In lieu of an abstract, here is a brief excerpt of the content:Medical Tourism:Crossing Borders to Access Health CareHarriet Hutson Gray (bio) and Susan Cartier Poland (bio)Traveling abroad for one's health has a long history for the upper social classes who sought spas, mineral baths, innovative therapies, and the fair climate of the Mediterranean as destinations to improve their health. The newest trend in the first decade of the twenty-first century has the middle class traveling from developed countries to those (...) with emerging economies to avoid treatment delays, prohibitive costs for life-saving procedures, or simply high costs for elective surgery. Others leave to have access to assisted suicide in countries that have legalized it: Belgium, The Netherlands, and Switzerland. This new era of globalization in health care has arrived without the benefit of international standards, government oversight, or ethical and legal review.Howard Staab, a self-employed carpenter from North Carolina, flew to India for his medically necessary heart surgery, scheduled a side trip to the Taj Mahal, and returned home to work in North Carolina. He spent a total of less than $10,000, instead of the $200,000 required from the local hospital (I, Milstein and Smith 2006).At first blush, the outsourcing of medical care to India seems to be a particular solution for a particular problem. However, the particularity of Mr. Staab is not unique. His experience is emblematic of those patients in the United States with a medical need for major and elective procedures, but who also must bear the total cost of these procedures. These middle-class, under-insured Americans go abroad.In tandem with increasingly aggressive marketing campaigns, American hospitals and companies have begun to leverage their connections in Asia to grow the medical tourism business into a major economic force. What are the consequences of this?Several authors point to the effect on the host country's population, particularly the poor, to be pushed farther down the queue to receive adequate, affordable care. Resources are applied to the foreign trade instead of building the local [End Page 193] medical infrastructure. Another potential problem is the obligation of the home-country physician to provide follow-up care. What are the legal ramifications when the procedure was illegal to begin with? Are there opportunities for redress for medical errors?These factors may be converging into a "perfect storm" for health care in the U.S., in which the potential participation of the major insurance companies in promoting offshore care will be the tipping point in the precarious structure that represents the economic currents in health care. Third-party administrators and self-funded employers may be on the cutting edge in 2009 by providing incentives to employees to travel overseas for care.I. Economic ConsiderationsConnell, John. Medical Tourism: Sea, Sun, Sand and... Surgery. Tourism Management 27: 1093–1100, 2006.As evidence of the interest of traditional tour operators in this newer twist on the industry, the author explores medical tourism as an element of the growth of world tourism. In promoting medical tourism, he urges consideration of such issues as the privatization of health care, the foundational role of technology, and uneven access to health resources.Dunn, Philip. Medical Tourism Takes Flight. H and HN: Hospitals and Health Networks: 40–44, November 2007.Writing for U.S. health care executives, Dunn emphasizes that the reality of medical tourism competes with the local medical center for patients and their insurance dollars in a significant way. He examines the possibility that U.S. insurance plans soon may offer to pay for what is currently a cash only business and that the economic impact to the local medical center could be significant or even devastating.Frontiers of Health Services Management [Selected Articles] 24 (2), Winter 2007.In "Managing Healthcare Services in the Global Marketplace" (pp. 3–18), Bruce J. Fried and Dean M. Harris consider legal, ethical, and financial implications of the international workforce. In "Globalization of Health Care" (pp. 19–30), Lynn Schroth and Ruthy Khawahja point out that the transfer of comprehensive management expertise and intellectual property from U.S. medical centers to international sites is driving the success of collaboration between U.S. and foreign health care centers. In "Is... (shrink)

The iCat is a user-interface robot with the ability to express a range of emotions through its facial features. This article summarizes our research to see whether we can increase the believability and likability of the iCat for its human partners through the application of gaze behaviour. Gaze behaviour serves several functions during social interaction such as mediating conversation flow, communicating emotional information and avoiding distraction by restricting visual input. There are several types of eye and head (...) movements that are necessary for realizing these functions. We designed and evaluated a gaze behaviour system for the iCat robot that implements realistic models of the major types of eye and head movements found in living beings: vergence, vestibulo ocular reflexive, smooth pursuit movements and gaze shifts. We discuss how these models are integrated into the software environment of the iCat and can be used to create complex interaction scenarios. We report about some user tests and draw conclusions for future evaluation scenarios. (shrink)

Gaze plays a fundamental role in the processing of facial expressions from birth. Gaze direction is a crucial part of the social signal encoded in and decoded from faces. The ability to discriminate gaze direction, already evident early in life, is essential for the development of more complex socially relevant tasks, such as joint and shared attention. At the same time, facial expressions play a fundamental role in the encoding of gaze direction and, when combined, expression (...) and gaze communicate behavioural motivation to approach or avoid. However, the investigation of how gaze direction and emotional expression interact during the processing of a face has been relatively neglected, and is the key question of this review. (shrink)

Prior to the pandemic of 2020, global tourism accounted for over ten percent of global GDP, for a total of $9.6 trillion USD; one in every four jobs created that year, across the globe, was in the travel and tourism sector. And yet the figure of the international tourist is often regarded with an attitude ranging from bemusement to outright contempt so much so that a series of books exists to guide tourists on how to avoid looking or acting (...) like tourists. Why, though, is the figure of the tourist —especially the international tourist— so disreputable? Given the sheer number of such tourists (over 1.4 billion, in 2018 alone) it seems odd to think that there is something shameful or problematic about tourism as a practice. What accounts for our seeming disdain for the tourist, even as so many of us engage in tourism ourselves?There are, of course, many obvious answers to this question. The tourist —especially the international tourist— is often a figure of some wealth and privilege; that tourist is likely to be clumsy, at best, in his or her navigating of a foreign society; and he or she is often likely to be less careful in her caretaking of the physical and social spaces into which she travels, given the fact that she is as it were on vacation. These facts may be enough to engender some antipathy towards the tourist especially one who, as Jarvis Cocker noted thirty years ago, regards the local inhabitants as somehow amusing. Tourists are likely to be —as the British aphorism had it about American GIs— oversexed, overpaid, and over here. In this paper, though, I want to suggest a slightly different story for our ethical disquiet with the figure of the tourist. I will argue that the practice of international tourism raises two distinct sorts of ethical worries —both of which reflect the fact that international tourism requires a local industry in which cultural difference is curated and made consumable by the foreign tourist—. This fact may lead to ethical disquiet, I argue, because it can represent a site at which there is a maldistribution of the benefits and burdens of intercultural conversation; the local who works in the tourism industry must become adept at performing his or her culture for the outsider, while that outsider gains the benefits of intercultural conversation without bearing a similar burden of epistemic labor. A second reason for concern, however, stems from the ways in which this demand for epistemic labor can end up deforming and destabilizing local forms of citizenship and political agency. Those who spend their days performing a debased and simplified version of their cultural identity for outsiders may be, I believe, marked by that effort and their own ability to engage in political conversations with fellow local members may be made more difficult as a result. International tourism, in short, may be a site from which both distributive and political injustices might emerge. These concerns, I should note, may exacerbate already objectionable relationships reflecting colonial legacies of oppression; but they may exist even in the absence of any history of colonialism. The mere fact of a market in the curated experience of cultural difference may be enough to raise these worries; and international tourism, I believe, often involves exactly this form of market. (shrink)

Poverty tours - actual visits as well as literary and cinematic versions - are characterized as morally controversial trips and condemned in the press as voyeuristic endeavors. In this collaborative essay, we draw from personal experience, legal expertise, and phenomenological philosophy and introduce a conceptual taxonomy that clarifies the circumstances in which observing others has been construed as an immoral use of the gaze. We appeal to this taxonomy to determine which observational circumstances are relevant to the poverty tourism (...) debate. While we do not defend all or even most poverty tourism practices, we do conclude that categorical condemnation of poverty tourism is unjustified. (shrink)

Poverty tours—actual visits as well as literary and cinematic versions—are characterized as morally controversial trips and condemned in the press as voyeuristic endeavors. In this collaborative essay, we draw from personal experience, legal expertise, and phenomenological philosophy and introduce a conceptual taxonomy that clarifies the circumstances in which observing others has been construed as an immoral use of the gaze. We appeal to this taxonomy to determine which observational circumstances are ethically relevant to the poverty tourism debate. While we (...) do not defend all or even most poverty tourism practices, we do conclude that categorical condemnation of poverty tourism is unjustified. (shrink)

This article examines the ways in which French tourist officers manage impartiality in telephone calls when faced with recommendation-seeking questions. Using Conversation Analysis and drawing on a corpus of 700+ telephone calls, it shows that, by typically avoiding conforming responses, officers resist confirming the evaluative element embodied in RSQs and, thus, avoid making recommendations. Instead, they opt to treat the questions as unanswerable in their own terms, a practice that may be deployed on its own or in conjunction (...) with other practices such as supplying information that will assist callers in making their choices and/or constructing responses as contingent. Further, officers typically do not decline to make recommendations on institutional grounds and, through their choices of interactional practices, obscure the institutional restrictions under which they operate. Thus, the selection of nonconforming responses by tourist officers is shown to contribute to the maintenance of an impartial stance. Finally, the article addresses the notions of affiliation and alignment and shows that nonconforming responses are less disaffiliative than outright rejections. (shrink)

Are Detroit ruin tours a form of morally permissible cultural tourism, or do these tours amount to a form of exploitation? To answer this question I compare Detroit ruin tours with ‘slum tours’ – guided tours of slums in the world's major cities. I argue that exploitation of the sort we find in slum tourism also exists, to a lesser extent, in Detroit ruin tours. To show this I detail two different accounts of exploitation and argue that Ruth Sample's account (...) best captures what is most morally problematic with slum tours and ruin tours. I then identify the similarities and differences between slum tours and ruin tours, and provide suggestions for how ruin tours could be retooled to avoid some of the worries of exploitation. Finally, I suggest that with the proper framing Detroiters could embrace photographic tours as a new form of cultural tourism. (shrink)

Socially Assistive Robots are increasingly conceived as applicable tools to be used in aged care. However, the use carries many negative and positive connotations. Negative connotations come forth out of romanticized views of care practices, disregarding their already established technological nature. Positive connotations are formulated out of techno-deterministic views on SAR use, presenting it as an inevitable and necessary next step in technological development to guarantee aged care. Ethical guidance of SAR use inspired by negative connotations tends to be over-restrictive (...) whereas positive connotations tend to provide over-permissive guidance. To avoid these extremes, we report on the development and content of 21 ethical orientations regarding SAR use in aged care. These orientations resulted from a multi-phased project, which consisted of empirical-ethical research focusing on older adults’ intuitions regarding SAR use and philosophical-ethical research focusing on philosophical-ethical argumentations regarding SAR use. This project led to the Socio-historical contextualization of the ethics of SAR use, in which the ethical impact of SAR use is localized on three interrelated analysis levels: societal, organizational, and individual-relational. The 21 novel orientations regarding SAR use are structured according to these levels and further categorized into foundational and applied orientations. The first category leads to critical reflection on SAR use while the latter category inspires decision-making processes regarding this use. While going beyond the care-romantic and techno-deterministic gaze of SAR use in aged care, the described orientations balance themselves between their over-restrictiveness and over-permissiveness. (shrink)

For many years, the actions of Myanmar's military government have provoked domestic discontent and strong condemnation overseas. The government is encouraging tourism in an attempt to legitimize its actions whilst generating valuable foreign currency. However, a number of organizations are urging people to avoid travel to Myanmar and thus prevent the military junta from obtaining the hard currency and global legitimacy it needs to survive. In this article, the ethical arguments for and against tourism in Myanmar are discussed, and for (...) the first time the ethical perceptions of tourists themselves are explored. The study applied the Multidimensional Ethics Scale to a group of 376 Myanmar visitors, finding that respondents were generally in favor of tourism in Myanmar, but were uncomfortable with the ethical implications of their visit. (shrink)

For many years, the actions of Myanmar’s military government have provoked domestic discontent and strong condemnation overseas. The government is encouraging tourism in an attempt to legitimize its actions whilst generating valuable foreign currency. However, a number of organizations are urging people to avoid travel to Myanmar and thus prevent the military junta from obtaining the hard currency and global legitimacy it needs to survive. In this article, the ethical arguments for and against tourism in Myanmar are discussed, and for (...) the first time the ethical perceptions of tourists themselves are explored. The study applied the Multidimensional Ethics Scale to a group of 376 Myanmar visitors, finding that respondents were generally in favor of tourism in Myanmar, but were uncomfortable with the ethical implications of their visit. (shrink)

This study examines whether human gaze lacking the confounding factor of eye whites can be processed unconsciously and explores the critical aspects for such process. Utilizing the continuous flash suppression paradigm, a schematic face—with direct or averted gaze, and with neutral, fearful or happy expressions—was presented to one eye while dynamic masks rendered it invisible to the other eye. Schematic faces were used to avoid unwanted influence from salient eye whites. Participants’ detection time of anything other than the (...) masks was used as an index of unconscious processing time. Faster detection was found for faces with direct gaze than those with averted gaze. However, there was no difference between detection times for different facial expressions and upright-face, inverted-face, and eyes-only conditions . These results confirm that, with schematic faces, gaze can be processed unconsciously regardless of facial expression, and eyes alone are sufficient for such process. (shrink)

PurposeWe conducted a driving simulator study to investigate the effects of monitoring intersection cross traffic on gaze behaviors and responses to pedestrians by drivers with hemianopic field loss.MethodsSixteen HFL and sixteen normal vision participants completed two drives in an urban environment. At 30 intersections, a pedestrian ran across the road when the participant entered the intersection, requiring a braking response to avoid a collision. Intersections with these pedestrian events had either no cross traffic, one approaching car from the side (...) opposite the pedestrian location, or two approaching cars, one from each side at the same time.ResultsOverall, HFL drivers made more of cross-traffic on both the blind and seeing sides. They made more numerous and larger gaze scans when they fixated cars on both sides and had lower rates of unsafe responses to blind- but not seeing-side pedestrians. They were more likely to demonstrate compensatory blind-side fixation behaviors when there was no car on the seeing side. Fixation behaviors and unsafe response rates were most similar to those of NV drivers when cars were fixated on both sides.ConclusionFor HFL participants, making more scans, larger scans and safer responses to pedestrians crossing from the blind side were associated with looking at cross traffic from both directions. Thus, cross traffic might serve as a reminder to scan and provide a reference point to guide blind-side scanning of drivers with HFL. Proactively checking for cross-traffic cars from both sides could be an important safety practice for drivers with HFL. (shrink)

This paper researches and analyzes the evaluation of the competitiveness of ice and snow tourism, uses the improved fuzzy neural network algorithm to process the system flow diagram of ice and snow tourism development through the function and characteristics of the power system of ice and snow tourism, and finally selects more than 40 indicators of the three subsystems of resources, economy, and culture. Based on the construction of cloud fuzzy neural network model, the above method is used for experimental (...) comparison analysis, and experiments are conducted through University of California Irvine dataset and engineering examples to compare with the traditional cloud model, fuzzy neural network, and BP neural network to analyze the operation efficiency, accuracy rate, and several rules of the algorithm. Through the experimental comparative analysis, the cloud fuzzy neural network can fully take into account the randomness and fuzziness of the data, optimize the generation of cloud rules, avoid multidimensional rule disasters, and ensure the operational efficiency of the algorithm; the accuracy rate of the algorithm is improved relative to that of the traditional technology, and it applies to a variety of datasets. And the software is used to test the ice and snow tourism industry system dynamics model to realize the correctness and robustness testing of the model. After the constructed model can reflect the real situation within the error range, the final policy simulation of the model is carried out. (shrink)

The authors co-organized (Snyder and Crooks) and gave a keynote presentation at (Turner) a conference on ethical issues in medical tourism. Medical tourism involves travel across international borders with the intention of receiving medical care. This care is typically paid for out-of-pocket and is motivated by an interest in cost savings and/or avoiding wait times for care in the patient’s home country. This practice raises numerous ethical concerns, including potentially exacerbating health inequities in destination and source countries and disrupting (...) continuity of care for patients. In this report, we synthesize conference presentations and present three lessons from the conference: 1) Medical tourism research has the potential for cross- or inter-disciplinarity but must bridge the gap between researchers trained in ethical theory and scholars unfamiliar with normative frameworks; 2) Medical tourism research must engage with empirical research from a variety of disciplines; and 3) Ethical analyses of medical tourism must incorporate both individual and population-level perspectives. While these lessons are presented in the context of research on medical tourism, we argue that they are applicable in other areas of research where global practices, such as human subject research and health worker migration, are occurring in the face of limited regulatory oversight. (shrink)

The ability to distinguish between subtle differences among emotions of similar valence is labelled emotion differentiation (ED). Previous research has demonstrated that people high in ED are less likely to use disengagement regulation strategies (i.e. avoidance/distraction) during negative affective states.The present eye-tracking study examined associations between ED and visual attention/avoidance of affective stimuli. A total of 160 participants viewed emotional video clips (positive/ negative), which were concurrently presented with a non-affective distractor image. After each video, participants verbally described their experienced (...) emotions with adjectives in an open-response format. Moreover, they completed an ED questionnaire.The computed ED specificity index for the negative videos (the number of specific adjectives divided by all adjectives used) was positively associated with the scores on the ED questionnaire and visual revisits for the negative videos (how many times the participants gazed back and forth between video and distractor). This viewing style might reflect more active exploratory behaviour directed toward acquiring information about the negative stimulus and its context. The ED measures were not associated with the gaze behaviour for positive videos. (shrink)

Data about flow rate, fishing intensity, and expenditures made by anglers can be used to capture some of the recreational value of waterways in economic terms in a way that avoids a number of the weaknesses of the most commonly used tools such as the contingent valuation method. Furthermore, recreational fishing may spur more economic activity than competing uses of riverine flows such as agriculture. This suggests that potential opportunity cost in regards to recreation ought to be a factor considered (...) in management decisions. (shrink)

This paper examines visual representation from a distinctive, interdisciplinary perspective that draws on ethics, visual studies and critical race theory. Suggests ways to clarify complex issues of representational ethics in marketing communications and marketing representations, suggesting an analysis that makes identity creation central to societal marketing concerns. Analyzes representations of the exotic Other in disparate marketing campaigns, drawing upon tourist promotions, advertisements, and mundane objects in material culture. Moreover, music is an important force in marketing communication: visual representations in (...) music promotions are also explored as data for inquiry. Offers an alternative to phenomenologically based approaches in marketing and consumer research scholarship that use consumer responses to generate data. Contributes additional insight into societal marketing and places global marketing processes within the intersection of ethics, aesthetics and representation. (shrink)

Failure increases the motivation to escape self-awareness. To date, however, the role of self-conscious emotions (shame and guilt) in triggering escape responses after failure has not been sufficiently addressed. In this pre-registered study (N = 156 undergraduates), we adapted a classic paradigm (avoidance of one’s image in a mirror) to a modern eye-tracking technology to test the hypothesis that shame proneness moderates the effect of failure on self-awareness avoidance. Individual differences in guilt and shame proneness were assessed before priming thoughts (...) of failure or success. Then, an eye-tracking paradigm was used to monitor gaze avoidance of one’s screen-reflected face during a neutral, unrelated task. Unexpectedly, results showed that guilt but not shame proneness exacerbated self-avoidance after failure. The present findings challenge the dominant view that shame fosters avoidance more so than guilt. (shrink)

Cognitive Reserve, according to a recent consensus definition of the NIH-funded Reserve and Resilience collaboratory,1 is constituted by any mechanism contributing to cognitive performance beyond, or interacting with, brain structure in the widest sense. To identity multivariate activation patterns fulfilling this postulate, we investigated a verbal Sternberg fMRI task and imaged 181 people with age coverage in the ranges 20–30 and 55–70. Beyond task performance, participants were characterized in terms of demographics, and neuropsychological assessments of vocabulary, episodic memory, perceptual speed, (...) and abstract fluid reasoning. Participants studied an array of either one, three, or six upper-case letters for 3 s, then a blank fixation screen was presented for 7 s, to be probed with a lower-case letter to which they responded with a differential button press whether the letter was part of the studied array or not. We focused on identifying maintenance-related activation patterns showing memory load increases in pattern score on an individual participant level for both age groups. We found such a pattern that increased with memory load for all but one person in the young participants, and such a pattern for all participants in the older group. Both patterns showed broad topographic similarities; however, relationships to task performance and neuropsychological characteristics were markedly different and point to individual differences in Cognitive Reserve. Beyond the derivation of group-level activation patterns, we also investigated the inter-subject spatial similarity of individual working memory rehearsal patterns in the older participants’ group as a function of neuropsychological and task performance, education, and mean cortical thickness. Higher task accuracy and neuropsychological function was reliably associated with higher inter-subject similarity of individual-level activation patterns in older participants. (shrink)

A t first glance you might not noorder, which afflicts about 0.5 percent of tice anything odd on meeting a American children. Neither researcher young boy with autism. But if had any knowledge of the other’s work, you try to talk to him, it will and yet by an uncanny coincidence each quickly become obvious that gave the syndrome the same name: autism, something is seriously wrong. He may not which derives from the Greek word autos, make eye contact with (...) you; instead he may meaning “self.” The name is apt, because avoid your gaze and fidget, rock his body the most conspicuous feature of the disorto and fro, or bang his head against the der is a withdrawal from social interacwall. More disconcerting, he may not be tion. More recently, doctors have adopted able to conduct anything remotely resemthe term “autism spectrum disorder” to bling a normal conversation. Even though make it clear that the illness has many rehe can experience emotions such as fear, lated variants that range widely in severity rage and pleasure, he may lack genuine but share some characteristic symptoms. empathy for other people and be oblivious Ever since autism was identified, reto subtle social cues that most children searchers have struggled to determine would pick up effortlessly. what causes it. Scientists know that sus- In the 1940s two physicians—Americeptibility to autism is inherited, although.. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:You Mean It’s Not My Fault:Learning about Lipedema, a Fat DisorderCatherine A. Seo“As a surgeon there is nothing more I can do for you. You need to lose 75 pounds before I can even consider repairing the damage done.” Implied and not directly stated, “… Because it’s your fault.” I sat listening, dumbfounded. I was at one of the top teaching hospitals in the country, face to face with (...) a respected Harvard Medical School trained surgeon who came highly recommended.I had seemingly irreversible damage that was leading to permanent immobility. I was experiencing excessive and uncontrollable swelling in my extremities. I was in unrelenting pain that prevented me from sleeping through the night.The surgeon looked down at the floor avoiding my gaze and—after never before mentioning weight as a possible contraindication to surgery during any of our interactions associated with five surgeries, in over two years, including at least 25 consultations, pre-op, post-op, or follow-up visits stated—in essence, “I can’t help you. You are too fat. It’s your fault.” Not until now, this moment, a couple of months after “the-surgery-gone-wrong-that-ended-in-terrible-complications,” I was being told that it was my fault.He then looked down at his pager that had conveniently buzzed within minutes after he delivered this news, and then walked out of the examining room leaving me to fend for myself in dealing with serious and life-changing complications. Susan1*, his Nurse Practitioner, printed out and handed me a standard listing of BMI calculations, marched me into the common hallway to weigh me, pointed out my BMI >30, reinforced the message that he would do nothing to remedy this horrific situation unless I lost 75 pounds, and then sent me on my way.I stood outside the hospital in shock. This just wasn’t happening, and it couldn’t be happening to me. I had grown to trust this surgeon, and I was struggling to comprehend what had just happened. As the shock wore off, I reengaged in several failed attempts to get help from him. He seemed to have convinced himself that the reason the surgery had gone awry was because of my excess weight, and not because, as I later learned, I had been misdiagnosed and the procedure, as it was performed, was far too aggressive. My health condition was deteriorating and it appeared as if weight was being scapegoated for the complications.If a solution was to be found, I was going to have to find it. After many months of research, I discovered that I have lipedema, an unrecognized [End Page E6] and generally misdiagnosed hereditary, genetically-based fat disorder. I had always had lipedema, which in my case seems to have been triggered at least since puberty. There are an estimated 17 million women in the USA alone who have lipedema, unrecognized or misdiagnosed.I, like most other women in America, knew that weight was a personal choice, and fat is a result of eating too much. Or was it? This ingrained and culturally accepted structure of knowledge began to disintegrate. I then asked the question, if this disease of lipedema is a fat disorder—and I had been to many, many doctors in my 63 years—why was it never identified? Why was I left to struggle in a constant battle trying to accomplish the impossible? I then learned about and named “anti-fat bias” and began to unravel the answers.About LipedemaAccording to Karen L. Herbst, Ph.D., M.D., endocrinologist and expert on fat disorders, lipedema (lipoedema in Europe) is an inherited genetic disease, affecting at least 11% of women of all sizes, from the extremely thin to the morbidly obese, resulting in localized fat that is bilateral, symmetrical and usually from the waist to just above the ankles. It can also affect the upper arms. Unlike the “normal” fat of obesity, lipedemic fat cannot be lost through diet and exercise. It is not uncommon for the comorbidity of overweight or obesity to accompany lipedema. Allen and Hines, physicians at the Mayo Clinic, first named Lipedema in 1940.Believed... (shrink)

The activity of wildlife viewing rests on an underlying contradiction. Wild animals are generally human-averse; they avoid humans and respond to human encounters by fleeing and retreating to cover. One would therefore expect human viewing of wild animals to be at best unpredictable, intermittent, and fleeting. Yet in recent decades, wildlife viewing has become a major recreational activity for millions of people around the world and has emerged as a thriving commercial industry. How can these two things—widespread wildlife intolerance of (...) humans and large-scale human observation of wildlife—be squared? The answer is that wild animals are only viewed on this scale because they have been made viewable through human intervention. This article examines two kinds of intervention—habituation and attraction—that change wildlife behavior toward humans and render hitherto elusive animals susceptible to regular, proximate, and protracted human viewing. (shrink)

In order to avoid the reduction of desire to demand and to produce a theory in keeping with the insights of psychoanalysis, Lacan had to move beyond Hegel’s theorization based on recognition. To do so, Lacan had to come up with a new form of object, an object irreducible to the signifier but with the power to arouse the desire of the subject. The theorization of the objet a enables Lacan to make an important advance on Hegel’s theory of desire, (...) an advance that effectively reverses the priority that Hegel establishes between the object and the Other. Despite the widespread association of Lacan with the signifier and its laws, his one great theoretical breakthrough concerns what remains absolutely irreducible to signification. My central contention in this essay is that Lacan’s theory of desire allows us to understand how singularity appears in the cinema, despite the medium’s inherent resistance to it. I examine this appearance of singularity through two filmic occasions—Sergei Eisenstein’s Battleship Potemkin and Michael Mann’s Heat. It is a medium in which recognition predominates, and yet the singularity of the objet a nonetheless emerges and animates the desire of the spectator. (shrink)

Hospitality industry plays a crucial role in the development of tourism. Predicting the future demand of a hotel is a key step in the process of hotel revenue management. Hotel passenger flow prediction plays an important role in guiding the formulation of hotel pricing and operating strategies. On the one hand, hotel passenger flow prediction can provide decision support for hotel managers and effectively avoid the waste of hotel resources and loss of revenue caused by the loss of customers. On (...) the other hand, it is the guarantee of the priority occupation of business opportunities by hotel enterprises, which can help hotel enterprises adjust their operation strategies reasonably to better adapt to the market situation. In addition, hotel passenger flow prediction is helpful to judge the overall operating condition of the hotel industry and assess the risk level of the hotel project to be built. Hotel passenger flow is affected by many factors, such as weather, environment, season, holidays, economy, and emergencies, and has the characteristics of complex nonlinear fluctuation. The existing demand predicting methods include linear methods and nonlinear methods. The linear prediction methods rely on the stability of environment and time series, so they cannot completely simulate the complex nonlinear fluctuations characteristics of hotel passenger flow. Traditional nonlinear prediction methods need to improve the prediction accuracy, and they are difficult to deal with the increasing data of hotel passenger flow. Based on the above analysis, this paper constructs a deep learning prediction model based on Long Short-Term Memory to predict the number of actual monthly arrival bookings. The number of actual monthly arrival bookings can reflect the actual monthly passenger flow of a hotel. The prediction model can effectively reduce the loss caused by cancellation or nonarrival of bookings due to various reasons and improve the hotel revenue. The experimental part of this paper is based on the booking demand dataset of a resort hotel in Portugal from July 1, 2015, to August 31, 2017. Artificial neural network and support vector regression are built as benchmark models to predict the number of actual monthly arrival bookings of this hotel. The experimental results show that, compared with the benchmark models, the LSTM model can effectively improve the prediction ability and provide necessary reference for the hotel's future pricing decision and operation mode arrangement. (shrink)

This Viewpoint calls attention to the pervasive wrongs related to knowledge production, use, and circulation in global health, many of which are taken for granted. We argue that common practices in academic global health (eg, authorship practices, research partnerships, academic writing, editorial practices, sensemaking practices, and the choice of audience or research framing, questions, and methods) are peppered with epistemic wrongs that lead to or exacerbate epistemic injustice. We describe two forms of epistemic wrongs, credibility deficit and interpretive marginalisation, which (...) stem from structural exclusion of marginalised producers and recipients of knowledge. We then illustrate these forms of epistemic wrongs using examples of common practices in academic global health, and show how these wrongs are linked to the pose (or positionality) and the gaze (or audience) of producers of knowledge. The epistemic injustice framework shown in this Viewpoint can help to surface, detect, communicate, make sense of, avoid, and potentially undo unfair knowledge practices in global health that are inflicted upon people in their capacity as knowers, and as producers and recipients of knowledge, owing to structural prejudices in the processes involved in knowledge production, use, and circulation in global health. (shrink)

There has long been a politics around the way in which women are represented, with objection not so much to specific images as to a regime of looking which places the represented woman in a particular relationship to the spectator's gaze. Artists have sometimes avoided the representation of women altogether, but they are now producing images which challenge the regime. How do these images succeed in their challenge? The Emptiness of the Image offers a psychoanalytic answer. Parveen Adams argues (...) that, despite flaws in some of the details of its arguments, psychoanalytic theory retains an overwhelming explanatory strength in relation to questions of sexual difference and representation. She goes on to show how the issue of desire changes the way we can think of images and their effects. Throughout she discusses the work of theorists, artists and filmmakers such as Helene Deutsch, Catherine MacKinnon, Mary Kelly, Francis Bacon, Michael Powell and Della Grace. The Emptiness of the Image shows how the very space of representation can change to provide a new way of thinking the relation between the text and the spectator. It shows how psychoanalytic theory is supple enough to slide into and transform the most unexpected situations. (shrink)

This article examines how the global traumas of resource-driven conflicts and acts of terrorism are mapped in 21st-century US and UK narrative cinema, and suggests that guilt, elicited in the implied Western viewer, is displaced in the films onto images of Western women. Revisiting Mulvey’s influential theory of ‘visual pleasure’ through the ‘male gaze’, this article analyses the films Traffic, a depiction of US complicity with global drug cartels, Babel, the story of a global media frenzy surrounding American tourists (...) victimized in Morocco, and three films about crises in Africa: Shooting Dogs, a dramatization of Western apathy during the 1994 Rwandan genocide, The Constant Gardener, about pharmaceutical testing in Kenya, and Lord of War, based upon the life of an arms dealer. A theoretical re-engagement with feminist film theory is followed by analyses of the films to illustrate how the guilt elicited by each of the films’ traumatic contexts conjoins with the primal psychological experience of lack. Viewers’ and their screen surrogates’ combined sense of helplessness in the face of others’ trauma is displaced ‘hysterically’ onto images of women, exposing a troubling new looking relation in our traumatic age. (shrink)

This article considers the role of beauty in Costa Rican sex work. In the context of sex tourism, beauty operates as affective labour performed by sex workers, labour that is mediated by deeply contradictory understandings of race and nation. Theorising beauty as a form of affective labour means thinking about beauty as value, as something that circulates, can be exchanged and is ultimately relational. While Costa Rica's national mythology has long focused on claims to white origins, sex tourists identify local (...) women's ‘exoticism’ and non-whiteness as particularly appealing. Commercial sex does not simply depend on an imperial male gaze, but rather requires us to consider how particular national mythologies about race are linked to ideals of attractiveness in complex ways. I also explore how women experience and manage their sexual attractiveness to foreign tourists in their daily lives and work. (shrink)