activity during antidepressant administration.<br/

Treatment with citalopram, but not with agomelatine, adversely affects sperm parameters: a case report and translational review

BackgroundAdverse effects of antidepressant drug treatmenton sexual function are well documented but the effects of antidepressants on sperm production have not been researched extensively.MethodsA narrative of an interventional case report of sperm parameters in a 30-year-old Caucasian man with a diagnosis of mixed depressive and anxiety disorder, who underwent citalopram treatment, followed by agomelatine treatment. Clinical observations prompted a review of the pre-clinical and clinical literature on the effects of antidepressant administration or treatment on sperm production and parameters. Findings from the review are discussed to suggest potential underlying mechanisms.ResultsAbnormal sperm parameters were associated with treatment with the SSRI citalopram. There was an improvement in sperm concentration, motility, progressive motility and sperm morphology following its withdrawal. There was no similar association during subsequent treatment with agomelatine. The clinical observations reflect findings from animal studies, which indicate that antidepressants can have untoward effects on spermatogenesis.ConclusionsSSRI treatment can be associated with impaired semen quality. Potential underlying mechanisms include changes in sperm DNA integrity, activation of IDO and shifting tryptophan metabolism. Further studies of the effects of antidepressants on spermatogenesis might benefit from including investigation of changes in IDO activity during antidepressant administration.</jats:sec

Structured review of the use of the Arizona Sexual Experiences scale (ASEX) in clinical settings

Background. Approximately 40% of women and 30% of men describe sexual dysfunction, although recognition in medical settings is sub-optimal, due to problems in reporting and eliciting concerns relating to sexual function and satisfaction. Screening questionnaires may help to support this aspect of clinical practice. The Arizona Sexual Experiences Scale (ASEX) includes items that quantify sex drive, arousal, vaginal lubrication or penile erection, ability to reach orgasm, and satisfaction from orgasm. Method. We investigated the validity and other psychometric properties of the ASEX, and the findings from the populations in which it has been employed, by searching MEDLINE, EMBASE and Google Scholar using the terms, Arizona Sexual Experiences Scale, Arizona Sexual Experience Questionnaire and ASEX. We eliminated duplications, letters and papers not available in English, and grouped the remaining papers into the categories of psychometric, epidemiological, and outcome-based studies. Results. After elimination of letters and duplicates, papers not in English, and pre-clinical and irrelevant studies, 104 papers were analysed. The ASEX has excellent internal consistency and scale reliability (Cronbach α=0.9055) and strong test–retest reliability (patients, r=0.801, p&lt;0.01; controls, r=0.892, p&lt;0.01). Analyses of variance revealed significant differences in total ASEX scores between patients and controls (males F=18.1, p&lt;0.000; females F=31.71, p&lt;0.000) and between females and males (patients F=5.22, p=0.026; controls F=5.05, p=0.031). ASEX appears useful in a range of clinical situations including patients with primary sexual dysfunction, specific psychiatric disorders, specific physical illnesses, and treatment emergent sexual dysfunction. Discussion. The ASEX appears to be a reliable instrument for identifying and quantifying sexual dysfunction across a range of populations in various clinical settings. Little is known about its utility in patients with anxiety disorders or relationships between ASEX scores and biological parameters