Reproductive Tourism in Argentina: Clinic Accreditation and its Implications for Consumers, Health Professionals and Policy Makers

A subcategory of medical tourism, reproductive tourism has been the subject of much public and policy debate in recent years. Specific concerns include: the exploitation of individuals and communities, access to needed health care services, fair allocation of limited resources, and the quality and safety of services provided by private clinics. To date, the focus of attention has been on the thriving medical and reproductive tourism sectors in Asia and Eastern Europe; there has been much less consideration given to more recent ‘players’ in Latin America, notably fertility clinics in Chile, Brazil, Mexico and Argentina. In this paper, we examine the context-specific ethical and policy implications of private Argentinean fertility clinics that market reproductive services via the internet. Whether or not one agrees that reproductive services should be made available as consumer goods, the fact is that they are provided as such by private clinics around the world. We argue that basic national regulatory mechanisms are required in countries such as Argentina that are marketing fertility services to local and international publics. Specifically, regular oversight of all fertility clinics is essential to ensure that consumer information is accurate and that marketed services are safe and effective. It is in the best interests of consumers, health professionals and policy makers that the reproductive tourism industry adopts safe and responsible medical practices.

Quels sont les facteurs menant à la consommation de services sexuels rémunérés dans un contexte touristique à l’étranger? : le cas du tourisme sexuel au Mexique

Il a été montré que l’Homme a un penchant latent à poser des gestes prohibés qui sont contrôlés par les normes formelles et informelles de sa communauté. Si nous sortons un individu de sa communauté sera-t-il plus enclin à poser ces gestes? C’est cette situation que le présent mémoire cherche à exposer. Nous visons à comprendre le processus menant à la consommation de services sexuels rémunérés dans un contexte touristique à l’étranger par l’étude du tourisme sexuel au Mexique. Nous cherchons à définir les facteurs qui motivent, ou du moins favorisent ce type de consommation dans un tel contexte. Pour rendre compte de ces facteurs, nous utilisons un corpus de données composé de commentaires publiés par des touristes sexuels sur un forum de clavardage, se trouvant sur la Toile, et de données existantes. Nous analysons ce corpus de données par une combinaison théorique de l’intersectionnalité et du contrôle social. Précisément, nous analysons les commentaires seuls afin de rendre compte des motivations des touristes à pratiquer le tourisme sexuel, puis nous analysons les données existantes en établissant des liens avec les commentaires publiés pour connaitre les facteurs qui permettent aux touristes cette pratique.

On administrative borders and accessibility to public services: : The case of hospitals in Sweden.

An administrative border might hinder the optimal allocation of a given set of resources by restricting the flow of goods, services, and people. In this paper we address the question: Do administrative borders lead to poor accessibility to public service such as hospitals? In answering the question, we have examined the case of Sweden and its regional borders. We have used detailed data on the Swedish road network, its hospitals, and its geo-coded population. We have assessed the population’s spatial accessibility to Swedish hospitals by computing the inhabitants’ distance to the nearest hospital. We have also elaborated several scenarios ranging from strongly confining regional borders to no confinements of borders and recomputed the accessibility. Our findings imply that administrative borders are only marginally worsening the accessibility.

Trade in services in Latin America and the Caribbean: an analysis of recent trends

Includes bibliography

Brazil's emergence at the regional export leader in services: a case specialization in business services

Includes Bibliography

The development of services in the Caribbean

Includes bibliography

Tourist Cruise Ships and the Trade in Services: Recent Trends in Countries of the Caribbean Basin

This issue of the Bulletin reviews the main trends of trade in goods and services for the countries of the Association of Caribbean States (ACS) in 2004. The strong recovery of trade in goods and the robust expansion of trade in services are highlighted, emphasizing the increase in services as a proportion of total exports for the smaller Caribbean economies, which may even exceed 80%.A detailed analysis of the performance of the tourism component, especially travel, showed that in 2004 there was a boom in cruise ship arrivals, a situation which poses a real challenge for some islands in terms of ensuring a permanent flow of tourists and making use of the main comparative advantages -sun, sea and beaches- and possible linkages with the rest of the economy such as the hotel industry, restaurants, business and entertainment centres, guided excursions, transport, yachting, and others. In some islands, the ratio of cruise passengers to inhabitants is particularly high, and can reach a significant factor of about 11 tourists for every inhabitant in the Bahamas, 8 in Aruba, 7 in Antigua and Barbuda and 5 in Dominica, and around 4 for a sample of eleven countries.One of the main challenges for a number of Caribbean islands is how to capitalize on such linkages by developing sustainable tourism that minimizes the possible adverse impacts on the environment and the everyday life of the citizens.

An assessment of the economic impact of climate change on the tourism sector in Montserrat

This report provides an analysis and evaluation of the likely effects of climate change on the tourism sector in Montserrat. Clayton (2009) identifies three reasons why the Caribbean should be concerned about the potential effects of climate change on tourism: (a) the relatively high dependence on tourism as a source of foreign exchange and employment; (b) the intrinsic vulnerability of small islands and their infrastructure (e.g. hotels and resorts) to sea level rise and extreme climatic events (e.g. hurricanes and floods); and, (c) the high dependence of the regional tourist industry on carbon-based fuels (both to bring tourist to the region as well as to provide support services in the region). The effects of climate change are already being felt on the island. Between 1970 and 2009, there was a rise in the number of relatively hot days experienced on the island. Added to this, there was also a decline in mean precipitation over the period. Besides temperature, there is also the threat of wind speeds. Since the early 20th century, the number of hurricanes passing through the Caribbean has risen from about 5-6 per year to more than 25 in some years of the twenty-first century. In Montserrat, the estimated damage from four windstorms (including hurricanes) affecting the island was US$260 million or almost five times 2009 gross domestic product (GDP). Climate change is also likely to significantly affect coral reefs. Hoegh-Guldberg (2007) estimates that should current concentrations of carbon dioxide in the Earth’s atmosphere rise from 380ppm to 560ppm, decreases in coral calcification and growth by 40% are likely. The report attempted to quantify the likely effects of the changes in the climatic factors mentioned above. As it relates to temperature and other climatic variables, a tourism climatic index that captures the elements of climate that impact on a destination’s experience was constructed. The index was calculated using historical observations as well as those under two likely climate scenarios: A2 and B2. The results suggest that under both scenarios, the island’s key tourism climatic features will likely decline and therefore negatively impact on the destination experience of visitors. Including this tourism climatic index in a tourism demand model suggests that this would translate into losses of around 145% of GDP. As it relates to coral reefs, the value of the damage due to the loss of coral reefs was estimated at 7.6 times GDP, while the damage due to land loss for the tourism industry was 45% of GDP. The total cost of climate change for the tourism industry was therefore projected to be 9.6 times 2009 GDP over a 40-year horizon. Given the potential for significant damage to the industry, a large number of potential adaptation measures were considered. Out of these, a short-list of 9 potential options was selected using 10 evaluation criteria. These included: (a) Increasing recommended design wind speeds for new tourism-related structures; (b) Construction of water storage tanks; (c) Irrigation network that allows for the recycling of waste water; (d) Enhanced reef monitoring systems to provide early warning alerts of bleaching events; (e) Deployment of artificial reefs and fish-aggregating devices; (f) Developing national evacuation and rescue plans; (g) Introduction of alternative attractions; (h) Providing re-training for displaced tourism workers, and; (i) Revised policies related to financing national tourism offices to accommodate the new climatic realities Using cost-benefit analysis, three options were put forward as being financially viable and ready for immediate implementation: (a) Increase recommended design speeds for new tourism-related structures; (b) Enhance reef monitoring systems to provide early warning alerts of bleaching events, and; (c) Deploy artificial reefs or fish-aggregating devices. While these options had positive benefit cost ratios, other options were also recommended based on their non-tangible benefits: an irrigation network that allows for the recycling of waste water, development of national evacuation and rescue plans, providing retraining for displaced tourism workers and the revision of policies related to financing national tourism offices to accommodate the new climatic realities.

An assessment of the economic impact of climate change on the tourism sector in Saint Lucia

This report provides an analysis and evaluation of the likely effects of climate change on the tourism sector in Saint Lucia. Clayton (2009) identifies three reasons why the Caribbean should be concerned about the potential effects of climate change on tourism: (a) the relatively high dependence on tourism as a source of foreign exchange and employment; (b) the intrinsic vulnerability of small islands and their infrastructure (e.g. hotels and resorts) to sea level rise and extreme climatic events (e.g. hurricanes and floods); and, (c) the high dependence of the regional tourist industry on carbon-based fuels (both to bring tourist to the region as well as to provide support services in the region). The effects of climate change are already being felt on the island. Between 1970 and 2009 there was a rise in the number of relatively hot days experienced on the island. Added to this, there was also a decline in mean precipitation over the period. In addition to temperature, there is also the threat of increased wind speeds. Since the early twentieth century, the number of hurricanes passing through the Caribbean has risen from about 5-6 per year to more than 25 in some years of the twenty-first century. In Saint Lucia, the estimated damage from 12 windstorms (including hurricanes) affecting the island was US$1 billion or about 106% of 2009 GDP. Climate change is also likely to significantly affect coral reefs. Hoegh-Guldberg (2007) estimates that should current concentrations of carbon dioxide in the Earth’s atmosphere rise from 380ppm to 560ppm, decreases in coral calcification and growth by 40% are likely. This report attempted to quantify the likely effects of the changes in the climatic factors mentioned above on the economy of Saint Lucia. As it relates to temperature and other climatic variables, a tourism climatic index that captures the elements of climate that impact on a destination’s experience was constructed. The index was calculated using historical observations, as well as those under two, likely, Special Report on Emissions Scenarios (SRES) climate scenarios: A2 and B2.

The tourism sector and the global economic crisis: development implicatins for the Caribbean

Over the past two years the global economy has experienced substantial economic turmoil, resulting in severe economic contraction. While there has been a recent return to growth, this situation has impacted all economic sectors worldwide. In the highly tourism-dependent region of the Caribbean, the impact of the global economic crisis has been most notable on the tourism sector, which, from the early 1990s, became the key driver of economic growth for the region. The eventual emergence of this sector reflects an economic development history which was previously underpinned by the export of agricultural commodities, and subsequently by the adoption of the import substitution industrialization model as promulgated by Arthur Lewis. This was further stimulated by spectacular economic contraction in Caribbean economies during the 1980s as a result of changes in the global terms of trade for commodities, generally low levels of competitiveness for manufactured goods, as well as weak institutional and governance frameworks. Ultimately, many economies began to reflect fiscal and balance of payments constraints. By the end of the 1990s, too, evidence of declining competitiveness even in the tourism sector began to become apparent particularly when evaluated under the framework of the Butler Tourism Area Life- Cycle (TALC) model. The recent economic crisis, therefore, provides an opportunity to reflect on the overall approach to economic development in the Caribbean, and to assess the implications of the region’s response to the crisis. This analysis makes the case for the future development of the sector to be based on two broad strategies. The first is to deepen the integration of the tourism sector into the broader economy through the diversification of the regional tourism product, as well as the enhancement of linkages with other sectors, while the second is to expand the tourism sector into a total service economy through the introduction of new services. Considering linkages, the development of clusters and value chains to support the tourism sector is identified with respect to agriculture and food, handicraft, and furnishings. Among the new services identified are education, wellness, yachting and boating, financial services, and information and communications technologies (ICT). This overall strategy is deemed to be better suited to the macroeconomic realities of the Caribbean, where high labour costs and other structural rigidities require a high-valued specialty tourism product in order to sustain the sector’s global competitiveness.

Linking rural tourism to agriculture. Evidences from comparative case studies in Kosovo, Italy and Spain

Rural tourism has been widely promoted in the European Union as an effective measure counteracting economic and social challenges facing rural areas especially those with declining agriculture economies. Particularly its role is seen in provision and maintenance of public goods which are more and more demanded by the public and considered in the policymaking. In Kosovo, rural tourism has been developed through the support of the international organizations and private sector initiatives, with primary aim to generate additional income for rural households and sustainable management of natural and cultural resources. Anyhow, it could be stated that the use of territorial capital to enhance the quality of the tourist offer and undertake promotion at wider circles of people has not been well explored so far, particularly possible links with agriculture that would satisfy visitors demand. In this regard this research study analyzes involvement of local stakeholders and use of territorial capital to develop tourist offer in rural areas of Kosovo. Beside, study applies comparative approach with other two areas of the European Union, Appennino Bolognese in Italy and Alpujara in Spain, to understand and compare the process of rural tourism development and demand characteristics between Kosovo and these areas. A survey has been conducted in all three study areas with rural tourism visitors to understand their preferences for public and private goods and services when visiting rural areas and the role of agriculture in sustaining rural tourism. Results show that there is a potential to link rural tourism with agriculture in Kosovo, which would help in sustaining agriculture and add additional value to local food products, which in return would enhance the tourist offer and make it more attractive for the visitors but also for the farmers as an additional revenue generating sector.

Territorial quality and sustainable development : Indicators of performance in the context of a model for participatory rural tourism certification

El turismo rural ha sido incorporado por pequeños establecimientos agropecuarios del partido de Cnel. Suárez, provincia de Buenos Aires, Argentina, como actividad alternativa para mejorar la calidad de vida de sus miembros y superar situaciones de crisis agravadas por la marginalidad productiva del SO bonaerense, región a la que pertenecen. Bajo el programa Cambio Rural del INTA (Instituto Nacional de Tecnología Agropecuaria) conforman el Grupo 'Cortaderas II', junto a otros emprendedores interesados en valorar el medio rural. Han avanzado en el proceso de reconocimiento de su identidad y puesta en valor de recursos específicos con anclaje en el territorio. Esta identidad comienza a apreciarse internamente, a raíz de la dinámica grupal lograda y la incipiente articulación con otros actores para la construcción de un partenariado público y privado que genere sinergias y contribuya al desarrollo sustentable del territorio. Sin embargo, aún no es claramente percibida por el turista, cada vez más exigente. Por lo tanto, el presente trabajo persigue proponer indicadores para evaluar el desempeño de un Sistema de Gestión de Calidad con enfoque territorial que, adaptando el modelo europeo 'Marca de Calidad Territorial', sustente una estrategia comercial de diferenciación del servicio y simultáneamente, mida el progreso hacia una mejor calidad de vida y fortalecimiento de vínculos con la cultura local y el entorno físico-natural en el marco del desarrollo sustentable. La investigación se plantea para la micro escala, ya que se trata de un estudio de caso, relevándose información primaria mediante observación directa y entrevistas semi-estructuradas, complementada con información secundaria diagnóstica utilizada por INTA. Las características del grupo y su dinámica de funcionamiento bajo el programa Cambio Rural revelan que es posible adoptar un proceso de certificación participativa propuesto para cuatro pilares de la calidad: de Bienes y Servicios, Institucional, Social y Ambiental. El modelo se integra con indicadores de evaluación de desempeño, agrupados en áreas clave para cada una de las dimensiones de la sustentabilidad, que contemplan el paisaje y la gestión de los recursos naturales; el impacto económico de la actividad, la calidad de la oferta y satisfacción del turista; así como las relaciones sociales internas y los vínculos con otros actores del territorio. Principalmente se encontraron fortalezas en la búsqueda de partenariados y debilidades en aspectos de comunicación y promoción. Se considera que este sistema de herramientas de gestión sustentable permitiría superar las dificultades de una certificación individual, pudiendo aplicarse a emprendimientos con otra ubicación geográfica

Territorial quality and sustainable development : Indicators of performance in the context of a model for participatory rural tourism certification

El turismo rural ha sido incorporado por pequeños establecimientos agropecuarios del partido de Cnel. Suárez, provincia de Buenos Aires, Argentina, como actividad alternativa para mejorar la calidad de vida de sus miembros y superar situaciones de crisis agravadas por la marginalidad productiva del SO bonaerense, región a la que pertenecen. Bajo el programa Cambio Rural del INTA (Instituto Nacional de Tecnología Agropecuaria) conforman el Grupo 'Cortaderas II', junto a otros emprendedores interesados en valorar el medio rural. Han avanzado en el proceso de reconocimiento de su identidad y puesta en valor de recursos específicos con anclaje en el territorio. Esta identidad comienza a apreciarse internamente, a raíz de la dinámica grupal lograda y la incipiente articulación con otros actores para la construcción de un partenariado público y privado que genere sinergias y contribuya al desarrollo sustentable del territorio. Sin embargo, aún no es claramente percibida por el turista, cada vez más exigente. Por lo tanto, el presente trabajo persigue proponer indicadores para evaluar el desempeño de un Sistema de Gestión de Calidad con enfoque territorial que, adaptando el modelo europeo 'Marca de Calidad Territorial', sustente una estrategia comercial de diferenciación del servicio y simultáneamente, mida el progreso hacia una mejor calidad de vida y fortalecimiento de vínculos con la cultura local y el entorno físico-natural en el marco del desarrollo sustentable. La investigación se plantea para la micro escala, ya que se trata de un estudio de caso, relevándose información primaria mediante observación directa y entrevistas semi-estructuradas, complementada con información secundaria diagnóstica utilizada por INTA. Las características del grupo y su dinámica de funcionamiento bajo el programa Cambio Rural revelan que es posible adoptar un proceso de certificación participativa propuesto para cuatro pilares de la calidad: de Bienes y Servicios, Institucional, Social y Ambiental. El modelo se integra con indicadores de evaluación de desempeño, agrupados en áreas clave para cada una de las dimensiones de la sustentabilidad, que contemplan el paisaje y la gestión de los recursos naturales; el impacto económico de la actividad, la calidad de la oferta y satisfacción del turista; así como las relaciones sociales internas y los vínculos con otros actores del territorio. Principalmente se encontraron fortalezas en la búsqueda de partenariados y debilidades en aspectos de comunicación y promoción. Se considera que este sistema de herramientas de gestión sustentable permitiría superar las dificultades de una certificación individual, pudiendo aplicarse a emprendimientos con otra ubicación geográfica

Territorial quality and sustainable development : Indicators of performance in the context of a model for participatory rural tourism certification

El turismo rural ha sido incorporado por pequeños establecimientos agropecuarios del partido de Cnel. Suárez, provincia de Buenos Aires, Argentina, como actividad alternativa para mejorar la calidad de vida de sus miembros y superar situaciones de crisis agravadas por la marginalidad productiva del SO bonaerense, región a la que pertenecen. Bajo el programa Cambio Rural del INTA (Instituto Nacional de Tecnología Agropecuaria) conforman el Grupo 'Cortaderas II', junto a otros emprendedores interesados en valorar el medio rural. Han avanzado en el proceso de reconocimiento de su identidad y puesta en valor de recursos específicos con anclaje en el territorio. Esta identidad comienza a apreciarse internamente, a raíz de la dinámica grupal lograda y la incipiente articulación con otros actores para la construcción de un partenariado público y privado que genere sinergias y contribuya al desarrollo sustentable del territorio. Sin embargo, aún no es claramente percibida por el turista, cada vez más exigente. Por lo tanto, el presente trabajo persigue proponer indicadores para evaluar el desempeño de un Sistema de Gestión de Calidad con enfoque territorial que, adaptando el modelo europeo 'Marca de Calidad Territorial', sustente una estrategia comercial de diferenciación del servicio y simultáneamente, mida el progreso hacia una mejor calidad de vida y fortalecimiento de vínculos con la cultura local y el entorno físico-natural en el marco del desarrollo sustentable. La investigación se plantea para la micro escala, ya que se trata de un estudio de caso, relevándose información primaria mediante observación directa y entrevistas semi-estructuradas, complementada con información secundaria diagnóstica utilizada por INTA. Las características del grupo y su dinámica de funcionamiento bajo el programa Cambio Rural revelan que es posible adoptar un proceso de certificación participativa propuesto para cuatro pilares de la calidad: de Bienes y Servicios, Institucional, Social y Ambiental. El modelo se integra con indicadores de evaluación de desempeño, agrupados en áreas clave para cada una de las dimensiones de la sustentabilidad, que contemplan el paisaje y la gestión de los recursos naturales; el impacto económico de la actividad, la calidad de la oferta y satisfacción del turista; así como las relaciones sociales internas y los vínculos con otros actores del territorio. Principalmente se encontraron fortalezas en la búsqueda de partenariados y debilidades en aspectos de comunicación y promoción. Se considera que este sistema de herramientas de gestión sustentable permitiría superar las dificultades de una certificación individual, pudiendo aplicarse a emprendimientos con otra ubicación geográfica

The "other" cities: urban planning and architecture for tourism: the case of the Spanish Mediterranean (1945-1975)

There we analyce the first touristic nucleus arouse in the Spanish Mediterranean coast between World War II and the Petroleum Crisis (1945-75). Special attention is payed to the characteristics of these new villages: the relation of their urban frame with nature -original or artificial- and the lack of industry. We make a distintion of three types: cluster nucleus (La Manga and El Saler), tridimentional urbanism (Playa de San Juan y Urbanova) and extreme typologies (Campoamor and Benidorm). With them the cities for vacations are discovered, mainly for second home purpouse (vacation home/holiday home). The panorama after the current crisis is a lineal chain of small urban settlements on the coast. Finally, Finally, we can see how these "secondary cities" without industry and specialized in leisure, are developing to our days until become new cities of services, doubling the existing ones; now they are "the other cities".