Decomposing the Tourist’s Satisfaction Gap: The Role of Expectations and Cognitions

In this paper we present an empirical methodology that allows the tourist’s satisfaction gap between two destinations to be decomposed into two components. One explains the role of differences in observed characteristics of the tourists and the stay (endowments). The other captures the share of the gap due to differences in the utility that tourists derive from those characteristics (cognitive). To illustrate the use of this method, we employ data coming from a sample of tourists visiting two touristic enclaves in Tarragona (Spain). Our results indicate that the cognitive component explains most of the satisfaction gap. Keywords: Satisfaction, expectations, cognition, touristic destination

The gap between scientific evidence and clinical practice : 5-aminosalicylates are frequently used for the treatment of Crohn's disease

BACKGROUND: There is uncertain evidence of effectiveness of 5-aminosalicylates (5-ASA) to induce and maintain response and remission of active Crohn's disease (CD), and weak evidence to support their use in post-operative CD. AIM: To assess the frequency and determinants of 5-ASA use in CD patients and to evaluate the physicians' perception of clinical response and side effects to 5-ASA. METHODS: Data from the Swiss Inflammatory Bowel Disease Cohort, which collects data since 2006 on a large sample of IBD patients, were analysed. Information from questionnaires regarding utilisation of treatments and perception of response to 5-ASA were evaluated. Logistic regression modelling was performed to identify factors associated with 5-ASA use. RESULTS: Of 1420 CD patients, 835 (59%) were ever treated with 5-ASA from diagnosis to latest follow-up. Disease duration >10 years and colonic location were both significantly associated with 5-ASA use. 5-ASA treatment was judged to be successful in 46% (378/825) of treatment episodes (physician global assessment). Side effects prompting stop of therapy were found in 12% (98/825) episodes in which 5-ASA had been stopped. CONCLUSIONS: 5-Aminosalicylates were frequently prescribed in patients with Crohn's disease in the Swiss IBD cohort. This observation stands in contrast to the scientific evidence demonstrating a very limited role of 5-ASA compounds in the treatment of Crohn's disease.

Regulation of membrane trafficking and organ separation by the NEVERSHED ARF-GAP protein.

Cell separation, or abscission, is a highly specialized process in plants that facilitates remodeling of their architecture and reproductive success. Because few genes are known to be essential for organ abscission, we conducted a screen for mutations that alter floral organ shedding in Arabidopsis. Nine recessive mutations that block shedding were found to disrupt the function of an ADP-ribosylation factor-GTPase-activating protein (ARF-GAP) we have named NEVERSHED (NEV). As predicted by its homology to the yeast Age2 ARF-GAP and transcriptional profile, NEV influences other aspects of plant development, including fruit growth. Co-localization experiments carried out with NEV-specific antiserum and a set of plant endomembrane markers revealed that NEV localizes to the trans-Golgi network and endosomes in Arabidopsis root epidermal cells. Interestingly, transmission electron micrographs of abscission zone regions from wild-type and nev flowers reveal defects in the structure of the Golgi apparatus and extensive accumulation of vesicles adjacent to the cell walls. Our results suggest that NEV ARF-GAP activity at the trans-Golgi network and distinct endosomal compartments is required for the proper trafficking of cargo molecules required for cell separation.

Changes in the NI life expectancy gap 1999/01 to 2004/06

In Northern Ireland between 1999-01 and 2004-06 male life expectancy at birth increased from 74.8 to 76.2 years (an increase of 1.4 years) and female life expectancy increased from 79.8 to 81.0 years (an increase of 1.3 years). Declining mortality rates due to Coronary Heart Disease, strokes and other circulatory causes, as well as cancer and respiratory disease caused life expectancy to increase.However, these increases were partially offset by increasing mortality rates over time due to accidental deaths, suicides and chronic liver disease and other causes of death (not separately identified).

Closing the gap (Care Quality Commission national study)

Closing the gap: Tackling cardiovascular disease and health inequalities by prescribing statins and stop smoking services

World class healthcare for London. Mind the gap! A briefing on equity of health and healthcare in the capital

This briefing provides an overview of equity of access to some of the essential elements of healthcare in the capital

Closing the gap: Setting local targets to reduce health inequalities

This briefing paper provides a summary of the policies, theory and practice of setting targets to reduce health inequalities. It offers some guidance for those responsible for setting local targets and sets this in the context of local experience drawn from documentary evidence from health improvement programmes (HImPs), community strategies and health action zones (HAZs).

Quantifying the gap between policy and practice in cardiovascular risk reduction: a review of evidence from recent cardiovascular and diabetes audits in the UK

As part of CHD NSF implementation, a pilot project is being undertaken under the auspices of the National Screening Committee to test the practical implications and outcomes of implementing a systematic programme of cardiovascular risk reduction in primary care, initially identifying those at high risk due to pre-existing cardiovascular disease or diabetes. To assist in assessing the magnitude of the challenge faced by the pilot programmes, the UK National Screening Committee (NSC) commissioned a review of current practice based on recent cardiovascular and diabetes audits in the UK. This report details the findings of the review, providing 6 key recommendations for future cardiovascular audits.

Collagen (NeuraGen®) nerve conduits and stem cells for peripheral nerve gap repair.

Collagen nerve guides are used clinically for peripheral nerve defects, but their use is generally limited to lesions up to 3 cm. In this study we combined collagen conduits with cells as an alternative strategy to support nerve regeneration over longer gaps. In vitro cell adherence to collagen conduits (NeuraGen(®) nerve guides) was assessed by scanning electron microscopy. For in vivo experiments, conduits were seeded with either Schwann cells (SC), SC-like differentiated bone marrow-derived mesenchymal stem cells (dMSC), SC-like differentiated adipose-derived stem cells (dASC) or left empty (control group), conduits were used to bridge a 1cm gap in the rat sciatic nerve and after 2-weeks immunohistochemical analysis was performed to assess axonal regeneration and SC infiltration. The regenerative cells showed good adherence to the collagen walls. Primary SC showed significant improvement in distal stump sprouting. No significant differences in proximal regeneration distances were noticed among experimental groups. dMSC and dASC-loaded conduits showed a diffuse sprouting pattern, while SC-loaded showed an enhanced cone pattern and a typical sprouting along the conduits walls, suggesting an increased affinity for the collagen type I fibrillar structure. NeuraGen(®) guides showed high affinity of regenerative cells and could be used as efficient vehicle for cell delivery. However, surface modifications (e.g. with extracellular matrix molecule peptides) of NeuraGen(®) guides could be used in future tissue-engineering applications to better exploit the cell potential.

A Public Service Gap: Capturing Contexts in a Comparative Approach of Street-Level Bureaucracy

Studies of street-level bureaucracy have introduced a variety of conceptualizations, research approaches, and causal inferences. While this research has produced several insights, the impact of variety in the institutional context has not been adequately explored. We present the construct of a public service gap as a way to incorporate contextual factors and facilitate comparison. This construct addresses the differences between what is asked of and what is offered to public servants working at the street level. The heuristic enables the systematic capture of macro- and meso-contextual influences, thus enhancing comparative research on street-level bureaucracy.

Increased neurotransmitter release at the neuromuscular junction in a mouse model of polyglutamine disease.

In Huntington's disease (HD), the expansion of polyglutamine (polyQ) repeats at the N terminus of the ubiquitous protein huntingtin (htt) leads to neurodegeneration in specific brain areas. Neurons degenerating in HD develop synaptic dysfunctions. However, it is unknown whether mutant htt impacts synaptic function in general. To investigate that, we have focused on the nerve terminals of motor neurons that typically do not degenerate in HD. Here, we have studied synaptic transmission at the neuromuscular junction of transgenic mice expressing a mutant form of htt (R6/1 mice). We have found that the size and frequency of miniature endplate potentials are similar in R6/1 and control mice. In contrast, the amplitude of evoked endplate potentials in R6/1 mice is increased compared to controls. Consistent with a presynaptic increase of release probability, synaptic depression under high-frequency stimulation is higher in R6/1 mice. In addition, no changes were detected in the size and dynamics of the recycling synaptic vesicle pool. Moreover, we have found increased amounts of the synaptic vesicle proteins synaptobrevin 1,2/VAMP 1,2 and cysteine string protein-α, and the SNARE protein SNAP-25, concomitant with normal levels of other synaptic vesicle markers. Our results reveal that the transgenic expression of a mutant form of htt leads to an unexpected gain of synaptic function. That phenotype is likely not secondary to neurodegeneration and might be due to a primary deregulation in synaptic protein levels. Our findings could be relevant to understand synaptic toxic effects of proteins with abnormal polyQ repeats.

Regulation of the vascular gap junctions in a mouse model of intimal hyperplasia

Objective: Intimal hyperplasia (IH) is one of the leading causes of failure¦after vascular interventions. It involves the proliferation of smooth muscle¦cells (SMCs) and the production of extracellular fibrous matrix. Gap junctional¦communication, mediated by membrane connexins (Cx), participates to the¦control of proliferation and migration. In human and mice vessels, endothelial¦cells (ECs) express Cx37, Cx40 and Cx43, whereas SMCs are coupled by Cx43.¦We previously reported that Cx43 was increased in the SMCs of a human vein¦during the development of IH.¦In our experimental model of mice carotid artery ligation (CAL), luminal¦narrowing occurred by SMCs-rich neointima after 2-4 weeks of ligation.¦This experimental model of mice allows us to decipher the regulation of the¦cardiovascular connexins in the mouse.¦Methods: C57BL/6 mice were anesthetized and the left common carotid artery¦was dissected through a neck incision and ligated near the carotid bifurcation.¦The mice were then euthanized at 7, 14 and 28 days. Morphometric analyses¦were then performed with measurements of total area, lumen and intimal area¦and media thickness. Western blots, immunocytochemistry and quantitative¦RT-PCR were performed for Cx43, Cx40 and Cx37.¦Results: All animals recovered with no symptom of stroke. Morphometric¦analysis demonstrated that carotid ligation resulted in an initial increase (after¦7 days) of the total vessel area followed by its reduction (after 28 days). This¦phenomena was associated with a progressive increase in the intimal area and a¦consecutive decrease of the lumen. The media thickness was also increased after¦14 and 28 days. This neointima formation was associated to a marked increase¦in the expression of Cx43 at both protein and RNA levels. Concomitantly,¦Cx40 and Cx37 protein expression were reduced in the endothelium. This was¦confirmed by en face analyses showing reduced Cx37 and Cx40 levels in the¦endothelial cells covering the lesion.¦Conclusion: This study assessed the regulation of the cardiovascular connexins¦in the development of IH. This model will allow us to characterize the¦involvement of gap junctions in the IH. In turn, this understanding is¦instrumental for the development of new therapeutical tools, as well as for¦the evaluation of the effects of drugs and gene therapies of this disease for which¦there is no efficient therapy available.

[Phot. du Gap of Dunloe (Killarney, Irlande), don E. Reclus en 1886]

Donateur : Reclus, Élisée (1830-1905)