Prevalence and time course of acute mountain sickness in older children and adolescents after rapid ascent to 3450 meters

OBJECTIVE: Acute mountain sickness is a frequent and debilitating complication of high-altitude exposure, but there is little information on the prevalence and time course of acute mountain sickness in children and adolescents after rapid ascent by mechanical transportation to 3500 m, an altitude at which major tourist destinations are located throughout the world. METHODS: We performed serial assessments of acute mountain sickness (Lake Louise scores) in 48 healthy nonacclimatized children and adolescents (mean +/- SD age: 13.7 +/- 0.3 years; 20 girls and 28 boys), with no previous high-altitude experience, 6, 18, and 42 hours after arrival at the Jungfraujoch high-altitude research station (3450 m), which was reached through a 2.5-hour train ascent. RESULTS: We found that the overall prevalence of acute mountain sickness during the first 3 days at high altitude was 37.5%. Rates were similar for the 2 genders and decreased progressively during the stay (25% at 6 hours, 21% at 18 hours, and 8% at 42 hours). None of the subjects needed to be evacuated to lower altitude. Five subjects needed symptomatic treatment and responded well. CONCLUSION: After rapid ascent to high altitude, the prevalence of acute mountain sickness in children and adolescents was relatively low; the clinical manifestations were benign and resolved rapidly. These findings suggest that, for the majority of healthy nonacclimatized children and adolescents, travel to 3500 m is safe and pharmacologic prophylaxis for acute mountain sickness is not needed.

Cultural events and tourist development in Catalonia (Spain)

From the point of view of local development cultural tourism events represent an opportunity since they are distributed homogeneously by the Catalan territory and are experiencing a vertiginous growth as a way to differentiate the existing supply. In our study a sample of 264 telephone surveys made to organizers of events in Catalonia has been compiled, with the purpose of characterizing the existing supply, thematic typologies, management models, commercialization inputs and economic impact. The results allow us to characterize events from the point of view of their tourist potential. Finally some recommendations are set out to develop future tourism policies based on events according to product differentiation, seasonality, competitiveness and creativity.

Modelling tourist itineraries in heritage cities: Routes around Old The District of Girona

Tourists do not follow random behavior in heritage cities, but they are consciously or unconsciously guided by socially constructed itineraries. This article studies the shaping of these itineraries in a heritage city (Girona), using the direct observation methodology during the visit (following the tourists from a prudent distance and gathering all the information about their visits) and the conventional questionnaire at the end of the visit. It also establishes which the sociodemographic, environmental and informative factors are that explain this behavior. The simultaneous use of the observation method and a questionnaire was found to be a useful technique for analyzing tourists' behavior and the factors that explain this behavior

Considering tourist perceptions and network configuration in destination management

The competitiveness of tourism destinations is a relevant issue for tourism studies, moreso, is a key element on the daily basis of tourism destinations. In this sense, the management of tourism destinations is essential to maintain competitive advantages. In this article tourism destination is considered as a relational network, where interaction and cooperation is needed among tourist agents, to achieve major levels of competitive advantage and a more effective destination management system. In addition, the perceptions of tourists are obtained from two main sources. The first one is the social construction of a tourism destination previous to the visit and the second one is obtained from the interaction between tourists and tourism destination agents during the visit. In this sense, the management of tourism destination to emit a homogenous and collective image is a factor that can reduce the gap if dissatisfaction from the previous and real tourist perception. The discussion is centered on the relationship within a destination, between the supply network and the targeted demand, considering these two approaches jointly, to benefit destination management. The main result is a conceptual model that shows how tourism agents and tourists in the tourism destination interact to improve the destination competitiveness

Acute and Chronic Altitude-Induced Cognitive Dysfunction in Children and Adolescents.

OBJECTIVE: To assess whether exposure to high altitude induces cognitive dysfunction in young healthy European children and adolescents during acute, short-term exposure to an altitude of 3450 m and in an age-matched European population permanently living at this altitude. STUDY DESIGN: We tested executive function (inhibition, shifting, and working memory), memory (verbal, short-term visuospatial, and verbal episodic memory), and speed processing ability in: (1) 48 healthy nonacclimatized European children and adolescents, 24 hours after arrival at high altitude and 3 months after return to low altitude; (2) 21 matched European subjects permanently living at high altitude; and (3) a matched control group tested twice at low altitude. RESULTS: Short-term hypoxia significantly impaired all but 2 (visuospatial memory and processing speed) of the neuropsychological abilities that were tested. These impairments were even more severe in the children permanently living at high altitude. Three months after return to low altitude, the neuropsychological performances significantly improved and were comparable with those observed in the control group tested only at low altitude. CONCLUSIONS: Acute short-term exposure to an altitude at which major tourist destinations are located induces marked executive and memory deficits in healthy children. These deficits are equally marked or more severe in children permanently living at high altitude and are expected to impair their learning abilities.

Inns and communications maintained by the Finnish Tourist Association 1932

kuv., 10 x 19 cm

Inns and communications maintained by the Finnish Tourist Association 1933

kuv., 10 x 22 cm

Inns and communications maintained by the Finnish Tourist Association 1934

kuv., 10 x 22 cm

Tourist inns and communications 1936

kuv., 10 x 20 cm

Tourist inns and communications 1937

kuv., 10 x 20 cm

Tourist inns and communications 1939

kuv., 10 x 22 cm

Tourist inns and communications 1938

kuv., 10 x 20 cm