Estimates of global and regional potential health gains from reducing multiple major risk factors

Background Estimates of the disease burden due to multiple risk factors can show the potential gain from combined preventive measures. But few such investigations have been attempted, and none on a global scale. Our aim was to estimate the potential health benefits from removal of multiple major risk factors. Methods We assessed the burden of disease and injury attributable to the joint effects of 20 selected leading risk factors in 14 epidemiological subregions of the world. We estimated population attributable fractions, defined as the proportional reduction in disease or mortality that would occur if exposure to a risk factor were reduced to an alternative level, from data for risk factor prevalence and hazard size. For every disease, we estimated joint population attributable fractions, for multiple risk factors, by age and sex, from the direct contributions of individual risk factors. To obtain the direct hazards, we reviewed publications and re-analysed cohort data to account for that part of hazard that is mediated through other risks. Results Globally, an estimated 47% of premature deaths and 39% of total disease burden in 2000 resulted from the joint effects of the risk factors considered. These risks caused a substantial proportion of important diseases, including diarrhoea (92%-94%), lower respiratory infections (55-62%), lung cancer (72%), chronic obstructive pulmonary disease (60%), ischaemic heart disease (83-89%), and stroke (70-76%). Removal of these risks would have increased global healthy life expectancy by 9.3 years (17%) ranging from 4.4 years (6%) in the developed countries of the western Pacific to 16.1 years (43%) in parts of sub-Saharan Africa. Interpretation Removal of major risk factors would not only increase healthy life expectancy in every region, but also reduce some of the differences between regions, The potential for disease prevention and health gain from tackling major known risks simultaneously would be substantial.

Numerical simulations of wind and temperature structure within an Alpine lake basin, Lake Tekapo, New Zealand

High-resolution numerical model simulations have been used to study the local and mesoscale thermal circulations in an Alpine lake basin. The lake (87 km(2)) is situated in the Southern Alps, New Zealand and is located in a glacially excavated rock basin surrounded by mountain ranges that reach 3000 m in height. The mesoscale model used (RAMS) is a three-dimensional non-hydrostatic model with a level 2.5 turbulence closure scheme. The model demonstrates that thermal forcing at local (within the basin) and regional (coast-to-basin inflow) scales drive the observed boundary-layer airflow in the lake basin during clear anticyclonic summertime conditions. The results show that the lake can modify (perturb) both the local and regional wind systems. Following sunrise, local thermal circulations dominate, including a lake breeze component that becomes embedded within the background valley wind system. This results in a more divergent flow in the basin extending across the lake shoreline. However, a closed lake breeze circulation is neither observed nor modelled. Modelling results indicate that in the latter part of the day when the mesoscale (coast-to-basin) inflow occurs, the relatively cold pool of lake air in the basin can cause the intrusion to decouple from the surface. Measured data provide qualitative and quantitative support for the model results.

Measuring the accumulated hazards of smoking: global and regional estimates for 2000

Objective: Current prevalence of smoking, even where data are available, is a poor proxy for cumulative hazards of smoking, which depend on several factors including the age at which smoking began, duration of smoking, number of cigarettes smoked per day, degree of inhalation, and cigarette characteristics such as tar and nicotine content or filter type. Methods: We extended the Peto-Lopez smoking impact ratio method to estimate accumulated hazards of smoking for different regions of the world. Lung cancer mortality data were obtained from the Global Burden of Disease mortality database. The American Cancer Society Cancer Prevention Study, phase 11 (CPS-II) with follow up for the years 1982 to 1988 was the reference population. For the global application of the method, never-smoker lung cancer mortality rates were chosen based on the estimated use of coal for household energy in each region. Results: Men in industrialised countries of Europe, North America, and the Western Pacific had the largest accumulated hazards of smoking. Young and middle age males in many regions of the developing world also had large smoking risks. The accumulated hazards of smoking for women were highest in North America followed by Europe. Conclusions: In the absence of detailed data on smoking prevalence and history, lung cancer mortality provides a robust indicator of the accumulated hazards of smoking. These hazards in developing countries are currently more concentrated among young and middle aged males.

The influence of nationalism in Mercosur and in South America: can the regional integration project survive?

The article discusses if nationalism is getting in the way of regional integration through a Brazilian prism due to Brazil’s pivotal role in regional integration in Mercosur and South America.

Motivations to visit and image destination of Guimarães: differences between Portuguese and foreign tourists during 2012 Guimarães European Capital of Culture (ECOC)

Guimarães hosted the European Capital of Culture (ECOC) during the year of 2012. This study investigates the differences between Portuguese and foreign tourists regarding the main motivations to visit Guimarães and the retained perceived image of the destination. To achieve that purpose a survey was administered to 390 tourists that visited the city during the cultural event. The results show that tourists who visited Guimarães are relatively young, wealthy, employed and well educated. They are touring around the northern part of the country which includes an itinerary beginning in Porto, and extended to other important neighboring cities such as Braga or Viana do Castelo. The main motivations to visit the city, for both Portuguese and foreign tourists, are its historical heritage and the title of ECOC, the associated cultural events and celebrations that take place during 2012. However, these items were more valued by foreigners than Portuguese tourists. Using a factor analysis the tourists’ perceived attributes of Guimarães were described in four dimensions: “material heritage”, “intangible heritage”, “cultural performance”, and “sport and education”. Although foreigners and nationals perceived the tourism attributes of the city differently, the comparison of the mean scores of the four factors across Portuguese and foreigner tourists reveals that the most valued and least valued factors are common to both groups.

Perceptions of residents of hosting the “Guimarães 2012 European Capital of Culture”: An ex-ante approach

The European Capital of Culture is an annual mega-event, which can provide a good forum though which to challenge and engage local citizens, thus generating feelings of common citizenship. In addition, it presents an ideal opportunity to promote the restructuring of the hosting urban space. However, the success of both the organization and the city that hosts the cultural event depends on the residents’ commitment towards it, the consistency of the tourism attractions and activities supplied, and the capacity of anticipating and monitoring the evolution of tourists’ preferences. The present study aims to assess the intention to participate and the impacts perceived by residents of Guimarães from hosting one of the 2012 European Capitals of Culture (2012 ECOC) in the ex-ante period (2011). Through a convenience sample of 471 usable surveys applied to the local population, conducted between October and December 2011, we tried to identify some of these potential impacts. According to the results received, 40% of residents had a low or very low knowledge of the cultural program, although only 11% demonstrated no intention of attending any activity during the event. The comparison of the mean scores of the expected 2012 ECOC impacts by gender reveals that the most valued and least valued factors are common to female and male respondents. With regard to the differences between those that intended to attend the event and the ones that did not, expected participants rated positive and negative impact factors more than did the ones that did not intend to attend.

Perceptions of residents of hosting the “Guimarães 2012 European Capital of Culture”: an ex-ante approach

The European Capital of Culture is an annual mega-event, which can provide a good forum though which to challenge and engage local citizens, thus generating feelings of common citizenship. In addition, it presents an ideal opportunity to promote the restructuring of the hosting urban space. However, the success of both the organization and the city that hosts the cultural event depends on the residents’ commitment towards it, the consistency of the tourism attractions and activities supplied, and the capacity of anticipating and monitoring the evolution of tourists’ preferences. The present study aims to assess the intention to participate and the impacts perceived by residents of Guimarães from hosting one of the 2012 European Capitals of Culture (2012 ECOC) in the ex-ante period (2011). Through a convenience sample of 471 usable surveys applied to the local population, conducted between October and December 2011, we tried to identify some of these potential impacts. According to the results received, 40% of residents had a low or very low knowledge of the cultural program, although only 11% demonstrated no intention of attending any activity during the event. The comparison of the mean scores of the expected 2012 ECOC impacts by gender reveals that the most valued and least valued factors are common to female and male respondents. With regard to the differences between those that intended to attend the event and the ones that did not, expected participants rated positive and negative impact factors more than did the ones that did not intend to attend.

Ex-ante evaluation by the media of the Guimarães 2012 European Capital of Culture

The nomination of Guimarães to host the 2012 European Capital of Culture (ECC) has put on the agenda of the city the need of measuring the effects that the implementation of this mega event could have in it and in the municipality a whole. The balance of the benefits and costs and an extended community involvement tend to reduce negative impacts and enhance positive ones. This chapter analyzes the involvement of population and local associations in the planning and organization of the 2012 Guimarães European Capital of Culture, using the coverage made during 2011 by local and national press of the mega event. A content analysis of the news published covering the period between January and December 2011 and using three newspapers was conducted. From those, two were local and weekly newspapers and one was a national daily one. Looking to data results, it can be concluded that it was poor the community involvement and, also, the one of the cultural associations in the organizations of the 2012 ECC. A strong negative reaction to the model choose to plan the mega event conducted by official organizers was found, which has cast doubts on the desirable participation of the residents and, consequently, on the success of the mega event, especially in a perspective of a medium and long term effects.

Evaluating the Guimarães 2012 European Capital of Culture: National and International Tourists’ Behaviors and Perceptions

In 2012, Guimarães hosted the European Capital of Culture (ECOC). An evaluation of this event was needed because public, private, and community funds were involved. This analysis considers tourists as external and independent stakeholders who assessed the cultural activities developed during the event as well as the attributes of the city. The main objectives of the research conducted were to assess the visitors` motivations during the hosting of the Guimarães ECOC 2012, their perceptions towards the city and if national and international visitors kept different perceptions of it. For two months, in the summer of 2012, a survey was applied to 390 visitors. The results revealed that hosting the 2012 ECOC was a major contribution towards attracting new visitors to the city (though many of the visitors stayed only for a short period of time). Based on tourists’ perceptions, the tangible heritage was clearly detached from the set of attributes associated to Guimarães, whereas the intangible heritage was less noted. The Portuguese tourists seem to be more prone to value the tangible heritage than the foreign tourists. Overall, Guimarães received a very positive evaluation relating to the city’s image and, as stated by tourists, visiting it was declared to be highly recommended. Following the obtained empirical results, the need for changing the city’s promoted image emerges, which has been too centered on its tangible heritage. In doing so, it is believed that there will be longer overnight stays by visitors.

Higher education of tourism in Spain and its adaptation to the European higher education area

The international tourism system has deeply undergone structural changes in the last decades which not remain outside the subsystem higher education in tourism, especially in the European case. This article has two objectives: firstly, describes the European higher education area and the objectives, skills and subjects taught in the main Spanish universities that offer higher education in tourism. On the other hand, in the light of knowledge that researchers' descriptive models, provide experience of the implementation of European credit and thorough a deeply review of the literature on the topic higher education in tourism, to propose strategies that will enable other tourism higher education systems approach to the European reality. These policy proposals are aimed at agents and elements from higher education in tourism subsystem and they specifically include: the institutions providing education in tourism, the curriculum, the teaching methods, teachers and students.

The European challenge of KMN and innovation: a skills and competence portfolio for knowledge worker in SME's

Versão editor: http://www.isegi.unl.pt/docentes/acorreia/documentos/European_Challenge_KM_Innovation_2004.pdf

Moisture recycling in the Iberian Peninsula from a regional climate simulation: spatiotemporal analysis and impact on the precipitation regime

The contribution of the evapotranspiration from a certain region to the precipitation over the same area is referred to as water recycling. In this paper, we explore the spatiotemporal links between the recycling mechanism and the Iberian rainfall regime. We use a 9 km resolution Weather Research and Forecasting simulation of 18 years (1990-2007) to compute local and regional recycling ratios over Iberia, at the monthly scale, through both an analytical and a numerical recycling model. In contrast to coastal areas, the interior of Iberia experiences a relative maximum of precipitation in spring, suggesting a prominent role of land-atmosphere interactions on the inland precipitation regime during this period of the year. Local recycling ratios are the highest in spring and early summer, coinciding with those areas where this spring peak of rainfall represents the absolute maximum in the annual cycle. This confirms that recycling processes are crucial to explain the Iberian spring precipitation, particularly over the eastern and northeastern sectors. Average monthly recycling values range from 0.04 in December to 0.14 in June according to the numerical model and from 0.03 in December to 0.07 in May according to the analytical procedure. Our analysis shows that the highest values of recycling are limited by the coexistence of two necessary mechanisms: (1) the availability of sufficient soil moisture and (2) the occurrence of appropriate synoptic configurations favoring the development of convective regimes. The analyzed surplus of rainfall in spring has a critical impact on agriculture over large semiarid regions of the interior of Iberia.