Equestrian tourism: an opportunity for portuguese

Portugal provides a large number of factors that boost the development of the national equestrian tourism. It represents an opportunity for the qualification and differentiation of the national tourism, to stimulate rural economies, to combat seasonality and asymmetries.This study want to understand the importance, for the equestrian tourist, of the critical success factors such as the Lusitano horse, the national equestrian culture, the landscape diversity, among others. Also, how they can contribute to the differentiation of the national equestrian tourism for international destinations that are already deployed in the market.For this study is crucial to know the perspective of those involved in the various equestrian tourism activities. In this sense, a group of companies were selected and exploratory interviews were conducted that contributed to important outputs in the construction of the questionnaire.The research was attended by 110 individuals, with different profiles, motivations and types of involvement. From the analysis, it is concluded that the critical success factors are significant in motivating equestrian tourists, namely the quality of equestrian infrastructures, the Lusitano horse, the hospitality, among others. It is also possible to analyze that the equestrian tourist demonstrates a strong commitment: they are knowledgeable, read a lot about riding and belong to equestrian clubs.Finally, the factor analysis highlight the agreement between participants and a significant number of statements made in the questionnaire related to motivation and involvement. It is possible to conclude that equestrian tourists look for relaxing moments and opportunities to expand their equestrian knowledge.

Nocardia infection in solid organ transplant recipients: a multicenter European case-control study.

BACKGROUND  Nocardiosis is a rare, life-threatening opportunistic infection, affecting 0.04% to 3.5% of patients after solid organ transplantation (SOT). The aim of this study was to identify risk factors for Nocardia infection after SOT and to describe the presentation of nocardiosis in these patients. METHODS  We performed a retrospective case-control study of adult patients diagnosed with nocardiosis after SOT between 2000 and 2014 in 36 European (France, Belgium, Switzerland, Netherlands, Spain) centers. Two control subjects per case were matched by institution, transplant date and transplanted organ. A multivariable analysis was performed using conditional logistic regression to identify risk factors for nocardiosis. RESULTS  One hundred and seventeen cases of nocardiosis and 234 control patients were included. Nocardiosis occurred at a median of 17.5 [range 2-244] months after transplantation. In multivariable analysis, high calcineurin inhibitor trough levels in the month before diagnosis (OR=6.11 [2.58-14.51]), use of tacrolimus (OR=2.65 [1.17-6.00]) and corticosteroid dose (OR=1.12 [1.03-1.22]) at the time of diagnosis, patient age (OR=1.04 [1.02-1.07]) and length of stay in intensive care unit after SOT (OR=1.04 [1.00-1.09]) were independently associated with development of nocardiosis; low-dose cotrimoxazole prophylaxis was not found to prevent nocardiosis. Nocardia farcinica was more frequently associated with brain, skin and subcutaneous tissue infections than were other Nocardia species. Among the 30 cases with central nervous system nocardiosis, 13 (43.3%) had no neurological symptoms. CONCLUSIONS  We identified five risk factors for nocardiosis after SOT. Low-dose cotrimoxazole was not found to prevent Nocardia infection. These findings may help improve management of transplant recipients.

Great Himalaya: Tourism and the dynamics of change in Nepal

Based on extensive field work and years of personal experience, the authors discuss the development of tourism in the Great Himalaya of Nepal from the early days of mountaineering to present-day trekking. Tourism and its potentials, drawbacks, and risks are illustrated with a focus on the Khumbu/Everest and Annapurna regions, the most popular mountain destinations in the country. The themes addressed include: growth and expansion of mountain tourism; employment and income generation; wealth, poverty, and livelihood as reflected in statistics and personal accounts by local people; the revival of trade with Tibet; tourism and the role of women; the crucial role played by institutions, policies and political stability; and environmental issues such as forest degradation, garbage management, and trail damage. With its numerous illustrations, text boxes and quotes, the book is intended for a broad readership of policy- and decision-makers in tourism and development, scholars, and tourists and mountaineers who take an interest in mountain development in the Great Himalaya and elsewhere.