Search Results (3)

Recent investigations have supported the safety and benefits of discharging women on the same day following a minimally invasive hysterectomy (MIH) for both benign and malignant indications. Not all eligible candidates for same-day discharge (SDD) are discharged the same day, and patients undergoing an MIH for malignant indications have decreased the odds of receiving SDD despite established safety. The objective of this study was to use qualitative interviews to explore physician decision making regarding SDD after an MIH for malignant indications. Six qualitative interviews of gynecologic oncologists were analyzed using recurrent theme analysis for distinct themes in physician decision making regarding SDD. Results suggest that physician-perceived barriers to SDD include patient health characteristics, patient social characteristics, and hospital-system factors. Cited factors influencing SDD include patient travel, social support, practice setting (urban vs. rural) and staff comfort with the recommendation. Obstructive sleep apnea and post-surgical oxygenation appear to be a recurring reason for unplanned admission. The utilization of SDD after an MIH in the gynecologic oncology patient population is influenced by patient, physician, and system factors. Addressing the physician’s perceived barriers to SDD and catering recommendations to the gynecologic oncology population may increase utilization. Full article

Prior to the COVID-19 pandemic, tourism had permeated all spaces of experience, reaching nearly every country, region, community, and corner of the globe. In recent decades, the meanings, implications, and roles of tourism have also expanded significantly. This article focuses on unconventional tourism mobilities, including same-day visits, which are an important but often neglected part of the tourism system, constantly challenging both scholars and tourism industry stakeholders. Unconventional tourism is an umbrella term that covers most kinds of unregistered or unaccounted tourist mobilities, some of which might not appear to be ‘tourism’ but should be in certain localities and under certain conditions. Given the growth of unregistered tourist flows and unaccounted leisure (or utilitarian) mobilities, there is a need in tourism studies to apply innovative research methods and to reconceptualize the meanings of tourism in different geographical and social contexts. It is expected that people’s desire to travel in the post-pandemic era will educe new spatial and temporal travel experiences and behaviours in which unconventional tourisms will play an important role. To better understand this phenomenon and to evaluate the development of new approaches to travel and behavioural spatialities, new ways of thinking, new theoretical constructs, and new methodologies are needed. This article seeks to explore certain hidden or invisible tourism mobilities, focusing on the geographical patterns, processes, and hidden aspects of unconventional tourism. Full article

Time-sensitive parcel deliveries—shipments requested for delivery in a day or less—are an increasingly important aspect of urban logistics. It is challenging to deal with these deliveries from a carrier perspective. These require additional planning constraints, preventing the efficient consolidation of deliveries that is possible when demand is well known in advance. Furthermore, such time-sensitive deliveries are requested to a wider spatial scope than retail centers, including homes and offices. Therefore, an increase in such deliveries is considered to exacerbate negative externalities, such as congestion and emissions. One of the solutions is to leverage spare capacity in passenger transport modes. This concept is often denominated as cargo hitching. While there are various system designs, it is crucial that such a solution does not deteriorate the quality of service of passenger trips. This research aims to evaluate the use of mobility-on-demand (MOD) services that perform same-day parcel deliveries. To test the MOD-based solutions, we utilize a high-resolution agent- and activity-based simulation platform of passenger and freight flows. E-commerce demand carrier data collected in Singapore are used to characterize simulated parcel delivery demand. We explore operational scenarios that aim to minimize the adverse effects of fulfilling deliveries with MOD service vehicles on passenger flows. Adverse effects are measured in fulfillment, wait, and travel times. A case study on Singapore indicates that the MOD services have potential to fulfill a considerable amount of parcel deliveries and decrease freight vehicle traffic and total vehicle kilometers travelled without compromising the quality of MOD for passenger travel. Insights into the operational performance of the cargo-hitching service are also provided. Full article