Pulmonary artery pressure and cardiac function in children and adolescents after rapid ascent to 3,450 m

High-altitude destinations are visited by increasing numbers of children and adolescents. High-altitude hypoxia triggers pulmonary hypertension that in turn may have adverse effects on cardiac function and may induce life-threatening high-altitude pulmonary edema (HAPE), but there are limited data in this young population. We, therefore, assessed in 118 nonacclimatized healthy children and adolescents (mean ± SD; age: 11 ± 2 yr) the effects of rapid ascent to high altitude on pulmonary artery pressure and right and left ventricular function by echocardiography. Pulmonary artery pressure was estimated by measuring the systolic right ventricular to right atrial pressure gradient. The echocardiography was performed at low altitude and 40 h after rapid ascent to 3,450 m. Pulmonary artery pressure was more than twofold higher at high than at low altitude (35 ± 11 vs. 16 ± 3 mmHg; P < 0.0001), and there existed a wide variability of pulmonary artery pressure at high altitude with an estimated upper 95% limit of 52 mmHg. Moreover, pulmonary artery pressure and its altitude-induced increase were inversely related to age, resulting in an almost twofold larger increase in the 6- to 9- than in the 14- to 16-yr-old participants (24 ± 12 vs. 13 ± 8 mmHg; P = 0.004). Even in children with the most severe altitude-induced pulmonary hypertension, right ventricular systolic function did not decrease, but increased, and none of the children developed HAPE. HAPE appears to be a rare event in this young population after rapid ascent to this altitude at which major tourist destinations are located.

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.

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.

High-speed rail systems and tourists´ destination choice: the case studies of Paris and Madrid

The analysis of how tourists select their holiday destinations along with the factors determining their choices is very important for promoting tourism. In particular, transportation is supposed to have a great influence on the tourists’ decisions. The aim of this paper is to investigate the role of High Speed Rail (HSR) systems with respect to a destination choice. Two key tourist destinations in Europe namely Paris, and Madrid, have been chosen to identify the factors influencing this choice. On the basis of two surveys to obtain information from tourists, it has been found that the presence of architectural sites, the promotion quality of the destination itself, and the cultural and social events have an impact when making a destination choice. However the availability of the HSR systems affects the choice of Paris and Madrid as tourist destinations in a different way. For Paris, TGV is considered a real transport mode alternative among tourists. On the other hand, Madrid is chosen by tourists irrespective of the presence of an efficient HSR network. Data collected from the two surveys have been used for a further quantitative analysis. Regression models have been specified and parameters have been calibrated to identify the factors influencing holidaymakers to revisit Paris and Madrid and visit other tourist places accessible by HSR from these capitals

Impact of High-Speed Rail on Tourists' Decisions: Evidence from a Survey Conducted in Paris and in Madrid

The analysis of how tourists select their holiday destinations along with the factors that determine their choices is very important for promoting tourism. In particular, transportation is supposed to have influence on tourists? decissions. The objective of this paper is to investigate more especifically the role of High Speed Rail (HSR) in this choice. Two key tourist destinations in Europe, Paris and Madrid, have been chosen to understand the factors influencing this choice. On the basis of a survey conducted to tourists, we found out that some aspects such as the presence of architectural sites, the quality of promotion of the destination itself, and cultural and social events, have an impact on their choice. However the presence of the HSR system affects the choice of Paris and Madrid as a touristic destination in a different way. For Paris, TGV is considered a real transport mode alternative among tourists who use it quite often. On the other hand, Madrid is chosen by tourists irrespective of the presence of an efficient HSR network. Data collected from the two surveys have been used for a further quantitative analysis. Regression models have been specified and parameters have been calibrated to identify the factors influencing holidaymakers to revisit Paris and Madrid and visit other touristic spots accesible from HSR from these cities.

Beyond megaprojects?. Water alternatives for mass tourism in coastal Mediterranean Spain

Water availability in adequate quantities and qualities is a fundamental requirement for tourism. In the Mediterranean, one of the world’s leading tourist destinations, water availability is subject to modest and erratic precipitation figures which may decline with climate change. The tourist industry therefore may have to assure future supplies by either recurring to new technologies such as desalination or increasing efficiency in water use. A third and yet little explored alternative would be to seek for complementary of uses with irrigation, the traditional user in many coastal Mediterranean areas and holder of substantial amounts of water. In this paper we present the example of the Consorcio de Aguas de la Marina Baja to show how Benidorm, in Mediterranean Spain and one of the most important tourist centers of the Mediterranean, obtains part of its water through agreements with farmers by which these trade their water with Benidorm and other towns’ treated wastewater of enough quality to be used for irrigation, and obtain several compensations in return. The advantages and disadvantages of the water trade between farmers and tourist interests in the Benidorm area are discussed and we argue that solutions to the pending water crisis of many coastal Mediterranean tourist areas may not need to rely uniquely on expensive technologies to generate new resources but may attempt other alternatives.

Grupos estratégicos en el sector hotelero español: diferencias de desempeño intra e intergrupo

El mundo es cada vez más pequeño debido a los avances tecnológicos y a la mayor experiencia de los directivos hoteleros y de los turistas, lo que provoca que la rivalidad entre destinos en el sector turístico sea cada vez mayor. Ante esta situación, este estudio se centra en el sector hotelero español y aplica los grupos estratégicos para determinar de qué forma compiten los hoteles y cómo influyen sus comportamientos estratégicos en su desempeño. Asimismo, se ofrecen acciones para mejorar el desempeño de un hotel en función del grupo estratégico al que pertenezca. La relevancia de este estudio radica en que clarifica la complejidad estratégica a la que están sometidos los directivos de los hoteles y les sirve de guía para la toma de decisiones estratégicas.

Innovative Tourism Clusters: Myth or Reality? Empirical Evidence from Benidorm

Paper submitted to TCVT3 Bozen/Bolzano, 10-12 April 2014, International workshop on Tourists as Consumers, Visitors, Travellers

La cuota de mercado como indicador de competitividad en los destinos turísticos: sentido y limitaciones

La cuota de mercado es el indicador más difundido en el análisis de la competitividad empresarial para todo tipo de bienes y servicios. Sin embargo, su uso en turismo está sometido a una amplia controversia, especialmente cuando el objeto de estudio es la competitividad de los destinos turísticos. Ello es debido a que objetivos de maximización de esta variable en la planificación, pueden conllevar la implementación de políticas de crecimiento comprometedoras de la sostenibilidad económica y ambiental de los citados destinos. Teniendo en cuenta estas consideraciones, en el presente trabajo se discute el uso, validez y limitaciones de la cuota de mercado como indicador de la competitividad de los destinos turísticos.

Is a cluster a necessary condition for success? The case of Benidorm

This paper analyses the application of the cluster concept to tourist destinations using Benidorm as a case study. A questionnaire was administered to tourism firms based in Benidorm in order to determine whether this destination currently constitutes a tourism cluster or whether it possesses the ideal characteristics to become a cluster with the private agents' collaboration, that is, whether it is a potential cluster. The results obtained from this research indicate that Benidorm's success is not derived from the presence of a cluster due to a series of elements that prevent its existence. In this destination there is a need to strengthen cooperation between public and private agents (especially in those areas that determine the competitive advantage of the destination) and to design a strategy based on shared goals. Both of these elements are fundamental for the characterisation of a cluster.

La incuestionabilidad del riesgo: vulnerabilidad social y riesgo sísmico en municipios turísticos

Los estudios sobre la vulnerabilidad social han ampliado la gestión de los riesgos naturales tradicionalmente direccionada a la amenaza natural y soluciones tecnológicas. Sin embargo la visión dominante se mantiene hegemónica sin un análisis adecuado de las causas que originan vulnerabilidad social. Este artículo propone un nuevo argumento, organizado en torno al concepto de la incuestionabilidad del riesgo, entendido como la incapacidad cultural y política de objetar el modelo socioeconómico imperante en donde residen las causas de fondo productoras de riesgo. Para concretar el concepto, a modo de ejemplo, se analizan el Plan de Actuación Municipal frente al Riesgo Sísmico de la ciudad de Torrevieja.

Gestión turística y tecnologías de la información y la comunicación (TIC): El nuevo enfoque de los destinos inteligentes

Este artículo analiza el nuevo enfoque de los destinos inteligentes para la gestión turística a escala local. Se estudia su génesis y se realiza una propuesta de conceptualización desde una perspectiva sistémica, que se contrasta con la gestión turística actual mediante una encuesta a municipios turísticos de la Comunidad Valenciana. Los resultados ponen de relieve que no se ha asumido como objetivo de gestión el enfoque de los destinos inteligentes, el cual requiere un proyecto global que incorpore cinco ámbitos fundamentales: gobernanza, sostenibilidad, conectividad, sistema de información e innovación. No obstante, la complejidad asociada a este enfoque hace aconsejable un desarrollo de tipo flexible, escalable y adaptado a cada entorno territorial.

3D Reconstruction and Digital Visualization of the South of the Royal Palace in Great Preslav

The report presents the film 10th century. The South of the Royal Palace in Great Preslav. It consists of two parts – 10th century. The Royal Palace in Great Prelsav. The Square with the Pinnacle and The Ruler’s Lodgings. 3D and virtual reconstructions of an architectural ensemble – part of the Preslav Royal Court unearthed during archaeological researches are used in the film. 3D documentaries have already gained popularity around the world and are well received by both scholars and the public at large. One of the distinguished tourist destinations in Bulgaria is Great Preslav – capital of the mediaeval Bulgarian state and a significant cultural center of the European Southeast in 9th–10th centuries, too. The first part of the film is created with the financial support of America for Bulgaria Foundation and the second – with the funding of Bulgarian National Science Fund at the Ministry of Education, Youth and Science. A team of almost 20 members worked on the film, including computer specialists, professional actors, and translators in the four main European languages – English, German, French and Russian, Trima Sound Recording Studio. In the first part of the 3D film are shown a segment of the Royal Palace, the square with the water pinnacle and the adjacent buildings – an important structural element of the town-planning of the Preslav Court center in the 10th century. In the second part the accent is the southern part of the Royal Palace in Great Preslav, where the personal residence of the Preslav ruler’s dynasty is situated. The work on the virtual reconstruction was done by Virtual Archaeology club at the Mathematical School, Shumen. Due to the efforts of its members it is now clear how the square in front of the southern gate looked like.

Human Capital Decisions and Employee Satisfaction at Selected Hotels in India

Understanding the role of human capital is one of the key considerations in delivering and sustaining competitiveness. Managing employees in the hospitality industry is particularly a challenging task as the industry is considered to be labor intensive. High turnover and increasing employee demands are among the problems that are identified as threats to maintaining a strong competitive position. Successful hotels attempt to retain their best employees in an effort to adapt to changing environments and increased competition. Effective hotel human resource systems can produce positive outcomes, through effective employee retention strategies that focus on work force motivation, attitudes and perception. The positive implementation of these strategies can influence and create employee satisfaction. This study aims to focus on the relationship between the mediating variables of motivation, attitudes, perception and their effect on employee satisfaction. These findings are based upon an extensive survey carried out between April 2009 and June 2009 in the small mountainous state of Uttarakhand, located within the Indian sub-continent. Although the area of study is confined to the Kumaon region of Uttarakhand, the authors contend that the findings and implications can be applied to other remote developing tourist destinations in other regions.

"Aqui se faz Gostoso”: uma etnografia do turismo em São Miguel do Gostoso (RN)

This study it is an ethnography on the process of the tourist coast area of São Miguel do Gostoso, whose origin is made from a village of traditional fishermen located on the northeast coast of Rio Grande do Norte. From the late 90s, there were the first initiatives that transformed São Miguel do Gostoso in one of the state's major tourist destinations. The municipality is promoted within the national and international tourism scene through the sun and beach tourism - whose object of consumption is the natural landscape - and sports tourism - which exploited element is the "natural" geographic location (in the continent curve) of municipality that provides winds considered ideal for the practice of “Kitesurfing “ and Windsurfing. From this context, this ethnography had as a theme the social changes promoted by the tourism process in place here addressed, taking into account the perceptions produced by the actors involved in this social net. In this qualitative research, I endeavored to me in the methodological use of ethnographic techniques - bibliographic and field research, participant observation, open and structured interviews recorded by recording and field notes and photographic record. I also made use of theoretical tools and methodology inherent in ciberetnografia when analyzing the blogs and websites of intermediaries and institutions linked to local tourism.