How to take advantage of wine tourism: Creation of a new concept for central Alentejo based on its potential and worldwide success factors

Wine Tourism is gaining importance in today’s world and more destinations and establishments have been arising. After understanding the importance of this economic activity and the factors it must have to succeed, a new project was conceived for Central Alentejo taking into account its potential. This project is an example of how to take advantage of Wine Tourism in wine regions that are underexplored, such as Aldeias de Montoito, the village near Redondo to which a Business Plan will be created, explaining the strategies to pursue in order to have a successful Wine Tourism destination.

Cruise tourism in Lisbon - Cruise tourism activity and its impact on the city

Field lab: Tourism

Healthcare and medical tourism - Cascais Municipality case study

The purpose of this work project is to evaluate Cascais’ potential of becoming a reference in Health Care and Medical Tourism in the near future. It is done a careful research about the industry, followed by a thorough analysis of the region. It is concluded that it holds many key characteristics and conditions for the development of this kind of clusters, even though it lacks consumers’ perception regarding this product. Some guidelines are suggested in order to position Cascais as a competitive player in this field.

Hotel industry: An answer to the emerging trends on the global demand side of tourism

This dissertation studies essentially how Millennials are changing the hotel industry, in the sense that new trends are emerging with this generation and hotels need to respond accordingly, in order to survive within their competitive industry. Emphasis is also given to Asian travellers, as the enlargement of these countries’ middle class populations is predicted, therefore making Asian travellers a valuable target for the hotel industry. To successfully target this segment, hoteliers need also to consider the cultural differences and aspirations that come together with the Asian travellers, and appropriately adapt their offer to them. I will then redirect this study to the city of Lisbon, the Portuguese capital, to analyse if Lisbon’s four and five-star hotel managers are aware of the new market trends, and to understand how they are changing their hotels in order to make them more attractive to Millennials and Asian travellers. Using a sample of 12 hotels (four and five-stars ratings), I have concluded that, although there is a notable undergoing process of adaptation to these guests, there is a long way ahead in order for Lisbon’s hotels to entirely please and retain millennial guests.

"Managing the impact of tourism in historic urban destinations. A sustainability approach: Case study of Sintra"

In this Work Project, it will be assessed how Sintra’s sustainability is affected by the consequences of the visitor flow on its urban historical center. Two research questions will support this case study: What is the main problem affecting Sintra as a tourism destination? How sustainable will Sintra be in the next 10-15 years? The main findings suggest Sintra faces an intense seasonal pressure on its historical city center and its sustainability might be seriously affected in the near future, whereby three domains of the destination deserve a serious strategy reassessment: promotion, management, and supply.

Management of post-transplant Epstein-Barr virus-related lymphoproliferative disease in solid organ and hematopoietic stem cell recipients

Epstein-Barr virus (EBV)-related post-transplant lymphoproliferative disease (PTLD) is one of the most serious complications associated with solid organ and hematopoietic stem cell transplantation. PTLD is most frequently seen with primary EBV infection post-transplant, a common scenario for pediatric solid organ recipients. Risk factors for infection or reactivation of EBV following solid organ transplant are stronger immunosuppressive therapy regimens, and being seronegative for receptor. For hematopoietic stem cell transplantation, the risk factors relate to the type of transplant, human leukocyte antigen disparity, the use of stronger immunosuppressants, T-cell depletion, and severe graft-versus-host disease. Mortality is high, and most frequent in patients who develop PTLD in the first six months post-transplant. The primary goal of this article is to provide an overview of the clinical manifestations, diagnosis, accepted therapies, and management of EBV infection in transplant recipients, and to suggest that the adoption of monitoring protocols could contribute to a reduction in related complications.

Study of the risk factors related to acquisition of urinary tract infections in patients submitted to renal transplant

INTRODUCTION: Urinary tract infections (UTI) among transplant recipients are usually caused by gram-negative microorganisms and can provoke a high incidence of morbidity and mortality. The aim of this study was to evaluate the risk factors associated with the acquisition of UTIs during the first year after renal transplantation. METHODS: Here, we report a single-center retrospective cohort study of 99 renal transplant patients followed for the first year after surgery. The definition of a UTI episode was a urine culture showing bacterial growth and leucocyturia when patients presented with urinary symptoms. The absence of infection (asymptomatic bacteriuria) was defined as an absence of symptoms with negative urine culture or bacterial growth with any number of colonies. RESULTS: Ninety-nine patients were included in the study. During the study, 1,847 urine cultures were collected, and 320 (17.3%) tested positive for bacterial growth. Twenty-six (26.2%) patients developed a UTI. The most frequent microorganisms isolated from patients with UTIs were Klebsiella pneumoniae (36%), with 33% of the strains resistant to carbapenems, followed by Escherichia coli (20%). There were no deaths or graft losses associated with UTI episodes. CONCLUSIONS: Among the UTI risk factors studied, the only one that was associated with a higher incidence of infection was female sex. Moreover, the identification of drug-resistant strains is worrisome, as these infections have become widespread globally and represent a challenge in the control and management of infections, especially in solid organ transplantation.

Hyperhomocyst(e)inemia in chronic stable renal transplant patients

PURPOSE: Hyperhomocyst(e)inaemia is an important risk factor for atherosclerosis, which is currently a major cause of death in renal transplant patients. The aim of this study was to assess the influence of immunosuppressive therapy on homocyst(e)inemia in renal transplant recipients. METHODS: Total serum homocysteine (by high performance liquid chromatography), creatinine, lipid profile, folic acid (by radioimmunoassay-RIA) and vitamin B12 (by RIA) concentrations were measured in 3 groups. Group I patients (n=20) were under treatment with cyclosporine, azathioprine, and prednisone; group II (n=9) were under treatment with azathioprine and prednisone; and group III (n=7) were composed of renal graft donors for groups I and II. Creatinine, estimated creatinine clearance, cyclosporine trough level, lipid profile, folic acid, and vitamin B12 concentrations and clinical characteristics of patients were assessed with the aim of ascertaining determinants of hyperhomocyst(e)inemia. RESULTS: Patient ages were 48.8 ± 15.1 yr (group I), 43.3 ± 11.3 yr (group II); and 46.5 ± 14.8 yr (group III). Mean serum homocyst(e)ine (tHcy) concentrations were 18.07 ± 8.29 mmol/l in renal transplant recipients; 16.55 ± 5.6 mmol/l and 21.44 ± 12.1 mmol/l respectively for group I (with cyclosporine) and group II (without cyclosporine) (NS). In renal donors, tHcy was significantly lower (9.07 ± 3.06 mmol/l; group I + group II vs. group III, p<0.008). There was an unadjusted correlation (p<0.10) between age (r=0.427; p<0.005) body weight (r=0.412; p<0.05), serum creatinine (r=0.427; p<0.05), estimated creatinine clearance (r=0.316; p<0.10), and tHcy in renal recipients (group I +II). Independent regressors (r²=0.46) identified in the multiple regression model were age (coefficient= 0.253; p=0.009) and serum creatinine (coefficient=8.07; p=0.045). We found no cases of hyperhomocyst(e)inemia in the control group. In contrast, 38% of renal recipients had hyperhomocyst(e)inemia: 7 cases (35%) on cyclosporine and 4 (45%) without cyclosporine, based on serum normal levels. CONCLUSIONS: Renal transplant recipients frequently have hyperhomocyst(e)inemia. Hyperhomocyst(e)inemia in renal transplant patients is independent of the scheme of immunosuppression they are taking. The older the patients are and the higher are their serum creatinine levels, the more susceptible they are to hyperhomocyst(e)inemia following renal transplantation.

Growth strategies in tourism entertainment industry - a pratical application-

In the past few years, prompted by the globalization and the quality and ease of travel, the world has witnessed a boom in the tourism sector. The forecast is that this tendency will continue in the upcoming years, representing a set of opportunities for companies operating in this business area. Boost Tourism operates in the tourism entertainment industry. Its revenues growth has been exponential so the founders decided that it was time to take it to new heights. This Work Project aims to study three alternative growth strategies and, based on a comprehensive analysis of the industry and the market, provide recommendations to outline the optimal expansion path.

PTX3-based genetic testing for risk of aspergillosis after lung transplant

PTX3-based genetic testing for risk of aspergillosis after lung transplant

Holistic approach, tourism

Holistic refers to something that emphasizes the whole and the interdependence of its parts. It can be conceptualized as interdisciplinary: the claim that most social and economic phenomena cannot be fully understood or explained without adopting an approach that goes beyond the aims of a single scientific discipline.

Heart transplant in a patient with complete absence of the pericardium

We report the case of a heart transplant in which the recipient patient had a total congenital absence of the pericardium. Associated with this, we found a major disproportion between the size of the recipient's mediastinal cavity and the size of the donor's heart. To prevent twisting of the great arteries, we placed the graft on the left diaphragm muscle and beneath the left lung, which resulted in an uneventful early and late postoperative course.

Myocardial revascularization in renal transplant patients

OBJECTIVE: To assess the results of surgical myocardial revascularization in renal transplant patients. METHODS: From 1991 to 2000, 11 renal transplant patients, whose ages ranged from 36 to 59 (47.5±8) years, 8 males and 3 females, underwent myocardial revascularization. The time interval between renal transplantation and myocardial revascularization ranged from 25 to 120 (mean of 63.8±32.7) months. RESULTS: The in-hospital mortality rate was 9%. One patient died on the 4th postoperative day from septicemia and respiratory failure. The mean graft/patient ratio was 2.7±0.8. Only 1 patient required slow hemodialysis during 24 hours in the postoperative period, and no patient had a definitive renal lesion or lost the transplanted kidney. The actuarial survival curves after 1, 2, and 3 years were, respectively, 90.9%, 56.8%, and 56.8%. CONCLUSION: Renal transplant patients may undergo myocardial revascularization with no lesion in or loss of the transplanted kidney.

A comparative analysis of sustainable tourism, planning and development between Sligo and Donegal County Councils

Sustainable Development requires appropriate and continuous planning and management of economic, socio cultural and environmental resources. Tourism planning calls for continuous collaboration among tourism agencies, local authorities and local communities for success of the industry. While evidence suggests that tourism planning has been extensively documented, it is apparent that Donegal and Sligo County Councils have, in some cases failed to adequately address the significance of planning of the tourism industry for the North West of Ireland. This was investigated through interviews with chief planners of Donegal and Sligo county councils and was conducted in conjunction with the analysis of county development plans; which were formulated by both organisations involved in this study. Evidence suggests that although tourism is extensively documented by Donegal and Sligo county councils, neither of the two local authorities have developed implementation strategies to facilitate the promotion of sustainable tourism development. This research compares and analyses Donegal and Sligo county councils and how they plan for sustainable tourism development. It outlines the role of the county councils in relation to tourism planning and how Donegal and Sligo compare in how they plan for such a significant industry in the North West o f Ireland. It highlights the importance of implementation tools and methods and offers future directions that can assist in the development of sustainable tourism.