Badgasten in een werelderfgoed:de ontwikkeling van het toerisme in het Nederlandse waddengebied nader beschouwd

Elk jaar bezoeken tussen de een en twee miljoen mensen het waddengebied. Het toerisme is daar uitgegroeid tot een van de belangrijkste economische activiteiten. In Nederland zijn vooral de eilanden een populaire vakantiebestemming. Fietsen, wandelen en strandbezoek zijn populaire activiteiten. De authentieke atmosfeer, het strand en het duinlandschap worden het meest gewaardeerd. De natuurwaarden van de Waddenzee spelen een minder grote rol, hoewel uit onderzoek blijkt dat er een zekere relatie bestaat tussen natuurervaringen en de plaatsgebondenheid van de toerist. In tegenstelling tot Duitsland komt het toerisme op de vastelandskust van Noord-Holland, Friesland en Groningen nauwelijks op gang en kan niet profiteren van de stroom bezoekers naar de Waddeneilanden. De recente aanwijzing van de Waddenzee tot werelderfgoed wordt over het algemeen gezien als een belangrijke stimulans voor de ontwikkeling van het toerisme. In Nederland blijkt de werelderfgoedstatus echter nog relatief onbekend te zijn. In tegenstelling tot het Duitse kustgebied wordt door ondernemers deze status niet of nauwelijks benut. Met de werelderfgoedstatus van de Waddenzee en de voorgenomen uitbreiding van het vliegveld Eelde als nieuwe uitdagingen zijn met behulp van scenarioplanning een aantal richtingen voor de ontwikkeling van het toerisme in Noord-Nederland geïdentificeerd en uitgewerkt in 23 product-markt-partner-combinaties. Deze hebben het karakter van shortbreaks waarin een bezoek aan het waddengebied gekoppeld wordt aan andere highlights in Noord-Nederlan

Застосування ідарубіцину в сучасній гематологічній практиці

Узагальнені результати застосування ідарубіцину при різних формах злоякісних гематологічних захворювань. Представлені сучасні уявлення про механізм дії ідарубіцину, зокрема, висвітлені нові можливості в подоланні множинної медикаментозної резистентності. Показані переваги ідарубіцину порівняно з іншими цитостатичними препаратами групи антрациклінів. Наведені традиційні дози та режими застосування ідарубіцину, а також можливості комбінацій з іншими цитостатичними засобами.The results of treatment of various neoplastic disorders with idarubicin are summarized. The review presents modern concepts of the mechanisms of idarubicin action, including as a means of overcoming multiple drug resistance, along with advantages of idarubicin in comparison with other anthracyclines. Information is provided on conventional doses and schedules of idarubicin administration as well as new possibilities of the most efficient combinations with other cytotoxic drugs

Анализ использования рабочего времени директоров центров гигиены и эпидемиологии

Представлены результаты изучения и дана объективная оценка использования рабочего времени директоров центров гигиены и эпидемиологии г. Баку. Даны научно обоснованные рекомендации по повышению рациональности использования рабочего времени руководителей учреждений санитарно−эпидемиологического обслуживания населения.The findings of the study and objective evaluation of the working time use by the directors of centers for hygiene and epidemiology (Baku) are reported. Scientifically validated recommendations on rational use of the working time by the managers of the establishments for sanitary−epidemiological service are given

Determining Group Structure from Sets of Irreducible Character Degrees

Catecholaminergic polymorphic ventricular tachycardia (CPVT) is an uncommon heritable disease presenting with syncope or sudden cardiac death. Two genes involved in calcium homeostasis, the ryanodine receptor gene and the calsequestrin 2 (CASQ2) gene, have been implicated in this disease. We describe a young man presenting with exercise-induced syncope, clinically diagnosed as CPVT. Genetic analysis revealed two mutations, p.Y55C (C.164A>G) and p.P308L (c.923C>T), in the CASQ2 gene. Subsequent familial analysis indicates a compound heterozygous form of inheritance. (PACE 2008; 31:916-919). © 2008, The Authors. Journal compilation © 2008, Blackwell Publishing, Inc

В. Липинський про бюрократію ("Листи до братів-хліборобів"): до проблеми визначення теоретичного підґрунтя поглядів

Розглянуто формування поглядів В. Липинського на бюрократію під впливом ідей Ж. Сореля, Р. Міхельса, К. Маркса, А. де Токвіля. Стверджено, що основу його поглядів становлять ідеї про бюрократію, запозичені у Ж. Сореля та Р. Міхельса. Підкреслено, що під час розгляду проблеми бюрократії вітчизняний мислитель не звертався до ідей М. Вебера.Deals with the formation of attitudes of Viacheslav Lypynsky on bureaucracy under the influence of Georges Sorel, Robert Michels, Karl Marx, Alexis de Tocqueville. It is alleged that his views were based on ideas of the bureaucracy borrowed from Georges Sorel and Robert Michels. Emphasizing that, in considering the problem of bureaucracy Ukrainian thinker did not approach the ideas of Max Weber

Лечение послеинсультной депрессии

Выявлены метаболические нарушения в серотониновой системе, которые могут быть общим патогенетическим звеном развития послеинсультной депрессии и других депрессивных расстройств различного генеза. Показана эффективность применения селективных ингибиторов захвата серотонина для лечения послеинсультной депрессии и возможность ее контроля с помощью определения уровня серотонина в крови.The metabolic disorders in the serotonin system, which can be a common pathogenetic link of post−stroke depression and other depressive disorders of various origin, were revealed. The efficacy of selective inhibitors of serotonin uptake in treatment of post−stroke depression as well as possibility to control it with determining blood serotonin level were shown

Cost-minimization analysis favours intravenous ferric carboxymaltose over ferric sucrose for the ambulatory treatment of severe iron deficiency

Objective: Intravenous iron is widely used to treat iron deficiency in day-care units. Ferric carboxymaltose (FCM) allows administration of larger iron doses than iron sucrose (IS) in each infusion (1000 mg vs. 200 mg). As FCM reduces the number of infusions required but is more expensive, we performed a cost-minimization analysis to compare the cost impact of the two drugs. Materials and Methods: The number of infusions and the iron dose of 111 consecutive patients who received intravenous iron at a gastrointestinal diseases day-care unit from 8/2007 to 7/2008 were retrospectively obtained. Costs of intravenous iron drugs were obtained from the Spanish regulatory agencies. The accounting department of the Hospital determined hospital direct and indirect costs for outpatient iron infusion. Non-hospital direct costs were calculated on the basis of patient interviews. In the pharmacoeconomic model, base case mean costs per patient were calculated for administering 1000 mg of iron per infusion using FCM or 200 mg using IS. Sensitivity analysis and Monte Carlo simulation were performed. Results: Under baseline assumptions, the estimated cost of iron infusion per patient and year was €304 for IS and €274 for FCM, a difference of €30 in favour of FCM. Adding non-hospital direct costs to the model increased the difference to €67 (€354 for IS vs. €287 for FCM). A Monte Carlo simulation taking into account non-hospital direct costs favoured the use of FCM in 97% of simulations. Conclusion: In this pharmacoeconomic analysis, FCM infusion reduced the costs of iron infusion at a gastrointestinal day-care unit

Brain areas involved in spatial working memory

Spatial working memory entails the ability to keep spatial information active in working memory over a short period of time. To study the areas of the brain that are involved in spatial working memory, a group of stroke patients was tested with a spatial search task. Patients and healthy controls were asked to search through a number of boxes shown at different locations on a touch-sensitive computer screen in order to find a target object. In subsequent trials, new target objects were hidden in boxes that were previously empty. Within-search errors were made if a participant returned to an already searched box; between-search errors occurred if a participant returned to a box that was already known to contain a target item. The use of a strategy to remember the locations of the target objects was calculated as well. Damage to the right posterior parietal and right dorsolateral prefrontal cortex impaired the ability to keep spatial information [`]on-line', as was indicated by performance on the Corsi Block-Tapping task and the within-search errors. Moreover, patients with damage to the right posterior parietal cortex, the right dorsolateral prefrontal cortex and the hippocampal formation bilaterally made more between-search errors, indicating the importance of these areas in maintaining spatial information in working memory over an extended time period.http://www.sciencedirect.com/science/article/B6T0D-4HM7WH2-2/1/b6b13c7b404377bae2b8cf632eb61fe

Understanding millennials' tourism experience: values and meaning to travel as a key for identifying target clusters for youth (sustainable) tourism

Purpose The purpose of this paper is to better understand the tourism experience of millennials by connecting their value orientations to the meaning that they give to travel. In doing so, it also aims at discovering profiles of young tourists that can be targeted both now and in the future by tourism organisations. Design/methodology/approach A survey based on validated scales reached 423 Dutch millennials. An integrated multidimensional research strategy has been applied where models that reduce the gathered data to fewer components (principal component analyses) were followed by a cluster analysis. Findings Ten value orientations (Schwartz, 1994) and four travel meanings have been identified. By combining these ten value orientations and four meanings, nine clusters have been identified representing groups of millennial tourists with different needs. For example, while two clusters fit into the popular description of young travellers seeking only unpretentious enjoyment, millennials represented in two other clusters are strongly motivated by self-transcending values, distance themselves from the travel meaning escapism and relaxation and will therefore not positively respond to a merely hedonic travel offer. Research limitations/implications Replication of this research is recommended in other national contexts, possibly using a longitudinal approach. Practical implications The nine clusters should be approached with a dedicated travel offer. In particular, at least two clusters of millennials may be successfully approached with a sustainable tourism offer. Originality/value The combination of value orientations and travel meanings portrays a detailed and realistic picture of the tourism experience looked for by millennials

A cost effectiveness and capacity analysis for the introduction of universal rotavirus vaccination in Kenya : comparison between Rotarix and RotaTeq vaccines

Background Diarrhoea is an important cause of death in the developing world, and rotavirus is the single most important cause of diarrhoea associated mortality. Two vaccines (Rotarix and RotaTeq) are available to prevent rotavirus disease. This analysis was undertaken to aid the decision in Kenya as to which vaccine to choose when introducing rotavirus vaccination. Methods Cost-effectiveness modelling, using national and sentinel surveillance data, and an impact assessment on the cold chain. Results The median estimated incidence of rotavirus disease in Kenya was 3015 outpatient visits, 279 hospitalisations and 65 deaths per 100,000 children under five years of age per year. Cumulated over the first five years of life vaccination was predicted to prevent 34% of the outpatient visits, 31% of the hospitalizations and 42% of the deaths. The estimated prevented costs accumulated over five years totalled US$1,782,761 (direct and indirect costs) with an associated 48,585 DALYs. From a societal perspective Rotarix had a cost-effectiveness ratio of US$142 per DALY (US$5 for the full course of two doses) and RotaTeq US$288 per DALY ($10.5 for the full course of three doses). RotaTeq will have a bigger impact on the cold chain compared to Rotarix. Conclusion Vaccination against rotavirus disease is cost-effective for Kenya irrespective of the vaccine. Of the two vaccines Rotarix was the preferred choice due to a better cost-effectiveness ratio, the presence of a vaccine vial monitor, the requirement of fewer doses and less storage space, and proven thermo-stability