In an effort to combine tourism with pro-social giving and personal development, more and more people choose to go abroad on volunteer tourism trips. We explore the potential transformational influence such trips have on travelers, aiming to map the transformation process stages and examine their boundary conditions. In doing so, we follow a mixed methods approach using a qualitative study comprising ethnographically informed in-depth interviews and a quantitative one, by means of a structured questionnaire. Findings indicate that the transformation process volunteer tourists undergo involves three stages related to liminality. We conceptualize the degree of liminality as immersiveness and show how the transformation process is significantly influenced by the degree of authenticity and the immersiveness of volunteer tourists’ experiences, as well as their own perceptions on how societally meaningful their actions were during their trips. Based on our conclusions, we present important implications for academics, managers, and tour operators.
The growth in health care spending in the United States, though slowed in the last few years, remains unsustainable. Since higher health care spending does not correlate with most measures of improved patient outcome, there are new attempts to define "value" in health care as the ratio of quality to cost. This article reviews newer proposed models for provider payment and organization and their possible effects on neurologic practice.
Measuring the carbonation of cementitious materials has taken many forms over many decades. Objectives for understanding this chemical reaction with the atmosphere have varied. Some investigations have focused on quantifying the potential shrinkage of concrete as it carbonated to mitigate cracking, whereas other studies have measured changes in pH levels within the concrete and the resulting effects on the corrosion of embedded ferrous metals. Current market drivers, however, have shifted beyond the functional performance aspects of carbon sequestration of cement-based materials and are now placing much more emphasis on the embodied carbon, and potential carbon sequestration, of construction materials. The thesis of this investigation centers on the relatively porous nature of dry-cast concrete compared to wet-cast concrete, making it a potentially attractive candidate for carbon sequestration. While considerable research has been conducted on carbonation of wet-cast concrete, there has been limited research on quantifying carbon uptake in manufactured, dry-cast concrete products, including concrete masonry units (CMUs). Therefore, this research investigation was undertaken to develop and refine testing protocols that deliver repeatable, accurate measurement of the carbon dioxide (CO2) uptake of manufactured, dry-cast concrete products. This paper summarizes the testing methods used and the preliminary measurements of carbon sequestration of dry-cast CMUs sourced from multiple producers across North America. Raw materials and finished concrete products were characterized and analyzed using x-ray fluorescence and thermogravimetric analysis to quantify the amount of carbon sequestration that occurred over time due to the carbonation of the cementitious paste in the CMUs. Although testing associated with this project is still under way to define the long-term sequestration characteristics of dry-cast concrete, the 28-day (cradle-to-gate) carbon sequestration measured in this project averaged 1.30 lb/ft3 (21 kg/m3), a quantity significantly higher than would have been predicted using wet-cast concrete carbonation data.
Accurate coding is an important function of neurologic practice. This section of CONTINUUM, contributed by members of the AAN Medical Economics and Management Committee, includes helpful coding information and examples related to the issue topic. This section may include diagnosis coding, evaluation and management coding, procedure coding, or a combination, depending on which is most useful for the subject area of the issue.
We thank our invaluable reviewers. The reviewers listed below with 1 asterisk have reviewed 5 or more papers. Two asterisks indicate that the reviewer has reviewed 10 or more manuscripts. This list includes those reviewers who returned a review or reviews of initial submissions (rereviews of the same manuscript are not included) between December 1, 2016 and December 1, 2017.We welcome new reviewers! Please send an e-mail to ncpjournal@neurology.org if you have never reviewed for the journal but are interested in doing so. Please include a description of your credentials and expertise in the areas in which you are qualified to review.
Accurate coding is an important function of neurologic practice. This section of CONTINUUM, contributed by members of the AAN Medical Economics and Management Committee, includes helpful coding information and examples related to the issue topic. This section may include diagnosis coding, evaluation and management coding, procedure coding, or a combination, depending on which is most useful for the subject area of the issue.
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