RESUMEN
As many business activities-especially those associated with the energy-intensive industries-continue to be major sources of greenhouse gas emissions, and hence significantly contributing to global warming, there is a perceived need to identify ways to make business activities eventually carbon neutral. This paper explores the implications of a changing climate for the global tourism business and its intertwining global aviation industry that operates in a self-regulatory environment. Adopting a bibliometric analysis of the literature in the domain of global tourism and climate change (772 articles), the paper reveals the underlying sustainability issues that entail unsustainable energy consumption. The aviation industry as a significant source of carbon emission within the sector is then examined by analyzing the top 20 largest commercial airlines in the world with respect to its ongoing mitigating measures in meeting the Paris Agreement targets. While self-regulatory initiatives are taken to adopt Sustainable Aviation Fuels (SAF) as alternative fuel production and consumption for drastically reducing carbon emission, voluntary alignment and commitment to long-term targets remain inconsistent. A concerted strategic approach to building up complementary sustainable infrastructures among the global network of airports based in various international tourist destination cities to enable a measurable reduction in carbon emission is necessary to achieve a transformational adaptation of a business sector that is of essence to the recovery of the global economy while attempting to tackle climate change in a post-COVID-19 era.
RESUMEN
AIM: To examine incidence and outcome following out-of-hospital cardiac (OHCA) arrest in a high-risk area characterised by high density of potential bystanders and easy access to nearby automated external defibrillators (AEDs). METHODS: This retrospective observational study investigated pre-hospital and in-hospital treatment, as well as survival amongst persons with OHCA at Copenhagen International Airport between May 25, 2015 and May 25, 2019. OHCA data from pre- and in-hospital medical records were obtained and compared with public bystander witnessed OHCAs in Denmark. RESULTS: Of the 23 identified non-traumatic OHCAs, 91.3% were witnessed by bystanders, 73.9% received bystander cardiopulmonary resuscitation (CPR), and 43.5% were defibrillated by a bystander. Survival to hospital discharge was 56.5%, with 100% survival among persons with an initial shockable heart rhythm. Compared with nationwide bystander witnessed OHCAs, persons with OHCA at the airport were less likely to receive bystander CPR (73.9% vs. 89.4%, OR 0.33; 95% CI, 0.13-0.86), more likely to receive bystander defibrillation (43.5% vs. 24.8%, OR 2.32; 95% CI, 1.01-5.31), to achieve return of spontaneous circulation (78.2% vs. 50.6%, OR 3.51; 95% CI, 1.30-9.49), and survive to hospital discharge (56.5% vs. 45.2%, OR 1.58; 95% CI, 0.69-3.62). CONCLUSION: We found a high proportion of bystander defibrillation indicating that bystanders will quickly apply an AED, when accessible. Importantly, 56% of all persons, and all persons with a shockable heart rhythm survived. These findings suggest increased potential for survival following OHCA and support current guidelines to strategically deploy accessible AEDs in high-risk OHCA areas.