Repeat Visits Research Articles

The Influence of Destination Image on Tourists' Behavioural Intentions: Explore How Tourists' Perceptions of a Destination Affect Their Intentions to Visit, Revisit, or Recommend It to Others

Tourism is a dynamic and highly competitive industry, with destinations worldwide vying for the attention of travelers. Central to tourists' decision-making processes are their perceptions of a destination, often encapsulated in the concept of "destination image." This study seeks to unravel the intricate relationship between destination image and tourists' behavioral intentions, specifically examining how tourists' perceptions of a destination influence their intentions to visit, revisit, and recommend it to others. To achieve this, a comprehensive review of the literature on destination image and its impact on tourists' behavior was conducted. Empirical research findings from various destinations and cultural contexts were analyzed to provide insights into the multi-faceted nature of destination image and its effects on tourists' behavioral intentions. The study explores the dimensions that contribute to the formation of destination image, including cultural, natural, social, and marketing factors. The research reveals that tourists' perceptions of a destination significantly affect their intentions. A positive destination image often leads to a higher likelihood of initial visitation, repeat visitation, and word-of-mouth recommendations to others. Conversely, negative perceptions may deter potential tourists and discourage repeat visits or advocacy. Furthermore, the study discusses the role of destination marketing and management in shaping and enhancing destination image. Strategies such as effective communication, experiential marketing, and sustainable development are identified as critical elements in managing and improving destination image. The findings of this study provide valuable insights for destination marketers, policymakers, and industry stakeholders. Understanding the dynamics of destination image and its impact on behavioral intentions can inform the development of more targeted and effective marketing campaigns, as well as sustainable destination management practices. Ultimately, a positive destination image can not only attract more tourists but also foster a loyal and enthusiastic visitor base, contributing to the long-term success and sustainability of tourism destinations

A longitudinal study on how smart tourism technology influences tourists’ repeat visit intentions

ABSTRACT This study addresses this knowledge deficit by developing and testing a model that examines the effect of smart technologies on tourists’ satisfaction and intentions to repeat visit a travel destination. This study used a longitudinal approach and collected data from 438 tourists between December 2020 and March 2021, followed by another survey between September 2021 and March 2022. Technology characteristics such as accessibility, information quality, and personalisation positively influence tourists’ satisfaction, which mediates the relationship between trust and repeat visit intentions of tourists.

Augmented and virtual reality in hotels: Impact on tourist satisfaction and intention to stay and return

Augmented reality (AR) and virtual reality (VR) have emerged as transformative technologies, revolutionizing the way tourists engage with hospitality service providers. A prime application is facilitating hotel bookings. Employing quantitative methods, this study establishes and validates a conceptual model that deciphers tourists’ inclinations towards hotel reservations and returns via AR and VR. Findings indicate that the perceived ease of use, innovativeness, and usefulness of AR and VR positively influence tourists’ satisfaction, driving them to embrace these technologies for hotel bookings. While there might be underlying concerns about associated risks, these risks do not significantly deter repeat visits. Consequently, this study illuminates the immense potential of AR and VR in elevating tourist experiences and promoting revisits. Hoteliers and marketers are advised to leverage these findings, fine-tuning their strategies to synchronize with this tech evolution and cater to evolving tourist expectations.

How Memorable Are Agrifood Travel Experiences?

Destinations seek to increase their competitiveness by offering memorable experiences that can stimulate repeat visitation and positive word of mouth. Travel experiences centered on agrifood systems (i.e., agrifood tourism) encompass a set of attributes (e.g., authenticity and interaction with locals) that tend to be memorable. However, the extent to which these attributes contribute to memorability warrants further investigation. Thus, this study identified common and distinct elements of memorability across agritourism, culinary tourism, and craft-beverage tourism compared to beach tourism (control group). We surveyed a panel (n = 1019) in 2023 using a hypothetical travel scenario with four experience options. A multivariate analysis of variance showed high levels of memorability across various attributes of the agrifood experiences (e.g., learning opportunities and hands-on participation), with few differences across them, as compared to beach tourism. This study advances the scholarly construct of agrifood tourism by incorporating memorability within its complex dynamics. The study results also provide insights that marketers and managers of destinations with a mix of agrifood experiences can use to improve destination competitiveness and memorability (e.g., increasing educational offerings and adding more participative activities).

Kontribusi Promosi dalam Mempengaruhi Minat Kunjung Ulang Wisatawan ke Destinasi Wisata Bukit Langkisau

This study intends to see the effect of promotion on tourist interest in repeat visits to Bukit Langkisau Tourism Destinations. This research uses quantitative methods with a causal associative approach. The data collection technique uses a questionnaire or questionnaire given to respondents or tourists who have visited the Bukit Langkisau Tourism Destination. Data analysis was assisted by using SPSS version 23.00 program assistance techniques, the estimated output was presented in tabular form. Based on the research that has been done, the following outputs are produced: (1) based on the character of the respondents, the majority of visitors are women aged 21-30 years, work as students, visit 2-5 times and the promotional media seen is social media. (2) based on variable data of interest in repeat visits obtained from 97 respondents, interest in repeat visits shows a good category with a percentage of 49.5% and promotion variables obtained from 97 respondents, promotions show a good category with a percentage of 45.4%. (3) Based on testing the hypothesis using the coefficient of determination test, an R square value of 0.619 is obtained. This explains that promotion has an influence of 69.1% on tourists' intention to return to Bukit Langkisau Tourism Destinations and 38.1% is influenced by other variables

Preventing HIV Infection in Pregnant Women in Western Uganda Through a Comprehensive Antenatal Care-Based Intervention: An Implementation Study.

We implemented and assessed a comprehensive, antenatal care (ANC)-embedded strategy to prevent HIV seroconversions during pregnancy in Uganda. HIV-negative first-time ANC clients were administered an HIV risk assessment tool and received individual risk counseling. Those attending ANC without partners obtained formal partner invitation letters. After three months, repeat HIV testing was carried out; non-attending women were reminded via phone. We analyzed uptake and acceptance, HIV incidence rate, and risk behavior engagement. Among 1081 participants, 116 (10.7%) reported risk behavior engagement at first visit; 148 (13.7%) were accompanied by partners. At the repeat visit (n = 848), 42 (5%, p < 0.001) reported risk behavior engagement; 248 (29.4%, p < 0.001) women came with partners. Seroconversion occurred in two women. Increased odds for risk behavior engagement were found in rural clients (aOR 3.96; 95% CI 1.53-10.26), women with positive or unknown partner HIV-status (2.86; 1.18-6.91), and women whose partners abused alcohol (2.68; 1.15-6.26). Overall, the assessed HIV prevention strategy for pregnant women seemed highly feasible and effective. Risk behavior during pregnancy was reduced by half and partner participation rates in ANC doubled. The observed HIV incidence rate was almost four times lower compared to a pre-intervention cohort in the same study setting.

Evaluating efficiency of electronic consult requests in an outpatient classical hematology clinic.

46 Background: The classical hematology department at Beth Israel Deaconess Medical Center had 2,200 new outpatient consults in 2022. The conventional process for initiating consults was provider dependent, involving emails to practice hematologists and calls to clinic. Without a standardized process of requesting consults and providing relevant data, providers are not able to efficiently prepare for new visits, which can lead to patient/provider dissatisfaction and repetitive visits. Methods: As a convenience baseline sample in January 2023, hematology-oncology fellows were asked how often they were able to determine the consult reason in coagulation clinic, using a 5-point Likert scale. On 2/1/23, an electronic consult request became available to referring providers within the electronic medical record, and fellows received shared access of the consult list. Following the interventions, fellows were asked how often they were able to determine the consult reason and how often they utilized the electronic order and shared consult list. An additional metric included how often a follow up visit was needed due to insufficient information prior to the appointment. Results: Prior to the intervention, 212 new consults were requested in January 2023. Since the intervention, there have been 963 new consults requested in 115 days, 291 of which were submitted by electronic request [30.2%]. Prior to the intervention, fellows rated ease of finding the consult question an average of 2.2 with median 2.0 on a 5-point Likert scale (1=very difficult, 5=very easy). After addition of the electronic consult request, the average rating improved to 3.75 with median 4.0. To determine the consult question after the intervention, fellows utilized various resources including the new electronic order (28.6%), shared consult list (71.4%) and scanned records or forward emails (42.9%). Prior to the intervention, 3/20 [15%] classical hematology patients in a convenience sample required a follow up visit due to insufficient information available to the provider pre-initial visit. This improved to 0/20 patients after the intervention. Conclusions: Adding electronic consult requests and sharing referral reasons with the entire clinical team improved provider satisfaction with new visits and decreased need for repeat visits. However, utilization of a new electronic consult request by referring physicians remains low. Next steps include efforts to increase electronic consult request use, so that classical hematology clinic visits can be more efficient, which is essential to patient and staff satisfaction and value-based healthcare. [Table: see text]

HUSBAND'S SUPPORT WITH ADHERENCE TO THE INJECTION SCHEDULE FOR MOTHERS

Introduction: Contraception is a method or tool used to prevent pregnancy. Injectable contraception is a type of hormonal contraceptive method. Contraceptive failure is the main source of unwanted pregnancies, failures can be caused by a lack of support from the closest people. The study aimed to determine the relationship between husband's support and adherence to repeat contraceptive injections by mothers. Methods: This research is analytic research with a cross-sectional design. The study population was 219 couples of childbearing age who were injectable contraceptive acceptors. The sample technique is purposive sampling, with a total sample of 40 couples of childbearing age. For data collection techniques researchers use a questionnaire. The analytical test used is the Chi Square Test. Results: Results showed that 28 respondents received high support from their husbands (70%), and 33 respondents adhered to repeat injection contraceptive visits (82.5%). Results of bivariate analysis with Chi Square obtained p value = 0.000. Conclusions: There is a relationship between husband's support and compliance with injection contraceptive repeat visits. Health education is needed for the husband and family to support regular repeat visits to minimize the occurrence of contraceptive failure.

CULTURAL TOURISM IN INDONESIA: SYSTEMATIC LITERATURE REVIEW

This systematic literature review, based on 33 studies from the Scopus database, explores the dynamic landscape of cultural tourism in Indonesia, a sector that plays a vital role in the country's socio-economic development. The analysis identifies several key antecedents affecting tourist experience and satisfaction, such as destination image and promotion, heritage preservation, crisis and disaster management, and local product promotion. Despite the wealth of research in the area, gaps and contradictions persist, making it challenging to develop a holistic understanding of the complex interplay of factors that influence revisit intention. This study addresses this concern by examining the potential moderating effects of contextual factors, such as destination type, tourist demographics, cultural background, seasonality, and technology, on the relationships between antecedents, mediators (tourist experience and satisfaction), and revisit intention. The review reveals that accounting for these contextual factors enhances our understanding of the intricacies involved in shaping tourists' decisions to revisit a destination, ultimately contributing to the sustainable growth of the tourism sector in Indonesia. By integrating these findings into tourism management and promotion strategies, stakeholders can better cater to the diverse needs and preferences of tourists, fostering increased satisfaction and repeat visitation.

Recurrence of wheeze in preschool aged children: a retrospective cohort study in primary care

Abstract Background Approximately 1 in 7 children with wheeze will be admitted to hospital for treatment, often leading to repeat visits to emergency departments and hospital admissions. The UK lags other wealthy countries in the management of preschool wheeze and has amongst the highest rates of asthma deaths in Europe. There were reports that wheeze and asthma admissions to hospitals fell during the Covid-19 pandemic lockdowns, but the changing community incidence is unknown. We aimed to report the changing incidence of recurrent wheeze across the Covid-19 pandemic. Methods Using data from the UK Clinical Practice Datalink, a nationally representative sample of the UK population, we followed a cohort of 57,603 children aged 1-5 years who consulted their general practitioner with their first wheeze attack between January 2009 and July 2020. We calculated the incidence of wheezing recurrence by calendar year. We will calculate the incidence rate ratios for recurrent wheeze by level of area-based deprivation whilst accounting for potential confounders including child age, sex, birth weight, gestation age, ethnicity, comorbidities, bronchiolitis, maternal smoking, maternal asthma, and maternal age at birth. Results The incidence of recurrent preschool wheeze remained stable across the Covid-19 pandemic (e.g., 2019: 27% vs 2020: 23%) even though total wheeze events in general practice fell from 3,135 in 2019 to 1,280 in 2020. Conclusions Around a quarter of children with wheeze have repeat visits to the GP. Our next steps are to identify preventive actions to reduce the risks of recurrent wheeze for children presenting with their first wheeze attack in primary care. Key messages • Around a quarter of children will have a repeat visit to the GP for wheeze within the first year after their initial wheeze attack. • The incidence of recurrent preschool wheeze remained stable across the Covid-19 pandemic.

PENGARUH PROMOSI WISATA, KUALITAS PELAYANAN DAN FASILITAS WISATA TERHADAP MINAT KUNJUNG ULANG MELALUI KEPUASAN PENGUNJUNG SEBAGAIVARIABEL INTERVENING PADA WISATAWANKAMPUNG BLEKOK KABUPATEN SITUBONDO

The purpose of this study was to analyze and test the influence of tourism promotion, service quality and tourist facilities on repeat visit intentions through visitor satisfaction as an intervening variable in tourists from Blekok Village, Situbondo Regency. The population in this study is visitors or tourists from Kampung Blekok. The sampling method is determined by probability sampling. Data analysis and hypothesis testing in this study used the Structural Equation Model - Partial Least Square (PLS-SEM).&#x0D; The results of the direct influence hypothesis test using the Smart PLS 3.0 application, indicate that tourism promotion has a significant effect on visitor satisfaction. Service quality has a significant effect on visitor satisfaction. Tourism facilities have a significant effect on visitor satisfaction. Tourism promotion has a significant effect on intention to revisit. Service quality has no significant effect on intention to revisit. Tourist facilities have no significant effect on intention to revisit. Visitor satisfaction has a significant effect on intention to revisit. Tourism promotion has a significant effect on intention to revisit through satisfaction. Service quality has a significant effect on intention to revisit through visitor satisfaction. Tourism facilities have a significant effect on intention to revisit through visitor satisfaction.

REGENOPIA – PROMISING NEW TREATMENT FOR DRY EYE DISEASE

Dry eye syndrome is one of the main problems of modern ophthalmological pathology. Although the treatment of dry eye syndrome has made great strides, the development of new treatments continues to be a major challenge for scientists and ophthalmologists around the world. The development of highly effective and safe eye drops is especially important. The aim of the article is to conduct research on new eyedrops called Regenopia – the unique combination of three active substances: sodium hyaluronate, trehalose, and D-panthenol in the treatment of DED. Clinical observation of 128 patients (256 eyes) (85 women and 43 men 18-60 years age group with DED (patients with any chronic or autoimmune diseases were excluded from the research) treated with Regenopia was conducted from February 1-st to May 30-th, 2023. DED was diagnosed by anamnesis and instrumental clinical investigations (Visometry, Biomicroscopy, Schirmer’s test, Tear Break up time (TBUT)). Moderate dry eye - 75% (192 eyes), severe dry eye - 25% (64 eyes). In 24 eyes Superficial Punctate Keratitis (SPK) was determined after examination of the epithelial layer of the cornea and conjunctiva. One drop of Regenopia was instilled 3 times a day in both eyes by patients (in cases of SPK complex method of treatment was prescribed) and patients were called for a repeat visit in 3 weeks and 6 weeks after the start of treatment. The condition was assessed using the same methods as at the time of diagnosis. The bioprotective, osmoprotective, regenerative properties of trehalose significantly enhance hyaluronic acid’s ability to provide effective hydration and long-term symptom relief along with the regenerative action of dexpanthenol. Using Regenopia significantly reduced the intensity of symptoms, increased the patient’s ability to work, and improved the quality of life, which allows us to recommend Regenopia as an effective, safe and reliable treatment for moderate to severe dry eye disease.

Associations Between Management Pathway and Opioid Prescriptions for Patients Entering the Emergency Department With Neck and Back Pain

ObjectiveTo determine associations between post-emergency department (ED) management pathways and downstream opioid prescriptions in patients seeking care for incident neck and/or back pain. Patients and MethodsWe identified patients seeking first-time ED care for neck and/or back pain from January 1, 2013, through November 6, 2017. We reported demographic characteristics and opioid prescriptions across management pathways using descriptive statistics and assessed the relative risk of any opioid prescription 12 months post-ED visit among 5 different post-ED management pathways using Poisson regression adjusted for patient demographic characteristics. ResultsWithin 12 months after the index ED visit, 58.0% (n=10,949) were prescribed an opioid, with most patients prescribed an opioid within the first week (average daily morphine milligram equivalents of 6.8 mg (SD 9.6 mg). The morphine milligram equivalents decreased to 0.7 mg (SD 8.2 mg) by week 4 and remained consistently less than 1 mg between week 4 and 12 months. Compared with the ED to primary care provider pathway, the relative risk of opioid prescription between 7 days and 12 months after the index ED visit was similar for the ED to physical therapy pathway, higher for both the ED to hospital admission or repeat ED visit pathway (30% increase; relative risk (RR), 1.3; 95% CI, 1.17-1.44) and the ED to specialist pathway (19% increase; RR, 1.19; 95% CI, 1.07-1.33), and lower in the ED with no follow-up visits pathway (41% decrease; RR, 0.59; 95% CI, 0.54-0.65). ConclusionIn general, more conservative care was associated with lower opioid prescription rates, and escalated care was associated with higher opioid prescription rates.

THE EFFECT OF EXPERIENCE QUALITY ON RETURN VISIT INTEREST THROUGH PERCEPTION OF VALUE, DESTINATION IMAGE AND SATISFACTION

The problem in this study is the low interest in revisiting tourist objects Kuningan Botanical Gardens. The research objectives are: (1) to analyze the effect of image destination for repeat visits; (2) analyzing the effect of perceived value on the image of the destination; (3) analyze the effect of satisfaction on destination image; (4) analyzing the effect of experience quality on perceived value; (5) analyze the effect of experience quality on satisfaction; (6) analyze perceived value and image of the destination in mediating the influence of experience quality to interest in repeat visits; (7) analyze the satisfaction and image of the destination in mediate the effect of experience quality on intention to revisit. The research population includes all tourists who have visited the object Kuningan Botanical Garden Tourism (starting as a tourist attraction until now) namely as many as 87,288 visitors. The sampling technique uses sampling&#x0D; incidental (visitors encountered by chance). Determination of the number of samples using the slovin formula with an error rate of 5% so that samples are found as many as 400 tourists. Methods of data analysis using SEM analysis with analysis tool in the form of SmartPLS. The results of the study: (1) destination image has a significant positive effect on interest revisit; (2) perceived value has a significant positive effect on image destination; (3) satisfaction has a positive and significant effect on destination image; (4) experience quality has a positive and significant effect on perceived value; (5) experience quality has a significant positive effect on satisfaction; (6) perception the value and image of the destination are able to mediate the effect of experience quality on interest in repeat visits; (7) satisfaction and destination image are able to mediate influence experience quality on intention to revisit.&#x0D; Keywords: Interest in Repeat Visits; Destination Image; Experience Quality; Perception of value; Satisfaction&#x0D;

OVERARCHING OVERTONES: ORACLES ON CAREER CHRONICLES OF WOMEN IN INDIAN HOTEL INDUSTRY

The hospitality sector has been witnessing tremendous changes of late in terms of gender diversity with the increased participatory role of women at all levels of the workforce. The global food and beverage, and lodging industries have been proactively getting women on board down the years, recognising their important role in enhancing visitor satisfaction translating into repeat visits. This trend is however more widespread and popular in developed countries. India’s unique cultural values, social traditions, conventional customs, gender stereotyping, conservative attitudes and religious beliefs have all been challenging age-old obstacles that have largely hindered the greater employment and integration of women in the hospitality sector’s labour market. It is only from the 1960s that the women workforce in the Indian precincts saw limited presence and then slowly grew in numbers. This analytical research paper actively seeks to explore and highlight the trajectory of women employees in the hotel industry. Accurate and objective data for this investigative analysis is obtained from several leading five-star hotels in Chennai. Insights into the hospitality sector are obtained through interaction with a number of women holding managerial positions. The gathered data is decoded, and variables that help it are extracted. This research study on the work trends, changing industry dynamics and administrative challenges encountered by women in the hospitality sector can help establish gender parity by promoting a greater number of women to join the ranks and raise the profile of women in the hotel industry.

Reaching the Frail Elderly for the Diagnosis and Management of Atrial Fibrillation-REAFEL.

Frail elderly patients are exposed to suffering strokes if they do not receive timely anticoagulation to prevent stroke associated to atrial fibrillation (AF). Evaluation in the cardiological ambulatory can be cumbersome as it often requires repeated visits. To develop and implement CardioShare, a shared-care model where primary care leads patient management, using a compact Holter monitor device with asynchronous remote support from cardiologists. CardioShare was developed in a feasibility phase, tested in a pragmatic cluster randomization trial (primary care clinics as clusters), and its implementation potential was evaluated with an escalation test. Mixed methods were used to evaluate the impact of this complex intervention, comprising quantitative observations, semi-structured interviews, and workshops. Between February 2020 and December 2021, 314 patients (30% frail) were included, of whom 75% had AF diagnosed/not found within 13 days; 80% in both groups avoided referral to cardiologists. Patients felt safe and primary care clinicians satisfied. In an escalation test, 58 primary-care doctors evaluated 93 patients over three months, with remote support from four hospitals in the Capital Region of Denmark. CardioShare was successfully implemented for AF evaluation in primary care.

THE INFLUENCE OF BRAND IMAGE AND COMPLAINT HANDLING ON REVISIT INTENTION WITH PATIENT EXPERIENCE AS AN INTERVENING VARIABLE

This research is based on a decrease in the number of patient visits in 2022 when compared to 2021. The purpose of this study was to empirically reveal the effect of brand image and complaint handling on intention to return visits with patient experience as an intervening variable. This research is included in the quantitative research with a causality approach, the population used is patients who have visited more than once, the sample calculation uses the indicator formula x 5, so that a sample of 240 respondents is obtained using accidental sampling technique. The analytical method used is the three-box method and SEM analysis. The results of the analysis concluded that brand image and complaint handling had an effect on repeat visit intentions with trust as an intervening variable, brand image and complaint handling had an effect on experience and intention to revisit, and patient experience had an effect on repeat visits intentions, as well as providing positive intervention on brand image relations. and handling of complaints about intention to return visits. Several things that must be done to maintain the patient's intention to return visits are to make improvements to the promotion system using methods to build patient trust and loyalty, improvements to the system for conveying patient complaints, improvements to the patient centered care system and improvements to the promotion system uses the endorsement method.Keywords: Brand image, complaint handling, patient experience, repeat visit intention

Prevalence and implications of perinephric fluid on renal point-of-care ultrasound in the emergency department

BackgroundPoint-of-care ultrasound (PoCUS) is commonly utilized in the setting of renal colic. The presence of perinephric fluid may be an overlooked finding associated with ureteral obstruction. Our aims were to determine the prevalence of perinephric fluid on emergency physician-performed PoCUS and to determine whether perinephric fluid was associated with stone size or urologic intervention. MethodsThis was a 12-month cross-sectional study at an academic emergency department (ED) that took place from January 1, 2022, to December 31, 2022. All adult ED patients ≥18 years of age who had a renal PoCUS examination performed were included. Patients with missing or inadequate PoCUS images were excluded. Investigators blinded to PoCUS images and interpretations performed chart review for demographic data and outcome variables, while separate investigators blinded to clinical data reviewed PoCUS images to assess for perinephric fluid and hydronephrosis. A chi-square analysis was used to determine significance of association between perinephric fluid and outcome variables (stone size, urologic intervention). ResultsThere were 442 patients screened; 18 were excluded due to inadequate images and 4 were repeat visits of which only the initial visit was analyzed. Of the remaining 420 patients included, the prevalence of perinephric fluid was 6.2% (n = 26). Most patients (23/26) with perinephric fluid had final diagnoses consistent with ureterolithiasis. Hydronephrosis was present in 115 of the 420 patients (27.4%) and of these, 22 (19.1%) had perinephric fluid which was significantly associated with a need for urologic intervention; odds ratio (OR) 10.38 (95% CI 2.70–39.85), p < 0.01. Among the 67 patients with confirmed ureterolithiasis on computed tomography, perinephric fluid was associated with stone size ≥5 mm; OR 4.00 (95% CI 1.01–15.85), p = 0.04. ConclusionThe prevalence of perinephric fluid on emergency physician-performed renal PoCUS was 6.2% of all studies and 19.1% of patients with hydronephrosis. In the setting of ureterolithiasis, perinephric fluid was associated with larger stone size and need for urologic intervention.

Repeat Fall Risk in Geriatric Patients After Fall-Induced Head Trauma.

Introduction There are many known risk factors for falls, with poor health and physiologic decreases in function as the major contributors to fall risk in older adults. However, risk factors for repeat falls after initial ED discharge are not well-described. This study seeks to prospectively investigate risk factors for short-term repeat falls in geriatric ED patients with fall-related head trauma who do not require hospital admission. Methods This is a prospective study of patients aged 65 years and older with fall-related head trauma who presented to the EDs of two community level I trauma centers. Patients were excluded for intracerebral hemorrhage, admission during initial ED visit, or death in the hospital. Patients were followed for 14 days. Patient characteristics, repeat ED visits, and reason for returns were noted. Results About 2,143 patients were identified as meeting the inclusion criteria. Within 14 days of the initial presentation, 14.1% of patients returned to the ED, with 8.3% presenting with a complaint related to the initial trauma and 2.6% with a new injury. Patients with comorbidities of dementia (OR 3.02, 95% CI, 1.72-5.33, p<0.001), stroke (OR 2.12, 95% CI, 1.05-4.27, p=0.031), and smoking (OR 4.27, 95% CI,1.76-10.37, p<0.001) were significantly more likely to sustain a new injury leading to a repeat ED visit within 14 days. Conclusions After an ED visit due to a fall, over one in 10 patients will re-present to the ED due to a new injury or sequelae from the initial fall. In the immediate period after a fall, enhanced outpatient follow-up or risk mitigation strategies should be considered to lessen return visits and decrease morbidity.

CUSTOMER SATISFACTION IN LAKAWON ISLAND: A CONTENT ANALYSIS OF TRIPADVISOR REVIEWS

Customer satisfaction plays a vital role in the success of a tourist destination. Most tourists rely on online reviews written by others in various tourist destinations. Fulfilling and exceeding visitor expectations is critical for attracting repeat visitors, cultivating positive word-of-mouth, and maintaining a competitive advantage in the tourism industry. This study used qualitative content analysis to determine the dimension influencing customer satisfaction in Lakawon Island, as evidenced by a TripAdvisor review content analysis. The researcher used Microsoft Excel to categorize the reviews into the SERVQUAL dimensions of Tangible, Reliability, Responsiveness, Assurance, and Empathy, as well as Price. The results show that Tangibles plays a vital role, with 34% mention, in shaping customer perceptions of service quality, while Responsiveness, with 11% mention, is the least influential. This study aims to provide valuable insights for the service providers of Lakawon Island, aiming to enhance customer satisfaction and improve service quality.