Non-constant reputation effect in tourism demand at Spanish Mediterranean destinations

© 2019 Springer Nature Switzerland AG. This document is the Accepted Manuscript version of a Published Work that appeared in final form in Tourist Tourist destination management. Tourism, hospitality & event management.This study analyzes the international tourism demand at Spanish Mediterranean area. This destination receives the highest number of international arrivals in Spain. A dynamic econometric model is built following the Tourism Area Life Cycle (TALC) theory. Unlike other dynamic tourism demand models, our specification allows that the reputation and persistence effect (the effect of the lagged demand on current tourism demand) not to be constant. We estimate the model using panel data consisting of the 11 provinces which make up the Spanish Mediterranean area, and the 7 European countries which are the main origin markets, for the period 2001 to 2015. The results show a strong persistence in tourism demand. Furthermore, the reputation and persistence effect is positive and decreasing with the ratio between tourists and carrying capacity of the destination. Thus, this effect is not constant but varies across provinces and over time

A922 Sequential measurement of 1 hour creatinine clearance (1-CRCL) in critically ill patients at risk of acute kidney injury (AKI)

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The arterial wall: A new pharmacological and therapeutic target

In recent years, two key concepts having numerous interrelationships were advanced for the understanding of various cardiovascular diseases: the 'endothelial dysfunction' and the 'arterial remodelling'. Both endothelial dysfunction and arterial remodelling occur in various pathologies including essential hypertension, heart failure, atherosclerosis, restenosis after angioplasty, and pulmonary hypertension, and have modified the therapeutic approach by offering new pharmacological targets: specific receptors not only at the site of the vascular smooth muscle cells but also on the endothelial cells, growth factors that stimulate proliferation of smooth muscle, and receptors and enzymes of the extra-cellular matrix. Among the various substances under research, the present review will discuss angiotensin II receptor antagonists, endothelin receptor antagonists, nitrates-NO donors, potassium channel activators, and substances interfering with proteoglycans and other components of the extra-cellular matrix.link_to_subscribed_fulltex

ESICM LIVES 2016: part two : Milan, Italy. 1-5 October 2016.

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Mortality after surgery in Europe: a 7 day cohort study

SummaryBackgroundClinical outcomes after major surgery are poorly described at the national level. Evidence of heterogeneity between hospitals and health-care systems suggests potential to improve care for patients but this potential remains unconfirmed. The European Surgical Outcomes Study was an international study designed to assess outcomes after non-cardiac surgery in Europe.MethodsWe did this 7 day cohort study between April 4 and April 11, 2011. We collected data describing consecutive patients aged 16 years and older undergoing inpatient non-cardiac surgery in 498 hospitals across 28 European nations. Patients were followed up for a maximum of 60 days. The primary endpoint was in-hospital mortality. Secondary outcome measures were duration of hospital stay and admission to critical care. We used χ2 and Fisher's exact tests to compare categorical variables and the t test or the Mann-Whitney U test to compare continuous variables. Significance was set at p<0·05. We constructed multilevel logistic regression models to adjust for the differences in mortality rates between countries.FindingsWe included 46 539 patients, of whom 1855 (4%) died before hospital discharge. 3599 (8%) patients were admitted to critical care after surgery with a median length of stay of 1·2 days (IQR 0·9–3·6). 1358 (73%) patients who died were not admitted to critical care at any stage after surgery. Crude mortality rates varied widely between countries (from 1·2% [95% CI 0·0–3·0] for Iceland to 21·5% [16·9–26·2] for Latvia). After adjustment for confounding variables, important differences remained between countries when compared with the UK, the country with the largest dataset (OR range from 0·44 [95% CI 0·19–1·05; p=0·06] for Finland to 6·92 [2·37–20·27; p=0·0004] for Poland).InterpretationThe mortality rate for patients undergoing inpatient non-cardiac surgery was higher than anticipated. Variations in mortality between countries suggest the need for national and international strategies to improve care for this group of patients.FundingEuropean Society of Intensive Care Medicine, European Society of Anaesthesiology