Frequent Flyers Research Articles

Effective Strategies for Managing Substance Use Disorders in Older Adults in Nursing Homes

Substance use disorder is very prevalent in nursing home (NH) residents due to aging, the number of prescription drugs that are being used to manage their physical and psychological pain, and several discharges with the diagnosis of substance use disorder from hospitals to NH for aftercare support. However, many nursing homes are not equipped to provide adequate care for residents with a diagnosis of substance use. The staff is not well-trained to care for this type of population, which is becoming a challenge for the staff to manage residents in-house, leading to overdose, recurrent hospitalization, and unsuccessful discharges to communities due to relapses and an increase in the number of frequent flyers. Substance use disorder has become a significant public health concern in the United States, especially in the older population from the past couple of decades, which tends to increase. Discharging older adults with substance use disorders into nursing homes without ensuring established resources in the long-term care setting raises safety and quality concerns, emphasizing a pressing need for innovative preventive and management approaches for substance use disorders to meet unique needs of older adults in nursing homes. Purpose: The purpose of the study is to explore and identify the interventions, treatments and care models to effectively manage substance use disorders in older residents who are living in nursing homes. The study further focuses on the unique challenges that are faced by older adults and staff in nursing homes to understand the need for integrating addiction treatments in Long-term care settings to assess the need to enhance care strategies to improve resident outcomes, which includes handling overdose emergencies, prevention, rehabilitation and relapse management of substance use disorders (SUDs). Scope: Provides valuable insights for future researchers and points out the need for collaborative models among the rehabilitation, addiction centers, and LTC and the need for virtual health platforms to improve access to care, interdisciplinary approaches, and policy innovation on resident retention and optimum resource allocation to reduce the health care cost of frequent flyers or unnecessary hospitalizations, therefore, improve patient outcomes.

Do healthy and environmentally sustainable inflight foods matter to international flight passengers? Frequent vs. occasional flyers

Airlines continuously seek strategic ways to impress their passengers and build memorable experiences. Inflight food services as an imperative interaction, the research included healthy and environmentally sustainable attributes (e.g., production method, product origin), reflecting the emphasis on longevity/well-being and sustainability to design optimal inflight food bundles as well as the brand and taste attributes. This exploratory research investigated differences in inflight food preferences between frequent and occasional flyers. A total of 16 full-profile pairwise comparison questions of mixed levels for five attributes were given to the sample of international flight passengers (n = 490). The participants were asked to rate inflight food bundles using a 9-point Likert scale. The results indicate that healthy and environmentally sustainable inflight foods will be preferred over brand-named or tasty foods when served onboard. There were notable differences in inflight food preferences between occasional and frequent flyers. While both flyers preferred low-calorie and tasty foods made with nationally sourced ingredients, frequent flyers highly preferred branded foods made with organically grown ingredients. In contrast, occasional flyers desired generic branded foods made with conventionally grown ingredients. The study findings are discussed further to help airline marketers build a desirable inflight food bundle.

Health complaints among frequent flyers

Health complaints among frequent flyers

Prevention and control of jet lag symptoms and temporary impairment of cognitive function with Pycnogenol® in healthy individuals and in hypertensives.

The aim of this registry study was to evaluate the efficacy of Pycnogenol® in controlling signs/symptoms and temporary impairment of cognitive function (COFU) associated with jet lag. Previous flight studies have shown a decrease in the level of jet lag symptoms with Pycnogenol®. The control of jet lag signs/symptoms appeared to be correlated with flight-related microangiopathy and peripheral edema. Pycnogenol® - a standardized extract from the bark of French maritime pine - has significant antiedema, anti-inflammatory and antioxidant properties. A group of subjects flying east in economy class for 10-12 hours used Pycnogenol® 150 mg/day and a similar group without supplementation served as controls. A subgroup of mild hypertensive subjects using a single ACE inhibitor was also included. One hundred twenty-seven subjects completed the study. Of the participants, 48 were aviation professionals like pilots, flight attendants or air company staff - 24 of them took Pycnogenol® and 24 served as controls. Forty-seven study participants were frequent flyers and non-staff professionals, 25 of which took Pycnogenol® and 22 served as controls. In addition, a group of 32 subjects with mild hypertension was included, 16 took Pycnogenol® and 16 served as controls. No side effects and a good tolerability were observed. The registry groups were comparable for baseline characteristics. Eastbound flights' duration was 11.22±0.4 hours in supplemented subjects and 11.14±0.32 in controls. Dropouts were due to logistical problems. Post flight Visual Analogue Scale (VAS) scores were significantly lower in all Pycnogenol® groups, including hypertensives for all signs and symptoms of jet lag compared to controls, showing prevention and improvement of jet lag symptoms. The duration of any sign/symptom of jet lag with Pycnogenol® intake was significantly shorter (P<0.05) post-flight compared to controls (P<0.05). The number of nights of altered/disturbed sleep was also lower in the Pycnogenol® groups compared to controls. Leg edema was present in almost all subjects with different degrees especially in the hypertensive group. The increase in ankle circumference before and after flight was significantly lower with Pycnogenol® compared to controls (P<0.05). After the flight, average scores of the single COFU tasks were significantly higher in the Pycnogenol® groups compared to controls, showing preserved cognitive function. In conclusion, in this registry study Pycnogenol® was effective in preventing jet lag-related symptoms and preserving cognitive functions without tolerability problems. These observations should be tested in a larger group of subjects including complex individuals prone to edema (i.e. diabetics, hypertensive or older patients).

Evaluating The Impact of Mindfulness Service on Air Travel Experience and Satisfaction: A Mediation and Moderation Model

The concept of mindfulness is enhanced now a days over the world. It’s significant positive effects on person’s health not only valuable solution for people facing problems, like depression and anxiety but also makes a desire for society to enhance individual’s quality in many phases of life. To fulfilment of the objective of this study convenient sampling techniques is used to collected the data from the concerned respondents. To access and measurement of the model convergent validity, and discriminant validity is used and to measure the hypothesis path analysis is used. The results of it create positive travel experience which lead to higher customer satisfaction. Moreover, due to significant effects on travel anxiety and higher satisfaction with the service, customer more attract and loyal to airline. In order to take the large range of passengers the study was conducted as a survey which was taken at the international departure gate of Allama Iqbal International Airport Lahore. Data was collected and compiled from passengers who were frequent flyers in different airlines. The study also focusses on the relationship between mindfulness and travel experience with airlines of their choice. The Service quality acting as a moderator between mindfulness mediation and its effects on travel experience to improve customer satisfaction. Mindfulness has a limited attention in business perspective but this study investigates mindfulness as a business model. Mindfulness service create a positive effect to satisfied airline passengers during different phases of flight to enhance positive travel experience. There for, the possible impact of flight anxiety is investigated for better understanding of mindfulness meditation effect with the help of airline service quality.

(185) C-L “Frequent Flyers:” Why Do Some Patients Have So Many Consults?

(185) C-L “Frequent Flyers:” Why Do Some Patients Have So Many Consults?

Why Fly? Prudential Value, Climate Change, and the Ethics of Long-distance Leisure Travel

We argue that the prudential benefits of long-distance leisure travel can justify such trips even though there are strong and important reasons against long-distance flying. This is because prudential benefits can render otherwise impermissible actions permissible, and because, according to dominant theories about wellbeing, long-distance leisure travel provides significant prudential benefits. However, this ‘wellbeing argument’ for long-distance leisure travel must be qualified in two ways. First, because travellers are epistemically privileged with respect to knowledge about what is good for them, they must look critically at their own assessment of the prudential benefits of a trip. Second, the wellbeing argument is unlikely to support prudential arguments for long-distance leisure trips made by frequent flyers.

Relationship Modeling of Travel Website Quality toward Customer Satisfaction Influencing Purchase Intention

Consumer behavior is an important area for the tourism sector that needs to be continuously explored. Tourism is a sensitive sector influenced by several factors, like pandemics, government intervention, international cooperation, etc. The tourist industry is rapidly expanding, influenced by social media and digital marketing, which act as influencers. The current study investigates the association between travel website quality and customer satisfaction to lead to purchase intention. The research undertook a statistical path analysis of feedback from 500 frequent flyers, who use travel websites for international travel. SmartPLS 4.0 was applied to prepare a structural equation model by partial least squares. The study indicates that the caliber of travel websites is linked to customers’ satisfaction, which, in turn, impacts their intention to make a purchase.

Fibromyalgia Increases Post-operative Healthcare Utilization Following total Hip Arthroplasty

BackgroundPreoperative factors can complicate the postoperative course and increase health care utilization following total hip arthroplasty (THA). Fibromyalgia is not generally recognized as a modifiable risk factor prior to THA. The aim of this investigation was to assess the effect of fibromyalgia on postoperative health care utilization following THA. MethodsPatients who underwent primary THA from 2018 to 2019 were identified from a large national database using Current Procedural Terminology and International Classification of Diseases, tenth revision (International Classification of Diseases-10) codes. Patient demographics, age, sex, and preoperative opioid use were collected. Analysis compared patients who did and did not have fibromyalgia for postoperative health care utilization metrics; lengths of stay (LOS), 90-day postoperative opioid usages, dislocations, and emergency room visits. Independent t-tests were used to compare LOS and rates of ongoing opioid use. Logistic regression analyses with adjusted odds ratios evaluated the risk of dislocation and emergency room visit after adjusting for demographic characteristics and comorbidities. ResultsCompared to those who did not have fibromyalgia, patients who had fibromyalgia experienced longer LOS (P < .0001), increased odds of opioid use 90 days postoperatively (P < .0001) as well as increased odds of hip dislocation (P < .0001) and presentation to the emergency room (P < .0001). Patients who had fibromyalgia were also more likely to be “frequent flyers” with ≥5 emergency room visits after THA (P < .0001). ConclusionsFibromyalgia can complicate postoperative care following THA with increased LOS, higher rates of opioid use, and increased odds of dislocation and emergency room visits. As focus shifts to preoperative optimization and risk stratification, more attention should be placed on fibromyalgia prior to THA.

The Plight of Persistently Disciplined Students: Examining Frequent Flyers and the Conversion of Office Discipline Referrals Into Suspensions

Racial inequality in exclusionary discipline is a salient educational equity issue. The implications of educators’ discretion in administering discipline and the complexity of repeated office discipline referrals (ODRs) and suspensions are reflected in school discipline policy debates nationwide. This brief uses New York City to learn more about persistently disciplined students. Black students are more likely to be persistently referred than other students. The disparities in the students who are persistently suspended are not as stark as the disparities in the students who are persistently referred. School characteristics play an essential role in predicting persistently disciplined students and the findings reinforce the value of teachers’ diversity and experience and school climate for reducing racial inequality in school discipline.

Risk of Venous Thromboembolism Among Individuals who Frequently Travel by Flight for Work

Many research studies have found that venous thromboembolism is common among frequent travellers in all form mainly air travel. Few Indian studies in acute care settings had also mentioned travel history as an important element. Nowadays a section of corporate employees are frequent flyers in India. Hence, we conducted a pilot project to assess and analyze the risk category among these employees. A snowball sampling was used as a sampling technique. The data collection method was done using a google survey link. An anonymous questionnaire link with a unique code of four digit inserted by the participants, had been circulated among the identified study participants. Out of the total 30 respondents, 13 (43.3%) were at high risk, 8(26.7%) at medium risk and 9 (30%) at low-risk categories of venous thromboembolism development. Pre-existing risk factors and post-travel observation (within 8 weeks of flight travel) were recorded and analysed with SPSS 22 version. Family history was significantly associated with risk category of the employees with chi-square (χ²) value of 22.46 (p&lt;0.05). For high-risk category employees, the venous thromboembolism risk was increased by 44 times (OR 44, 95% CI 3.4-573.4) and for medium-risk category employees 13 times (OR 13.3, 95% CI 1.07-166.4) with the history of infectious disease exposure. Overall presence of certain pre-existing clinical parameters (like heart disease, congenital heart disease, varicose veins, pregnancy, exposure to infectious disease) were significantly associated with a chi-square (χ²) value of 6.09 (p&lt;0.05). Further knowledge level and practice level of these frequent corporate flyers had a statistically significant association with their risk category. This paved the way to develop holistic need-based guidelines covering all relevant key aspects of venous thromboembolism including the head-neck-foot exercise to prevent venous thromboembolism while flying.

Data, Anomalies; a Call to Cease and Desist.

Data, Anomalies; a Call to Cease and Desist.

Next Flight Prediction for PKX's Frequent Flyers

Frequent flyers have been shown to have a significant impact on airline long-term profitability, so it is becoming increasingly crucial to understand their needs. Objective of this paper is to forecast the next flight of frequent flyers, which will not only improve the customer experience but also assist airlines optimize their ticketing service platforms. In the data preparation phase, we use methods including data transformation and genetic algorithms (GA) to directly extract statistical features or excavate new predictors, which is inspired by the characteristics of the frequent flyers of Beijing Daxing International Airport (PKX). We synthesize ensemble models, linear regression models, evolutionary computation models, and fusion models for prediction. The hyperparameters can be optimized by the Tree-structured Parzen Estimator (TPE). After extensive comparison, the model developed with the average fusion strategy obtains the best prediction on the test set with a minimal MSLE of 0.7893.

Nationwide study of the characteristics of frequent attenders with multiple emergency department attendance patterns

The burden of frequent attenders (FAs) of emergency departments (EDs) on healthcare resources is underestimated when single-centre analyses do not account for utilisation of multiple EDs by FAs. We aimed to quantify the extent of multiple ED use by FAs and to characterise FAs. We reviewed nationwide ED attendance in Singapore data from 1 January 2006 to 31 December 2018 (13 years). FAs were defined as patients with ≥4 ED visits in any calendar year. Single ED FAs and multiple ED FAs were patients who attended a single ED exclusively and ≥2 distinct EDs within the year, respectively. Mixed ED FAs were patients who attended a mix of a single ED and multiple EDs in different calendar years. We compared the characteristics of FAs using multivariable logistic regression. We identified 200,130 (6.3%) FAs who contributed to1,865,704 visits (19.6%) and 2,959,935 (93.7%) non-FAs who contributed to 7,671,097 visits (80.4%). After missing data were excluded, the study population consisted of 199,283 unique FAs. Nationwide-linked data identified an additional 15.5% FAs and 29.7% FA visits, in addition to data from single centres. Multiple ED FAs and mixed ED FAs were associated with male sex, younger age, Malay or Indian ethnicity, multiple comorbidities, median triage class of higher severity, and a higher frequency of ED use. A nationwide approach is needed to quantify the national FA burden. The multiple comorbidities and higher frequency of ED use associated with FAs who visited multiple EDs and mixed EDs, compared to those who visited a single ED, suggested a higher level of ED burden in these subgroups of patients. The distinct characteristics and needs of each FA subgroup should be considered in future healthcare interventions to reduce FA burden.

How socially just are taxes on air travel and ‘frequent flyer levies’?

Policies to reduce air travel demand, including in the tourism sector, are urgently required as air travel’s climate impact keeps growing while low-carbon aviation remains a distant perspective. Policy options include flat rate taxes per flight, taxes on flight miles or emissions, or frequent flyer levies, yet little is known about how their distributional impacts compare. This paper examines the distributional effects of various air travel tax options for the UK, informed by an analysis of the distribution of (frequent) flights and associated emissions over income and other social characteristics. We find that ‘frequent flights’ are even more unequally distributed than all flights and that all taxes on air travel are distributionally neutral or progressive. The most progressive option is a ‘frequent air miles tax’ based on both the number of flights and emissions. At the same time, some social groups like recent migrants are relatively likely to be ‘frequent flyers’ even on lower incomes. Overall however, our results show that taxing air travel is far less regressive than taxing home energy or motor fuels. Taxes on air travel, while often portrayed as unfair in public discourses, therefore raise fewer fairness concerns than other types of carbon taxes.

“I Am Here to Fly, but Better Get the Environment Right!” Passenger Response to Airport Servicescape

This study deploys environmental and positive psychology models to develop and test the influence of substantive and communicative staging of airport servicescape (i.e., SSoS and CSoS) on passengers’ emotional and subsequent behavioral responses. Furthermore, we examined the extent to which the strength of these associations is contingent upon passengers’ travel frequency (passengers’ familiarity with airport facilities and processes). The study’s sample (n = 387) was drawn from passengers departing from Shanghai Hongqiao International Airport (SHA). The results indicate that airport servicescape robustly engenders passengers’ positive emotion and satisfaction (with SSoS having more potent effects), facilitating intentions to repurchase, recommend, pay more, and partly, spend more. The interaction effects demonstrate that while pleasant CSoS induces higher satisfaction in frequent flyers, pleasing SSoS generates higher satisfaction in infrequent flyers. In addition, positive emotion appears more vital in predicting infrequent passengers’ behavioral intentions to repeat purchase, recommend, and pay more. Passenger satisfaction seems relevant for different passengers regarding their familiarity levels depending on the kind of behavioral response under consideration. Thus, satisfied frequent travelers are more inclined to repeat purchase and pay more; however, satisfied infrequent travelers are more likely to recommend and spend more at airport terminals. The summary, interpretation, and implication of the results conclude the study.

Give Up Flights? Psychological Predictors of Intentions and Policy Support to Reduce Air Travel.

Concerted, timely action for mitigating climate change is of uttermost importance to keep global warming as close to 1.5°C as possible. Air traffic already plays a strong role in driving climate change and is projected to grow—with only limited technical potential for decarbonizing this means of transport. Therefore, it is desirable to minimize the expansion of air traffic or even facilitate a reduction in affluent countries. Effective policies and behavioral change, especially among frequent flyers, can help to lower greenhouse gas emissions. For both, a positive evaluation and public support is indispensable. This study contributes to understanding air travel behavior and the perception of regulative policies. We examined the role of attitudes, perceived behavioral control, efficacy, global identity, and justice concerns for intentions to avoid flights and aviation-related environmental policy support. We conducted an online survey study with a quota sample of N = 2,530 participants in Germany. The strongest positive predictors of intentions to refrain from flying and policy support were perceived behavioral control to travel without flying, efficacy beliefs that avoiding air travel contributes to climate change mitigation, and intergenerational justice concerns; pro-travel attitude was a negative predictor. Moreover, we tested whether the provision of additional information on climate impact, global and intranational inequalities as well as subsidies (implying intranational inequality) affected the intention to avoid air travel and policy support. We found no effects of the different types of information. Nor did we find an interaction between the type of information provided and global or national identity. Our results highlight the need for a shift within the mobility sector that facilitates attractive and accessible transport alternatives in order to strengthen people’s behavioral control to choose other means than planes and their efficacy perceptions. Moreover, raising awareness of the impacts of climate change on future generations and developing strategies to promote people’s concern for intergenerational justice might motivate people to reduce air travel and thereby contribute to a livable future for new generations.

Febrile children with comorbidities at the emergency department — a multicentre observational study

We aimed to describe characteristics and management of children with comorbidities attending European emergency departments (EDs) with fever. MOFICHE (Management and Outcome of Fever in children in Europe) is a prospective multicentre study (12 European EDs, 8 countries). Febrile children with comorbidities were compared to those without in terms of patient characteristics, markers of disease severity, management, and diagnosis. Comorbidity was defined as a chronic underlying condition that is expected to last > 1 year. We performed multivariable logistic regression analysis, displaying adjusted odds ratios (aOR), adjusting for patient characteristics. We included 38,110 patients, of whom 5906 (16%) had comorbidities. Most common comorbidities were pulmonary, neurologic, or prematurity. Patients with comorbidities more often were ill appearing (20 versus 16%, p < 0.001), had an ED-Paediatric Early Warning Score of > 15 (22 versus 12%, p < 0.001), or a C-reactive protein > 60 mg/l (aOR 1.4 (95%CI 1.3–1.6)). They more often required life-saving interventions (aOR 2.7, 95% CI 2.2–3.3), were treated with intravenous antibiotics (aOR 2.3, 95%CI 2.1–2.5), and were admitted to the ward (aOR 2.2, 95%CI 2.1–2.4) or paediatric intensive care unit (PICU) (aOR 5.5, 95% CI 3.8–7.9). They were more often diagnosed with serious bacterial infections (aOR 1.8, 95%CI 1.7–2.0), including sepsis/meningitis (aOR 4.6, 95%CI 3.2–6.7). Children most at risk for sepsis/meningitis were children with malignancy/immunodeficiency (aOR 14.5, 8.5–24.8), while children with psychomotor delay/neurological disease were most at risk for life-saving interventions (aOR 5.3, 4.1–6.9) or PICU admission (aOR 9.7, 6.1–15.5).Conclusions: Our data show how children with comorbidities are a population at risk, as they more often are diagnosed with bacterial infections and more often require PICU admission and life-saving interventions.What is Known:• While children with comorbidity constitute a large part of ED frequent flyers, they are often excluded from studies.What is New:• Children with comorbidities in general are more ill upon presentation than children without comorbidities.• Children with comorbidities form a heterogeneous group; specific subgroups have an increased risk for invasive bacterial infections, while others have an increased risk of invasive interventions such as PICU admission, regardless of the cause of the fever.

Understanding the Navigation Experience: Do Virtual Customer Service Agents Make a Difference?

The purpose of this study is to contribute to understanding website usage and loyalty and specifically whether the navigation experience varies with the presence of a virtual customer service agent (VCSA) on the website. Two online surveys were carried out with a random sample of 1,000 frequent flyers before and after the inclusion of the VCSA in an airline company website. Results are tested using partial least squares (PLS) structural equation modelling and importance–performance map analysis. Results show that perceived ease of use (PEU), perceived usefulness (PU), perceived visual attractiveness, perceived enjoyment and social presence impact website loyalty. In the website without the VCSA, usability variables (PU and PEU) and perceived visual attractiveness are the strongest antecedents of loyalty, while perceived visual attractiveness and social presence are the strongest predictors in the VCSA setting.

Radiation Exposure in the Lower Atmosphere during Different Periods of Solar Activity

In recent years, there has been a huge increase in air travel, both for business and leisure. For this reason, entities such as the European Commission and the International Committee on Radiological Protection have provided several recommendations for the radiation protection of aviation crews and frequent flyers, as well as highlighted the need for accurate tools for radiation assessment in the atmosphere. With a focus on the most frequent commercial flying altitudes, this work has performed dosimetry calculations in the lower atmosphere of Earth for different values of cut-off rigidity, covering the recent solar cycles 23 and 24. Results are based on Monte Carlo simulations performed with the validated Geant4 software application Dynamic Atmospheric Shower Tracking Interactive Model Application (DYASTIMA) and its extension, DYASTIMA-R.