Nature dependent tourism - Combining big data and local knowledge.

The ability to quantify nature's value for tourism has significant implications for natural resource management and sustainable development policy. This is especially true in the Eastern Caribbean, where many countries are embracing the concept of the Blue Economy. The utilization of user-generated content (UGC) to understand tourist activities and preferences, including the use of artificial intelligence and machine learning approaches, remains at the early stages of development and application. This work describes a new effort which has modelled and mapped multiple nature dependent sectors of the tourism industry across five small island nations. It makes broad use of UGC, while acknowledging the challenges and strengthening the approach with substantive input, correction, and modification from local experts. Our approach to measuring the nature-dependency of tourism is practical and scalable, producing data, maps and statistics of sufficient detail and veracity to support sustainable resource management, marine spatial planning, and the wider promotion of the Blue Economy framework.

Pulmonary rehabilitation in bronchiectasis: a propensity-matched study.

International guidelines recommend pulmonary rehabilitation for patients with bronchiectasis, supported by small trials and data extrapolated from chronic obstructive pulmonary disease (COPD). However, it is unknown whether real-life data on completion rates and response to pulmonary rehabilitation are similar between patients with bronchiectasis and COPD.Using propensity score matching, 213 consecutive patients with bronchiectasis referred for a supervised pulmonary rehabilitation programme were matched 1:1 with a control group of 213 patients with COPD. Completion rates, change in incremental shuttle walk (ISW) distance and change in Chronic Respiratory Disease Questionnaire (CRQ) score with pulmonary rehabilitation were compared between groups.Completion rate was the same in both groups (74%). Improvements in ISW distance and most domains of the CRQ with pulmonary rehabilitation were similar between the bronchiectasis and COPD groups (ISW distance: 70 versus 63 m; CRQ-Dyspnoea: 4.8 versus 5.3; CRQ-Emotional Function: 3.5 versus 4.6; CRQ-Mastery: 2.3 versus 2.9; all p>0.20). However, improvements in CRQ-Fatigue with pulmonary rehabilitation were greater in the COPD group (bronchiectasis 2.1 versus COPD 3.3; p=0.02).In a real-life, propensity-matched control study, patients with bronchiectasis show similar completion rates and improvements in exercise and health status outcomes as patients with COPD. This supports the routine clinical provision of pulmonary rehabilitation to patients with bronchiectasis.