994 resultados para tourism-first
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Paper presented at the 2000 seminar of the International Chair in Olympism. Key issues of the seminar included references to the concern for legacy in terms of tourism, benefits and challenges of the Olympic Games and strategic needs, among others.
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Ascarophis brasiliensis recovered from the stomach of Trachinotus carolinus (L. 1766), is proposed as a new species and Procamallanus (Spirocamallanus) pereirai Annereaux, 1946 is redescribed from a new host: Paralonchurus brasiliensis (Steind., 1875). A. brasiliensis is more closely related to A. crassicolis Dollfus & Campana-Rouget, 1956, from which it differs mainly by the absence of cervical cuticular expansion and size of the eggs. The new species is also compared to A. cooperi johnston & Mawson, 1945 and A. girellae (Yamaguti, 1935) Campana-rouget, 1955. The validity of the proposed species is discussed.
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L’augment del turisme experimentat des de principis dels anys 70 a l’illa de Menorca (Illes Balears, Espanya) ha provocat un impacte sobre les seves platges, el seu principal atractiu turístic. Molts d’aquests impactes s’incrementen durant la temporada alta, compresa entre els mesos de maig a octubre. L’objectiu principal d’aquest projecte és l’elaboració d’un sistema d’indicadors de pressió ambiental útils per a l’anàlisi de les platges. La zona objecte d’estudi de la prova-pilot, correspon a les platges del sud-oest de Menorca, aquestes cales són les que actualment es troben sotmeses a una major pressió. Es tracta de catorze platges tipificades en tres categories (A, B, C) segons les característiques del tipus d’espai on es troben situades. Són les platges de: Cala Degollador, Cala Blanca, Cala’n Bosch, Son Xoriguer, Son Saura-Es Banyul, Son Saura-Bellavista, Es Talaier, Cala Turqueta, Cala Macarelleta, Cala Macarella, Cala Galdana, Cala Mitjana, Cala Trebalúger i Cala Escorxada. Partint d’un treball bibliogràfic, s’ha realitzat una selecció de mig centenar d’indicadors potencials dels quals catorze han format part dels IPAPM’pp, mitjançant l’elaboració d’una anàlisi multicriteri. Per a cada un dels IPAPM’pp s’ha desenvolupat una metodologia amb les corresponents fitxes individuals descriptives per al seu seguiment temporal. En aquest primer estudi, l’indicador que presenta un nombre de valors no acceptables en una major proporció de platges, és l’indicador 3. Índex de valoració de les mesures de conservació del sistema natural, seguit de l’indicador 6. Superfície subsistema sorra per usuari. El 2006, les platges de tipologia A, presenten un major percentatge positiu de les variables dels indicadors. Les platges de tipologia B i C presenten un percentatge menor d’acceptabilitat dels valors dels indicadors.
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La conca del riu Quiroz, al nord del Perú, està influenciada per dues zones d’endemisme d’aus i conté quatre àrees importants per a la conservació d’aus. Malgrat això, la informació sobre l’avifauna present a la conca és poc coneguda ja que no s’ha realitzat, fins al moment, cap estudi avifaunístic del global de la conca. En aquest estudi s’han mostrejat nou zones de la conca. A cadascuna s’ha valorat el potencial per al desenvolupament de l’aviturisme i la seva importància per a la conservació de les aus. A més, s’ha calculat un índex que permet valorar l’aviturisme i la conservació conjuntament. Els mostrejos realitzats a la conca demostren la seva riquesa avifaunística doncs, en una superfície mostrejada de 684ha, s’hi han reportat 151 espècies de les quals 34 són endèmiques i 7 estan catalogades com a amenaçades. Al llarg de la conca s’han identificat tres zones amb una importància ornitològica per damunt de la resta. Suyo és la zona de la conca amb un potencial aviturístic més elevat. ChinChin, el lloc amb més importància i possibilitats de dur a terme actuacions encaminades a la conservació. Yanta, destaca en ambdós sentits sent el desenvolupament de l’aviturisme la millor alternativa per garantir la conservació de la zona i, en especial, la seva diversitat avifaunistica.
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BACKGROUND: First hospitalisation for a psychotic episode causes intense distress to patients and families, but offers an opportunity to make a diagnosis and start treatment. However, linkage to outpatient psychiatric care remains a notoriously difficult step for young psychotic patients, who frequently interrupt treatment after hospitalisation. Persistence of symptoms, and untreated psychosis may therefore remain a problem despite hospitalisation and proper diagnosis. With persisting psychotic symptoms, numerous complications may arise: breakdown in relationships, loss of family and social support, loss of employment or study interruption, denial of disease, depression, suicide, substance abuse and violence. Understanding mechanisms that might promote linkage to outpatient psychiatric care is therefore a critical issue, especially in early intervention in psychotic disorders. OBJECTIVE: To study which factors hinder or promote linkage of young psychotic patients to outpatient psychiatric care after a first hospitalisation, in the absence of a vertically integrated program for early psychosis. Method. File audit study of all patients aged 18 to 30 who were admitted for the first time to the psychiatric University Hospital of Lausanne in the year 2000. For statistical analysis, chi2 tests were used for categorical variables and t-test for dimensional variables; p<0.05 was considered as statistically significant. RESULTS: 230 patients aged 18 to 30 were admitted to the Lausanne University psychiatric hospital for the first time during the year 2000, 52 of them with a diagnosis of psychosis (23%). Patients with psychosis were mostly male (83%) when compared with non-psychosis patients (49%). Furthermore, they had (1) 10 days longer mean duration of stay (24 vs 14 days), (2) a higher rate of compulsory admissions (53% vs 22%) and (3) were more often hospitalised by a psychiatrist rather than by a general practitioner (83% vs 53%). Other socio-demographic and clinical features at admission were similar in the two groups. Among the 52 psychotic patients, 10 did not stay in the catchment area for subsequent treatment. Among the 42 psychotic patients who remained in the catchment area after discharge, 20 (48%) did not attend the scheduled or rescheduled outpatient appointment. None of the socio demographic characteristics were associated with attendance to outpatient appointments. On the other hand, voluntary admission and suicidal ideation before admission were significantly related to attending the initial appointment. Moreover, some elements of treatment seemed to be associated with higher likelihood to attend outpatient treatment: (1) provision of information to the patient regarding diagnosis, (2) discussion about the treatment plan between in- and outpatient staff, (3) involvement of outpatient team during hospitalisation, and (4) elaboration of concrete strategies to face basic needs, organise daily activities or education and reach for help in case of need. CONCLUSION: As in other studies, half of the patients admitted for a first psychotic episode failed to link to outpatient psychiatric care. Our study suggests that treatment rather than patient's characteristics play a critical role in this phenomenon. Development of a partnership and involvement of patients in the decision process, provision of good information regarding the illness, clear definition of the treatment plan, development of concrete strategies to cope with the illness and its potential complications, and involvement of the outpatient treating team already during hospitalisation, all came out as critical strategies to facilitate adherence to outpatient care. While the current rate of disengagement after admission is highly concerning, our finding are encouraging since they constitute strategies that can easily be implemented. An open approach to psychosis, the development of partnership with patients and a better coordination between inpatient and outpatient teams should therefore be among the targets of early intervention programs. These observations might help setting up priorities when conceptualising new programs and facilitate the implementation of services that facilitate engagement of patients in treatment during the critical initial phase of psychotic disorders.
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We show that K1(E) of an exact category E agrees with K1(DE) of the associated triangulated derivator DE. More generally we show that K1(W) of a Waldhausen category W with cylinders and a saturated class of weak equivalences agrees with K1(DW) of the associated right pointed derivator DW.
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"Vegeu el resum a l'inici del document del fitxer adjunt."
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INTRODUCTION: We examined the positive and negative subjective feelings associated with initial tobacco and cannabis use as well as the role of these experiences in regular use. Additionally, we investigated the effect of the first substance experienced on initial subjective experiences and later regular use. METHODS: Baseline data from a representative sample of young Swiss men were obtained from an ongoing Cohort Study on Substance Use Risk Factors, which includes 2,321 lifetime tobacco and cannabis users. We assessed the age of first tobacco and cannabis use along with the subjective experiences associated with initial use. Additionally, subjective experiences related to regular use of both substances were analyzed. RESULTS: The initial subjective experiences were divided into positive and negative for each substance, and we found that the feelings associated with first use of tobacco and cannabis were similar. Moreover, the participants who used cannabis before tobacco reported fewer negative experiences associated with first tobacco use, whereas the participants who initially used tobacco reported more negative experiences related to first cannabis use. Also, we identified that regular use was encouraged by positive experiences and that negative experiences were more adverse for regular use of cannabis compared with tobacco. CONCLUSIONS: Taken together, these results indicate that similar subjective experiences were associated with the first use of tobacco and cannabis. Also, the use of cannabis before tobacco, which occurred in only a minority of users, had the potential to enhance the effects of initial tobacco use.
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Background a nd Aims: T he international E EsAI study g roupis currently developing the first activity index (EEsAI) specificfor Eosinophilic Esophagitis (EoE). Goal: To develop, evaluateand validate the EEsAI.Methods: T he d evelopment comprises three phases: 1.Selection of candidate items; 2. Evaluation of the activity indexin a f irst patient cohort; and 3. V alidation in a s econd EoEpatient cohort. Focus group interviews with patients were usedin p hase 1 to generate p atient r eported outcomes ( PRO)according to guidelines o f regulatory authorities ( FDA andEMA), whereas the section of biologic items was developed byDelphi r ounds of i nternational E oE experts from E urope andNorth America.Results: The EEsAI has a modular composition to assess thefollowing components o f EoE activity: p atient reportedoutcomes, endoscopic activity, histologic activity, laboratoryactivity, a nd quality of life. D efinitions f or all aspects o fendoscopic and histologic appearance were established byconsensus rounds among EoE experts. Symptom assessmenttools were created that take into account d ifferent foodconsistencies as w ell as f ood avoidance and specificprocessing strategies. T he EEsAI is evaluated in a c ohort ofadult EoE patients since March 2011.Conclusions: After successful validation, the EEsAI will allowto standardize outcome assessment in E oE t rials which w illlikely lead to its wide applicability.
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En el present projecte s’analitza el turisme i la seva relació amb la figura del Parc Natural de l’Alt Pirineu (a partir d’ara PNAP). A la zona d’estudi el turisme és una de les principals activitats econòmiques, donat el notable valor ecologico-cultural de l’indret. L’activitat turística al PNAP és molt diversa, és per aquest motiu que s’observen diverses repercussions en l’entorn segons la tipologia de turisme que es doni. Donada aquesta realitat, l’estudi que es presenta està centrat en el sector hoteler de l’àmbit d’influència del PNAP. D’aquesta forma, s’analitza i diagnostica l’estat de qualitat ambiental dels hotels i pensions que componen el sector. Les eines emprades en aquest estudi han estat dues. Primerament, s’avalua la implantació del Distintiu de Garantia de Qualitat Ambiental (a partir d’ara DGQA). El DGQA és una ecoetiqueta de serveis, de recent creació, que atorga la Generalitat de Catalunya a partir de la revisió de l’establiment per mitjà d’un tècnic autoritzat. En segon terme, s’ha creat i emprat un producte anomenat Enquesta Bàsica d’Auto-xequeig de Qualitat Ambiental (a partir d’ara EBAQA). L’EBAQA té una doble finalitat. Per una banda respon a la necessitat d’autodiagnosi que tenen els propietaris, al ser aquests qui realitzen l’enquesta. Per altra banda, permet determinar quin és l’estat de qualitat ambiental del sector hoteler a la zona d’estudi a partir de l’avaluació de 35 dels 67 establiments existents a l’àmbit d’influència del PNAP, el qual representa una mostra del 61%.
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The egg and the first instar larva of Dermatobia hominis were described based on observation with a scanning electron microscope.
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Scholars and local planners are increasingly interested in tourism contribution to economic and social development. To this regard, several European cities lead the world rankings on tourist arrivals, and their governments have promoted tourism activity. Mobility is an essential service for tourists visiting large cities, since it is a crucial factor for their comfort. In addition, it facilitates the spread of benefits across the city. The aim of this study is to determine whether city planners respond to this additional urban transport demand pressure by extending supply services. We use an international database of European cities. Our results confirm that tourism intensity is a demand enhancing factor on urban transport. Contrarily, cities do not seem to address this pressure by increasing service supply. This suggests that tourism exerts a positive externality on public transport since it provides additional funding for these services, but it imposes as well external costs on resident users because of congestion given supply constraints.
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The FIT trial was conducted to evaluate the safety and efficacy of 90Y-ibritumomab tiuxetan (0.4 mCi/kg; maximum dose 32 mCi) when used as consolidation of first complete or partial remission in patients with previously untreated, advanced-stage follicular lymphoma (FL). Patients were randomly assigned to either 90Y-ibritumomab treatment (n = 207) or observation (n = 202) within 3 months (mo) of completing initial induction therapy (chemotherapy only: 86%; rituximab in combination with chemotherapy: 14%). Response status prior to randomization did not differ between the groups: 52% complete response (CR)/CR unconfirmed (CRu) to induction therapy and 48% partial response (PR) in the 90Y-ibritumomab arm vs 53% CR/CRu and 44% PR in the control arm. The primary endpoint was progression-free survival (PFS) of the intent-to-treat (ITT) population. Results from the first extended follow-up after a median of 3.5 years revealed a significant improvement in PFS from the time of randomization with 90Y-ibritumomab consolidation compared with control (36.5 vs 13.3 mo, respectively; P < 0.0001; Morschhauser et al. JCO. 2008; 26:5156-5164). Here we report a median follow-up of 66.2 mo (5.5 years). Five-year PFS was 47% in the 90Y-ibritumomab group and 29% in the control group (hazard ratio (HR) = 0.51, 95% CI 0.39-0.65; P < 0.0001). Median PFS in the 90Y-ibritumomab group was 49 mo vs 14 mo in the control group. In patients achieving a CR/CRu after induction, 5-year PFS was 57% in the 90Y-ibritumomab group, and the median had not yet been reached at 92 months, compared with a 43% 5-year PFS in the control group and a median of 31 mo (HR = 0.61, 95% CI 0.42-0.89). For patients in PR after induction, the 5-year PFS was 38% in the 90Y-ibritumomab group with a median PFS of 30 mo vs 14% in the control group with a median PFS of 6 mo (HR = 0.38, 95% CI 0.27-0.53). Patients who had received rituximab as part of induction treatment had a 5-year PFS of 64% in the 90Y-ibritumomab group and 48% in the control group (HR = 0.66, 95% CI 0.30-1.47). For all patients, time to next treatment (as calculated from the date of randomization) differed significantly between both groups; median not reached at 99 mo in the 90Y-ibritumomab group vs 35 mo in the control group (P < 0.0001). The majority of patients received rituximab-containing regimens when treated after progression (63/82 [77%] in the 90Y-ibritumomab group and 102/122 [84%] in the control group). Overall response rate to second-line treatment was 79% in the 90Y-ibritumomab group (57% CR/CRu and 22% PR) vs 78% in the control arm (59% CR/CRu, 19% PR). Five-year overall survival was not significantly different between the groups; 93% and 89% in the 90Y-ibritumomab and control groups, respectively (P = 0.561). To date, 40 patients have died; 18 in the 90Y-ibritumomab group and 22 in the control group. Secondary malignancies were diagnosed in 16 patients in the 90Y-ibritumomab arm vs 9 patients in the control arm (P = 0.19). There were 6 (3%) cases of myelodysplastic syndrome (MDS)/acute myelogenous leukemia (AML) in the 90Y-ibritumomab arm vs 1 MDS in the control arm (P = 0.063). In conclusion, this extended follow-up of the FIT trial confirms the benefit of 90Y-ibritumomab consolidation with a nearly 3 year advantage in median PFS. A significant 5-year PFS improvement was confirmed for patients with a CR/CRu or a PR after induction. Effective rescue treatment with rituximab-containing regimens may explain the observed no difference in overall survival between both patient groups who were - for the greater part - rituximab-naïve.
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Mazocraeoides georgei price, 1936 and mazocraeoides opisthonema Hargis, 1955 are reported for the first time in Brazil in Brevoortia aurea (Spix, 1829) and in Harengula clupeola (Cuvier, 1829) respectively, clupeid fishes from the littoral of Rio de janeiro State, which represent new host records. Mazocraeoides olentangiensis Sroufe, 1958 and mazocraeoides hargisi Price, 1961 are considered new synonyms for Mazocraeoides georgei.
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This paper shows that tourism specialisation can help to explain the observed high growth rates of small countries. For this purpose, two models of growth and trade are constructed to represent the trade relations between two countries. One of the countries is large, rich, has an own source of sustained growth and produces a tradable capital good. The other is a small poor economy, which does not have an own engine of growth and produces tradable tourism services. The poor country exports tourism services to and imports capital goods from the rich economy. In one model tourism is a luxury good, while in the other the expenditure elasticity of tourism imports is unitary. Two main results are obtained. In the long run, the tourism country overcomes decreasing returns and permanently grows because its terms of trade continuously improve. Since the tourism sector is relatively less productive than the capital good sector, tourism services become relatively scarcer and hence more expensive than the capital good. Moreover, along the transition the growth rate of the tourism economy holds well above the one of the rich country for a long time. The growth rate differential between countries is particularly high when tourism is a luxury good. In this case, there is a faster increase in the tourism demand. As a result, investment of the small economy is boosted and its terms of trade highly improve.