Sample records for device destination therapy
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Ethical challenges with the left ventricular assist device as a destination therapy
Directory of Open Access Journals (Sweden)
Rady Mohamed Y
2008-08-01
Full Text Available Abstract The left ventricular assist device was originally designed to be surgically implanted as a bridge to transplantation for patients with chronic end-stage heart failure. On the basis of the REMATCH trial, the US Food and Drug Administration and the US Centers for Medicare & Medicaid Services approved permanent implantation of the left ventricular assist device as a destination therapy in Medicare beneficiaries who are not candidates for heart transplantation. The use of the left ventricular assist device as a destination therapy raises certain ethical challenges. Left ventricular assist devices can prolong the survival of average recipients compared with optimal medical management of chronic end-stage heart failure. However, the overall quality of life can be adversely affected in some recipients because of serious infections, neurologic complications, and device malfunction. Left ventricular assist devices alter end-of-life trajectories. The caregivers of recipients may experience significant burden (e.g., poor physical health, depression, anxiety, and posttraumatic stress disorder from destination therapy with left ventricular assist devices. There are also social and financial ramifications for recipients and their families. We advocate early utilization of a palliative care approach and outline prerequisite conditions so that consenting for the use of a left ventricular assist device as a destination therapy is a well informed process. These conditions include: (1 direct participation of a multidisciplinary care team, including palliative care specialists, (2 a concise plan of care for anticipated device-related complications, (3 careful surveillance and counseling for caregiver burden, (4 advance-care planning for anticipated end-of-life trajectories and timing of device deactivation, and (5 a plan to address the long-term financial burden on patients, families, and caregivers. Short-term mechanical circulatory devices (e
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Maltais, Simon; Tchantchaleishvili, Vahtang; Schaff, Hartzell V; Daly, Richard C; Suri, Rakesh M; Dearani, Joseph A; Topilsky, Yan; Stulak, John M; Joyce, Lyle D; Park, Soon J
2014-04-01
Patients with severe ischemic cardiomyopathy (left ventricular ejection fraction assist device as destination therapy is reserved for patients who are too high risk for conventional surgery. We evaluated our outcomes with conventional surgery within this population and the comparative effectiveness of these 2 therapies. We identified patients who underwent conventional surgery or left ventricular assist device as destination therapy for severe ischemic cardiomyopathy (left ventricular ejection fraction assist device as destination therapy. We compared baseline patient characteristics and outcomes in terms of end-organ function and survival. A total of 88 patients were identified; 55 patients underwent conventional surgery (63%), and 33 patients (37%) received a left ventricular assist device as destination therapy. Patients who received left ventricular assist device as destination therapy had the increased prevalence of renal failure, inotrope dependency, and intra-aortic balloon support. Patients undergoing conventional surgery required longer ventilatory support, and patients receiving a left ventricular assist device required more reoperation for bleeding. Mortality rates were similar between the 2 groups at 30 days (7% in the conventional surgery group vs 3% in the left ventricular assist device as destination therapy group, P = .65) and at 1 year (22% in the conventional surgery group vs 15% in the left ventricular assist device as destination therapy group, P = .58). There was a trend toward improved survival in patients receiving a left ventricular assist device compared with the propensity-matched groups at 1 year (94% vs 71%, P = .171). The operative mortality and early survival after conventional surgery seem to be acceptable. For inoperable or prohibitive-risk patients, left ventricular assist device as destination therapy can be offered with similar outcomes. Copyright © 2014 The American Association for Thoracic Surgery. Published by Mosby
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Lee, Ga Yeon; Park, Sung-Ji; Kim, Sujin; Choi, Namgyung; Jeong, Dong Seop; Jeon, Eun-Seok; Lee, Young Tak
2014-01-01
Left ventricular assist device (LVAD) is a good treatment option for the patients ineligible for cardiac transplantation. Several studies have demonstrated that a ventricular assist device improves the quality of life and prognosis of the patients with end-stage heart failure. A 75-yr-old man debilitated with New York Heart Association (NYHA) functional class III-IV due to severe left ventricular systolic dysfunction received LVAD implantation as a destination therapy. The patient was discharged with improved functional status (NYHA functional class II) after appropriate cardiac rehabilitation and education about how to manage the device and potential emergency situations. This is the first case of successful continuous-flow LVAD implantation as a destination therapy in Korea.
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Paine, Arcadia M; Allen, Larry A; Thompson, Jocelyn S; McIlvennan, Colleen K; Jenkins, Amy; Hammes, Andrew; Kroehl, Miranda; Matlock, Daniel D
2016-11-01
People with end-stage heart failure may have to decide about destination-therapy left ventricular assist device (DT-LVAD). Individuals facing difficult decisions often rely on heuristics, such as anchoring, which predictably bias decision outcomes. We aimed to investigate whether showing a larger historical Heartmate XVE creates an anchoring effect, making the smaller Heartmate II (HMII) appear more favorable. With the use of Amazon Mechanical Turk, participants watched videos asking them to imagine themselves dying of end-stage heart failure, then were presented the option of LVAD as potentially life-prolonging therapy. Participants were randomized to a control group who were only shown the HMII device, and the intervention group who saw the XVE device before the HMII. Participants then completed surveys. A total of 487 participants completed the survey (control = 252; intervention = 235); 79% were affect likelihood of accepting the LVAD, it did affect device perception. This article highlights an important point with clinical implications: factors such as anchoring have the potential to inappropriately influence perceptions and decisions and should be carefully considered in research and practice. Copyright © 2016 Elsevier Inc. All rights reserved.
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Frailty and outcomes after implantation of left ventricular assist device as destination therapy.
Dunlay, Shannon M; Park, Soon J; Joyce, Lyle D; Daly, Richard C; Stulak, John M; McNallan, Sheila M; Roger, Véronique L; Kushwaha, Sudhir S
2014-04-01
Frailty is recognized as a major prognostic indicator in heart failure. There has been interest in understanding whether pre-operative frailty is associated with worse outcomes after implantation of a left ventricular assist device (LVAD) as destination therapy. Patients undergoing LVAD implantation as destination therapy at the Mayo Clinic, Rochester, Minnesota, from February 2007 to June 2012, were included in this study. Frailty was assessed using the deficit index (31 impairments, disabilities and comorbidities) and defined as the proportion of deficits present. We divided patients based on tertiles of the deficit index (>0.32 = frail, 0.23 to 0.32 = intermediate frail, <0.23 = not frail). Cox proportional hazard regression models were used to examine the association between frailty and death. Patients were censored at death or last follow-up through October 2013. Among 99 patients (mean age 65 years, 18% female, 55% with ischemic heart failure), the deficit index ranged from 0.10 to 0.65 (mean 0.29). After a mean follow-up of 1.9 ± 1.6 years, 79% of the patients had been rehospitalized (range 0 to 17 hospitalizations, median 1 per person) and 45% had died. Compared with those who were not frail, patients who were intermediate frail (adjusted HR 1.70, 95% CI 0.71 to 4.31) and frail (HR 3.08, 95% CI 1.40 to 7.48) were at increased risk for death (p for trend = 0.004). The mean (SD) number of days alive out of hospital the first year after LVAD was 293 (107) for not frail, 266 (134) for intermediate frail and 250 (132) for frail patients. Frailty before destination LVAD implantation is associated with increased risk of death and may represent a significant patient selection consideration. Copyright © 2014 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.
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Swetz, Keith M; Freeman, Monica R; AbouEzzeddine, Omar F; Carter, Kari A; Boilson, Barry A; Ottenberg, Abigale L; Park, Soon J; Mueller, Paul S
2011-06-01
To assess the benefit of proactive palliative medicine consultation for delineation of goals of care and quality-of-life preferences before implantation of left ventricular assist devices as destination therapy (DT). We retrospectively reviewed the cases of patients who received DT between January 15, 2009, and January 1, 2010. Of 19 patients identified, 13 (68%) received proactive palliative medicine consultation. Median time of palliative medicine consultation was 1 day before DT implantation (range, 5 days before to 16 days after). Thirteen patients (68%) completed advance directives. The DT implantation team and families reported that preimplantation discussions and goals of care planning made postoperative care more clear and that adverse events were handled more effectively. Currently, palliative medicine involvement in patients receiving DT is viewed as routine by cardiac care specialists. Proactive palliative medicine consultation for patients being considered for or being treated with DT improves advance care planning and thus contributes to better overall care of these patients. Our experience highlights focused advance care planning, thorough exploration of goals of care, and expert symptom management and end-of-life care when appropriate.
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Exercise therapy for an older patient with left ventricular assist device.
Park, Won Hah; Seo, Yong Gon; Sung, Ji Dong
2014-06-01
A left ventricular assist device (LVAD) is a mechanical circulation support implanted for patients with end-stage heart failure. It may be used either as a bridge to cardiac transplantation or as a destination therapy. The health of a 75-year-old man with a medical history of systolic heart failure worsened. Therefore, he was recommended to have implanted a LVAD (Thoratec Corp.) as a destination therapy. After the surgery, he was enrolled in patient cardiac rehabilitation for the improvement of dyspnea and exercise capacity. In results, there is an improvement on his exercise capacity and quality of life. For the first time in Korea, we reported a benefit of exercise therapy after being implanted with a LVAD.
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Tourists’ Risk Perception and the Use of Mobile Devices in Beach Tourism Destinations
Directory of Open Access Journals (Sweden)
Francesc González-Reverté
2018-02-01
Full Text Available The perceived risk of tourists’ use of smartphones is a key issue in shaping the tourist experience in terms of sustainability, as it can affect the behaviour of tourists and influence their satisfaction with that experience. However, little empirical research exists on the relationship between tourists’ risk perception and the perceived value of mobile device usage. This paper measures the association between tourists’ perceived risk of mobile device usage and several variables that demonstrate the perceived usefulness of mobile devices: utility, hedonic value and future intention of use. A survey on tourists’ use of smartphones was conducted in 2016 and, by means of a cluster analysis, four groups of tourists were identified with significant differences in their perception of the risk and use value of smartphones. Differences between tourists suggest that a single digital tourist profile does not exist and that tourism destinations and smart tourism DMOs (destination marketing organisations should include risk perception in their management agenda. This will allow them to achieve a better understanding of tourist behaviour and to adapt the commercialisation of tourism products and services to a wide range of tourism needs. In addition, four regression models were applied to measure the association between the risk and perceived usefulness of mobile devices. On the one hand, dependence on mobile devices was associated positively with the perceived usefulness of mobile devices. On the other hand, the tourists surveyed saw privacy risk as having a major negative impact on the tourist experience, although it did not affect their perceived utility value and future use of mobile devices. Smart tourism destination managers should bear in mind that privacy risk issues related to the use of mobile devices must be integrated into an ethical perspective when marketing a destination.
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Magid, Molly; McIlvennan, Colleen K; Jones, Jaqueline; Nowels, Carolyn T; Allen, Larry A; Thompson, Jocelyn S; Matlock, Dan
2016-10-01
Cognitive biases are psychological influences, which cause humans to make decisions, which do not seemingly maximize utility. For people with heart failure, the left ventricular assist device (LVAD) is a surgically implantable device with complex tradeoffs. As such, it represents an excellent model within which to explore cognitive bias in a real-world decision. We conducted a framework analysis to examine for evidence of cognitive bias among people deciding whether or not to get an LVAD. The aim of this study was to explore the influence of cognitive bias on the LVAD decision-making process. We analyzed previously conducted interviews of patients who had either accepted or declined an LVAD using a deductive, predetermined framework of cognitive biases. We coded and analyzed the interviews using an inductive-deductive framework approach, which also allowed for other themes to emerge. We interviewed a total of 22 heart failure patients who had gone through destination therapy LVAD decision making (15 who had accepted the LVAD and 7 who had declined). All patients appeared influenced by state dependence, where both groups described high current state of suffering, but the groups differed in whether they believed LVAD would relieve suffering or not. We found evidence of cognitive bias that appeared to influence decision making in both patient groups, but groups differed in terms of which cognitive biases were present. Among accepters, we found evidence of anchoring bias, availability bias, optimism bias, and affective forecasting. Among decliners, we found evidence of errors in affective forecasting. Medical decision making is often a complicated and multifaceted process that includes cognitive bias as well as other influences. It is important for clinicians to recognize that patients can be affected by cognitive bias, so they can better understand and improve the decision-making process to ensure that patients are fully informed. Published by Elsevier Inc.
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Park, S J; Kushwaha, S S; McGregor, C G A
2012-01-01
Congestive heart failure is associated with poor quality of life (QoL) and low survival rates. The development of state-of-the-art cardiac devices holds promise for improved therapy in patients with heart failure. The field of implantable cardiac assist devices is changing rapidly with the emergence of continuous-flow pumps (CFPs). The important developments in this field, including pertinent clinical trials, registry reports, innovative research, and potential future directions are discussed in this paper.
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Magnetta, Defne A; Kang, JaHyun; Wearden, Peter D; Smith, Kenneth J; Feingold, Brian
2018-05-17
Destination ventricular assist device therapy (DT-VAD) is well accepted in select adults with medically refractory heart failure (HF) who are not transplant candidates; however, its use in younger patients with progressive diseases is unclear. We sought to evaluate the cost-effectiveness of DT-VAD in Duchenne muscular dystrophy (DMD) patients with advanced HF. We created a Markov-state transition model (5-year horizon) to compare survival, costs, and quality of life (QOL) between medical management and DT-VAD in DMD with advanced HF. Model input parameters were derived from the literature. We used sensitivity analyses to explore uncertainty around model assumptions. DT-VAD had higher costs ($435,602 vs. $125,696), survival (3.13 vs. 0.60 years), and quality-adjusted survival (1.99 vs. 0.26 years) than medical management. The incremental cost-effectiveness ratio (ICER) for DT-VAD was $179,086 per quality-adjusted life year (QALY). In sensitivity analyses that were widely varied to account for uncertainty in model assumptions, the DT-VAD strategy generally remained more costly and effective than medical management. Only when VAD implantation costs were <$113,142 did the DT-VAD strategy fall below the $100,000/QALY willingness-to-pay threshold commonly considered to be "cost-effective." In this exploratory analysis, DT-VAD for patients with DMD and advanced HF exceeded societal expectations for cost-effectiveness but had an ICER similar to the accepted practice of DT-VAD in adult HF patients. While more experience and research in this population is needed, our analysis suggests that DT-VAD for advanced HF in DMD should not be dismissed solely based on cost.
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McIlvennan, Colleen K; Allen, Larry A; Nowels, Carolyn; Brieke, Andreas; Cleveland, Joseph C; Matlock, Daniel D
2014-05-01
Destination therapy left ventricular assist devices (DT LVADs) are one of the most invasive medical interventions for end-stage illness. How patients decide whether or not to proceed with device implantation is unknown. We aimed to understand the decision-making processes of patients who either accept or decline DT LVADs. Between October 2012 and September 2013, we conducted semistructured, in-depth interviews to understand patients' decision-making experiences. Data were analyzed using a mixed inductive and deductive approach. Twenty-two eligible patients were interviewed, 15 with DT LVADs and 7 who declined. We found a strong dichotomy between decision processes with some patients (11 accepters) being automatic and others (3 accepters, 7 decliners) being reflective in their approach to decision making. The automatic group was characterized by a fear of dying and an over-riding desire to live as long as possible: "[LVAD] was the only option I had…that or push up daisies…so I automatically took this." By contrast, the reflective group went through a reasoned process of weighing risks, benefits, and burdens: "There are worse things than death." Irrespective of approach, most patients experienced the DT LVAD decision as a highly emotional process and many sought support from their families or spiritually. Some patients offered a DT LVAD face the decision by reflecting on a process and reasoning through risks and benefits. For others, the desire to live supersedes such reflective processing. Acknowledging this difference is important when considering how to support patients who are faced with this complex decision. © 2014 American Heart Association, Inc.
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McIlvennan, Colleen K.; Allen, Larry A.; Nowels, Carolyn; Brieke, Andreas; Cleveland, Joseph C.; Matlock, Daniel D.
2014-01-01
Background Destination therapy left ventricular assist devices (DT LVAD) are one of the most invasive medical interventions for end-stage illness. How patients decide whether or not to proceed with device implantation is unknown. We aimed to understand the decision-making processes of patients who either accept or decline DT LVADs. Methods and Results Between October 2012–September 2013, we conducted semi-structured, in-depth interviews to understand patients’ decision-making experiences. Data were analyzed using a mixed inductive and deductive approach. Twenty-two eligible patients were interviewed, 15 with DT LVADs and 7 who declined. We found a strong dichotomy between decision processes with some patients (11 accepters) being “automatic” and others (3 accepters, 7 decliners) being “reflective” in their approach to decision making. The automatic group was characterized by a fear of dying and an overriding desire to live as long as possible: “[LVAD] was the only option I had…that or push up daisies…so I automatically took this”. In contrast, the reflective group went through a reasoned process of weighing risks, benefits, and burdens: “There are worse things than death.” Irrespective of approach, most patients experienced the DT LVAD decision as a highly emotional process and many sought support from their families or spiritually. Conclusion Some patients offered a DT LVAD face the decision by reflecting on a process and reasoning through risks and benefits. For others, the desire to live supersedes such reflective processing. Acknowledging this difference is important when considering how to support patients who are faced with this complex decision. PMID:24823949
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Spiliopoulos, Sotirios; Koerfer, Reiner; Tenderich, Gero
2014-06-01
The SynCardia total artificial heart is currently used as a bridge to transplantation therapy in cases of irreversible, acute or chronic, biventricular heart failure. We describe the implementation of this technology in the context of destination therapy in a patient with an end-stage heart failure on grounds of primary amyloidosis. © The Author 2014. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.
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Generating Multi-Destination Maps.
Zhang, Junsong; Fan, Jiepeng; Luo, Zhenshan
2017-08-01
Multi-destination maps are a kind of navigation maps aimed to guide visitors to multiple destinations within a region, which can be of great help to urban visitors. However, they have not been developed in the current online map service. To address this issue, we introduce a novel layout model designed especially for generating multi-destination maps, which considers the global and local layout of a multi-destination map. We model the layout problem as a graph drawing that satisfies a set of hard and soft constraints. In the global layout phase, we balance the scale factor between ROIs. In the local layout phase, we make all edges have good visibility and optimize the map layout to preserve the relative length and angle of roads. We also propose a perturbation-based optimization method to find an optimal layout in the complex solution space. The multi-destination maps generated by our system are potential feasible on the modern mobile devices and our result can show an overview and a detail view of the whole map at the same time. In addition, we perform a user study to evaluate the effectiveness of our method, and the results prove that the multi-destination maps achieve our goals well.
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21 CFR 882.5940 - Electroconvulsive therapy device.
2010-04-01
... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Electroconvulsive therapy device. 882.5940 Section 882.5940 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... Electroconvulsive therapy device. (a) Identification. An electroconvulsive therapy device is a device used for...
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Narrowing of the Coronary Sinus: A Device-Based Therapy for Persistent Angina Pectoris.
Konigstein, Maayan; Verheye, Stefan; Jolicœur, E Marc; Banai, Shmuel
2016-01-01
Alongside the remarkable advances in medical and invasive therapies for the treatment of ischemic heart disease, an increasing number of patients with advanced coronary artery disease unsuitable for revascularization continue to suffer from angina pectoris despite optimal medical therapy. Patients with chronic angina have poor quality of life and increased levels of anxiety and depression. A considerable number of innovative therapeutic modalities for the treatment of chronic angina have been investigated over the years; however, none of these therapeutic options has become a standard of care, and none are widely utilized. Current treatment options for refractory angina focus on medical therapy and secondary risk factor modification. Interventions to create increased pressure in the coronary sinus may alleviate myocardial ischemia by forcing redistribution of coronary blood flow from the less ischemic subepicardium to the more ischemic subendocardium, thus relieving symptoms of ischemia. Percutaneous, transvenous implantation of a balloon expandable, hourglass-shaped, stainless steel mesh in the coronary sinus to create a fixed focal narrowing and to increase backwards pressure, may serve as a new device-based therapy destined for the treatment of refractory angina pectoris.
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Jennings, Douglas L; Chambers, Rachel M; Schillig, Jessica M
2010-10-01
Advanced heart failure continues to be a significant cause of morbidity and mortality in the US. Patients with advanced heart failure have a poor prognosis without cardiac transplantation. The use of left ventricular assist devices (LVADs) as destination therapy for these patients is therefore expected to increase in the coming years as technology advances. The HeartMate II, a continuous flow implantable device, is currently the only LVAD that has been approved by the Food and Drug Administration for destination therapy in patients with advanced heart failure. The pharmacotherapy associated with this device is very complex and, therefore, the need for expertly trained clinical pharmacists to care for this expanding patient population will also likely increase. Unfortunately, most pharmacists are unfamiliar with the effect of LVADs on the physiology and pharmacotherapy of a patient's heart failure. The purpose of this article is to give clinical pharmacists an introduction to the most common pharmacotherapeutic issues for patients with LVADs and present practical solutions for managing common drug therapy problems.
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Sladen, Robert N
2017-04-01
The past decade has seen an exponential increase in the application and development of durable long-term as well as nondurable short-term mechanical circulatory support for cardiogenic shock and acute or chronic heart failure. Support has evolved from bridge-to-transplant to destination therapy, bridge to rescue, bridge to decision making, and bridge to a bridge. Notable trends include device miniaturization, minimally invasive and/or percutaneous insertion, and efforts to superimpose pulsatility on continuous flow. We can certainly anticipate that innovation will accelerate in the months and years to come. However, despite-or perhaps because of-the enhanced equipment now available, mechanical circulatory support is an expensive, complex, resource-intensive modality. It requires considerable expertise that should preferably be centralized to highly specialized centers. Formidable challenges remain: systemic inflammatory response syndromes and vasoplegia after device insertion; postoperative sepsis; optimal anticoagulation regimens to prevent device-induced thrombosis and cerebral thromboembolism; wound site, intracranial, and gastrointestinal bleeding; multisystem injury and failure; patient dissatisfaction (even when providers consider the procedure a "success"); and ethical decision making in conditions of futility.
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Pagani, Francis D; Aaronson, Keith D; Kormos, Robert; Mann, Douglas L; Spino, Cathie; Jeffries, Neal; Taddei-Peters, Wendy C; Mancini, Donna M; McNamara, Dennis M; Grady, Kathleen L; Gorcsan, John; Petrucci, Ralph; Anderson, Allen S; Glick, Henry A; Acker, Michael A; Eduardo Rame, J; Goldstein, Daniel J; Pamboukian, Salpy V; Miller, Marissa A; Timothy Baldwin, J
2016-11-01
The National Institutes of Health National Heart, Lung, and Blood Institute convened a working group in March 2008 to discuss how therapies for heart failure (HF) might be best advanced using clinical trials involving left ventricular assist devices (LVAD). This group opined that the field was ready for a trial to assess the use of long-term ventricular assist device therapy in patients who are less ill than patients currently eligible for destination therapy, which resulted in the Randomized Evaluation of VAD InterVEntion before Inotropic Therapy (REVIVE-IT) pilot study. The specific objective of REVIVE-IT was to compare LVAD therapy with optimal medical management in patients with less advanced HF than current LVAD indications to determine if wider application of permanent LVAD use to less ill patients would be associated with improved survival, quality of life, or functional capacity. REVIVE-IT represented an extraordinary effort to provide data from a randomized clinical trial to inform clinicians, scientists, industry, and regulatory agencies about the efficacy and safety of LVAD therapy in a population with less advanced HF. Despite significant support from the medical community, industry, and governmental agencies, REVIVE-IT failed to accomplish its goal. The reasons for its failure are instructive, and the lessons learned from the REVIVE-IT experience are likely to be relevant to any future study of LVAD therapy in a population with less advanced HF. Copyright © 2016 International Society for Heart and Lung Transplantation. All rights reserved.
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Messori, Andrea; Trippoli, Sabrina; Bonacchi, Massimo; Sani, Guido
2009-08-01
Value-based methods are increasingly used to reimburse therapeutic innovation, and the payment-by-results approach has been proposed for handling interventions with limited therapeutic evidence. Because most left ventricular assist devices are supported by preliminary efficacy data, we examined the effectiveness data of the HeartMate (Thoratec Corp, Pleasanton, CA) device to explore the application of the payment-by-results approach to these devices and to develop a model for handling reimbursements. According to our model, after establishing the societal economic countervalue for each month of life saved, each patient treated with one such device is associated to the payment of this countervalue for every month of survival lived beyond the final date of estimated life expectancy without left ventricular assist devices. Our base-case analysis, which used the published data of 68 patients who received the HeartMate device, was run with a monthly countervalue of euro 5000, no adjustment for quality of life, and a baseline life expectancy of 150 days without left ventricular assist devices. Sensitivity analysis was aimed at testing the effect of quality of life adjustments and changes in life expectancy without device. In our base-case analysis, the mean total reimbursement per patient was euro 82,426 (range, euro 0 to euro 250,000; N = 68) generated as the sum of monthly payments. This average value was close to the current price of the HeartMate device (euro 75,000). Sensitivity testing showed that the base-case reimbursement of euro 82,426 was little influenced by variations in life expectancy, whereas variations in utility had a more pronounced impact. Our report delineates an innovative procedure for appropriately allocating economic resources in this area of invasive cardiology.
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Destination Personality: An Application of Brand Personality to Tourism Destinations
Ekinci, Yuksel; Hosany, Sameer
2006-01-01
In an increasingly competitive tourism market place, destination marketers face the challenge of attracting tourists through destination branding and destination personality building practices. As places become substitutable, destination personality, defined as the set of human characteristics associated with a destination, is seen as a viable metaphor for crafting a destination’s unique identity. At the conceptual level, the importance of destination personality has been widely acknowledged,...
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International Nuclear Information System (INIS)
Tronc, D.
1994-01-01
The invention concerns a proton therapy device using a proton linear accelerator which produces a proton beam with high energies and intensities. The invention lies in actual fact that the proton beam which is produced by the linear accelerator is deflected from 270 deg in its plan by a deflecting magnetic device towards a patient support including a bed the longitudinal axis of which is parallel to the proton beam leaving the linear accelerator. The patient support and the deflecting device turn together around the proton beam axis while the bed stays in an horizontal position. The invention applies to radiotherapy. 6 refs., 5 figs
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A pneumatic muscle hand therapy device.
Koeneman, E J; Schultz, R S; Wolf, S L; Herring, D E; Koeneman, J B
2004-01-01
Intensive repetitive therapy improves function and quality of life for stroke patients. Intense therapies to overcome upper extremity impairment are beneficial, however, they are expensive because, in part, they rely on individualized interaction between the patient and rehabilitation specialist. The development of a pneumatic muscle driven hand therapy device, the Mentortrade mark, reinforces the need for volitional activation of joint movement while concurrently offering knowledge of results about range of motion, muscle activity or resistance to movement. The device is well tolerated and has received favorable comments from stroke survivors, their caregivers, and therapists.
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Evidence Considerations for Mobile Devices in the Occupational Therapy Process
Directory of Open Access Journals (Sweden)
Kelly Erickson
2015-04-01
Full Text Available Mobile app-based device utilization, including smartphones and handheld tablets, suggests a need to evaluate evidence to guide selection and implementation of these devices in the occupational therapy process. The purpose of the research was to explore the current body of evidence in relation to mobile app-based devices and to identify factors in the use of these devices throughout the occupational therapy process. Following review of available occupational therapy profession guidelines, assistive technology literature, and available mobile device research, practitioners using mobile app-based devices in occupational therapy should consider three areas: client needs, practitioner competence, and device factors. The purpose of this guideline is to identify factors in the selection and use of mobile app-based devices throughout the occupational therapy process based on available evidence. Considerations for mobile device implementation during the occupational therapy process is addressed, including evaluating outcomes needs, matching device with the client, and identifying support needs of the client.
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Smart tourism destination triggers consumer experience: the case of Porto
Directory of Open Access Journals (Sweden)
Pedro Liberato
2018-03-01
Full Text Available Purpose - The purpose of this paper is to emphasize the increasing importance of information and communication technologies (ICTs in smart tourism destinations, in their integration in the activity of the tourism companies, and in their interaction with visitors/tourists. In summary, it is intended to evaluate in the city of Porto how the use of technology before, during and after the visit influences the tourist experience. Design/methodology/approach - The authors empirically investigate the importance of using ICTs during tourism experience, assess the access/availability of ICT at the destination and its importance in tourist’s decisions. It is analyzed if the applications and/or information available on the internet are important and positively influence the tourism experience in Porto, that is, the degree of tourist satisfaction. The empirical evidence is based on a quantitative analysis, using a data set involving 423 tourists in the city of Porto. Findings - The importance of the internet access at the destination, especially in places like airports and hotels, since most tourists are primarily using their mobile devices and computers during the trip, and the existing information technologies available in the destination (internet, smartphones or other mobile devices and applications are considered very important in explaining tourists’ experience. Originality/value - This study identifies the strengths and weaknesses of the technological strategies, providing useful information for destination management, discussing innovation in tourism, and proposing a framework that empirically evaluates how technological components used in smart tourism destinations can improve tourists’ experiences.
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Implant Strategy-Specific Changes in Symptoms in Response to Left Ventricular Assist Devices.
Lee, Christopher S; Gelow, Jill M; Chien, Christopher V; Hiatt, Shirin O; Bidwell, Julie T; Denfeld, Quin E; Grady, Kathleen L; Mudd, James O
Although we know that the quality of life generally improves after left ventricular assist device (LVAD) implantation, we know little about how symptoms change in response to LVAD. The purpose of this study was to compare the changes in symptoms between bridge and destination therapy patients as part of a prospective cohort study. Physical (dyspnea and wake disturbances) and affective symptoms (depression and anxiety) were measured before LVAD and at 1, 3, and 6 months after LVAD. Multiphase growth modeling was used to capture the 2 major phases of change: initial improvements between preimplant and 1 month after LVAD and subsequent improvements between 1 and 6 months after LVAD. The sample included 64 bridge and 22 destination therapy patients as the preimplant strategy. Destination patients had worse preimplant dyspnea and wake disturbances, and they experienced greater initial improvements in these symptoms compared with bridge patients (all P .05). Destination patients had worse preimplant depression (P = .042) but experienced similar initial and subsequent improvements in depression in response to LVAD compared with bridge patients (both P > .05). Destination patients had similar preimplant anxiety (P = .279) but experienced less initial and greater subsequent improvements in anxiety after LVAD compared with bridge patients (both P < .05). There are many differences in the magnitude and timing of change in symptom responses to LVAD between bridge and destination therapy patients. Detailed information on changes in specific symptoms may better inform shared decision-making regarding LVAD.
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Current Trends in Implantable Left Ventricular Assist Devices
Directory of Open Access Journals (Sweden)
Jens Garbade
2011-01-01
Full Text Available The shortage of appropriate donor organs and the expanding pool of patients waiting for heart transplantation have led to growing interest in alternative strategies, particularly in mechanical circulatory support. Improved results and the increased applicability and durability with left ventricular assist devices (LVADs have enhanced this treatment option available for end-stage heart failure patients. Moreover, outcome with newer pumps have evolved to destination therapy for such patients. Currently, results using nonpulsatile continuous flow pumps document the evolution in outcomes following destination therapy achieved subsequent to the landmark Randomized Evaluation of Mechanical Assistance for the Treatment of Congestive Heart Failure Trial (REMATCH, as well as the outcome of pulsatile designed second-generation LVADs. This review describes the currently available types of LVADs, their clinical use and outcomes, and focuses on the patient selection process.
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DEFF Research Database (Denmark)
Kock, Florian; Josiassen, Alexander; Assaf, A. George
2016-01-01
Knowledge of the mental representations that individuals hold about tourist destinations are important to understand their intentions. These mental destination representations have often been investigated by applying the concept of destination image. This study argues that the extant literature...... is often rather atheoretical and lacks operational rigor. These are major shortcomings which undoubtedly hinder the development of academic and managerial insights. In response, this study draws on contemporary psychology to develop the destination content model, comprising three informational components...... held in individuals‘ minds about destinations. The present study further outlines preferable methods and measures for each component, thus aiding researchers to investigate mental destination representations...
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NHLBI's program for VAD therapy for moderately advanced heart failure: the REVIVE-IT pilot trial.
Baldwin, J Timothy; Mann, Douglas L
2010-11-01
Ventricular assist devices (VADs) are used to bridge heart failure patients to transplantation, to allow their own hearts to recover, or as permanent ("destination") therapy. To date, the use of VADs has been limited to late-stage heart failure patients because of the associated device risks. In 2008, a National Heart, Lung, and Blood Institute (NHLBI) working group met to evaluate the treatment of heart failure using VADs and to advise the institute on how therapy for heart failure may be best advanced by clinical trials involving the devices. Recognizing the improvements in VAD technology and in patient care and selection over the past decade, the working group recommended that a trial be performed to assess the use of chronic VAD therapy in patients who are less ill than those currently eligible for destination therapy. The hypothesis proposed for the trial is that VAD therapy may improve both survival and quality of life in moderately advanced heart failure patients who are neither inotrope-dependent nor exercise-intolerant and have not yet developed serious consequences such as malnourishment, end-organ damage, and immobility. Based on the group's recommendations, NHLBI issued an RFP in 2009 for the REVIVE-IT Pilot Trail, which will serve to test the hypothesis and inform the pivotal trial. Published by Elsevier Inc.
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Current State and Future Perspectives of Energy Sources for Totally Implantable Cardiac Devices.
Bleszynski, Peter A; Luc, Jessica G Y; Schade, Peter; PhilLips, Steven J; Tchantchaleishvili, Vakhtang
There is a large population of patients with end-stage congestive heart failure who cannot be treated by means of conventional cardiac surgery, cardiac transplantation, or chronic catecholamine infusions. Implantable cardiac devices, many designated as destination therapy, have revolutionized patient care and outcomes, although infection and complications related to external power sources or routine battery exchange remain a substantial risk. Complications from repeat battery replacement, power failure, and infections ultimately endanger the original objectives of implantable biomedical device therapy - eliminating the intended patient autonomy, affecting patient quality of life and survival. We sought to review the limitations of current cardiac biomedical device energy sources and discuss the current state and trends of future potential energy sources in pursuit of a lifelong fully implantable biomedical device.
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Destination Marketing and Management
Kocková, Jitka
2009-01-01
Work presents the theoretical aspects of destination management and marketing. It defines the destination management and sustainable development of tourism. The work is applied to destination management and destination marketing in region Sokolovsko. For this destiaci is proposed marketing strategy and marketing mix.
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LVAD pannus complicating destination therapy
Directory of Open Access Journals (Sweden)
Maya Ignaszewski
2017-11-01
Full Text Available Despite advances in technology, ventricular assist devices still experience a number of complications limiting their long-term use. We present a 73-year-old woman implanted with a left ventricular assist device (LVAD five years prior due to end-stage dilated cardiomyopathy, who died several weeks after admission to the hospital. Post-mortem examination revealed a large obstructing pannus in the LVAD inflow. As a result of increased LVAD use, complications such as infection, device thrombosis and pannus must be promptly recognized and managed appropriately to ensure the greatest chance of patient survival.
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DEFF Research Database (Denmark)
Josiassen, Alexander; Kock, Florian; Assaf, Albert G.
A central research question in tourism management concerns tourist’s choice of specific destinations. The present article reviews the extant literature on destination image. From this review we suggest that individuals have a multitude of destination associations – the total imagery which relates....... The article further provides an extensive review of the literature with regard to the definitions, dimensionality, antecedents, and outcomes of the focal concepts as well as geographical scope of destination imagery and image studies and methodologies. This review has led to a novel understanding...
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Directory of Open Access Journals (Sweden)
R Rajesh
2013-07-01
Full Text Available The objective this research paper is develops a destination loyalty theoretical model by using tourist perception, destination image and tourist satisfaction. These study analysis components, attributes, factor influencing the destination image and examine the tourist satisfaction and determinants of destination loyalty. This is a conceptual paper attempts at evaluating recent empirical on destination image, tourist satisfaction and loyalty. The conceptual framework model is developed on the basis of existing theoretical and empirical research in the field of destination marketing. The models include four constructs. Tourist Perception constructs has been influenced by factors like Historical and Cultural Attractions, Destination Affordability, Travel Environment, Natural Attractions, Entertainments and Infrastructure. Destination image construct has been influenced by factors like Infrastructure & Facilities, Heritage Attractions, Natural Made Attractions, Destination Safety & Cleanness, Friendly Local Community & Clam Atmosphere, Rejuvenation and Service Price and Affordability. The satisfaction construct has been influenced by factors like Entertainments, Destination Attractions and Atmosphere, Accommodation, Food, Transportation Services and Shopping. The destination loyalty construct has influenced by intentions to revisit, word of mouth promotion and recommending to others . The earlier study result reveals that tourist perception, destination image and tourist satisfaction directly influence destination loyalty. The outcomes of the study have significant managerial implications for destination marketing managers.
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Destination image and key drivers of perceived destination attractiveness
Directory of Open Access Journals (Sweden)
Josip Mikulić
2008-12-01
Full Text Available In this exploratory study authors combine several approaches to explore the images of two highly attractive tourist destinations: Hawai’i and Croatia. Two convenience samples were used: the image of Hawai’i was measured among Croatian undergraduate business students, and the image of Croatia was measured among Hawaiian tourism students. Functional and psychological image components were assessed at both a holistic and the attribute level. In addition, an importance-perception analysis was performed to assess the degree to which the destination image at the attribute level coincides with the students’ perception of an optimal destination. Finally, the authors conduct an importance grid analysis to explore the key drivers of the overall perceived destination attractiveness. The results provide a detailed insight into the images of Croatia and Hawaii, and reveal several interesting differences between the two student samples.
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A Research for Determining the Relationship between Destination Image and Destination Personality
Directory of Open Access Journals (Sweden)
Savaş Artuğer
2014-03-01
Full Text Available The aim of this study was to determine the relationship between destination image and destination personality. The sample group of the study consisted of tourists visiting Alanya district of Antalya province between June and August 2013. A brand personality scale developed by Aaker (1997 and a survey used for grading the destination image were used as tools for collecting data which were obtained from a total of 395 tourists for the application. Descriptive analyses such percentage, frequency, factor analysis (confirmatory and explanatory as well as statistical tests such as the reliability analysis were used for analyzing the obtained data. In addition the relationship between destination image and destination personality was analyzed with the Structural Equation Modeling (SEMAt the conclusion of the study there appeared to be negative and very weak relationship between affective image and destination personality while the relationship between cognitive image and destination personality appeared to be positive and strong. In addition Aaker’s (1997 5 dimensional brand personality grading turned out to be 4 dimensions. These dimensions were determined as excitement, ruggedness, competence and sincerity
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The Influence of Destination Image on Medical Tourist’s Intention for Future Destination Choice
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Norhaslin Abu Hassan
2016-01-01
Full Text Available This study proposed to explore how the image of a destination could influence medical tourists in choosing a destination as their future medical and tourism destination choice. Scholars argued that destination image had a significant relationship with behavioral intentions. Destination image influence not only the decision-making process but also conditions after-decision-making behaviors of tourists. In the current study context, the future destination choice behavior referred to the intention to revisit the previous destination and the intention to spread the positive word-of-mouth to others. For this study, inbound medical tourists from private hospitals registered with Malaysia Healthcare Travel Council (MHTC in Penang, Malacca, Kuala Lumpur and Selangor in Malaysia will be approached quantitatively by survey questionnaires. This study will contribute to an understanding of the significant factors influencing medical tourists’ intention for future destination choice.
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Directory of Open Access Journals (Sweden)
Stacia Reviany Mege
2017-12-01
Full Text Available The increasing popularity of reality shows renders them as potential media for tourism promotion. However, there is limited research regarding the impact of destination exposure in reality shows. This study aimed to investigate the impact of destination exposure in television reality shows on destination image, familiarity, and travel intention. To test the hypotheses, a within subject experiment was conducted. A worldwide popular reality show, The Amazing Race, was used as a stimulus for the participants. The results revealed that, in general, both cognitive and affective destination im- ages were rated higher after watching the reality show. Furthermore, familiarity with the destination and travel intention to the destination increased after watching the destination in the reality show. The result of this study will be useful for destination marketing organization and the government to explore alternative promotional media and aid the promotion of tourism destination.
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Making Strategies in Destination Branding
da Silva Oliveira, Eduardo
2013-01-01
The need for strategic thinking in destination branding has been demanded regarding the challenges tourism destinations are facing nowadays, such as at the digital level. The utilization of Information Communication Technology by tourism destinations, when well-articulated with a destination
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Advanced Small Animal Conformal Radiation Therapy Device.
Sharma, Sunil; Narayanasamy, Ganesh; Przybyla, Beata; Webber, Jessica; Boerma, Marjan; Clarkson, Richard; Moros, Eduardo G; Corry, Peter M; Griffin, Robert J
2017-02-01
We have developed a small animal conformal radiation therapy device that provides a degree of geometrical/anatomical targeting comparable to what is achievable in a commercial animal irradiator. small animal conformal radiation therapy device is capable of producing precise and accurate conformal delivery of radiation to target as well as for imaging small animals. The small animal conformal radiation therapy device uses an X-ray tube, a robotic animal position system, and a digital imager. The system is in a steel enclosure with adequate lead shielding following National Council on Radiation Protection and Measurements 49 guidelines and verified with Geiger-Mueller survey meter. The X-ray source is calibrated following AAPM TG-61 specifications and mounted at 101.6 cm from the floor, which is a primary barrier. The X-ray tube is mounted on a custom-made "gantry" and has a special collimating assembly system that allows field size between 0.5 mm and 20 cm at isocenter. Three-dimensional imaging can be performed to aid target localization using the same X-ray source at custom settings and an in-house reconstruction software. The small animal conformal radiation therapy device thus provides an excellent integrated system to promote translational research in radiation oncology in an academic laboratory. The purpose of this article is to review shielding and dosimetric measurement and highlight a few successful studies that have been performed to date with our system. In addition, an example of new data from an in vivo rat model of breast cancer is presented in which spatially fractionated radiation alone and in combination with thermal ablation was applied and the therapeutic benefit examined.
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Sami tourism in destination development
DEFF Research Database (Denmark)
Olsen, Lise Smed
2016-01-01
through stakeholder collaboration in Jokkmokk, Sweden and Kautokeino, Norway. The study indicates that collaboration between destination marketing organisations and Sami stakeholders has been initiated and has improved destination marketing. Conflicts relating to indigenous identity and land use are more......Indigenous tourism has become an important component of the tourism industry. Previous indigenous tourism research has indicated three conflict areas that can have an impact on destination development - internal conflicts over indigenous identity, the use of indigenous culture in destination...... marketing, and land-use conflicts. To varying degrees these areas of conflict have been found to impact local and regional destination development in northern Europe. This paper draws on case studies to understand how conflicts in Sami tourism in local and regional destination development are addressed...
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THE ONLINE COMMUNICATION MIX FOR TOURISM DESTINATIONS STUDY CASE ON ROMANIAN TOURISM DESTINATIONS
Directory of Open Access Journals (Sweden)
Adina CONSTANTINESCU
2013-06-01
Full Text Available The present research aims at contributing to the field of Online Communication for tourism destinations. It provides a study on online communication of Romanian main tourism destinations, focusing on DMOs’ websites completeness in terms of contents and on their capability to respond to users’ needs. The results of the current research show that the Romanian Destination Websites offer a poor online experience for users, in terms of content, functionalities and fail to fully satisfy the needs and wants of potential tourists. This study is important for establishing the strategies for developing the tourism destination management in Romania.
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TOURIST DESTINATION MANAGEMENT
Directory of Open Access Journals (Sweden)
Karmen Andrea MEZEI
2009-12-01
Full Text Available Tourism development has environmental and social consequences upon local and global communities. The impact of tourism must be kept within certain limits which are set up by sustainable tourism. Meanwhile the viability of the investment must be assured. Tourism development matrix is the tourist destination. Destination management must ensure the balance between economic, social, cultural, and environmental activities. Competitive destination management organization means a harmonious combination between planning, lobby, coordination and marketing (promotion. The recommendation of an integrated meta plan for Romanian balneal spa could be the choice for a successful tourism development.
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A Research for Determining the Relationship between Destination Image and Destination Personality
Savaş Artuğer; Burçin Cevdet Çetinsöz
2014-01-01
The aim of this study was to determine the relationship between destination image and destination personality. The sample group of the study consisted of tourists visiting Alanya district of Antalya province between June and August 2013. A brand personality scale developed by Aaker (1997) and a survey used for grading the destination image were used as tools for collecting data which were obtained from a total of 395 tourists for the application. Descriptive analyses such percentage, frequenc...
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Predicting Tourist Loyalty to a Small Emerging Destination – The Importance of Destination Image
Directory of Open Access Journals (Sweden)
Bình Nghiêm-Phú
2017-12-01
Full Text Available In the Southeast Asia region, Vietnam is a developing country and also a developing tourism destination. The number of international tourists to Vietnam has been increasing in recent years. However, the post-trip issues (e.g., not returning, bad word-of-mouth have become the focal points of many arguments. Based on the existing literature, this study devel- oped and tested a theoretical model to predict international tourists’ loyalty to Vietnam from a combination of destination image, tourist motivation, and overall trip satisfaction. The findings revealed that destination image significantly and positively predicted tourists’ overall satisfaction with the trip and their loyalty to the country in the future. Tourist motiva- tion had some weak but significant effects on both overall trip satisfaction and destination loyalty when tested separately; however, the effect on overall trip satisfaction could not be observed when controlled by destination image. Implications were discussed for Vietnam and other small emerging destinations.
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Design of a Novel Servo-motorized Laser Device for Visual Pathways Diseases Therapy
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Carlos Ignacio Sarmiento
2015-12-01
Full Text Available We discuss a novel servo-motorized laser device and a research protocol for visual pathways diseases therapies. The proposed servo-mechanized laser device can be used for potential rehabilitation of patients with hemianopia, quadrantanopia, scotoma, and some types of cortical damages. The device uses a semi spherical structure where the visual stimulus will be shown inside, according to a previous stimuli therapy designed by an ophthalmologist or neurologist. The device uses a pair of servomotors (with torque=1.5kg, which controls the laser stimuli position for the internal therapy and another pair for external therapy. Using electronic tools such as microcontrollers along with miscellaneous electronic materials, combined with LabVIEW based interface, a control mechanism is developed for the new device. The proposed device is well suited to run various visual stimuli therapies. We outline the major design principles including the physical dimensions, laser device’s kinematical analysis and the corresponding software development.
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Integrated model of destination competitiveness
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Armenski Tanja
2011-01-01
Full Text Available The aim of this paper is to determine the weakest point of Serbian destination competitiveness as a tourist destination in comparation with its main competitors. The paper is organized as follows. The short introduction of the previous research on the destination competitiveness is followed by description of the Integrated model of destination competitiveness (Dwyer et al, 2003 that was used as the main reference framework. Section three is devoted to the description of the previous studies on competitiveness of Serbian tourism, while section four outlines the statistical methodology employed in this study and presents and interprets the empirical results. The results showed that Serbia is more competitive in its natural, cultural and created resources than in destination management while, according to the Integrated model, Serbia is less competitive in demand conditions that refer to the image and awareness of the destination itself.
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El Haj, Mohamad; Raffard, Stéphane; Fasotti, Luciano; Allain, Philippe
2018-05-01
Destination memory, a memory component allowing the attribution of information to its appropriate receiver (e.g., to whom did I lend my pen?), is compromised in normal aging. The present paper investigated whether older adults might show better memory for older destinations than for younger destinations. This hypothesis is based on empirical research showing better memory for older faces than for younger faces in older adults. Forty-one older adults and 44 younger adults were asked to tell proverbs to older and younger destinations (i.e., coloured faces). On a later recognition test, participants had to decide whether they had previously told some proverb to an older/younger destination or not. Prior to this task, participants reported their frequency of contact with other-age groups. The results showed lower destination memory in older adults than in younger adults. Interestingly, older adults displayed better memory for older than for younger destinations. The opposite pattern was seen in younger adults. The low memory for younger destinations, as observed in older adults, was significantly correlated with limited exposure to younger individuals. These findings suggest that for older adults, the social experience can play a crucial role in the destination memory, at least as far as exposure to other-age groups is concerned.
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Wolburg, Thomas; Rapp, Walter; Rieger, Jochen; Horstmann, Thomas
2016-01-01
To test the hypotheses that less stable therapy devices require greater muscle activity and that lower leg muscles will have greater increases in muscle activity with less stable therapy devices than upper leg muscles. Cross-sectional laboratory study. Laboratory setting. Twenty-five healthy subjects. Electromyographic activity of four lower (gastrocnemius medialis, soleus, tibialis anterior, peroneus longus) and four upper leg muscles (vastus medialis and lateralis, biceps femoris, semitendinosus) during unipedal quiet barefoot stance on the dominant leg on a flat rigid surface and on five therapy devices with varying stability properties. Muscle activity during unipedal stance differed significantly between therapy devices (P < 0.001). The order from lowest to highest relative muscle activity matched the order from most to least stable therapy device. There was no significant interaction between muscle location (lower versus upper leg) and therapy device (P = 0.985). Magnitudes of additional relative muscle activity for the respective therapy devices differed substantially among lower extremity muscles. The therapy devices offer a progressive increase in training intensity, and thus may be useful for incremental training programs in physiotherapeutic practice and sports training programs. Copyright © 2015 Elsevier Ltd. All rights reserved.
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Directory of Open Access Journals (Sweden)
Ni Made - Asti Aksari
2016-03-01
Full Text Available Bali's economy has grown rapidly since a decade ago. This is possible because tourism is growing continuously. However, tourism growth is not optimal because of insufficient promotion and tourism destination identity is unclear. The growth of Web 2.0 as a platform to share travel information has prompted tourism bodies to pay closer attention to how their destinations are perceived by target markets. Set within the context of the emergence of Web 2.0, a platform designed to enable users to generate and share information on the Internet, this paper evaluates the relationship between destination identity and destination image and adopts the view that a successful destination brand relies on the congruence between destination identity and destination image. The elements of destination identity are composed from the supply side and the elements of destination image are composed from the consumer side. The objective of exploring the alignment between these two perspectives is to propose a model to encourage the alignment of these two perspectives and evaluate the effectiveness of a destination branding strategy.
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Network Analysis of Cooperation in Tourism Destinations
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Gajdošík Tomáš
2015-12-01
Full Text Available Globalisation on the tourism market causes that the competition is not formed only between stakeholders in a destination, but more and more it is created among destinations. Therefore tourism stakeholders in a destination have to act together and cooperate. The cooperative behaviour of destination stakeholders is seen as a main prerequisite of applying the cooperative destination management, which influences the competitiveness of destination on tourism market.
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A Model of Tourism Destination Competitiveness: The case of the Italian Destinations of Excellence
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Gianluca Goffi
2013-11-01
Full Text Available Tourism worldwide is becoming increasingly competitive. Competitiveness has been associated in the tourism literature as a critical element for the success of tourism destinations. Particular emphasis is placed on identifying and analyzing the various factors that influence the competitiveness of tourism destinations. The paper extends the Richie & Crouch (2000 model and develops a set of indicators that considers the different issues concerning tourism competitiveness. The indicators are focused on the various dimensions of sustainability. The paper offers insights into the model, each determinant has been extensively described. The aim of the paper is to test whether and to what extent the current set of indicators integrated into the present model can help explaining the competitiveness of a tourism destination. The model is tested on a unique dataset of 610 Italian Destinations of Excellence. Principal Component Analysis is applied on the responses to the items measuring destination competitiveness.
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Directory of Open Access Journals (Sweden)
Fabio Mozzarelli
2016-04-01
Full Text Available Ambulance crew’s choosing of appropriate destination hospital for trauma patients can affect survival and morbidity outcomes. Aim of the present study is to devise a decision-making algorithm in order to allow the best choice of destination hospital for trauma patients and to apply it on an electronic device able to facilitate the decision made by ambulance staff. The method used was analysis of literature data, context and workload with a retrospective observational study. A comparison between the destination hospitals actually chosen and those that could have been chosen with the Piacenza trauma algorithm has been applied. The data shows a 9.5% (P>0.10 more advantageous change in appropriateness in the choice of medical facility and a 1.4% increase in admissions to the Emergency Department of the provincial hospital. The creation and use of a medical protocol and its consequent installation on an electronic device (tablet that can be shared over a computer platform could help medical staff make appropriate pre-hospital choices as regards the destination hospital for trauma patients.
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Directory of Open Access Journals (Sweden)
Holešinská Andrea
2015-12-01
Full Text Available The management of a tourist destination in the form of networks is considered to be one of the possible approaches to destination governance structures. The concept of destination governance is based on the cooperation between actors from the public and private sectors. It is known that public–private relationships built on trust, joint risk taking and based on informal structures have a positive impact on the level of growth at a tourist destination. The aim of this paper is to quantify to what extent each of the determinants of the DMO success participate in the total destination performance, and thus point out the factors of a potential risk.
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Internal Brand Management of Destination Brands
DEFF Research Database (Denmark)
Cox, Natasha; Gyrd-Jones, Richard; Gardiner, Sarah
2014-01-01
Achieving a consistent brand experience across a destination and all brand-touch points is a major challenge in destination branding efforts. Strategies to manage the complexity of coordination across multiple network stakeholders are therefore critical for destination management organisations....... However, theories to inform these strategies are limited. This paper proposes that internal brand management theory provides a framework to explore strategies that may increase operator buy-in to the destination brand, thus creating a more consistent brand experience for visitors. Semi......-structured interviews with members of a destination brand network indicate that highly centralised networks hinder operator buy-in to the destination brand. Informal communication via more personalised sub-networks rather than directive leadership appear to facilitate knowledge sharing and create support mechanisms...
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Duncker, D; Veltmann, C
2018-05-09
In patients with heart failure with reduced ejection fraction (HFrEF), optimal medical treatment includes beta-blockers, ACE inhibitors/angiotensinreceptor-neprilysin inhibitors (ARNI), mineralocorticoid receptor antagonists, and ivabradine when indicated. In device therapy of HFrEF, implantable cardioverter-defibrillators and cardiac resynchronization therapy (CRT) have been established for many years. CRT is the therapy of choice (class I indication) in symptomatic patients with HFrEF and a broad QRS complex with a left bundle branch block (LBBB) morphology. However, the vast majority of heart failure patients show a narrow QRS complex or a non-LBBB morphology. These patients are not candidates for CRT and alternative electrical therapies such as baroreflex activation therapy (BAT) and cardiac contractility modulation (CCM) may be considered. BAT modulates vegetative dysregulation in heart failure. CCM improves contractility, functional capacity, and symptoms. Although a broad data set is available for BAT and CCM, mortality data are still lacking for both methods. This article provides an overview of the device-based therapeutic options for patients with HFrEF.
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Dynamics of device innovation: implications for assessing value.
Gelijns, Annetine C; Russo, Mark J; Hong, Kimberly N; Brown, Lawrence D; Ascheim, Deborah D; Moskowitz, Alan J
2013-10-01
In recent years, there has been growing interest in evaluating the health and economic impact of medical devices. Payers increasingly rely on cost-effectiveness analyses in making their coverage decisions, and are adopting value-based purchasing initiatives. These analytic approaches, however, have been shaped heavily by their use in the pharmaceutical realm, and are ill-adapted to the medical device context. This study focuses on the development and evaluation of left ventricular assist devices (LVADs) to highlight the unique challenges involved in the design and conduct of device trials compared with pharmaceuticals. Devices are moving targets characterized by a much higher degree of post-introduction innovation and "learning by using" than pharmaceuticals. The cost effectiveness ratio of left ventricular assist devices for destination therapy, for example, decreased from around $600,000 per life year saved based on results from the pivotal trial to around $100,000 within a relatively short time period. These dynamics pose fundamental challenges to the evaluation enterprise as well as the policy-making world, which this paper addresses.
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Directory of Open Access Journals (Sweden)
Korićanin Maja
2008-01-01
Full Text Available In taking an advantages in tourism seems that image of specific tourist destination play an important role. This is very complex process but also a target for a wide list of potential stakeholders - not only organizations in this industry. Paper discuss a few relevant issues in connection to importance as well as development process of creating an image of tourist destination including well known Anhold model.
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Home Healthcare Medical Devices: Infusion Therapy - Getting the Most Out of Your Pump
... Medical Procedures Home Health and Consumer Devices Brochure - Home Healthcare Medical Devices: Infusion Therapy - Getting the Most ... if needed. What is the role of your home healthcare provider and supplier in your infusion therapy? ...
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Promoting tourism destination image
R. Govers (Robert); F.M. Go (Frank); K. Kumar (Kuldeep)
2007-01-01
textabstractThis article examines the role of tourism promotion as a component of destination image formation. It reports the findings of a study in which 1,100 respondents from around the globe described their previsit perceived image of seven sample destinations, as well as the information sources
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Directory of Open Access Journals (Sweden)
Heike BÄHRE
2013-12-01
Full Text Available Bucovina is a cultural landscape in the triangle bordered between the Ukraine, Romania and Moldova. Based on a theoretical planning approach in destination marketing management, Bucovina is to be regarded as a destination situated at the end of the involvement stage of the Tourism Area Life Cycle (TALC. Literature, internet research, qualitative interviews, and on site-observations depict Bucovina as a travel destination. The authors explore the impact of the financial crisis on Bucovina and forecast the destination trend for the next few years. Finally, they give recommendations for development of the Bucovina region in a sustainable, rapid and regulated manner.
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Destination brand experience and visitor behavior
DEFF Research Database (Denmark)
Mattsson, Jan; Sørensen, Flemming; Barnes, Stuart
2014-01-01
Destination branding has developed considerably as a topic area in the last decade with numerous conceptualizations focusing on different aspects of the brand. However, a unified view has not yet emerged. This paper examines destination branding via a new conceptualization, destination brand expe...
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Statistical analysis of tourism destination competitiveness
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Attilio Gardini
2013-05-01
Full Text Available The growing relevance of tourism industry for modern advanced economies has increased the interest among researchers and policy makers in the statistical analysis of destination competitiveness. In this paper we outline a new model of destination competitiveness based on sound theoretical grounds and we develop a statistical test of the model on sample data based on Italian tourist destination decisions and choices. Our model focuses on the tourism decision process which starts from the demand schedule for holidays and ends with the choice of a specific holiday destination. The demand schedule is a function of individual preferences and of destination positioning, while the final decision is a function of the initial demand schedule and the information concerning services for accommodation and recreation in the selected destinations. Moreover, we extend previous studies that focused on image or attributes (such as climate and scenery by paying more attention to the services for accommodation and recreation in the holiday destinations. We test the proposed model using empirical data collected from a sample of 1.200 Italian tourists interviewed in 2007 (October - December. Data analysis shows that the selection probability for the destination included in the consideration set is not proportional to the share of inclusion because the share of inclusion is determined by the brand image, while the selection of the effective holiday destination is influenced by the real supply conditions. The analysis of Italian tourists preferences underline the existence of a latent demand for foreign holidays which points out a risk of market share reduction for Italian tourism system in the global market. We also find a snow ball effect which helps the most popular destinations, mainly in the northern Italian regions.
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Destination memory in traumatic brain injuries.
Wili Wilu, Amina; Coello, Yann; El Haj, Mohamad
2018-06-01
Destination memory, which is socially driven, refers to the ability to remember to whom one has sent information. Our study investigated destination memory in patients with traumatic brain injuries (TBIs). Patients and control participants were invited to tell proverbs (e.g., "the pen is mightier than the sword") to pictures of celebrities (e.g., Barack Obama). Then they were asked to indicate to which celebrity they had previously told the proverbs. Besides the assessment of destination memory, participants performed a binding task in which they were required to associate letters with their corresponding location. Analysis demonstrated less destination memory and binding in patients with TBIs than in controls. In both populations, significant correlations were observed between destination memory and performances on the binding task. These findings demonstrate difficulty in the ability to attribute information to its appropriate destination in TBI patients, perhaps owing to difficulties in binding separate information together to form a coherent representation of an event in memory.
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TOURIST DESTINATION MARKETING RADAUTI
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Liliana HÎNCU
2016-12-01
Full Text Available Tourism is a dynamic phenomenon, which is in continuous change. The tourism market is in constant transformation due to competition and growing. Tourist destinations, is facing many challenges in order to enter and remain on the market. Thus tourist destination is a well-defined service which is an assembly designed to meet tourists. The marketing mix includes the following elements: product, price, distribution, promotion. Tourists come to this area because of monasteries, some of which are included in UNESCO and are recognized nationally and internationally. Thus Romanian tourists choose this tourist destination just for a weekend. To prolong the stay of both foreigners and Romanians, as well as to attract a large number of tourists is necessary to develop tourism products type tours: 5-6 days for visiting the tourist area of Radauti. These products must contain an offer as varied and diverse, so every day contain different activities and be adjusted, for example by age segments. Linked pricing policy usually access tariffs are differentiated between Romanian and foreign tourists, being lower in the first category. Travel agencies prefer to organize package tours on request only devise some that distribute them internally and externally. There are initiatives to promote tourism area Radauti, due to the high attractiveness among destinations in Romania. Thus, this must be considered a tourist destination tourism brand renowned nationally and internationally.
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[Device-aided therapies in advanced Parkinson's disease].
Timofeeva, A A
Advanced stages of Parkinson's disease (PD) is a consequence of the severe neurodegenerative process and are characterized by the development of motor fluctuations and dyskinesia, aggravation of non-motor symptoms. Treatment with peroral and transdermal drugs can't provide an adequate control of PD symptoms and quality-of-life of the patients at this stage of disease. Currently, three device-aided therapies: deep brain stimulation (DBS), intrajejunal infusion of duodopa, subcutaneous infusion of apomorphine can be used in treatment of patients with advanced stages of PD. Timely administration of device-aided therapies and right choice of the method determine, to a large extent, the efficacy and safety of their use. Despite the high efficacy of all three methods with respect to the fluctuation of separate symptoms, each method has its own peculiarities. The authors reviewed the data on the expediency of using each method according to the severity of motor and non-motor symptoms, patient's age, PD duration, concomitant pathology and social support of the patients.
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Destination bonding: Hybrid cognition using Instagram
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Arup Kumar Baksi
2015-01-01
Full Text Available Empirical research has identified the phenomenon of destination bonding as a result of summated physical and emotional values associated with the destination. Physical values, namely natural landscape & other physical settings and emotional values, namely the enculturation processes, have a significant role to play in portraying visitors’ cognitive framework for destination preference. The physical values seemed to be the stimulator for bonding that embodies action or behavior tendencies in imagery. The emotional values were the conditions that lead to affective bonding and are reflected in attitudes for a place which were evident in text narratives. Social networking on virtual platforms offers the scope for hybrid cognitive expression using imagery and text to the visitors. Instagram has emerged as an application-window to capture these hybrid cognitions of visitors. This study focuses on assessing the relationship between hybrid cognition of visitors expressed via Instagram and their bond with the destination. Further to this, the study attempts to examine the impact of hybrid cognition of visitors on the behavioral pattern of prospective visitors to the destination. The study revealed that sharing of visual imageries and related text by the visitors is an expression of the physico-emotional bonding with the destination. It was further established that hybrid cognition strongly asserts destination bonding and has been also found to have moderating impact on the link between destination bonding and electronic-word-of-mouth.
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Devices and Endoscopic Bariatric Therapies for Obesity.
Saunders, Katherine H; Igel, Leon I; Saumoy, Monica; Sharaiha, Reem Z; Aronne, Louis J
2018-04-17
In this review, we describe the FDA-approved and investigational devices and endoscopic bariatric therapies for the treatment of obesity. We focus on literature published in the past few years and present mechanisms of action as well as efficacy and safety data. Devices and endoscopic procedures are emerging options to fill the significant treatment gap in the management of obesity. Not only are these devices and procedures minimally invasive and reversible, but they are potentially more effective than antiobesity medications, often safer for poor surgical candidates and possibly less expensive than bariatric surgery. As many patients require a variety of management strategies (medications, devices, procedures, and/or surgery) in addition to lifestyle modifications to achieve clinically significant weight loss, the future of obesity treatment involves a multidisciplinary approach. Combinations of advanced treatment strategies can lead to additive or synergistic weight loss. This is an area that requires further investigation.
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Destination and source memory in Huntington's disease.
El Haj, Mohamad; Caillaud, Marie; Verny, Christophe; Fasotti, Luciano; Allain, Philippe
2016-03-01
Destination memory refers to the recall of the destination of previously relayed information, and source memory refers to the recollection of the origin of received information. We compared both memory systems in Huntington's disease (HD) participants. For this, HD participants and healthy adults had to put 12 items in a black or a white box (destination task), and to extract another 12 items from a blue or a red box (source task). Afterwards, they had to decide in which box each item had previously been deposited (destination memory), and from which box each item had previously been extracted (source memory). HD participants showed poorer source as well as destination recall performance than healthy adults in the proposed tasks. Correlation analysis showed that destination recall was significantly correlated with episodic recall in HD participants. Destination memory impairment in HD participants seems to be considerably influenced by their episodic memory performance. © 2014 The British Psychological Society.
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Revisiting tourist behavior via destination brand worldness
Directory of Open Access Journals (Sweden)
Murat Kayak
2016-11-01
Full Text Available Taking tourists’ perspective rather than destination offerings as its core concept, this study introduces “perceived destination brand worldness” as a variable. Perceived destination brand worldness is defined as the positive perception that a tourist has of a country that is visited by tourists from all over the world. Then, the relationship between perceived destination brand worldness and intention to revisit is analyzed using partial least squares regression. This empirical study selects Taiwanese tourists as its sample, and the results show that perceived destination brand worldness is a direct predictor of intention to revisit. In light of these empirical findings and observations, practical and theoretical implications are discussed.
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Assistive acting movement therapy devices with pneumatic rotary-type soft actuators.
Wilkening, André; Baiden, David; Ivlev, Oleg
2012-12-01
Inherent compliance and assistive behavior are assumed to be essential properties for safe human-robot interaction. Rehabilitation robots demand the highest standards in this respect because the machine interacts directly with weak persons who are often sensitive to pain. Using novel soft fluidic actuators with rotary elastic chambers (REC actuators), compact, lightweight, and cost-effective therapeutic devices can be developed. This article describes modular design and control strategies for new assistive acting robotic devices for upper and lower extremities. Due to the inherent compliance and natural back-drivability of pneumatic REC actuators, these movement therapy devices provide gentle treatment, whereby the interaction forces between humans and the therapy device are estimated without the use of expensive force/torque sensors. An active model-based gravity compensation based on separated models of the robot and of the individual patient's extremity provides the basis for effective assistive control. The utilization of pneumatic actuators demands a special safety concept, which is merged with control algorithms to provide a sufficient level of safeness and to catch any possible system errors and/or emergency situations. A self-explanatory user interface allows for easy, intuitive handling. Prototypes are very comfortable for use due to several control routines that work in the background. Assistive devices have been tested extensively with several healthy persons; the knee/hip movement therapy device is now under clinical trials at the Clinic for Orthopaedics and Trauma Surgery at the Klinikum Stuttgart.
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Carotid Doppler ultrasound findings in patients with left ventricular assist devices.
Cervini, Patrick; Park, Soon J; Shah, Dipesh K; Penev, Irina E; Lewis, Bradley D
2010-12-01
Left ventricular assist devices (LVADs) have been used to treat advanced heart failure refractory to medical management, as bridge therapy to myocardial recovery, as bridge therapy to cardiac transplantation, or as destination therapy for patients with unfavorable transplant candidacy. Neurologic complications are some of the most common and devastating complications in these patients. Preoperative carotid ultrasound is, therefore, a standard evaluation in patients at risk for cerebrovascular disease. Postoperative carotid artery Doppler sonography is performed in those patients with neurologic symptoms. It is likely, therefore, that sonographers, radiologists, and other physicians working in a center where LVADs are implanted will likely encounter a carotid artery Doppler study in this patient group. To our knowledge, the carotid Doppler findings in these patients have never been published. We review the Doppler ultrasound findings in 6 patients after LVAD insertion.
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Destination Memory in Mild Alzheimer’s Disease
El Haj, Mohamad; Postal, Virginie; Le Gall, Didier; Allain, Philippe
2013-01-01
In order to assess their destination memory, sixteen patients with probable mild Alzheimer Disease (AD), sixteen older adults and 16 young adults were asked to tell facts to pictures. On a subsequent task, they were asked to remember whether they had previously told that fact to that face or not. AD patients showed poorer destination recall than the older adults, and the older adults showed poorer destination recall than the young adults. Our results suggest that destination memory is highly ...
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Endocarditis in left ventricular assist device
Thyagarajan, Braghadheeswar; Kumar, Monisha Priyadarshini; Sikachi, Rutuja R; Agrawal, Abhinav
2016-01-01
Summary Heart failure is one of the leading causes of death in developed nations. End stage heart failure often requires cardiac transplantation for survival. The left ventricular assist device (LVAD) has been one of the biggest evolvements in heart failure management often serving as bridge to transplant or destination therapy in advanced heart failure. Like any other medical device, LVAD is associated with complications with infections being reported in many patients. Endocarditis developing secondary to the placement of LVAD is not a frequent, serious and difficult to treat condition with high morbidity and mortality. Currently, there are few retrospective studies and case reports reporting the same. In our review, we found the most common cause of endocarditis in LVAD was due to bacteria. Both bacterial and fungal endocarditis were associated with high morbidity and mortality. In this review we will be discussing the risk factors, organisms involved, diagnostic tests, management strategies, complications, and outcomes in patients who developed endocarditis secondary to LVAD placement. PMID:27672540
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Design and control of RUPERT: a device for robotic upper extremity repetitive therapy.
Sugar, Thomas G; He, Jiping; Koeneman, Edward J; Koeneman, James B; Herman, Richard; Huang, H; Schultz, Robert S; Herring, D E; Wanberg, J; Balasubramanian, Sivakumar; Swenson, Pete; Ward, Jeffrey A
2007-09-01
The structural design, control system, and integrated biofeedback for a wearable exoskeletal robot for upper extremity stroke rehabilitation are presented. Assisted with clinical evaluation, designers, engineers, and scientists have built a device for robotic assisted upper extremity repetitive therapy (RUPERT). Intense, repetitive physical rehabilitation has been shown to be beneficial overcoming upper extremity deficits, but the therapy is labor intensive and expensive and difficult to evaluate quantitatively and objectively. The RUPERT is developed to provide a low cost, safe and easy-to-use, robotic-device to assist the patient and therapist to achieve more systematic therapy at home or in the clinic. The RUPERT has four actuated degrees-of-freedom driven by compliant and safe pneumatic muscles (PMs) on the shoulder, elbow, and wrist. They are programmed to actuate the device to extend the arm and move the arm in 3-D space. It is very important to note that gravity is not compensated and the daily tasks are practiced in a natural setting. Because the device is wearable and lightweight to increase portability, it can be worn standing or sitting providing therapy tasks that better mimic activities of daily living. The sensors feed back position and force information for quantitative evaluation of task performance. The device can also provide real-time, objective assessment of functional improvement. We have tested the device on stroke survivors performing two critical activities of daily living (ADL): reaching out and self feeding. The future improvement of the device involves increased degrees-of-freedom and interactive control to adapt to a user's physical conditions.
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Destination image: Origins, Developments and Implications
Directory of Open Access Journals (Sweden)
Sérgio Dominique Ferreira Lopes
2011-04-01
Full Text Available Over the last few decades, tourism has become one of the main sectors of the global economy, not only because of its contribution to the Gross Domestic Product (GDP of different countries, but also because of the employment it generates. Since 2009, however, the results of tourism have been severely affected by the economic and financial crisis and it is now essential to analyze the key elements of tourist consumer behavior. In this context, the image that a destination transmits to the market becomes one of the elements which influence tourists the most when choosing a tourist destination. The authors therefore aim to identify the main elements that characterize the image of a tourist destination, as well as their implications for the management of tourist destinations.
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FACTORS INFLUENCING BRAND EQUITY OF BALI AS A TOURISM DESTINATION
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I Ketut Surya Diarta
2016-03-01
Full Text Available Globally, competition among tourism destinations is more stringent in getting foreign tourists, including Bali. One effort to win the competition is increasing destination brand equity through maintaining its influencing factors and gaining tourist positive behavior toward destination. This effort, in long run, will increase and stabilize destination revenue and sustainability. This research aims to analyze factors influencing brand equity of Bali as a tourism destination. This research was conducted in Bali’s five major tourism objects. The 240 foreign tourists were chosen as respondents through convenience sampling technique. Data were analyzed using factor analysis. The results showed that factors that significantly influenced Bali brand equity were: symbolic and experiential benefit factor, direct and indirect destinations attributes, destination reliability and tangibility, assurance and empathy, brand destinations recognition and recall, destinations common psychological attributes, destination common functional attributes, unique functional attributes, behavioral loyalty, destination awareness, and attitudinal loyalty. Given the fluctuative nature of brand equity, Bali needs a consistent effort to maintain or to enhance brand equity of Bali as a tourism destination. Maintaining the dominant factors that influence the strength of brand equity can be used as a basis to develop destination branding strategy to expand market segment, choose the right target market, and anchoring destination position in world market competition.
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Role of specific geographic landscapes in city break destinations
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Štetić Snežana
2009-01-01
Full Text Available Urban tourist destinations or City Break destinations are representing one of main destination products on tourist market. City Break destinations are big cities, administrative, economic and political centers of states and regions. These cities are 'open' 24 hours per day, seven days in week. Inside these tourist destination we can find different range of products (culture, entertainment, recreation, leisure, history, modern infrastructure. In these destinations season is not present and it lasts trough out the year. Promotional campaigns in City Break destinations are truing to create distinguished images in tourists mind as also as on investors, consumers and future residents. They emphasize advantages that those cities are delivering to their consumers, but often we forget that all these cities are having specific geographic landscapes. In the era of limiting of mass tourism to preserve resources for future generations and emphasizing the importance of sustainable development for tourism perspectives, the importance of specific geographic landscapes inside urban destinations for their further development as tourist destinations an their overall development is slightly neglected.
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El Haj, M.; Raffard, S.; Fasotti, L.; Allain, P.
2018-01-01
Destination memory, a memory component allowing the attribution of information to its appropriate receiver (e.g., to whom did I lend my pen?), is compromised in normal aging. The present paper investigated whether older adults might show better memory for older destinations than for younger
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Nepal as a destination for Finnish travelers - Service Design
Rayamajhi, Subash; Nepali, Manoj
2016-01-01
Destination marketing is an important tool to attract travellers to the destination in this fast growing economic sector of tourism industry. The main factor which should be considered during destination marketing is customer environment where the customer experience, product and prices act as the value cluster for the traveller. The second factor includes competitor environment where destination should keep itself most popular among its competitor destinations to attract a significant share ...
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Review of Literature of the Rural Heritage Tourism Destination
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Kadi Alaa J.
2014-01-01
Full Text Available Rural heritage tourism destination management is an essential knowledge area that should be investigated to achieve sustainable destination, especially for an emerging destination. The goal of this process is to ensure that these elements are thoroughly inspected and rigidly organized due to the main concepts, theories, methods and approaches mentioning different perspectives to tackle these certain elements. In order to cope with the complexity of the relation between the destination elements and its characteristics and sequence of the maturity of the selected destination, all that needs in-depth knowledge to assist the researchers in developing and improving different types of approaches and tools, and in structuring and assessing the destination. We develop a neat backbone literature review concerning the all aspects of the sustainable rural heritage tourism destination. We review the existing methods, approaches and theories applied on the relative field, and further study the relevant challenges that have been the target of investigation in the academic literature. The paper is intended to be the newest and the most important existing study on the topic of rural heritage emerging tourism destination. The results are particularly relevant to practitioners seeking a better grasp on managing tourism destination as well as achieving sustainability in tourism destinations. As a major finding of the review, the results strongly suggest the need for more practitioner-oriented and industry-driven empirical studies in the area of flexible managerial framework to cope with special and dynamic characteristics of different tourism destinations.
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Validation of a Mobile Device for Acoustic Coordinated Reset Neuromodulation Tinnitus Therapy.
Hauptmann, Christian; Wegener, Alexander; Poppe, Hendrik; Williams, Mark; Popelka, Gerald; Tass, Peter A
2016-10-01
Sound-based tinnitus intervention stimuli include broad-band noise signals with subjectively adjusted bandwidths used as maskers delivered by commercial devices or hearing aids, environmental sounds broadly described and delivered by both consumer devices and hearing aids, music recordings specifically modified and delivered in a variety of different ways, and other stimuli. Acoustic coordinated reset neuromodulation therapy for tinnitus reduction has unique and more stringent requirements compared to all other sound-based tinnitus interventions. These include precise characterization of tinnitus pitch and loudness, and effective provision of patient-controlled daily therapy signals at defined frequencies, levels, and durations outside of the clinic. The purpose of this study was to evaluate an approach to accommodate these requirements including evaluation of a mobile device, validation of an automated tinnitus pitch-matching algorithm and assessment of a patient's ability to control stimuli and collect repeated outcome measures. The experimental design involved direct laboratory measurements of the sound delivery capabilities of a mobile device, comparison of an automated, adaptive pitch-matching method to a traditional manual method and measures of a patient's ability to understand and manipulate a mobile device graphic user interface to both deliver the therapy signals and collect the outcome measures. This study consisted of 5 samples of a common mobile device for the laboratory measures and a total of 30 adult participants: 15 randomly selected normal-hearing participants with simulated tinnitus for validation of a tinnitus pitch-matching algorithm and 15 sequentially selected patients already undergoing tinnitus therapy for evaluation of patient usability. No tinnitus intervention(s) were specifically studied as a component of this study. Data collection involved laboratory measures of mobile devices, comparison of manual and automated adaptive tinnitus
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Rosier, Arnaud; Mabo, Philippe; Chauvin, Michel; Burgun, Anita
2015-05-01
The patient population benefitting from cardiac implantable electronic devices (CIEDs) is increasing. This study introduces a device annotation method that supports the consistent description of the functional attributes of cardiac devices and evaluates how this method can detect device changes from a CIED registry. We designed the Cardiac Device Ontology, an ontology of CIEDs and device functions. We annotated 146 cardiac devices with this ontology and used it to detect therapy changes with respect to atrioventricular pacing, cardiac resynchronization therapy, and defibrillation capability in a French national registry of patients with implants (STIDEFIX). We then analyzed a set of 6905 device replacements from the STIDEFIX registry. Ontology-based identification of therapy changes (upgraded, downgraded, or similar) was accurate (6905 cases) and performed better than straightforward analysis of the registry codes (F-measure 1.00 versus 0.75 to 0.97). This study demonstrates the feasibility and effectiveness of ontology-based functional annotation of devices in the cardiac domain. Such annotation allowed a better description and in-depth analysis of STIDEFIX. This method was useful for the automatic detection of therapy changes and may be reused for analyzing data from other device registries.
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Destination Memory for Emotional Information in Older Adults
El Haj, M.; Fasotti, L.; Allain, P.
2015-01-01
Background/Study Context: Destination memory, remembering the destination of the information that one tells, shows significant age-related decline. In the present paper, the authors sought to determine whether destination memory can be improved in older adults using emotional stimuli. This aim was
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The influence of social media in destination choice
Tham, Min-En Aaron
2017-01-01
The aim of this research is to investigate the influence of social media in destination choice. The evolution of social media within tourism has provided further impetus towards destination information search and image formation. To this end, existing studies have presented the influence of social media at destination micro-levels, such as accommodation and restaurants. At a macro-level, some studies have investigated the influence of social media on a destination. However, current scope is l...
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A Dual Process Approach to Understand Tourists’ Destination Choice Processes
DEFF Research Database (Denmark)
Kock, Florian; Josiassen, Alexander; Assaf, Albert
2017-01-01
Most studies that investigate tourists' choices of destinations apply the concept of mental destination representations, also referred to as destination image. The present study investigates tourists’ destination choice processes by conceptualizing how different components of destination image...... are mentally processed in tourists' minds. Specifically, the seminal dual processing approach is applied to the destination image literature. By doing this, we argue that some components of mental destination representations are processed systematically while others serve as inputs for heuristics...... that individuals apply to inform their decision making. Understanding how individuals make use of their mental destination representations and how they color their decision-making is essential in order to better explain tourist behavior....
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MARKETING TRENDS AND STRATEGIC MANAGEMENT IN DESTINATION DEVELOPMENT
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Svetlana Mihić
2009-11-01
Full Text Available This paper examines the concept of the destination in strategic tourism develop- ment. It will then look at international best practice and how the SVP/ Hudson Model can be used as a tool to shape the planning, management and marketing of tourism destinations. This analysis will include a review of the critical success factors from lea- ding destinations and in particular, the role of and need for innovation. The concept ofinnovation in tourism will be examined and examples of how innovation has been used in a range of European destinations will be considered in detail. This will include evi- dence from key stakeholders, as well as analysis of the PR and media interest generated by an innovative approach to tourism destination development. The paper will examine key issues such as branding and positioning, along with the importance of clear strate- gic planning, having an effective destination management organisation and delivering benefits to the host community. In an increasingly competitive marketplace the need for destinations to ‘’stand out in a crowd” is essential. International benchmarking is vital to understand how well you are doing compa- red with your competitors whilst innovation ensures that the competitive edge is always maintained. The paper will include detailed case studies, consideration of the concepts of in- novation and benchmarking and focus on the main lessons for destinations in emerging tourism economies
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Destination competitivenes: A challenging process for Serbia
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Tanja Armenski
2011-05-01
Full Text Available The degree to which a country can benefit from its tourism industry depends largely on this competitive position on the international tourist market. Therefore, it is very important for one destination to realise its real competitive position on the tourism market as well as to address its weaknesses comparing them to its major competitors. There are different models for measuring the competitiveness. Among all, we follow the framework of authors Dwyer, Livaic and Mellor (2003, so called Integrated model of destination competitiveness. The aim of this paper is to present the model of destination competitiveness and results of the survey, based on indicators associated with the model. The results showed that Serbia is more competitive in its natural, cultural and created resources than in destination management while, according to the Integrated model, Serbia is less competitive in demand conditions, which refer to the image and awareness of the destination itself.
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Cross-border shopping and tourism destination marketing
DEFF Research Database (Denmark)
Makkonen, Teemu
2016-01-01
This article addresses the economic impact that cross-border shopping has on the local tourism industry and the ways that cross-border shopping is taken advantage of in tourism destination marketing. Southern Jutland–situated in Denmark just north of the German border, where border shops situated......-border shopping into tourism destination marketing strategies. The results have wider relevance for other border regions.......This article addresses the economic impact that cross-border shopping has on the local tourism industry and the ways that cross-border shopping is taken advantage of in tourism destination marketing. Southern Jutland–situated in Denmark just north of the German border, where border shops situated...... just south of the same border enable Danes to capitalize on the lower value added tax levels in Germany–is utilized as an illustrative case example. The data was collected by analysing the relevant tourism destination marketing material and via interviews with local destination marketing organizations...
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Destination Competitiveness: a Framework for Future Research
Gruescu, Ramona; Nanu, Roxana; Pirvu, Gheorghe
2009-01-01
We identify the competitive advantage of a tourist destination from a double perspective: the critical contribution of the employees and the ICT impact on promoting and selling the destination. Research methodology includes "bottom to top" analysis of the mentioned indicators. Thus, results include the eficientisation of tourist businesses and destinations due to both human element development and ICT. Two essential basis of the competitive advantage are isolated: differentiation and cost adv...
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Destination Competitiviness: A Framework for Future Research
Gruescu, Ramona; Nanu, Roxana; Pirvu, Gheorghe
2009-01-01
The paper envisages aspects concerning identification of the competitive advantage of a tourist destination from a double perspective: the critical contribution of the employees and the ICT impact on promoting and selling the destination. Research methodology includes ‘bottom to top’ analysis of the mentioned indicators. Thus, results include the eficientisation of tourist businesses and destinations due to both human element development and ICT technologies. Two essential basis of the compet...
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Cultural Centre, Destination Cultural Offer and Visitor Satisfaction
Directory of Open Access Journals (Sweden)
Benxiang Zeng
2017-10-01
Full Text Available This paper aims to establish the link between tourists’ perceptions on cultural offers and their overall satisfaction, and explore the implication of this link for sustainable tourist destination management. Assessing online customers’ reviews, this study identifies a positive correlation between visitors’ perspectives and experiences at the on-site cultural centre and visitors’ destination satisfaction. It suggests that the on-site cultural centre plays a critical role in building up visitors’ perception on cultural attributes of the destination, and its impact on visitor satisfaction is a double-edged sword. Visitors’ positive perspectives on the cultural centre enhance visitors’ experiences and contribute to their destination satisfaction; however, not only does a negative perspective on their cultural and spiritual experience compromise visitors’ satisfaction, but also subsequent negative online reviews damage the destination image and discourage visitor return/visit. The findings help destination management organisations to better understand visitors’ preference for cultural centres and therefore to improve visitors’ cultural experience. This paper appeals for further study of on-site cultural centres’ role in forming destination cultural attributes, and of social media’s potential in enriching cultural experience.
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Directory of Open Access Journals (Sweden)
I Gusti Bagus Rai Utama
2016-03-01
Full Text Available The strength of the senior traveler segment is the high purchasing power the length of stay in a destination, making this market segment increasingly important in present and future. Consequently, this research aims to establish a model of motivation and its relationship with the image of Bali as an international tourism destination, especially from the perspective of senior tourists. This research employed survey method and utilized a combination of quantitative and qualitative analytical techniques. Factor analysis condensed various indicators into several key indicators to form a model with goodness of fit. Indicators representing push motivation variable include the improvement of health/fitness and the drive to perform physical exercise. Indicators representing destination identity variable include the culture and nature of Bali. Indicators representing destination creation variable include the service quality of travel agencies and service quality of travel guides. Indicators representing destination image variable include the image of cultural uniqueness and holiday atmosphere of Bali. The survey in this study involved 400 respondents of senior tourists, exclusively only foreign nationals. Goodness of fit is affirmed on the results of the analysis model, which answered the hypothesis that push motivation and destination creation affect destination images.
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eWOM, Revisit Intention, Destination Trust and Gender
Abubakar, Abubakar Mohammed; Ilkan, Mustafa; Al-Tal, Raad Meshall; Eluwole, Kayode
2017-01-01
This article investigates the impact of eWOM on intention to revisit and destination trust, and the moderating role of gender in medical tourism industry. Result from structural equation modeling (n=240) suggests the following: (1) that eWOM influences intention to revisit and destination trust; (2) that destination trust influences intention to revisit; (3) that the impact of eWOM on intention to revisit is about 1.3 times higher in men; (4) that the impact of eWOM on destination trust is ab...
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Destination Strategy Marketing Analysis for Seaside Tourism
Institute of Scientific and Technical Information of China (English)
HUO Jiaying
2009-01-01
Seaside tourism has become one of the popular tourism destinations to the tourists. It is necessary for manager to study the strategy marketing of seaside tourism destination to promote the seaside tourism. This paper examines the characteristics of seaside tourism and uses the SWOT to analyze the strengths, weakness, opportunities and treats of seaside tourism. Then, the challenges of seaside tourism destination are introduced and should be noticed by the marketing managers.
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Tourist destination choice: A bibliometric study
Directory of Open Access Journals (Sweden)
Claudio Sunao Saito
2018-01-01
Full Text Available This bibliometric study aims to understand the main subjects, approaches, and theoretical references related to travel destination choice. The Scopus database, statistical software, and citation analysis defined the relevance and prestige of the articles, authors, models, and theoretical foundations, based on the number of citations in later articles. The results demonstrate that there are a diversity of perspectives and approaches related to the topic and the articles can be grouped into studies related to decision models or destination choice, motivating factors for tourism, personal characteristics or factors, destination characteristics and attractiveness, scope of the intended trip (holiday, size, distance, duration of the trip, etc., travel experiences (humor, feelings during the trip, post-purchase evaluations, etc., influence of the destination’s image, and influence of information/communication on the travel destination choice. The results also indicate a difference regarding the origin of the articles (countries/institution, authors, and theoretical references used in research related to the topic.
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Management of sustainable tourism destination through stakeholder cooperation
Directory of Open Access Journals (Sweden)
Božena Krce Miočić
2016-12-01
Full Text Available Destination presents a set of different organizations and individuals who can work towards realising the same objectives or their objectives can be diametrically opposed. Harmonisation of such objectives in a unique strategic development of the entire destination is usually taken over by destination management organization (DMO established to accomplish the mentioned objective. The opposed interests in such a system as complex as tourism result in the degradation of space and society in which tourism takes place. Therefore sustainable development in tourism represents a primary concept of development today. Tourism is a fast growing phenomenon and its sustainable development represents a necessity. Besides the positive economic outputs of tourism, we should also mention its negative impact on the particular destination, the environmental degradation to some extent, as well as socio-economic elements of local community. Accordingly, multi-stakeholder concept in destination management should include all interest and influential groups in tourism development planning. Such integrated destination management connects all stakeholders independent from influence or interest powers to participate directly or indirectly in creating and implementing the quality tourism development. This concept’s basic function is connecting and coordinating stakeholders with different interests within a tourism destination, in order to create quality product and a recognizable destination image, and to achieve a long-term sustainable competitiveness on the market. However, based on the stakeholder approach, the most emphasized issue in sustainable tourism development concept is the government that holds a key role in socio-economic development. In this paper, we analysed current involvement of stakeholders in Zadar County tourism development and examined their interest in future involvement in sustainable destination development. Based on the analysis of focus group
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DESTINATION BRANDING THROUGH BUSINESS TOURISM
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Doriana, MORAR
2014-11-01
Full Text Available Considering the fat that a rate of up to 70% of tourists visiting Romania have a professional motivation, the present papers intends to provide an overview of the advantages held by Romania for offering tourists the proper conditions for spending quality time in this emerging country. Within the present article, the authors provide to readers an overview regarding destination branding, business travel and the critical elements in achieving economic advantages over competing regions/countries; the article emphasizes the fact that -intelligently exploited-, business tourism can be an element of prosperity within the tumultuous period of time through which Romania and other emerging states are crossing nowadays. The results of this paper work are focused on the identifying, analysing and correlating the main factors that can influence a destination' development through its propulsion as a brand destination for business tourism. Generally speaking, the paper approaches aspects regarding business tourism. The methodology used in order to write the present article is limited to the collection and processing empirical data and information. In this regard, the literature in the field has been reviewed, so that the authors could identify and expose the importance of destination branding through business travel for sustainable development in Romania.
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Source and destination memory: two sides of the same coin?
Lindner, Isabel; Drouin, Héloïse; Tanguay, Annick F N; Stamenova, Vessela; Davidson, Patrick S R
2015-01-01
Whereas source memory involves remembering from whom you have heard something, destination memory involves remembering to whom you have told something. Despite its practical relevance, destination memory has been studied little. Recently, two reports suggested that generally destination memory should be poorer than source memory, and that it should be particularly difficult for older people. We tested these predictions by having young and older participants read sentences to two examiners (destination encoding) and listen to sentences read by two examiners (source encoding), under intentional (Experiment 1) or incidental encoding (Experiments 2 and 3). Only in Experiment 3 (in which cognitive demands during destination encoding were increased) was destination memory significantly poorer than source memory. In none of the experiments were older adults inferior to the young on destination or source memory. Destination- and source-memory scores were significantly correlated. Item memory was consistently superior for sentences that had been read out loud (during destination encoding) versus those that had been heard (during source encoding). Destination memory needs not always be poorer than source memory, appears not to be particularly impaired by normal ageing and may depend on similar processes to those supporting source memory.
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The impact of e-WOM on destination image, attitude toward destination and travel intention
RAMDAN MUHAMAD RIZKY; RAHARDJO KUSDI; ABDILLAH YUSRI
2017-01-01
Electronic word of mouth (e-WOM) is a new development of word of mouth by using social media platform to interact in the internet. Current studies only examine the model on its own basis by using theory planned behavior (TPB). Based on this idea, this research is trying to examine the model of e-WOM, Destination Image, Attitude Toward Destination together to reveal which factor that give the greater effects against travel intention both direct effect, indirect effects and total effects. The s...
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Portfolio analysis of a destination's tourism "product line"
Harold Daniel
2007-01-01
If we think of a tourist destination as a platform from which a variety of tourist experiences can be delivered, we could conceptualize these experiences as the "product line" offered by or associated with the tourist destination. That conceptualization enables the manager of the destination to employ the logic and discipline associated with product line...
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Evaluating Tourist Destination Performance: Expanding the Sustainability Concept
Directory of Open Access Journals (Sweden)
Wenbin Luo
2018-02-01
Full Text Available Performance evaluations are a critical tool in promoting the sustainability of tourist destinations. The literature shows a lack of consensus on basic terminology and definitions of destination performance. While research focuses on business efficiency, areas such as development effectiveness, social equality, and environmental integrity are still not well understood, even though these are salient elements of sustainable development. This paper provides a framework for evaluating destination performance under the 4E rubric of economy, efficiency, effectiveness, and environmental quality, which reflects a more holistic and effective destination performance. The information entropy weight method and a multi-factor comprehensive evaluation model are developed and applied to an international destination, Zhangjiajie, China, which was selected as a case study to test the framework developed. Results show that the economy, efficiency, effectiveness, and environmental quality aspects should be considered when evaluating tourism development performance. The empirical analysis shows that based on these criteria, Zhangjiajie’s destination performance improved measurably during the test period from 2005 to 2009. The results indicate that significant events, natural disasters, and financial crises influence performance most.
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Accessible virtual reality therapy using portable media devices.
Bruck, Susan; Watters, Paul A
2010-01-01
Simulated immersive environments displayed on large screens are a valuable therapeutic asset in the treatment of a range of psychological disorders. Permanent environments are expensive to build and maintain, require specialized clinician training and technical support and often have limited accessibility for clients. Ideally, virtual reality exposure therapy (VRET) could be accessible to the broader community if we could use inexpensive hardware with specifically designed software. This study tested whether watching a handheld non-immersive media device causes nausea and other cybersickness responses. Using a repeated measure design we found that nausea, general discomfort, eyestrain, blurred vision and an increase in salivation significantly increased in response to handheld non-immersive media device exposure.
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Destination Memory and Cognitive Theory of Mind in Alzheimer's Disease.
El Haj, Mohamad; Gély-Nargeot, Marie-Christine; Raffard, Stéphane
2015-01-01
Destination memory, or the ability to remember the destination to whom a piece of information was addressed, is found to be compromised in Alzheimer's disease (AD). Our paper investigated the relationship between destination memory and theory of mind in AD since both destination memory and theory of mind are social abilities that require processing attributes of interlocutors. Mild AD participants and controls were administered tasks tapping destination memory, affective theory of mind, and 1st and 2nd order cognitive theory of mind. Relative to controls, AD participants showed compromise in destination memory and 2nd order cognitive theory of mind, but preserved performance on affective and 1st order cognitive theory of mind. Significant correlations were observed between destination memory, and 1st and 2nd order cognitive theory of mind in AD participants and controls. By demonstrating a relationship between compromises in 2nd order theory of mind and in destination memory, our work highlights links between social cognition and memory functioning in AD.
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Destination memory impairment in older people.
Gopie, Nigel; Craik, Fergus I M; Hasher, Lynn
2010-12-01
Older adults are assumed to have poor destination memory-knowing to whom they tell particular information-and anecdotes about them repeating stories to the same people are cited as informal evidence for this claim. Experiment 1 assessed young and older adults' destination memory by having participants tell facts (e.g., "A dime has 118 ridges around its edge") to pictures of famous people (e.g., Oprah Winfrey). Surprise recognition memory tests, which also assessed confidence, revealed that older adults, compared to young adults, were disproportionately impaired on destination memory relative to spared memory for the individual components (i.e., facts, faces) of the episode. Older adults also were more confident that they had not told a fact to a particular person when they actually had (i.e., a miss); this presumably causes them to repeat information more often than young adults. When the direction of information transfer was reversed in Experiment 2, such that the famous people shared information with the participants (i.e., a source memory experiment), age-related memory differences disappeared. In contrast to the destination memory experiment, older adults in the source memory experiment were more confident than young adults that someone had shared a fact with them when a different person actually had shared the fact (i.e., a false alarm). Overall, accuracy and confidence jointly influence age-related changes to destination memory, a fundamental component of successful communication. (c) 2010 APA, all rights reserved).
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Dark Tourism and Destination Marketing
Jahnke, Daniela
2013-01-01
This thesis is about the dark tourism and destination marketing. The aim of the thesis is to display how these two terms can be combined. The term dark tourism is a relatively new research area; therefore the thesis will provide an outlook of the current situation of dark tourism. It starts with the beginning of dark tourism and continuous to the managerial aspects of dark tourism sites. The second part of the theoretical background is about destination marketing. It provides an overvie...
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The Ventricular Assist Device in the Life of the Child: A Phenomenological Pediatric Study.
van Manen, Michael A
2017-05-01
What is it like for a child to live with an artificial heart? The use of some medical therapies in children requires developmental considerations, is associated with psychosocial consequences, and calls for ethical sensitivities. A critical case is the ventricular assist device (VAD), a mechanical pump used to support the functioning of a failing heart. As a pediatric therapy, the device can be used as a temporary solution for poor heart function, a bridge to transplantation or recovery, or as a destination therapy. While the mechanical-technical operation of the VAD is well understood, the clinical-technical aspects of young people living with this device are largely unexplored. Drawing on interviews of school-aged children, the aim of this phenomenological study is to explore how a VAD may structure or condition a child's meaningful experience of their world outside the hospital. The driveline of an implanted VAD is the peripheral attachment, extruding through the skin to connect the controller-power supply. The materiality of the device may be interruptive, restrictive, and disturbing to the psycho-physical being and sense of self-identity of the child as a child. And while a child equipped with a VAD is not necessarily conspicuous among other children, the child may experience the device as an exposing presence, while living with the worry of a caregiver who takes on the role not simply of parent but of watchful health professional. A phenomenological understanding of the VAD should assist parents and caregiving health professionals knowing how to deal with specific issues arising in the life of the VAD child.
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MARKETING URBAN DESTINATIONS THROUGH FESTIVALS
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Lina Georgieva ANASTASSOVA
2016-07-01
Full Text Available Within the context of enormous competition on the international tourist market, destination branding is getting an increasing importance as a way to attract more tourists and visitors. There is an overall trend away from product features towards lifestyle or value systems which reveals that the consumer of today makes choices based on whether or not a product fits into her or his lifestyle and whether a destination represents a desirable tourist experience. After theoretical literature review on brand identity, the results of a festival visitors’ opinion survey about “Include the city” festival’s contribution to the brand identity of Burgas city are discussed. The survey methodology includes descriptive statistics, Z-score method in order to classify in groups visitor’s opinion as well as content analysis of visitors’ opinion. Three research hypotheses are checked and suggestions about the festival’s marketing contribution in three aspects to the brand identity extension of urban destination Burgas are presented.
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THE DESTINATION IMAGE OF BUCOVINA AMONG ROMANIAN TOURISTS
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Ariadna Ioana JURAVLE (GAVRA
2016-12-01
Full Text Available The aim of this article is to identify the destination image of Bucovina among Romanian tourists. Bucovina is one of the most important tourist destinations of Romania, it is located in the North Eastern region of Romania and tourism has the potential to provide significant support for economic development of this region. This economic development may occur if the elements of tourism are well-managed. One of the factors influencing the success of a destination is its image. Earlier studies showed the importance of destination image, even though no studies have been conducted for Bucovina to identify the image of this destination. To implement this study, we used survey as the research method and the questionnaire as our research tool. We conducted the content analysis of responses to open questions. The items were included into a broader questionnaire although this article comprises just the qualitative research in which we included emergent coding.
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Destination and source memory in Huntington's disease
El Haj, M.; Caillaud, M.; Verny, C.; Fasotti, L.; Allain, P.
2016-01-01
Destination memory refers to the recall of the destination of previously relayed information, and source memory refers to the recollection of the origin of received information. We compared both memory systems in Huntington's disease (HD) participants. For this, HD participants and healthy adults
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Measuring Tourism Risk Impacts on Destination Image
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Wen-Qi Ruan
2017-08-01
Full Text Available This study develops and tests an integrated model of the moderated mediation of risks (man-made and natural disasters that explains the associations between the benefits of tourism and the destination image. The study also considers how tourists are influenced by natural disasters and provides empirical evidence to predict the hypothesis models. The results of a study of 635 foreign tourists indicate that the tourism risks of man-made disasters positively influence the tourists’ experienced benefits and feeling experience. Foreign tourists’ risk evaluation may have a positive effect on their benefit and feeling experience and, thus, may link to the destination image. Somewhat as expected, the moderating effect of tourist benefit is found to strengthen the relationship between feeling experience and the destination image. Alternatively, foreign tourists’ feeling experiences foster a positive link between tourism risk and destination image. The implications of the moderated mediation results are discussed.
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Online information Impact in the virtual destination image formation
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Célia Maria Conceição Salmim Rafael
2014-05-01
Full Text Available The influence of the destination image in the decision process and choice of destination by tourists is transverse to its intangible nature. Recent studies expand and modify the conventional image constructs specifying information sources transmitted through the internet. The scenario resulting from the literature review allows us to understand the importance of experience for touristic activity and theoretical proposition of virtual tourism as "virtual tourist experience", its determinants and its implications for the overall image destination formation. This study presents a literature review base to the empiric research proposal whose general objective comprises the analysis of the influence of factors, such as interactivity, in online communication and contact with virtual tourism experiences online in image destination formation and image destination.
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Rural Tourism – Evaluating the Quality of Destination
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Ryglová Kateřina
2017-12-01
Full Text Available This paper concerns the topic of rural destination quality from the viewpoint of tourism development. The research exploring crucial quality factors from the viewpoint of demand is presented. Rural tourism participants attribute the highest significance to Destination cleanliness and Sense of security. The evaluation of the importance of most research quality factors is not dependent on gender and on the contrary, the importance of 16 quality factors depends on the visitor´s age. In the case of the factor of “Friendly acceptance by the locals”, the most significant influence on the visitor´s return to the destination was confirmed. On the contrary, this impact was not proven for the factor of “Level of prices of services and goods in the destination”. The research and the successive factor analysis revealed 6 dimensions representing the rural destination quality: Services, Image, Transportation, Well-being, Information/Communication and Attractions/ Experiences; Well-being was identified as the most important. This was consecutively confirmed by the analysis of the quality factors’ impact on the visitor´s overall satisfaction and loyalty to the destination. The research findings provide the theory with topical destination quality dimensions as well as contribute to better understanding of visitor´s behavioural mechanisms in rural areas.
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Indoor Navigation Design Integrated with Smart Phones and Rfid Devices
Ortakci, Y.; Demiral, E.; Atila, U.; Karas, I. R.
2015-10-01
High rise, complex and huge buildings in the cities are almost like a small city with their tens of floors, hundreds of corridors and rooms and passages. Due to size and complexity of these buildings, people need guidance to find their way to the destination in these buildings. In this study, a mobile application is developed to visualize pedestrian's indoor position as 3D in their smartphone and RFID Technology is used to detect the position of pedestrian. While the pedestrian is walking on his/her way on the route, smartphone will guide the pedestrian by displaying the photos of indoor environment on the route. Along the tour, an RFID (Radio-Frequency Identification) device is integrated to the system. The pedestrian will carry the RFID device during his/her tour in the building. The RFID device will send the position data to the server directly in every two seconds periodically. On the other side, the pedestrian will just select the destination point in the mobile application on smartphone and sent the destination point to the server. The shortest path from the pedestrian position to the destination point is found out by the script on the server. This script also sends the environment photo of the first node on the acquired shortest path to the client as an indoor navigation module.
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New HOLIDAY Destination Decision Making; a Singapore perspective
Bhagchandani, Neeraj Vishindas
2015-01-01
Singaporeans are known to have high disposable incomes and come from one of the more influential economies in Asia. Singaporeans have a sizeable impact on the world’s tourism industry. Thus, it is not surprising that they are the target of many tourism destination marketing organizations. Influencing this segment bears great international interest. Existing research identifies the many methods new destinations enter the holiday maker’s mind and move along the destination decision making p...
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Destination image, image at destination. Methodological aspects
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Pablo Díaz-Rodríguez
2013-01-01
Full Text Available Today, the part played by the image in the development of tourism, and, specially, as a diffe- rentiation element of a destination area is widely acknowledged. This is reflected to a great extent in the literature that focuses its interest on identifying the variables that motivate the purchase or stimulate the decision process. However, the reference to feedback processes or image control mechanisms as well as their creation, is surprising. An approach model to these processes will be exposed in this article.
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Dodd, Erin M; Winter, Margo A; Hordinsky, Maria K; Sadick, Neil S; Farah, Ronda S
2018-06-01
The market for home-use photobiomodulation devices to treat androgenetic alopecia has rapidly expanded, and the Food and Drug Administration (FDA) has recently cleared many devices for this purpose. Patients increasingly seek the advice of dermatologists regarding the safety and efficacy of these hair loss treatments. The purpose of this guide was threefold: (1) to identify all home-use photobiomodulation therapy devices with FDA-clearance for treatment of androgenetic alopecia; (2) to review device design, features and existing clinical evidence; and (3) to discuss practical considerations of photobiomodulation therapy, including patient suitability, treatment goals, safety, and device selection. A search of the FDA 510(k) Premarket Notification database was conducted using product code "OAP" to identify all home-use devices that are FDA-cleared to treat androgenetic alopecia. Thirteen commercially available devices were identified and compared. Devices varied in shape, wavelength, light sources, technical features, price, and level of clinical evidence. To date, there are no head-to-head studies comparing the efficacy of these devices. Photobiomodulation therapy devices have an excellent safety profile and mounting evidence supporting their efficacy. However, long-term, high quality studies comparing these devices in diverse populations are lacking. As these devices become increasingly popular, dermatologists should be familiar with this treatment modality to add to their therapeutic armamentarium. AGA, androgenetic alopecia; FDA, Food and Drug Administration; IEC, International Electrotechnical Commission; LED, light-emitting diode; PBMT, photobiomodulation therapy.
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Promotion as a Tool in Sustaining the Destination Marketing Activities
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Ivo Mulec
2010-01-01
Full Text Available Promoting the tourism destination in the right and best possible way is today one of vital marketing activities of all Destination Management Organizations. Only successful promotion can entice and attract potential travelers to visit the destination. The number of new destinations is increasing every year and some of them are quite similar. Market segmentation is one of the starting points for devising marketing strategy. Only by presenting the destination to the right segment of potential clients in the right way will a destination maximize the effectiveness of its marketing and promotion. Tourism destination marketers will continue to face considerable challenges in the future: they will have to take account of the needs, wants and expectations of more mature and knowledgeable customers, and the corresponding need for more up-to-date and reliable information upon which to base decision-making. In the future only marketing which includes collaborative dimensions will meet its objectives fully.
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Monitoring System of Sustainable Development in Cultural and Mountain Tourism Destinations
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Jurigova Zuzana
2015-03-01
Full Text Available Tourism destinations are vulnerable to negative impacts of tourism development and thus require a sustainable approach. It is significant mainly in destinations with fragile environments such as cultural destinations with their historical value and mountain destinations with specific natural conditions. The aim of this paper is to propose the monitoring system for sustainable development of cultural and mountain destinations based on the critical scientific literature review. The added value of this work resides in defining specific indicators (creating monitoring system for measurement of sustainability in cultural routes and mountain destinations.
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Assessing the effectiveness of consumer narratives for destination marketing
DEFF Research Database (Denmark)
Tussyadiah, Iis; Park, S.; Fesenmaier, D.R.
2011-01-01
Using tourists' stories to promote destinations is believed to be an innovative approach in destination marketing. This study conceptualizes and investigates the effectiveness of such an approach. This study supports the underlying premise of introducing narrative in marketing, that is......, the narrative reasoning that human beings possess with which they can retrieve information better through a story. Furthermore, it is argued that the increased knowledge of a destination will have a stronger effect on the intention to visit a destination if the audiences can identify themselves with the story...
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Sustainable Cultural Tourism in Urban Destinations: Does Space Matter?
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Ibon Aranburu
2016-07-01
Full Text Available Policy makers and tourism developers must understand visitors’ mobility behavior and how they consume space and tourism resources in order to set up sustainable cultural tourism destinations. With this in mind, it should also be pointed out that the mobility patterns of tourists in urban destinations are mainly located in the city center (spatial centrality, the analysis of which enables us to define “how central” the resources (museums, monuments, etc. are and what the interactions between them are. Comprehending which factors influence visitors’ urban mobility behavior is key to understanding tourists’ consumption of space and their connections with the tourism assets of the city. Furthermore, when tourists visit a destination, they make a mental representation of the destination, constructing a mental map of it. Thus, tourists consume not only spaces but also the image of a city/destination. Moreover, the latter influences the former. The quality of surrounding architecture and urbanism plays a crucial role in enhancing the experiential value of a destination and influencing space consumption preferences. Clearly, visitors are more likely to use/consume environments that are easily navigated and mentally legible. In order to explore these patterns, a real experiment was performed based on visitor behavior in the city of Bilbao. In addition, the central places of Bilbao were determined and an analysis of the spatial interaction between cultural sites was performed, making use of a new methodology based on GPS technologies, network analysis, and surveys. This methodology is the main contribution of this work. The results suggest that (1 easy mobility (walkability, accessibility, different transport modes of the visited space facilitates the tourist experience; (2 simple and eligible mental maps of the city that are easily perceived by visitors facilitate the rapid consumption of the tourist destination; and (3 the centrality of the
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System overview of the fully implantable destination therapy--ReinHeart-total artificial heart.
Pelletier, Benedikt; Spiliopoulos, Sotirios; Finocchiaro, Thomas; Graef, Felix; Kuipers, Kristin; Laumen, Marco; Guersoy, Dilek; Steinseifer, Ulrich; Koerfer, Reiner; Tenderich, Gero
2015-01-01
Owing to the lack of suitable allografts, the demand for long-term mechanical circulatory support in patients with biventricular end-stage heart failure is rising. Currently available Total Artificial Heart (TAH) systems consist of pump units with only limited durability, percutaneous tubes and bulky external equipment that limit the quality of life. Therefore we are focusing on the development of a fully implantable, highly durable destination therapy total artificial heart. The ReinHeart-TAH system consists of a passively filling pump unit driven by a low-wear linear drive between two artificial ventricles, an implantable control unit and a compliance chamber. The TAH is powered by a transcutaneous energy transmission system. The flow distribution inside the ventricles was analysed by fluid structure interaction simulation and particle image velocimetry measurements. Along with durability tests, the hydrodynamic performance and flow balance capability were evaluated in a mock circulation loop. Animal trials are ongoing. Based on fluid structure interaction simulation and particle image velocimetry, blood stagnation areas have been significantly reduced. In the mock circulation loop the ReinHeart-TAH generated a cardiac output of 5 l/min at an operating frequency of 120 bpm and an aortic pressure of 120/80 mmHg. The highly effective preload sensitivity of the passively filling ventricles allowed the sensorless integration of the Frank Starling mechanism. The ReinHeart-TAH effectively replaced the native heart's function in animals for up to 2 days. In vitro and in vivo testing showed a safe and effective function of the ReinHeart-TAH system. This has the potential to become an alternative to transplantation. However, before a first-in-man implant, chronic animal trials still have to be completed. © The Author 2014. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.
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Tourist destination image and consumer behaviour: The case of the Azores
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Helena Maria Pascoal Melo
2017-06-01
Full Text Available Destinations are currently seeking to become more distinctive in an increasingly competitive market in which image is a decisive element in tourists’ destination selection. This study sought to understand the Azores’ overall image as a tourist destination in major source markets and to ascertain these markets’ level of satisfaction and behavioural intentions concerning the archipelago. The literature review in this paper addresses the definition of tourist destination image and the issue of satisfaction, since these influence intention to return and/or intention to recommend tourist destinations. The results indicate that (1 overall image influences satisfaction and intention to recommend and/or return to tourist destinations and (2 satisfaction influences intention to recommend and/or return to tourist destinations. This study also verified that most tourists are very satisfied with the Azores, as well as having a quite positive overall image of this destination.
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Litzler, Pierre-Yves; Smail, Hassiba; Barbay, Virginie; Nafeh-Bizet, Catherine; Bouchart, François; Baste, Jean-Marc; Abriou, Caroline; Bessou, Jean-Paul
2014-01-01
We report our 5-year experience of continuous flow left ventricular assist device (LVAD) implantation without the use of anti-platelet therapy. Between February 2006 and September 2011, 27 patients (26 men; 1 woman) were implanted with a continuous flow LVAD (HeartMate II, Thoratec Corporation, Pleasanton, CA, USA). The mean age was 55.7 ± 9.9 years. The mean duration of support was 479 ± 436 (1-1555) days with 35.4 patient-years on support. Twenty-one patients were implanted as a bridge to transplantation and 6 for destination therapy. The anticoagulation regimen was fluindione for all patients, with aspirin for only 4 patients. At the beginning of our experience, aspirin was administered to 4 patients for 6, 15, 60 and 460 days. Due to gastrointestinal (GI) bleeding and epistaxis, aspirin was discontinued, and since August 2006, no patients have received anti-platelet therapy. At 3 years, the survival rate during support was 76%. The most common postoperative adverse event was GI bleeding (19%) and epistaxis (30%) (median time: 26 days) for patients receiving fluindione and aspirin. The mean International Normalized Ratio (INR) was 2.58 ± 0.74 during support. Fifteen patients have been tested for acquired Von Willebrand disease. A diminished ratio of collagen-binding capacity and ristocetin cofactor activity to Von Willebrand factor antigen was observed in 7 patients. In the postoperative period, 2 patients presented with ischaemic stroke at 1 and 8 months. One of these 2 patients had a previous history of carotid stenosis with ischaemic stroke. There were no patients with haemorrhagic stroke, transient ischaemic attack or pump thrombosis. The event rate of stroke (ischaemic and haemorrhagic) per patient-year was 0.059 among the patients without aspirin with fluindione regimen only. A fluindione regimen without aspirin in long-duration LVAD support appears to not increase thromboembolic events and could lead to a diminished risk of haemorrhagic stroke.
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Destination Quality Perception in the Context of Different Behavioural Characteristics of Visitors
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Ryglová Kateřina
2016-06-01
Full Text Available Visitors’ perceptions of the quality of a tourism destination are fundamental for effective destination management and marketing. This paper deals with the topic of destination quality from the viewpoint of demand, i.e. from the viewpoint of a destination visitor. The results of perceiving the destination quality partial factors in the context of different behavioural characteristics of a visitor are presented, particularly, the way how spending and organizing a holiday influences the perception of destination quality factors (Kruskal-Wallis test. The research nineteen factors were designed on the basis of contemporary theories and on qualitative research. Some important quality aspects related to tourism were identified and assessed for the Czech population. The primary data were obtained through a questionnaire survey with quota sampling (n = 1097. The dependence of destination quality perception on the way of spending the holiday was revealed in the case of 8 factors (e.g., Availability of transportation to the destination, Availability and quality of information; Additional infrastructure, Sense of security, Destination cleanliness, Uniqueness of destination, Price level in the destination, Cultural monuments. The significant differences identified among various groups of respondents are described in detail in this study. The research findings contribute to better understanding of the behavioural mechanism and can be used by destination managers to design communication strategies for different segments of consumers for individual destinations to improve their competiveness.
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Branding Serbia as a Tourist Destination on the Global Market
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Ivan Paunović
2014-04-01
Full Text Available Destination branding has become one of the most popular contemporary topics, both among tourism practitioners and politicians, because there is strong evidence that strong national destination brand supports commercial brands in industries related to tourism. Therefore, factors that influence destination brand loyalty are of crucial importance for understanding and promoting the brand. Building brand loyalty is not just about repeat buying, but also about building customers emotional attachment to the brand. Global growth and diversification of tourist markets has transformed destinations from “vacation industry” concept, to “industry of experience” concept.The study performed statistical tests with a goal to analyze the factors influencing brand loyalty in Serbia: age, length of stay and daily spending. Additionally, sub-brand loyalty levels are presented (by major destinations inside Serbia, markets of origin and by major themes for travel in order to identify groups of tourists that are more loyal, and the ones that are less loyal to the destination brand of Serbia. The study results and recommendations should be used as a contribution towards designing national and regional destination marketing strategies.
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The Process of Managing a Destination in Lower and Upper Austria
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Bobková Markéta
2015-12-01
Full Text Available The focus of the submitted article is to introduce the findings of author’s research in the area of destination management process conducted in the developed (Alpine tourist destinations in the year of 2014. The theoretical part based on a literature review summarizes current knowledge dealing with the destination management process in terms of approaches and research findings. Problems influencing either positively or negatively this process, e.g. financing, legislation or cooperation among stakeholders are also defined. The practical application part includes an analysis of model destinations in Lower Austria and Upper Austria and presents the results of qualitative research conducted in these destinations. The collected information can be used to design methods leading to the improvement of the destination management process in tourist less developed destinations.
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The potential of electrocardiographic markers to tune cardiac device therapy
Wijers, S.C.
2017-01-01
In this thesis an effort was made to translate basic research into clinical practice to improve cardiac device therapy. We showed the electrocardiogram (ECG) is everything but obsolete or outdated and is of great value as a simple non-invasive tool in identifying individuals that can benefit from
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The idea of destination brand licensing and the question of its effectiveness
Michal Zemla
2012-01-01
Purpose – Destination branding is one of the most popular topics among tourism destinations researchers and practitioners however recent research revealed that it doesn’t have a clear concept. The purpose of presented paper is to enhance the destination branding theory by introducing some new elements taken from other popular concepts used in destination management into destination branding theory. The concept of destination brand licensing was undertaken as a response to several critical arg...
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The quality of tourism destination – integrated quality management
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Ida Vajčnerová
2009-01-01
Full Text Available The paper deals with the quality of tourism services. It mentions various ways of approaching quality management, such as the standards of quality, systems based on ISO standards and systems of complex quality management. It describes approaches applied in the Czech Republic and points out the difficulty keeping the quality in tourism. Tourism services are not offered individually, which is why it is necessary to assess the quality of a whole complex of services within the frame of a tourism product or a tourist destination. The level of tourists' satisfaction is not based on the quality of individual tourism services or a destination product but it arises from their overall impression which is formed from the hospitality of local inhabitants, the willingness of employees, the cleanness of the environment, security and so on. The presumption of maintaining the quality of a destination is a unified approach of all participants in tourism development that can be reached by various forms of cooperation. Creating a strategic alliance is one of such possibilities. The main objective of the article is to introduce the European system of Integrated Quality Management (IQM and the tool for assessing the quality in a destination “Qualitest”. The Integrated Quality Management is an approach based on the cooperation of all areas taking part in tourism development in a destination. The quality is assessed in a complex way with respect to tourism development impacts on local inhabitants and the environment. “Qualitest” is made of 16 indexes that are focused on the quality of a destination and the quality of a product. Each index is evaluated by three indicators that asses the quality of conditions (QPCI, the quality of management (QMI and the quality of a destination performance (QPI. These indicators combine qualitative as well as quantitative values. The precondition for using “Qualitest” in our destinations is the existence of a
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Destination Information Management System for Tourist
Abdulhamid, Shafii Muhammad; Usman, Gana
2014-01-01
The use of information and communication technology in our day to day activities is now unavoidable. In tourism developments, destination information and management systems are used to guide visitors and provide information to both visitors and management of the tour sites. In this paper, information and navigation system was designed for tourists, taking some Niger state of Nigeria tourism destinations into account. The information management system was designed using Java Applet (NetBeans I...
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Destination Brand: Membangun Keunggulan Bersaing Daerah
Situmorang, Syafrizal Helmi
2010-01-01
All successful brands have social, emotional and identity value to users: they have personalities and enhance the perceived utility, desirability and quality of a product. Every country, regional or state should build destination brand for competitive advantage. A destination brand can be developed in a variety of ways, most obviously in advertising, through direct marketing, personal selling, on websites and in brochures, but also through public and media relations, and through the co-operat...
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Prologue: ventricular assist devices and total artificial hearts. A historical perspective.
Frazier, O H
2003-02-01
In the 1960s, when LVADs and TAHs were introduced into clinical use, researchers estimated that, with this technology, the problem of heart failure could be solved within 20 years. Unfortunately, the evolution of these devices has taken much longer than anticipated. Nevertheless, significant advances have been achieved in both cardiac assistance and replacement, and today's cardiac surgeons have a wide range of devices from which to choose (Table 4). This progress has largely been due to the support of the NHLBI, especially the Devices and Technology Division headed by John Watson, and of the devoted commitment of the investigators. Because of the long-term commitment required for both basic and clinical research, commercial medical technology companies are unable to assume this burden. Advances in mechanical circulatory support and replacement have benefited numerous patients worldwide who would otherwise have died of heart failure, and devices now exist for use as bridges to recovery, bridges to transplant, and destination therapy. The current challenge is to refine what we have and to apply these technologies to broader patient populations with maximal safety and at a reasonable cost.
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The Ventricular Assist Device in the Life of the Child: A Phenomenological Pediatric Study
van Manen, Michael A.
2017-01-01
What is it like for a child to live with an artificial heart? The use of some medical therapies in children requires developmental considerations, is associated with psychosocial consequences, and calls for ethical sensitivities. A critical case is the ventricular assist device (VAD), a mechanical pump used to support the functioning of a failing heart. As a pediatric therapy, the device can be used as a temporary solution for poor heart function, a bridge to transplantation or recovery, or as a destination therapy. While the mechanical-technical operation of the VAD is well understood, the clinical-technical aspects of young people living with this device are largely unexplored. Drawing on interviews of school-aged children, the aim of this phenomenological study is to explore how a VAD may structure or condition a child’s meaningful experience of their world outside the hospital. The driveline of an implanted VAD is the peripheral attachment, extruding through the skin to connect the controller-power supply. The materiality of the device may be interruptive, restrictive, and disturbing to the psycho-physical being and sense of self-identity of the child as a child. And while a child equipped with a VAD is not necessarily conspicuous among other children, the child may experience the device as an exposing presence, while living with the worry of a caregiver who takes on the role not simply of parent but of watchful health professional. A phenomenological understanding of the VAD should assist parents and caregiving health professionals knowing how to deal with specific issues arising in the life of the VAD child. PMID:28682718
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Smart tourism destinations: ecosystems for tourism destination competitiveness
Boes, Kim; Buhalis, Dimitrios; Inversini, Alessandro
2016-01-01
Purpose\\ud – Grounded in service-dominant (S-D) logic, the purpose of this paper is to explore the core components of smartness to present a framework for the development of the smart tourism destination.\\ud \\ud Design/methodology/approach\\ud – The paper explores the core components of smartness through case study analysis of well-established smart cities.\\ud \\ud Findings\\ud – The paper conceptualises smartness and argues ICT, leadership, innovation and social capital supported by human capit...
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Moderating Effects of Craftourism on Place Attachment and Destination Loyalty
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Arup Kumar Baksi
2015-09-01
Full Text Available Practice of traditional handicrafts play a significant role in enhancing destination attractiveness. Visitors assign considerable weightage to local craft practices to satisfy their desire to participate in the learning and production process, a case of role-reversal. Promoting this scope of role-reversal has been used by the Destination Marketing Organizations as differentiators. Craftourism has gained considerable momentum. This paper focuses on examining the moderating effects of craftourism on place attachment and destination loyalty. Dimensions of craftourism were identified by applying suitable statistical procedure. The results revealed craftourism, with option for visitors to enact role-reversal, improves the chances of destination loyalty following antecedent effects of place attachment. Keywords: craftourism, place attachment, destination loyalty, visitor, moderating
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Destination Memory Impairment in Older People
Gopie, Nigel; Craik, Fergus I. M.; Hasher, Lynn
2010-01-01
Older adults are assumed to have poor destination memory— knowing to whom they tell particular information—and anecdotes about them repeating stories to the same people are cited as informal evidence for this claim. Experiment 1 assessed young and older adults’ destination memory by having participants tell facts (e.g., “A dime has 118 ridges around its edge”) to pictures of famous people (e.g., Oprah Winfrey). Surprise recognition memory tests, which also assessed confidence, revealed that o...
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Research on Psychological Carrying Capacity of Tourism Destination
Institute of Scientific and Technical Information of China (English)
Fan Zhiyong; Zhong Sheng
2009-01-01
As a part of the carrying capacity system of tourism destination,tourism psychological carrying capacity and its makeup are very important indexes which reflect the harmonious development of tourism destination develops harmoniously,but the academy has not paid enough attention to them.Based on the concept and connotation of psychological carrying capacity,this paper explains the influencing factors which affect the psychological capacity of the tourist and the resident after the acknowledged concept,and then designs a harmonious development model of tourism destination.Finally,it offers some countermeasures against the overloading psychological capacity.
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Directory of Open Access Journals (Sweden)
Khayat Andre
2011-01-01
Full Text Available Abstract We challenge the hypothesis of enhanced myocardial reperfusion after implanting a left ventricular assist device together with bone marrow mononuclear stem cells in patients with end-stage ischemic cardiomyopathy. Irreversible myocardial loss observed in ischemic cardiomyopathy leads to progressive cardiac remodelling and dysfunction through a complex neurohormonal cascade. New generation assist devices promote myocardial recovery only in patients with dilated or peripartum cardiomyopathy. In the setting of diffuse myocardial ischemia not amenable to revascularization, native myocardial recovery has not been observed after implantation of an assist device as destination therapy. The hybrid approach of implanting autologous bone marrow stem cells during assist device implantation may eventually improve native cardiac function, which may be associated with a better prognosis eventually ameliorating the need for subsequent heart transplantation. The aforementioned hypothesis has to be tested with well-designed prospective multicentre studies.
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Scully, Maura King
2010-01-01
Increasingly today, with the growing and sophisticated skill set alumni professionals need to get the job done, alumni relations has become a destination career rather than a stop along the way. Modern alumni relations is "so much more than homecoming and punch-and-cookie receptions." It's marketing, volunteer management, and social networking. To…
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Destination memory and cognitive theory of mind in normal ageing.
El Haj, Mohamad; Raffard, Stéphane; Gély-Nargeot, Marie-Christine
2016-01-01
Destination memory is the ability to remember the destination to which a piece of information has been addressed (e.g., "Did I tell you about the promotion?"). This ability is found to be impaired in normal ageing. Our work aimed to link this deterioration to the decline in theory of mind. Forty younger adults (M age = 23.13 years, SD = 4.00) and 36 older adults (M age = 69.53 years, SD = 8.93) performed a destination memory task. They also performed the False-belief test addressing cognitive theory of mind and the Reading the mind in the eyes test addressing affective theory of mind. Results showed significant deterioration in destination memory, cognitive theory of mind and affective theory of mind in the older adults. The older adults' performance on destination memory was significantly correlated with and predicted by their performance on cognitive theory of mind. Difficulties in the ability to interpret and predict others' mental states are related to destination memory decline in older adults.
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Innovations and networking fostering tourist destination development in Slovakia
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Gajdošík Tomáš
2017-12-01
Full Text Available The paper focuses on the implementation of innovations and networking in the sector of tourism in two Slovak mountain destinations of international significance. The main objective of the paper is to identify and evaluate how innovations and networking contribute to tourist destination development in Slovakia. The implementation of institutional innovation resulted in the establishment of formal and informal networks. The developed networks consist of representatives of all sectors co-ordinating all relevant stakeholders. Formal and informal networks and the collaboration among stakeholders have launched other types of innovations in the tourism sector. The interactions and intensity of relations among stakeholders are analysed by network analysis. Destinations are compared with the network of the same size and density through quantitative network characteristics. Based on empirical research we investigate the impact of networks and innovations on tourist destination development. Due to the synergy effect of networking and implementation of multiple innovations, tourist destination development is observed.
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Interactive visual exploration and analysis of origin-destination data
Ding, Linfang; Meng, Liqiu; Yang, Jian; Krisp, Jukka M.
2018-05-01
In this paper, we propose a visual analytics approach for the exploration of spatiotemporal interaction patterns of massive origin-destination data. Firstly, we visually query the movement database for data at certain time windows. Secondly, we conduct interactive clustering to allow the users to select input variables/features (e.g., origins, destinations, distance, and duration) and to adjust clustering parameters (e.g. distance threshold). The agglomerative hierarchical clustering method is applied for the multivariate clustering of the origin-destination data. Thirdly, we design a parallel coordinates plot for visualizing the precomputed clusters and for further exploration of interesting clusters. Finally, we propose a gradient line rendering technique to show the spatial and directional distribution of origin-destination clusters on a map view. We implement the visual analytics approach in a web-based interactive environment and apply it to real-world floating car data from Shanghai. The experiment results show the origin/destination hotspots and their spatial interaction patterns. They also demonstrate the effectiveness of our proposed approach.
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Effects of Films and Television Dramas on Destination Image
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Pars Şahbaz
2009-09-01
Full Text Available The aim of this study is bring up the effects of films and television dramas on destination image. Image is a picture and a imagery which ia about destination and also image affects the purchase decision making. The population of the study contains domestic tourists who visited Mardin. The result of the study suggests that there is a substantive relationship between destination images and films and television dramas.
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Transformations in destination texture
DEFF Research Database (Denmark)
Gyimóthy, Szilvia
2018-01-01
This article takes heterogeographical approaches to understand Bollywood-induced destination transformations in Switzerland. Positioned within the theoretical field of mediatized mobility, the study contextualizes Bollywood-induced tourism in Europe the concept of texture. Textural analysis (base...
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The role of brand destination experience in determining revisit intention
DEFF Research Database (Denmark)
Mattsson, Jan; Barnes, Stuart; Sørensen, Flemming
Destination branding has developed considerably as a topic area in the last decade with numerous conceptualizations focusing on different aspects of the brand. However, a unified view has not yet emerged. This paper examines destination branding via a new conceptualization, brand destination...... experience, which provides a more holistic and unified view of the brand destination. The research uses a logistic regression model to determine the role of satisfaction and brand experience in determining revisit intentions. The study also examines differences among subgroups and four brand experience sub...
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What marketing strategy for destinations with a negative image?
Seraphin, Hugues; Gowreesunkar, Vanessa; Hugues Seraphin
2017-01-01
Purpose\\ud This concluding article filters out meaningful marketing strategies that aim at re-positioning and re-establishing struggling tourism destinations with negative image. Drawing from a collection of case studies around the world, the article provides evidences from post-colonial, post-conflict and post-disaster destinations to finally anchor the overall conclusion of the theme issue.\\ud \\ud Design\\ud The article summarizes key issues faced by destinations plagued with a negative imag...
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Exploring Familiarity and Destination Choice in International Tourism
DEFF Research Database (Denmark)
Lee, G.; Tussyadiah, Iis
2012-01-01
tourists' characteristics and the destination choices. The results indicate that (1) teens and people in their 50s and above were interested in visiting more popular places, (2) tourists who are more familiar with Japan tended to visit less popular destinations, and (3) tourists with more travel...
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Critical success factors of a business tourism destination: Supply side analysis
Milandrie Marais; Engelina du Plessis; Melville Saayman
2017-01-01
Orientation: Globally, destinations offer various products and services to visitors featuring different attributes and characteristics, making each destination unique. The critical success factors (CSFs) of each of these destinations may differ, making the management process more complex. Research purpose: The purpose of this research was to identify the CSFs for business tourism destinations in South Africa from a supply viewpoint. Motivation for the study: Because of the importance of...
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Competitiveness Benchmarking of Tourist Destinations in the Czech Republic and Slovenia
Ricková, Karla
2011-01-01
This diploma thesis deals with the benchmarking method and its practical use in continuous process of destinations' competitiveness enhancement. It describes the importance of tourism for destination's development and increasing need of its management, in order to become more competitive. Revealing the key factors of success that are created by destinations' competitive advantages enables destinations to keep or even to strengthen their position on the international tourism market. The main g...
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PROMOTION: BRANDING TOOL FOR MACEDONIA AS A TOURIST DESTINATION
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Violeta Milenkovska
2015-12-01
Full Text Available In times when competition between countries in the world is stronger, in order to attract as many tourists as possible, and strengthening their brand as a tourist destination, Republic of Macedonia started to build and strengthen its tourism brand. Due to the enormous competition, traditional destinations maintain and improve their brand through new innovative tourist attractions. On the contrary, the new tourist destinations strongly attack potential tourists with intention of gaining a better position on the tourist market. The subject of this paper is Macedonia as a tourist destination seen through the prism of promotional activities that Agency for promotion and support tourism in Republic of Macedonia realized in period 2009– 2012. This paper presents an action research conducted on a sample of 65 tourist stockholders (travel agencies and hotels in Macedonia in 2012. In this study it will be analyzed what other countries have undertaken regarding the aspect of promotion of their tourist product, concerning promotion of their tourist destination and what Macedonia has undertaken and should undertake regarding that aspect.
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NHLBI’s Program for VAD Therapy for Moderately Advanced Heart Failure: The REVIVE-IT Pilot Trial
Baldwin, J. Timothy; Mann, Douglas L.
2010-01-01
Background VADs are used to bridge heart failure patients to transplantation, to allow their own hearts to recover, or as permanent (“destination”) therapy. To date, the use of VADs has been limited to late-stage heart failure patients because of the associated device risks. In 2008, an NHLBI working group met to evaluate the treatment of heart failure using VADs and to advise the institute on how therapy for heart failure may be best advanced by clinical trials involving the devices. Discussion and Recommendations Recognizing the improvements in VAD technology and in patient care and selection over the past decade, the working group recommended that a trial be performed to assess the use of chronic VAD therapy in patients who are less ill than those currently eligible for destination therapy. The hypothesis proposed for the trial is that VAD therapy may improve both survival and quality of life in moderately advanced heart failure patients who are neither inotrope-dependent nor exercise-intolerant and have not yet developed serious consequences such as malnourishment, end-organ damage, and immobility. Based on the group’s recommendations, NHLBI issued an RFP in 2009 for the REVIVE-IT Pilot Trail which will serve to test the hypothesis and inform the pivotal trial. PMID:21055648
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The evolution of destination branding: A review of branding literature in tourism
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Marta Almeyda-Ibáñez
2017-03-01
Full Text Available Tourism is a promise and destinations communicate the credibility of that promise by means of destination brands. Branding has become a key tool for tourism destinations to make explicit the complexity of experiences to be expected by tourists visiting a destination. This paper provides a comprehensive literature review of various issues associated with tourism destination branding. It brings together a wide range of debates in the generic marketing literature, places them alongside the nuances of tourism, and thereby identifies unique challenges of branding in tourism destination contexts. Finally, a case study of USP based national tourism branding campaigns in the Caribbean is presented.
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Tourist destination branding on social networks
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Radenković-Šošić Bojana
2012-06-01
Full Text Available Social networks have become the modern means of communication. Intensive electronic word of mouth to mouth (eWOM leads to faster sharing of experiences, and the creation of positive and negative attitudes. On the other hand, branding of tourist destinations has become one of the most powerful resources in the implementation of marketing strategies in tourism. The aim of this study, which is based on primary research, is to examine the concept of electronic word of mouth, as well as the role of social networks in the process of branding tourist destinations.
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Clarifications regarding medical tourism destinations marketing
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STANCIOIU Aurelia-Felicia
2014-09-01
Full Text Available The development of new types of tourism (stand-alone, connected or components, from marketing experience, implies a broad spectrum of challenges, which, placed in a planned background, has the purpose the creation and then, the development of tourism products that correspond, at least, to consumers’ expectations. In order to optimize the new type of tourism, it is necessary to be correlated with the relevant resources of the destination, which, harmonized, can lead to the elaboration of destination marketing strategies, in this situation being the medical tourism, component of health tourism.
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The Achilles' heel of left ventricular assist device therapy: right ventricle.
Ranganath, Neel K; Smith, Deane E; Moazami, Nader
2018-06-01
Many patients suffer from either persistent right ventricular failure (RVF) at the time of left ventricular assist device (LVAD) or have ongoing symptoms consistent with RVF during chronic mechanical circulatory support. The lack of long-term right ventricular assist devices (RVADs) has limited the impact that mechanical circulatory support can provide to patients with biventricular failure. We aim to review the entire spectrum of RVF in patients receiving LVADs and reflect on why this entity remains the Achilles' heel of LVAD therapy. In the early postoperative period, LVAD implantation reduces right ventricle (RV) afterload, but RV dysfunction may be exacerbated secondary to increased venous return. With prolonged therapy, the decreased RV afterload leads to improved RV contractile function. Bayesian statistical models outperform previously published preoperative risk scores by considering inter-relationships and conditional probabilities amongst independent variables. Various echocardiographic parameters and the pulmonary artery pulsatility index have shown promise in predicting post-LVAD RVF. Recent publications have delineated the emergence of 'delayed' RVF. Several devices are currently being investigated for use as RVADs. Post-LVAD RVF depends on the RV's ability to adapt to acute hemodynamic changes imposed by the LVAD. Management options are limited due to the lack of an easily implantable, chronic-use RVAD.
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Tourists' Transformation Experience: From Destination Architecture to Identity Formation
DEFF Research Database (Denmark)
Ye, Helen Yi; Tussyadiah, Iis
2010-01-01
Today’s tourists seek unique destinations that could associate with their self identity in a profound way. It is meaningful for destinations to design unique physical elements that offer transformational travel experiences. This study aims at identifying how tourists encounter architecture...... in a destination and if architecture facilitates tourists’ self transformation. Based on narrative structure analysis by deconstruction of travel blog posts, the results suggest that tourists perceive architectural landscape as an important feature that reflects destinations’ identity. Four different interaction...
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Predicting Individual Trip Destinations With Artificial Potential Fields.
Zonta, A.; Smit, S.K.; Haasdijk, Evert
2017-01-01
This paper presents a method to model the intended destination of a subject in real time, based on a trace of position information and prior knowledge of possible destinations. In contrast to most work in this field, it does so without the need for prior analysis of habitual travel patterns. The
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[Role of context recall in destination memory decline in normal aging].
El Haj, Mohamad; Allain, Philippe
2014-12-01
Until recently, little was known about destination memory, or memory for the destination of outputted information. In the present work, this memory was evaluated in 32 older adults and 36 younger adults, who had to associate proverbs to pictures of famous people and decide, on a subsequent recognition task, whether they had previously told that proverb to that face or not. When deciding about the destination, participants had to provide contextual judgment, that is, whether each picture had been previously exposed in color or in black and white. Participants also performed a neuropsychological battery tapping episodic memory and executive functions. Findings showed poor destination recall in older participants. Destination recall in older adults was reliably predicted by with their context recall. Destination memory seems to be particularly affected by aging, a deterioration that can be related to deficits in processing contextual features during encoding.
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Categorization of Destinations and Formation of Mental Destination Representations
DEFF Research Database (Denmark)
Kano Glückstad, Fumiko; Kock, Florian; Josiassen, Alexander
2017-01-01
, a disruptive biclustering approach advanced by recent developments of Bayesian relational modeling. This new approach, for the first time in tourism research, allows to design and conduct a segmentation analysis by simultaneously biclustering multiple datasets consisting of cases and variables in a parallel...... format. We demonstrate how the new analytical framework can be applied to analyze and compare patterns of associations which individuals have of multiple destinations. Subsequently, this paper elaborates potential contributions the Bayesian relational modeling framework makes to the tourism research...
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Promoting tourism destinations: A strategic marketing approach
Soteriades, Marios D.; Avgeli, Vasiliki A.
2007-01-01
This paper provides an outline of principal marketing strategy issues and their application in promoting tourism destinations. It provides an overview of a report prepared for the Tourism Promotion Committee (T.P.C.) of Heraklion District, Crete. In the context of the tourist industry, the ‘product’ is an experience achieved through the combination of a diverse range of products and services. Nowadays tourism destinations face new and increasing marketing challenges arising from changing tour...
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Marketing of adventure tourism destination in Nepal
Baral, Nirajan
2016-01-01
Adventure tourism is one of the key factors of the Nepalese tourism industry. The main aim of this bachelor’s thesis was to clarify the current situation and challenges for developing adventure tourism in Nepal and to evaluate the importance of appropriate marketing strategies. The thesis also focuses on promoting adventure tourism activities and rural tourism destinations. The objective of the thesis was to explore Dhorpatan Hunting Reserve as an adventure tourism destination at internationa...
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The perception of destination competitiveness by tourists
Amaya-Molinar, Carlos Mario; Sosa-Ferreira, Ana Pricila; Ochoa-Llamas, Ileana; Moncada-Jiménez, Pedro
2017-01-01
Based on a review of the academic literature this study identifies some of the most frequently mentioned factors and indicators in the field of a tourist destination competitiveness to design a survey subsequently conducted among tourists in Cancun, México. An exploratory factor analysis was performed with the collected data; the result was the reduction from twelve competitiveness factors most commonly mentioned in academic literature to five: Destination marketing and attractions, Destinati...
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Jamaludin, Nor Lelawati; Sam, David Lackland; Sandal, Gro Mjeldheim
2018-01-01
This study aims to understand factors predicting destination-loyalty intention in international education. A sample of 378 long-term (n = 195) and short-term (n = 183) international students participated in the study carried out in 2014 through an on-line survey at the University of Bergen, Norway. Using a series of hierarchical regression…
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Virtual Community Based Destination Marketing with YouTube
DEFF Research Database (Denmark)
Sambhanthan, Arunasalam; Thelijjagoda, Samantha; Good, Alice
2016-01-01
YouTube has now evolved into a powerful medium for social interaction. Utilizing YouTube for enhancing marketing endeavours is a strategy practiced by marketing professionals across several industries. This paper rationalizes on the different strategies of leveraging YouTube-based platforms...... for effective destination marketing by the hospitality industry (hotels) and provides insights on the critical drivers and challenges embedded within YouTube-based community interactions for destination marketing. The comments made by YouTube users have been subjected to a content analysis and the results...... are reported under the five broad clusters of virtual communities. More broadly, the typology of virtual communities is adapted to evaluate the YouTube platform for effective destination marketing....
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Application of head-mounted devices with eye-tracking in virtual reality therapy
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Lutz Otto Hans-Martin
2017-03-01
Full Text Available Using eye-tracking to assess visual attention in head-mounted devices (HMD opens up many possibilities for virtual reality (VR-based therapy. Existing therapy concepts where attention plays a major role can be transferred to VR. Furthermore, they can be expanded to a precise real-time attention assessment, which can serve as a foundation for new therapy approaches. Utilizing HMDs and eye-tracking in a clinical environment is challenging because of hygiene issues and requirements of patients with heterogeneous cognitive and motor impairments. In this paper, we provide an overview of those challenges, discuss possible solutions and present preliminary results of a study with patients.
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Simulating continuous renal replacement therapy: usefulness of a new simulator device.
Mencía, Santiago; López, Manuel; López-Herce, Jesús; Ferrero, Luis; Rodríguez-Núñez, Antonio
2014-03-01
Simulation allows the training of life-support procedures without patient risk. We analyzed the performance and usefulness of a new device that makes feasible the external control of continuous renal replacement therapy (CRRT) machines in order to realistically generate clinical conditions and problems in simulated patients. A simple mechanical device was designed according to training needs and then hand made. This device permits the control of all monitorable pressures and therefore allows simulation of a range of clinical situations and eventual complications that might occur in real patients. We tested its performance in vitro and then during 16 high-fidelity patient-simulation scenarios included in the program of pediatric CRRT courses. Student and teacher satisfaction was assessed through an anonymous survey. Quick, accurate, real-time monitor of pressure changes, concordant with the usual clinical problems to be simulated (catheter complications, filter coagulation, inadequate CRRT device settings), were easily achieved with the new device. Instructors rated the device as user friendly and well adapted to the reality being simulated. During scenarios, students were not aware of the simulator and considered that simulated clinical conditions were realistic. Our device may be very useful for training healthcare professionals in CRRT management, thus avoiding risk to patients.
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Competitiveness of Serbia as a tourist destination: Analysis of selected key indicators
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Popesku Jovan
2013-01-01
Full Text Available To achieve the favourable competitiveness position, tourist destination has to offer quality experiences to tourists that can make the destination more attractive compared to other tourist destinations. The role of destination management is to exploit and develop existing resources by using clear and effective strategies for developing tourism products and creating additional value of tourist experience. The first step of analysis is to define destination competitiveness by using the indicators which will review and give the guidelines for improvement of competitive position. This paper discusses the tourist destinations' competitiveness and indicators for its measurement with a special reference to Serbia. Tourism development of Serbia is a big chance for overall economic development of the country. Current competitive position of Serbian tourism on international market is not satisfactory and this paper is trying to analyze and to point out the reasons of Serbia's tourism low competitiveness. Conclusions about the competitive positioning of Serbia as a tourist destination are drawn out firstly based on the relevant studies as well as on the Serbian Tourism Development Strategy. The results of Travel and Tourism Competitiveness Index (WEF TTCI reports for Serbia are also presented. Based on own research, this paper is also showing the results related to competitiveness of Serbia as a tourist destination in terms of two groups of indicators: natural, cultural and historical resources as well as destination management. According to the results, Serbia is more competitive in its natural, cultural and historical resources comparing to the role of destination management.
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PROMOTING TOURIST DESTINATIONS THROUGH SPORT EVENTS. THE CASE OF BRAŞOV
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Adina Nicoleta CANDREA
2010-12-01
Full Text Available Sport event tourism is a huge and growing global industry with important economic implications for both the sport, the event and the impact of travel and tourism related benefits on host destinations. A primary function of a sport event is to provide the host community with an opportunity to secure high prominence in the tourism market place. However, international or regional prominence may be gained with significant social and environmental costs. Hosting sport events has been a focus of destination marketers as a strategy to enhance its destination image and differentiate its tourism products. Communities are attracted to hosting sport events to draw marketing benefits that will contribute to the success of the destination in the long run by creating awareness, improving their image with visitors and attracting tourism business to generate future inbound travel. As such, destination images can be influenced by the hosting of a sport event and the attributes associated with this event. The purpose of this paper is to outline the role of sport event tourism in the promotion of tourist destinations. A case study has been chosen in order to illustrate the interdependence between event and destination marketing: Braşov, hosting the winter edition of The European Youth Olympic Festival in 2013. The paper includes a series of recommendations for destination managers in order to maximise the benefits of this event and take this opportunity to promote Braşov on the international market.
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Komparasi Destination Branding dalam Official Website Negara Singapura-Malaysia-Indonesia
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Ryan Pratama Sutanto
2010-01-01
Full Text Available High profit income has attracted South Asian countries to compete in the fields of tourism marketing. Destination branding as a differentiating factor is an alternative approach in marketing communication. The purpose of this research is to make a comparison study of destination branding application in Singapore's, Malaysia's and Indonesia's tourism official websites. Destination branding in websites as part of promotion campaigns is a strategy used by each country to promote tourism to consumers worldwide. This research uses qualitative method, and involves experts in the fields of Information Technology (IT and Visual Communication Design. Each website's elements contributes in the success of a country's destination branding and influences its brand image.
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THE BRAND EQUITY OF TOURISTIC DESTINATIONS - THE MEANING OF THE VALUE
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Silaghi Simona
2011-07-01
Full Text Available In today's global economy, each place competes with other places for economic benefits. Destination has become a product that has to be promoted and sold in the most advantageous terms. The work bellow is an analysis of "brand equity" concept for touristic destinations, as found in the specific literature. Destination brands differ from product brands, major distinction being given by their stability/ instability. Brands of products are stable; this constant is maintained by the use of quality standards. Even in case of services, situation can be controlled, as quality standards could be perpetuated by a franchise system. Destinations are not depending on a single person, who decides, but a variety of them, economic agents, businesses, institutions and local population that can create/print form and structure changes of the destination. The concept de brand equity applied for touristic destinations, is something relatively recent. The dimensions of a brand for touristic destinations are: awareness, image, loyalty, quality and value. All these dimensions build the branding equity of a destination. There is interdependency, between quality, image, loyalty and value. In order to determine the perception in regards to the quality of tourism services in Romania, in 2010 a comprehensive study was done among the inhabitants of Oradea city. Through this study we have pursued several objectives: to assess the importance of service characteristics, performance evaluation of tourism services in Romania, tourism personnel evaluation, in terms of evaluation and performance, perception of the quality-price ratio for Romania, compared with other tourist destinations. We call on the exploratory study conducted, as the value of the dimension- destination of the brand equity is given by the price-quality ratio. Using an explorative study on the market of Oradea city, it was highlighted the connection between perception of touristic services, estimation price
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13. Device therapy in secondary hospital (without a cath lab: Feasibility, logistics and outcome
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A. Jelani
2016-07-01
Full Text Available Device therapy for conduction abnormalities, heart failure, primary or secondary SCD preventions is under delivered to requiring patients. Most of these devices are implanted at tertiary care centers in major cities of most countries. This makes the availability of these guideline guided therapies to a very small percentage of needy patients. Implant of such devices at a secondary hospital (without a cardiac cath lab with training of previously novice hospital staff and available resources as well as support of the industry is an alternative and very viable option to have such important therapy delivered to requiring patients. The usage of simple-readily available-C-arm in operating theatre (OR or the interventional radiology suite can be utilized for this purpose. OR nursing staff and radiology technicians can be trained –with help of nursing education department– to help in such procedures over a relatively short period. Technical support utilized from the vendors representatives is an alternative to face the lack of EP technicians in local or international market. The follow up of these patients in OPD can be organized with help of the vendors on regular basis under supervision of trained cardiologist/s. This model can help establish device therapy service at a secondary hospital without huge expenditure on infrastructure or facing the lack of recruitment of specialized technical support that is difficult to find –especially for smaller cities–. We present our experience at a 250 bed secondary hospital, with a relatively small cardiac unit (3 consultants, 5 hospitalists, 10 cardiac ECG/Echo techs and no cath lab of introduction of this service with the help of nursing education department and vendors supplying these devices as well as OR and radiology departments. Training of radiology technicians and OR nursing staff on the basic procedural support with few in-service demonstration helped prepare adequate staff helping during implant
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Komparasi Destination Branding dalam Official Website Negara Singapura-Malaysia-Indonesia
Ryan Pratama Sutanto; Listia Natadjaja; Erandaru .
2010-01-01
High profit income has attracted South Asian countries to compete in the fields of tourism marketing. Destination branding as a differentiating factor is an alternative approach in marketing communication. The purpose of this research is to make a comparison study of destination branding application in Singapore's, Malaysia's and Indonesia's tourism official websites. Destination branding in websites as part of promotion campaigns is a strategy used by each country to promote tourism to consu...
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Sochi Market Analysis as a Health Tourism Destination
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Nadezhda K. Serdyukova
2013-01-01
Full Text Available The article considers major characteristics of Sochi market as a health tourism destination, analyses the structure of resort collective accommodation facilities, dynamics of tourist flows and their structure, prevailing kinds of tourism and estimates tourist flows of health tourism in Sochi in 2008-2012. The authors indicate major characteristics and trends of Sochi tourist market development and the prospects of Sochi development as a health tourism destination. The percent of health tourist flow in the general tourist flow of Sochi and the percent of domestic tourist flow in the sector of collective accommodation facilities are estimated. The authors came to the conclusion that to develop tourism in Sochi in post-Games period, it is necessary to promote Sochi as a health tourism destination.
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The Branding of Kharkov City as a Tourist Destination
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Danko Nataliya I.
2016-05-01
Full Text Available On the basis of analyzing publications and documents of the United Nations World Tourism Organization (UNWTO, the authors clarified the concept of «tourist destination»; considered and clarified the concept of «brand of the tourist destination»; suggested the mechanism for development of the brand of the tourist destination. The existing brand of Kharkiv – «Kharkiv – smart city» – has been analyzed and it was concluded that this brand is promising and successful for educational tourism, for attracting foreign students and scholars – connoisseurs of new technologies and science fiction. The direction of further work on the brand of Kharkiv city as a tourist destination is to enhance the already existing brand «Kharkiv – smart city» by introducing a set of marketing communications, aggressive advertising campaign in Ukrainian and international media and travel exhibitions. Besides, it is considered to be promising to design brands intended for other target segments of consumers – «Kharkiv – historic city», «Kharkiv – sport city», etc., which will lead to a synergistic effect in the tourism industry of Kharkiv. Prospects for further research in this direction are studying new strategic directions of development of Kharkiv city as a tourist destination
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Complexity in built environment, health, and destination walking: a neighborhood-scale analysis.
Carlson, Cynthia; Aytur, Semra; Gardner, Kevin; Rogers, Shannon
2012-04-01
This study investigates the relationships between the built environment, the physical attributes of the neighborhood, and the residents' perceptions of those attributes. It focuses on destination walking and self-reported health, and does so at the neighborhood scale. The built environment, in particular sidewalks, road connectivity, and proximity of local destinations, correlates with destination walking, and similarly destination walking correlates with physical health. It was found, however, that the built environment and health metrics may not be simply, directly correlated but rather may be correlated through a series of feedback loops that may regulate risk in different ways in different contexts. In particular, evidence for a feedback loop between physical health and destination walking is observed, as well as separate feedback loops between destination walking and objective metrics of the built environment, and destination walking and perception of the built environment. These feedback loops affect the ability to observe how the built environment correlates with residents' physical health. Previous studies have investigated pieces of these associations, but are potentially missing the more complex relationships present. This study proposes a conceptual model describing complex feedback relationships between destination walking and public health, with the built environment expected to increase or decrease the strength of the feedback loop. Evidence supporting these feedback relationships is presented.
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Directory of Open Access Journals (Sweden)
Shin Takayama
2012-01-01
Full Text Available Moxibustion therapy has been used in East Asian medicine for more than a thousand years. However, there are some problems associated with this therapy in clinical practice. These problems include lack of control over the treatment temperature, emission of smoke, and uneven temperature distribution over the treatment region. In order to resolve these problems, we developed a precise temperature-control device for use as an alternate for conventional moxibustion therapy. In this paper, we describe the treatment of a single patient with paralytic ileus that was treated with moxibustion. We also describe an evaluation of temperature distribution on the skin surface after moxibustion therapy, the development of a heat-transfer control device (HTCD, an evaluation of the HTCD, and the clinical effects of treatment using the HTCD. The HTCD we developed can heat the skin of the treatment region uniformly, and its effect may be equivalent to conventional moxibustion, without the emission of smoke and smell. This device can be used to treat ileus, abdominal pain, and coldness of abdomen in place of conventional moxibustion in modern hospitals.
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Brun, G; Verdoux, H; Couhet, G; Quiles, C
2018-02-28
Video games and virtual reality have recently become used by clinicians for training or information media or as therapeutic tools. The purpose is to review the use of these technologies for therapy destined for schizophrenia patients. We conducted a review in October 2016 using Pubmed, Scopus and PsychInfo using the following Medical Subject Headings (MESH): "video games", "virtual reality" and "therapy, computer-assisted/methods", each associated with "schizophrenia". Papers were included in the review if: (a) they were published in an English, Spanish or French-language peer-reviewed journal, (b) the study enrolled patients with schizophrenia or schizo-affective disorder, (c) the patients used a therapeutic video game or therapeutic virtual reality device. Eighteen publications were included. The devices studied are mainly therapeutic software developed specifically for therapeutic care. They can be classified according to their therapeutic objectives. These targets corresponded to objectives of psychosocial rehabilitation: improvement of residual symptomatology, cognitive remediation, remediation of cognition and social skills, improvement of everyday life activities, support for occupational integration. Very different devices were proposed. Some researchers analysed programs developed specifically for patients with schizophrenia, while others were interested in the impact of commercial games. Most of the studies were recent, preliminary and European. The impact of these devices was globally positive, particularly concerning cognitive functions. Computer-assisted therapy, video games and virtual reality cannot replace usual care but could be used as adjunctive therapy. However, recommending their use seems premature because of the recent and preliminary character of most studies. Moreover, a link is still lacking between this field of research in psychiatry and other fields of research, particularly game studies. Finally, it might be interesting to analyse more
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Evaluation of advanced cooling therapy's esophageal cooling device for core temperature control.
Naiman, Melissa; Shanley, Patrick; Garrett, Frank; Kulstad, Erik
2016-05-01
Managing core temperature is critical to patient outcomes in a wide range of clinical scenarios. Previous devices designed to perform temperature management required a trade-off between invasiveness and temperature modulation efficiency. The Esophageal Cooling Device, made by Advanced Cooling Therapy (Chicago, IL), was developed to optimize warming and cooling efficiency through an easy and low risk procedure that leverages heat transfer through convection and conduction. Clinical data from cardiac arrest, fever, and critical burn patients indicate that the Esophageal Cooling Device performs very well both in terms of temperature modulation (cooling rates of approximately 1.3°C/hour, warming of up to 0.5°C/hour) and maintaining temperature stability (variation around goal temperature ± 0.3°C). Physicians have reported that device performance is comparable to the performance of intravascular temperature management techniques and superior to the performance of surface devices, while avoiding the downsides associated with both.
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DIFFERENT PERCEPTIONS ABOUT TOURIST IDENTITY IN THE DANUBE GATE DESTINATION
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SABINA GHEORGHECI
2015-12-01
Full Text Available Thus, uncontrollable elements such as nice weather, nature/scenery, accessibility, transformed into controllable elements such as pleasant environment, relaxing atmosphere, infrastructure, can create a favourable artistic image that would determine the tourist to pick the destination. Uncontrollable elements such as local culture, diversity of sport activities, of restaurant, cafes etc. that can increase the value of a destination, transformed into controllable elements such as historical sites, events (cultural activities, festivals etc. form an environment where “there are plenty of things to do” and can create a favourable psychological image that will make the tourist return to this destination. The transformation of these attributes into advantages for the tourist, so that a destination can be differentiated, takes places within a positioning strategy.
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VARIABLES OF THE IMAGE OF TOURIST DESTINATION
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Ban Olimpia
2008-05-01
Full Text Available The image of a destination is more than a distinguishing element; it is a component of the supply and brings more value to it. The image of a destination can be the decisive component, while the other elements re relatively alike (1. The image of a tourist destination is strongly connected to the image of a country, the image of a nation and the image of a place. The image of a place is formed for a receiver naturally by accumulating experiences with that place, the use of the sources of personal and impersonal information. For the transmitter, the image is the result of some direct and indirect actions. The branding of the place is the conscientious and coordinated process of an image achievement. In the paper there are presented some examples of actions of image research, an essential step having in view the branding or re-branding It is presented a study of the citizens of Oradea regarding their perception of tourist Romania.
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Destination Characteristics that Drive Hotel Performance
DEFF Research Database (Denmark)
Assaf, A. George; Josiassen, Alexander; Woo, Linda
2017-01-01
, government support, disposable income, and number of international arrivals within a tourism destination. Results indicate that the most important barriers to hotel performance are the competition among accommodation providers, tax rate and fuel price. We argue for the need for hotel providers to develop......The increased market saturation and competition in both domestic and international tourism destinations have renewed interest among hotel operators in identifying the key drivers of hotel performance. This paper presents a comprehensive analysis of the determinants of hotel performance...... strategies that take cognisance of the key drivers and barriers to enhancing hotel performance in an ever-changing global tourism sector....
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Destination memory in Alzheimer's Disease: when I imagine telling Ronald Reagan about Paris.
El Haj, Mohamad; Postal, Virginie; Allain, Philippe
2013-01-01
Destination memory refers to remembering the destination of information that people output. This present paper establishes a new distinction between external and internal processes within this memory system for both normal aging and Alzheimer's Disease (AD). Young adults, older adults, and mild AD patients were asked either to tell facts (i.e., external destination memory condition) or to imagine telling facts (i.e., internal destination memory condition) to pictures of famous people. The experiment established three major findings. First, the destination memory performance of the AD patients was significantly poorer than that of older adults, which in turn was poorer than that of the young adults. Furthermore, internal destination processes were more prone to being forgotten than external destination memory processes. In other words, participants had more difficulty in remembering whether they had previously imagined telling the facts to the pictures or not (i.e., imagined condition) than in remembering whether they had previously told the facts to the pictures or not (i.e., enacted condition). Second, significant correlations were detected between performances on destination memory and several executive measures such as the Stroop, the Plus-Minus and the Binding tasks. Third, among the executive measures, regression analyses showed that performance on the Stroop task was a main factor in explaining variance in destination memory performance. Our findings reflect the difficulty in remembering the destination of internally generated information. They also demonstrate the involvement of inhibitory processes in destination memory. Copyright © 2011 Elsevier Ltd. All rights reserved.
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Tourist Satisfaction and Destination Loyalty intention: A Structural and Categorical Analysis
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Guerreiro, M.
2006-01-01
Full Text Available This study explores the relationship between travel satisfaction and destination loyalty intention. The research was conducted with 486 tourists visiting Arade, a Portuguese tourist destination. Taking as the basis the use of structural equation modelling (SEM, the results substantiate the importance of tourism satisfaction as a determinant of destination loyalty. Also, a categorical principal components analysis (CATPCA provides a detailed analysis of this cause-effect relationship by establishing that greater levels of satisfaction (measured by overall satisfaction in terms of holiday experience, destination ttributes and met expectations result in increased likelihood of future repeat visits and a keen willingness to recommend the destination to others. Clusters of tourists were also identified and characterized in relation to satisfaction levels and loyalty intentions. These analyses provide a useful background in the planning of future tourist marketing strategies.
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Alsara, Osama; Perez-Terzic, Carmen; Squires, Ray W; Dandamudi, Sanjay; Miranda, William R; Park, Soon J; Thomas, Randal J
2014-01-01
Because a limited number of patients receive heart transplantation, alternative therapies, such as left ventricular assist device (LVAD) therapy, have emerged. Published studies have shown that LVAD implantation, by itself, improves exercise tolerance to the point where it is comparable to those with mild heart failure. The improvement in exercise capacity is maximally achieved 12 weeks after LVAD therapy and can continue even after explantation of the device. This effect varies, depending on the type of LVAD and exercise training. The available data in the literature on safety and benefits of exercise training in patients after LVAD implantation are limited, but the data that are available suggest that training trends to be safe and have an impact on exercise capacity in LVAD patients. Although no studies were identified on the role of cardiac rehabilitation programs in the management of LVAD patients, it appears that cardiac rehabilitation programs offer an ideal setting for the provision of supervised exercise training in this patient group.
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Building Customer Loyalty in Rural Destinations as a Pre-Condition of Sustainable Competitiveness
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Kateřina Ryglová
2018-03-01
Full Text Available The paper is dedicated to the issues of rural tourism with regard to the visitor’s loyalty towards the destination in a sustainable development context. Particularly, the findings of the research focused on exploring mutual relations among quality dimensions of the rural destination, overall satisfaction of the visitor, and his or her loyalty towards the destination are presented. A structural model was used to explore the relations among quality dimensions, overall satisfaction, and loyalty in the specific environment of the Czech Republic (inland European country, EU member, until 1989 a socialist country, nearly 93% municipalities with fewer than 3000 inhabitants. The research results allow deeper understanding of the visitor’s behavior and the factors influencing the loyalty towards the destination. The significance order of the dimensions according to their direct influence on the required loyalty towards the destination, i.e., coming back to the destination and spreading positive references to the destination, is as follows: 1. well-being, 2. image, 3. services. We conclude that overall satisfaction directly influences loyalty towards the destination.
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Holiday Destination Choice Behavior Analysis Based on AFC Data of Urban Rail Transit
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Chang-jun Cai
2015-01-01
Full Text Available For urban rail transit, the spatial distribution of passenger flow in holiday usually differs from weekdays. Holiday destination choice behavior analysis is the key to analyze passengers’ destination choice preference and then obtain the OD (origin-destination distribution of passenger flow. This paper aims to propose a holiday destination choice model based on AFC (automatic fare collection data of urban rail transit system, which is highly expected to provide theoretic support to holiday travel demand analysis for urban rail transit. First, based on Guangzhou Metro AFC data collected on New Year’s day, the characteristics of holiday destination choice behavior for urban rail transit passengers is analyzed. Second, holiday destination choice models based on MNL (Multinomial Logit structure are established for each New Year’s days respectively, which takes into account some novel explanatory variables (such as attractiveness of destination. Then, the proposed models are calibrated with AFC data from Guangzhou Metro using WESML (weighted exogenous sample maximum likelihood estimation and compared with the base models in which attractiveness of destination is not considered. The results show that the ρ2 values are improved by 0.060, 0.045, and 0.040 for January 1, January 2, and January 3, respectively, with the consideration of destination attractiveness.
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Re-motivation in tourist destinations, redistribution and power
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Carmen Díaz Domínguez
2016-09-01
Full Text Available Tourist destinations are constantly required to renew their products, services and projected image. This is possible, among other processes, through business innovation and co-management between tour operators and administrations in order to reach markets. This paper focusses on case studies of two specialised agrotourism businesses located in Fuerteventura (Canary Islands, and shows how innovation in products is limited when tour operators also come to control the supply of small and medium-sized companies, at least in destinations where mass tourism predominate. Here remotivation is presented as a means of providing the tourist with local supply in the destination in a way that allows it to stand out, aid the creation of local businesses and products, enrich the tourist experience and redistribute the profits of tourism across the area.
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Modelling the Image Research of a Tourism Destination
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Nicolae Teodorescu
2014-11-01
Full Text Available The problematic area of the tourism destination image has a high expansion in marketing, the efforts of its conceptualization and phenomenalism being remarkable among specialists. In this context, the authors propose a systemic approach, the result of which refers to a model regarding the image research of a tourism destination, whose validation has been attained using Transalpina destination. The model created by the authors envisages morphological features and specific functional relationships, which are consistent with the marketing theory, and, in context, with the consumer behaviour theory. The conceptualmethodological solutions are magnified by applicative-experimental validations, which enhance the theoretical and practical valences of the created model. The main direction of developing the elaborated model consists in efforts of formalization and abstracting, in the perspective offered by several scientific disciplines.
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YouTube's Role in Destination Image Creation
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Hrvoje Jakopović
2015-09-01
Full Text Available Contemporary promotion of tourist destinations represents a challenge and gives rise to many questions in a regard to numerous ways of communicating and transferring information. With concern to modern communication practices in society and due to fast-paced lifestyle, individuals are looking for information online and are making decisions based on available Internet data. Attracting tourists through traditional promotional techniques such as brochures, leaflets, printed guidebooks, fairs and festivals are unsufficient with a respect to the rising number of online users. Promotion of tourism is based on destination image which is created through direct or mediated experience and projected on the minds of individuals. It is greatly dependent on available information mostly visual. YouTube is a popular video sharing site that counts over one billion users. It gives open access to a great number of videos and therefore could have an important role in promoting tourist destinations. The website was firstly used for non-commercial purposes but today it is very attractive for advertisers. The author examines phenomena of YouTube and its potential for destination image creation. The aim of this article is to give an insight on characteristics of promotional videos used for tourism and to explore how various national and local tourist boards can use them on YouTube. The author identifies the public relations profession’s role in creation of promotional audio-visual material.
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Bridging knowledge capital with tourism destination stakeholders
DEFF Research Database (Denmark)
d'Ambrosio, Luigi; Madsen, Jan Halberg; Wejrum, Lone Møller
2015-01-01
Backgorund: - The background of this paper is a student initiated study trip to the area of Campi Flegrei (Italy) in April 2014. The authors of this paper participated as lecturers and arranged meetings with a variety of tourism- and hospitality organizations operating in the destination. Through...... with their own research including data collection under the supervision of the lecturers. Methods/data: - The methodology of this study is based on a qualitative investigation of local tourism and hospitality stakeholders that operate in the destination collected by lecturers/researchers and students through...
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Destination visual image and expectation of experiences
DEFF Research Database (Denmark)
Ye, H.; Tussyadiah, Iis
2011-01-01
A unique experience is the essence of tourism sought by tourists. The most effective way to communicate the notion of a tourism experience at a destination is to provide visual cues that stimulate the imagination and connect with potential tourists in a personal way. This study aims...... at understanding how a visual image is relevant to the expectation of experiences by deconstructing images of a destination and interpreting visitors' perceptions of these images and the experiences associated with them. The results suggest that tourists with different understandings of desirable experiences found...
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Tourism destination development in Thailand
Pongajarn, Chalermpat
2017-01-01
Informed by actor-network theory (ANT), this research aims at improving understanding of the nature of tourism destinations in Thailand and their development by investigating through three main notions: ordering, materiality and multiplicity. These notions enabled to study how tourism
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Exploration Space Suit Architecture and Destination Environmental-Based Technology Development
Hill, Terry R.; McFarland, Shane M.; Korona, F. Adam
2013-01-01
This paper continues forward where EVA Space Suit Architecture: Low Earth Orbit Vs. Moon Vs. Mars left off in the development of a space suit architecture that is modular in design and could be reconfigured prior to launch or during any given mission depending on the tasks or destination. This space suit system architecture and technologies required based on human exploration (EVA) destinations will be discussed, and how these systems should evolve to meet the future exploration EVA needs of the US human space flight program. A series of exercises and analyses provided a strong indication that the Constellation Program space suit architecture, with its maximum reuse of technology and functionality across a range of mission profiles and destinations, is postured to provide a viable solution for future space exploration missions. The destination environmental analysis demonstrates that the modular architecture approach could provide the lowest mass and mission cost for the protection of the crew, given any human mission outside of low-Earth orbit. Additionally, some of the high-level trades presented here provide a review of the environmental and nonenvironmental design drivers that will become increasingly important as humans venture farther from Earth. The presentation of destination environmental data demonstrates a logical clustering of destination design environments that allows a focused approach to technology prioritization, development, and design that will maximize the return on investment, largely independent of any particular design reference mission.
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Destination brands and website evaluation: a research methodology
Directory of Open Access Journals (Sweden)
J Fernández-Cavia
2013-10-01
Full Text Available Introduction:The World Wide Web has become the primary instrument used by tourists in order to search for information. As a result, tourism websites pertaining to destinations need to be appealing and must convey their brand image in an appropriate, effective manner. However, there is no methodology in place to assess the quality and communicative effectiveness of destination websites that is scientifically sound and universally accepted. The development of such a methodology is one of the tasks we have proposed within the framework of the research project: “New strategies for advertising and promoting Spanish tourism brands online” (CSO2008-02627, funded by the Spanish Ministry of Science and Innovation. Method: The project team have developed an interdisciplinary, all-embracing analysis template combining certain automated analyses with other qualitative and quantitative ones. The template comprises a total of 12 subject areas and 154 indicators prepared on the basis of contributions from prominent experts in each of the fields of work. This article sets out the analysis methodology drawn up and possible applications are given. Results: The primary aim of the project is to provide an assessment methodology that would make it possible to optimise destination brand websites, thus providing a tool to support the work of public tourism destination managers.
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Surgical approach to end-stage heart failure.
Klotz, Stefan; Scheld, Hans H
2011-02-01
End-stage heart failure is a challenging disease with growing incidence. With decreasing heart transplant rates worldwide organ preserving therapies become, again, of interest. The purpose of the present review is to examine the potential challenges of surgical therapies in patients with end-stage heart failure. The gold-standard for end-stage heart failure is and will be cardiac transplantation. However, due to organ shortage this therapy is limited to a few patients. Therefore implantation of ventricular assist devices (VADs) or long-term minimal-invasive partial support devices will increase. Improvements in device design with smaller devices, easier implantation techniques, and modified anticoagulation outcome and long-term success will likely improve. In addition, good quality of life as destination therapy is almost available. Organ conservation surgery (coronary artery bypass grafting and surgical ventricular restoration or surgical repair of mitral valve regurgitation) in end-stage heart failure patients could not prove the expected results. Transcatheter or minimal-invasive approaches of these therapies might become routine in the near future. Due to the overwhelming outcome rates, cardiac transplantation is the most established surgical therapy for end-stage heart failure. VAD therapy is increasing and minimized VADs might further open the market for destination therapy/permanent support.
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Tourist Information Search and Destination Choice in a Digital Age
DEFF Research Database (Denmark)
Kristian Steen Jacobsen, Jens; Munar, Ana Maria
2012-01-01
word-of-mouth, Web 1.0 sources and own experience are highly resilient and influential when tourists to a well-known destination area decide where to spend their summer holiday. Moreover, results indicate a complementary nature of Web 1.0 and Web 2.0. In this context of destination decision......This study provides empirical evidence of self-reported impacts of selected electronic and other information sources on international tourists' destination choices regarding a popular, mature and mainstream summer holiday location. It is shown that traditional information provisions such as direct...
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Human Resources Development and ICT Contribution to the Tourist Destination Competitiveness
Ramona Gruescu; Roxana Nanu; Anca Tanasie
2009-01-01
The paper envisages aspects concerning identification of the competitive advantage of a tourist destination from a double perspective: the critical contribution of the employees and the ICT impact on promoting and selling the destination. Research methodology includes „bottom to top” analysis of the mentioned indicators. Thus, results include the eficientisation of tourist businesses and destinations due to both human element development and ICT technologies. Two essential basis of the compet...
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Destination Attributes and Chinese Outbound Tourism to Europe
Andreu, Rosario; Claver-Cortés, Enrique; Quer, Diego
2014-01-01
China is one of the fastest growing outbound tourism markets. Europe is an attractive destination for Chinese tourists. However, Europe still accounts for a small percentage of Chinese outbound tourism. If European countries want to benefit from this market, they should pay attention to Chinese tourists’ preferences. This article contributes to the understanding of Chinese outbound tourism by analyzing those destination attributes that can influence the number of Chinese tourists received. Fr...
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Directory of Open Access Journals (Sweden)
Elena PETKOVA
2017-03-01
Full Text Available In this paper, it is argued that there is a variety of products and accordingly a diversity of types of tourism in the municipality of Sofia, Bulgaria: urban and "non-urban", mass and specialized, tourism based on natural and anthropogenic, on tangible and intangible resources. In this regard, diverse tourism products of the destination may be offered to its visitors, which to a greater extent meets their various needs and contributes to the sustainable tourism development. Thus, the aim of the paper is to reveal whether tourism professionals in Sofia are aware of the possibilities for combining various types of tourism and promoting the diversified destination tourism product among local and foreign visitors.
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WEBSITES AS A PROMOTING TOOL FOR THE IDENTITY OF TOURISTIC DESTINATIONS
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Francisco Vicente Sales Melo
2013-06-01
Full Text Available Since its advent, the Internet has become an important tool for tourism. Furthermore, some studies tend to indicate that this may contribute directly to the process of identity formation of a tourism destination. Thus, this paper investigates how websites can help in promoting the identity of tourist destinations on the Internet. The study is characterized as exploratory qualitative in nature, which is constituted from a desk research. It was possible to verify that the website is a key means for managing the identity of a tourist destination, as this can help visitors to form a positive image of the place being visited from the information that makes up the identity of the destination.
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Tourism destination image of Russia in the perspective of the portuguese market
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Liliya Arslanova
2017-06-01
Full Text Available In recent decades the importance of destination image has been increasingly analyzed and it is generally considered to be vital in the marketing of destinations. It can be noted that the tourism industry in Russia has not been the subject of a great deal of research with regard to its destination image. Therefore the purpose of this work is to assess Russia’s destination image in the perspective of Portuguese people. The research instrument was an online questionnaire, comprised of open-ended and closed questions. A combination of two software programs, NVivo and IBM SPSS Statistics 21, was employed to analyze the data. This exploratory study suggests that Portuguese peoples’ perceptions of Russia are mostly favorable and they have a high awareness about Russia’s destination features.
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Aghajanyan, Ivan Gerasimovich; Allen, Simon
2016-04-18
The most common types of non-malignant prostate diseases are benign prostatic hyperplasia (BPH) and chronic prostatitis (CP). The aim of this study was to find out whether thermobalancing therapy with a physiotherapeutic device is effective for BPH and CP. During a 2.5-year period, 124 men with BPH over the age of 55 were investigated. Clinical parameters were tested twice: via the International Prostate Symptom Score (IPSS) and via ultrasound measurement of prostate volume (PV) and uroflowmetry maximum flow rate (Q max ), before and after six months of therapy. In 45 men with CP under the age of 55, the dynamics of the National Institute of Health Chronic Prostatitis Symptom Index (NIH-CPSI) were studied. The results of the investigated index tests in men with BPH confirmed a decrease in IPSS ( p BPH and the improvement in NIH-CPSI-QoL in patients with CP after using a physiotherapeutic device for six months as mono-therapy, support the view that thermobalancing therapy with the device can be recommended for these patients. Furthermore, the therapeutic device is free of side effects.
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Destination Information System for Bandung City Using Location-Based Services (LBS) on Android
Kurniawan, B.; Pranoto, H.
2018-02-01
Bandung is a city in West Java, Indonesia with many interesting locations to visit. For most favourite destinations, we can easily look for it on Google and we will find some blogs there discussing about related content. The problem is we can not guarantee that the destination is frequented by visitor. In this research, we utilizes an application to help everyone choosing destination frequented by visitor. The use of information technology in the form of picture, maps, and textual on Android application makes it possible for user to have information about destination with its visitor in a period of time. If destination has visit history, selection of proper destination will be given with fresh informations. This application can run well on Android Lollipop (API Level 21) or above with a minimum RAM of 2 GB since it will compare two coordinates for every data. The use of this app make it possible to access information about location with its visitor history and could help choosing proper destinations for the users.
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Comparing Destination Image and Loyalty between First-time and Repeat-visit Tourists
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Mohamad M.
2014-01-01
Full Text Available The objective of this study was to investigate the difference between destination image and loyalty among first-time and repeat-visit tourists. The study was undertaken to examine aspects of underlying factors of destination image that influenced tourists’ willingness to recommend Malaysia to their friends and relatives as well as spread positive word-of-mouth to others. In addition, it was to ascertain the relationship between destination image and loyalty among first-time and repeat-visit tourists. The data was collected at Kuala Lumpur International Airport at the departure hall using self-administered questionnaires. 248 usable questionnaires were returned and analysed. The findings of the study revealed that both groups of tourists perceived Malaysia as providing a nature-based destination. The study also empirically proved that both first-time and repeat-visit tourists were willing to disseminate positive word-of-mouth and recommend Malaysia to their friends and relatives as a vacation destination to visit. However, there was a significant difference in destination loyalty between first-visit and repeat-visit tourists.
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Fazekas, Levente; Sax, Balázs; Hartyánszky, István; Pólos, Miklós; Horkay, Ferenc; Varga, Tamás; Rácz, Kristóf; Németh, Endre; Székely, Andrea; Paulovich, Erzsébet; Heltai, Krisztina; Zima, Endre; Szabolcs, Zoltán; Merkely, Béla
2015-03-29
Since the celebration of the 20th anniversary of the first heart transplantation in Hungary in 2012 the emerging need for modern heart failure management via mechanical circulatory support has evolved. In May 2012 the opening of a new heart failure and transplant unit with 9 beds together with the procurement of necessary devices at Semmelweis University accomplished this need. The aim of the authors was to report their initial experience obtained in this new cardiac assist device program. Since May, 2012, mechanical circulatory support system was applied in 89 cases in 72 patients. Indication for support were end stage heart failure refractory to medical treatment and acute left or right heart failure. Treatment was initiated for acute graft failure after heart transplantation in 27 cases, for end stage heart failure in 24 cases, for acute myocardial infarction in 21 cases, for acute postcardiotomy heart failure in 14 cases, for severe respiratory insufficiency in 2 cases and for drug intoxication in one case. Among the 30 survivor of the whole program 13 patients were successfully transplanted. The available devices can cover all modalities of current bridge therapy from short term support through medium support to heart transplantation or long term support and destination therapy. These conditions made possible the successful start of a new cardiac assist device program.
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Social Media Strategies and Destination Management
DEFF Research Database (Denmark)
Munar, Ana Maria
2012-01-01
This study provides insights into social media practices and strategic considerations used by destination management organizations (DMOs). It examines a theoretical model of generic social media strategies for destination management and applies qualitative methods to analyze the social media...... initiatives of DMOs of Denmark, Norway, Finland, Sweden and the Scandinavian Tourist Board Asia/Pacific in the Nordic European Region. The study provides empirical evidence of emerging social media strategies among DMOs and confirms the growing importance of these new media. The findings point...... to the conflicting relationship between corporate culture and social media culture, the challenges innovative communication tools present for traditional management structures, poor levels of formalization and the lack of a knowledge base which results in ad-hoc decision making. Overall, the paper discusses...
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Moldovan Perception of Greece as a Tourism Destination
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Stela Cazacu
2017-06-01
Full Text Available Purpose: This research study analyzes Moldovans' intentions to visit Greece, and their perceptions of Greece's image as a tourism destination, according to the following dimensions: (1 environmental beauty and convenience, (2 country's citizens, (3 place and architectural structure, (4 shopping and tourist accommodation and (5 similarity of the local culture and cuisine with the Moldovan one. The goal is split into four objectives. Design/methodology/approach: For attaining the goal, a self-administered questionnaire was delivered. The empirical study was conducted in the capital of Moldova. The findings are based upon a sample of 139 respondents. Findings: The findings reveal that, overall, Greece's image as a tourist destination among Moldovan consumers is partially positive. The perceptions of the tourism dimensions were evaluated in the descending order as follows: place and architectural structure, shopping and tourist accommodation, environmental beauty and convenience, country's citizens and similarity of the local culture and cuisine with the Moldovan one. Research limitations/implications: As it was undertaken only in the capital of Republic of Moldova and because most respondents are young people and females, the findings of this investigation do not absolutely reflect the perceptions of all Moldovans. Also, because the number of respondents is small, it is not representative of the whole Moldovan population. Hence, the results might not be very realistic and accurate. Originality/value: This study provides insightful theoretical implications and practical recommendations in creating marketing strategies that would help in managing and improving Greece's image as a destination among Moldovan tourists. Also, no study, at least to the researcher's knowledge, has evaluated Greece's image as a destination among Moldovan consumers. Finally, due to the increasing number of Moldovan tourists in Greece, it is important that Greece grasps this
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Study of behavior, preferences and attitudes visitors tourist destinations Tara
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Rakić Mirjana
2010-01-01
Full Text Available One of the strategic development of the Serbian economy is tourism. Tourist destinations Tara has great tourism potential. The starting assumption for the development of tourism and creating a tourist destination brand of Tara is the analysis of image of tourism, and this is exactly the subject of the current paper. The image analysis includes the examination of preferences, attitudes and behavior of visitors to this tourist destination. This research is exploratory, but may be a useful starting point for further, more comprehensive research on which the results would be based upon serious analysis and making relevant decisions.
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Medical Tourist's Perception in Selecting their Destination: A Global Perspective.
Sarwar, Abdullah Am; Manaf, Noorhazilah A; Omar, Azura
2012-01-01
The need for better healthcare has grown significantly in recent years. In addition, the rising healthcare costs in the U.S. and in many European countries have forced many patients to seek medical treatment abroad, which has created the demand for medical tourism. With little yet known as to the perception of a medical tourist's destination selection, this study aims to explore medical tourist's perception in selecting their destination while going for medical treatment. Realizing the current need to examine closely the perception of medical tourists, this study had conducted a secondary study to collect data for assessing and identification of the key factors on patient's perception and destination selection criteria. The result confirms the existence of a very strong relationship between cost, service quality, treatment types and availability and marketing impact on the perception of the medical tourists' in selecting their medical tourism destination. This study offers support for the proposed conceptual model and an empirical basis for comparison in future research.
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Students in Action: Engaging Students with Destination Stakeholders
Craggs, Ruth; Gorman, Catherine; Griffin, Kevin; mottiar, ziene; Quinn, Deirdre; Quinn, Bernadette; Ryan, Theresa
2015-01-01
The Students in Action Project in the School of Hospitality Management and Tourism was established in 2012 as a way of engaging students and working with stakeholders in a destination. The overall aim of the project was to immerse students in an active collaborative learning environment within the destination to identify ways in which tourism could be enhanced. In the 2014/2015 academic year the project involved over 300 students from a variety of programmes and modules working with local sta...
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Amenity migration: the migratory phenomenon in mountain tourism destinations
Directory of Open Access Journals (Sweden)
Lía Domínguez de Nakayama
2007-12-01
Full Text Available Since long time ago population dynamics in Argentina has been linked to migration. Nevertheless, scientists have concluded that no research has found migration to be due to positive attractors. Almost every research presents migration as the unavoidable outcome of constraining environmental conditions. Recently a new type of migration has come to be, linked with tourism, which has received the denomination of amenity migration, and has as its subjects people who, after being tourist in a certain destination, decide to come back to it as dwellers. They can stay either for the season or the whole year. This movement produces important effects in the collective profile of tourism destinations. This article intends to study demographic and social processes quickened in mountain tourism destinations by this peculiar kind of migration, with a case study in two Argentinean cities San Martín de los Andes (Neuquén y Villa General Belgrano (Córdoba. Documental research and in-depth interviews with migrants as well as natives enables an preliminary understanding of the way this kind of migration affects socio cultural configuration in destination places as well as relationship amongst residents and newcomers and sustainability policies for local development.
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Tradition as an initiator of rural tourism destinations development
Directory of Open Access Journals (Sweden)
Antić Aleksandar
2015-01-01
Full Text Available Rural tourism is a form of tourism that best illustrates the importance of tradition in the development of tourist destinations. Music, dance, clothing, culinary specialties of local cuisine, unique natural beauty and the very mentality and hospitality of people in rural areas, represent some of the factors that influence the tourist's consciousness when choosing this type of holiday. The research is focused on the main hypothesis that the tradition is an initiator of rural tourism destinations development. Furthermore, this would imply positive effects in the field of tourism and economy in general and the economy of the region. The goal of the paper is to show the importance of tradition in the cultural identity of rural areas and potentials of tradition in the role of initiating rural tourism destinations development. The interview with staff members in Pozarevac Tourism Organization has helped in the SWOT analysis of the observed rural destination. An empirical research is conducted on a random sample of 232 participants in order to highlight the benefits of rural tourism development in Pozarevac and its surrounding area. The data were processed in SPSS program (version 17.0.
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International Nuclear Information System (INIS)
Gomez, Daniel R.; Poenisch, Falk; Pinnix, Chelsea C.; Sheu, Tommy; Chang, Joe Y.; Memon, Nada; Mohan, Radhe; Rozner, Marc A.; Dougherty, Anne H.
2013-01-01
Purpose: Photon therapy has been reported to induce resets of implanted cardiac devices, but the clinical sequelae of treating patients with such devices with proton beam therapy (PBT) are not well known. We reviewed the incidence of device malfunctions among patients undergoing PBT. Methods and Materials: From March 2009 through July 2012, 42 patients with implanted cardiac implantable electronic devices (CIED; 28 pacemakers and 14 cardioverter-defibrillators) underwent 42 courses of PBT for thoracic (23, 55%), prostate (15, 36%), liver (3, 7%), or base of skull (1, 2%) tumors at a single institution. The median prescribed dose was 74 Gy (relative biological effectiveness; range 46.8-87.5 Gy), and the median distance from the treatment field to the CIED was 10 cm (range 0.8-40 cm). Maximum proton and neutron doses were estimated for each treatment course. All CIEDs were checked before radiation delivery and monitored throughout treatment. Results: Median estimated peak proton and neutron doses to the CIED in all patients were 0.8 Gy (range 0.13-21 Gy) and 346 Sv (range 11-1100 mSv). Six CIED malfunctions occurred in 5 patients (2 pacemakers and 3 defibrillators). Five of these malfunctions were CIED resets, and 1 patient with a defibrillator (in a patient with a liver tumor) had an elective replacement indicator after therapy that was not influenced by radiation. The mean distance from the proton beam to the CIED among devices that reset was 7.0 cm (range 0.9-8 cm), and the mean maximum neutron dose was 655 mSv (range 330-1100 mSv). All resets occurred in patients receiving thoracic PBT and were corrected without clinical incident. The generator for the defibrillator with the elective replacement indicator message was replaced uneventfully after treatment. Conclusions: The incidence of CIED resets was about 20% among patients receiving PBT to the thorax. We recommend that PBT be avoided in pacing-dependent patients and that patients with any type of CIED receiving
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DeNASA: Destination-Naive AS-Awareness in Anonymous Communications
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Barton Armon
2016-10-01
Full Text Available Prior approaches to AS-aware path selection in Tor do not consider node bandwidth or the other characteristics that Tor uses to ensure load balancing and quality of service. Further, since the AS path from the client’s exit to her destination can only be inferred once the destination is known, the prior approaches may have problems constructing circuits in advance, which is important for Tor performance. In this paper, we propose and evaluate DeNASA, a new approach to AS-aware path selection that is destination-naive, in that it does not need to know the client’s destination to pick paths, and that takes advantage of Tor’s circuit selection algorithm. To this end, we first identify the most probable ASes to be traversed by Tor streams. We call this set of ASes the Suspect AS list and find that it consists of eight highest ranking Tier 1 ASes. Then, we test the accuracy of Qiu and Gao AS-level path inference on identifying the presence of these ASes in the path, and we show that inference accuracy is 90%. We develop an AS-aware algorithm called DeNASA that uses Qiu and Gao inference to avoid Suspect ASes. DeNASA reduces Tor stream vulnerability by 74%. We also show that DeNASA has performance similar to Tor. Due to the destination-naive property, time to first byte (TTFB is close to Tor’s, and due to leveraging Tor’s bandwidth-weighted relay selection, time to last byte (TTLB is also similar to Tor’s.
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Partners and innovation in American destination marketing organizations
DEFF Research Database (Denmark)
Zach, Florian
2012-01-01
Innovation and interorganizational collaboration have been identified as important elements of competitive tourism strategies. This study proposes a model that relates aspects of organizational settings and collaboration to the success of innovation within the organization. In particular, this st......Innovation and interorganizational collaboration have been identified as important elements of competitive tourism strategies. This study proposes a model that relates aspects of organizational settings and collaboration to the success of innovation within the organization. In particular......, this study focuses on destination marketing organizations (DMOs) as they collaborate with destination businesses to assist in the development of new services in marketing the destination. A national survey among American DMOs indicates that partner collaboration is a significant driver of visitor......-orientated innovation. Specifically, innovation success was found to be driven solely by the development of market-oriented rather than strategyoriented new services, indicating that many of the American DMOs respond to visitor changes at the expense of providing new services that somehow do not fit within current...
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Directory of Open Access Journals (Sweden)
Ljiljana Pjerotic
2017-06-01
Full Text Available The importance of involving diverse stakeholders in tourism planning is receiving growing recognition. Tourism destination planning is a complex process, due to the existence of a wide variety of stakeholders with a wide range of opinions, multiple problem visions and different interests. Despite the complexity of the planning process one feature acknowledged for successful destination management planning is high level of stakeholder cooperation. The paper examines the level of stakeholder cooperation on the specific example of the sustainable development concept implementation in Montenegrin tourism. It starts with two hypotheses: first, the development level of instruments for managing tourist destination depends on stakeholder cooperation level in a particular destination, and second, implementation of the sustainable development concept is positively correlated with the development of instruments for managing tourist destination. The results have indicated poor implementation of tourism development plans and low level of stakeholder cooperation.
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Destination Memory in Korsakoff's Syndrome
El Haj, M.; Kessels, R.P.C.; Matton, C.; Bacquet, J.E.; Urso, L.; Cool, G.; Guidez, F.; Potier, S.; Nandrino, J.L.; Antoine, P.
2016-01-01
BACKGROUND: Context memory, or the ability to remember the context in which an episodic event has occurred (e.g., where and when an event took place), has been found to be compromised in Korsakoff's syndrome. This study examined whether a similar deficit would be observed for destination memory,
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Destination memory in Korsakoff's syndrome
El Haj, M.; Kessels, R.P.C.; Matton, C.; Bacquet, J.E.; Urso, L.; Cool, G.; Guidez, F.; Potier, S.; Nandrino, J.L.; Antoine, P.
2016-01-01
Background: Context memory, or the ability to remember the context in which an episodic event has occurred (e.g., where and when an event took place), has been found to be compromised in Korsakoff's syndrome. This study examined whether a similar deficit would be observed for destination memory,
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How to develop sustainable tourism in rural destinations in Serbia
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Štetić Snežana
2008-01-01
Full Text Available The classical distinction between countries of tourist offer and countries of tourist demand has already been surpassed considering that many countries of tourist demand (USA, Germany, Great Britain … earn much more from tourism than the countries of tourist offer (Italy, Greece, Portugal …. The changes in customers' behaviour are reflected through restructuring of tourist movements towards new destinations. What is essential in creating, promoting and marketing tourist destinations for the specific tourism forms development is the identification of all the positive and negative factors that influence the development of these destinations. Converting a potential into a tourist destination depends on many factors both in qualitative and in quantitative sense. Discovering an area of preserved environment that also possesses attractive motifs presents the beginning of the possible tourist destination creating. Further 'destiny' of a tourist destination depends on its planning and development intensity. Rural tourism is a significant component of integral and sustainable development and revitalization of the village, as well as a component that is missing in stimulating the local market development for agricultural and non-agricultural activities in the country, along with a special stimulation to employment. Serbia possesses remarkable natural resources and other potentials for the development of all forms of rural tourism. However, rural tourism in Serbia is an insufficiently organized field that is not being developed adequately to the possibilities available to it. That is why this paper wants to point out the potential opportunities for the development of rural tourism in Serbia through sustainable development and correct performance policy on both national and international tourist market.
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Managements and marketing in Korca tourist destination
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Esmeralda Shkira
2012-12-01
Full Text Available Tourism is characterized as being a sector that stands out as one of the business activities with the greatest potential for worldwide expansion and as an engine for economic growth. If at the national level, the appeal of tourism is significant, on the local level this sector presents itself as an essential tool in regional development, as a means to avoid regional desertification and stagnation, stimulating the potential of more undeveloped regions. In such a competitive sector as tourism, companies should develop synergies and achieve competitive advantage. This paper reports on experiences and activities that are taken in destination management and marketing in Korça tourist region. Primarily it is told about importance of management and the role of marketing in the development of tourist destination and how to be combined them to grow up competitive advantages. Then are described all main problems of destination management and marketing in Korça region and all problems that are viewed in tourist villages of this region. In the end is suggested a model that can be used to develop sustainable tourism, to grow up profits and to reduce negative impacts that would come from this industry.
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RESEARCH ON TOURISM DESTINATIONS MARKETING FROM THE PUBLIC RELATIONS’ PERSPECTIVE
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Gabriela ARIONESEI
2012-12-01
Full Text Available Nowadays, tourism destinations are more and more determined to build a unique and competitive identity and image in consumers’ minds. Even though the marketing of tourism destinations has been awarded an intended purpose, in practice there is a lack of steadiness, sometimes an unexplained deficiency of empirical academic research. In some countries, many without "a tradition in tourism", building a marketing strategy for travel destinations is based on artificial and without substance images/perceptions of real and potential tourists. The paper describes the role of marketing in the domain of tourism, emphasizing the importance of public relations in the promotion process of the region of Bucovina.
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A novel vacuum assisted closure therapy model for use with percutaneous devices.
Cook, Saranne J; Nichols, Francesca R; Brunker, Lucille B; Bachus, Kent N
2014-06-01
Long-term maintenance of a dermal barrier around a percutaneous prosthetic device remains a common clinical problem. A technique known as Negative Pressure Wound Therapy (NPWT) uses negative pressure to facilitate healing of impaired and complex soft tissue wounds. However, the combination of using negative pressure with percutaneous prosthetic devices has not been investigated. The goal of this study was to develop a methodology to apply negative pressure to the tissues surrounding a percutaneous device in an animal model; no tissue healing outcomes are presented. Specifically, four hairless rats received percutaneous porous coated titanium devices implanted on the dorsum and were bandaged with a semi occlusive film dressing. Two of these animals received NPWT; two animals received no NPWT and served as baseline controls. Over a 28-day period, both the number of dressing changes required between the two groups as well as the pressures were monitored. Negative pressures were successfully applied to the periprosthetic tissues in a clinically relevant range with a manageable number of dressing changes. This study provides a method for establishing, maintaining, and quantifying controlled negative pressures to the tissues surrounding percutaneous devices using a small animal model. Published by Elsevier Ltd.
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A visual analysis of a cultural tourism destination | Eringa | Research ...
African Journals Online (AJOL)
... can help to frame the experience in all three stages. For that reason it is advisable for destinations to employ some kind of visual identity system management to package the city image into a clear brand. Keywords: European Capital of Culture, Leeuwarden 2018, Chinese visitors, destination branding, flanking research ...
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Directory of Open Access Journals (Sweden)
Márcio Marreiro das Chagas
2013-08-01
Full Text Available This paper analysis tourism destination image influences on satisfaction and loyalty to Sun and Sea tourism destinations, investigating Natal/RN as a case. Quality dimensions were control variables. Therefore, it was conducted an exploratory and descriptive research with quantitative analytical approach. Data collection was performed by a questionnaire addressed to International tourists at the Augusto Severo International Airport. The composition was a simple random sampling by reaching the final number of 300 international tourists interviewed. Among the main results, it was noted that nine are the dimensions of perceived Quality of Sun and Sea segment, it means, Beaches, Public Equipment, Restaurants, Transportation, Information and Finance Services, Hotel Equipment, Diversity of Restaurants and Food, Complementary Services and Access to the hotel and Tourism Attractions, Urban and Natural Scenery. From the results, it was concluded that tourism destination image influences satisfaction and loyalty. Moreover, quality seems to be other important dimension for the satisfaction and loyalty process.
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Stakeholder Colaboration in Tourism Destination Planning – The Case of Montenegro
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Pjerotić Ljiljana
2016-06-01
Full Text Available The importance of involving diverse stakeholders in tourism planning is receiving growing recognition. Effective tourism destination planning is a complex process, due to the existence of a wide variety of stakeholders with a wide range of opinions, multiple problem visions and different interests. Despite the complexity of the planning process one feature acknowledged for successful destination management planning is a high level of stakeholder engagement and cooperation. The implementation and success of a tourism plan often relies on the support of destination stakeholders.
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Cosmopolitanism Influence on Destination Image: An Analysis of São Paulo City
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Felipe Nasrallah Bedran
2014-12-01
Full Text Available This study aimed to find out how cosmopolitanism influences the destination image building. To accomplish this objective we interviewed foreign people, who know São Paulo, a city with national and international importance, due to its structure, economy, size, population and by its intense cultural and business life. This work reviewed cosmopolitanism that is the desire to know other cultures, besides his native one. This leads to an intention to travel through different regions, countries, to deepen in other societies and try to blend into it. Thus, one has particular characteristics, which influence the way one lives and consume products. The destination image can be defined as the sum of beliefs, ideas and impressions that a person has about a destination. To understand how cosmopolitanism influences the destination image, two approaches were used. A qualitative approach used interviews with professionals from SPTuris, as well as personal interviews with foreign tourists at the airport., This data was analyzed using content analysis. The quantitative approach included a survey with 205 foreigners. Data was analyzed using univariate and multivariate statistics, ANOVA and structural equation modeling. The result showed that cosmopolitanism and income influences the affective aspect in the destination image formation. It also showed that the stay purpose influenced the cognitive aspect, and that the length of stay influenced both aspects of the destination image. The research result showed that the cosmopolitanism influences mainly the affective aspect of São Paulo destination image.
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The destinal question of language
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Saitya Brata Das
2011-06-01
Full Text Available How can we think the destinal place of language in the essentially historical condition of our existence if such historicity cannot be understood on the basis of the labor of negativity alone? The attempt is made here to think language in a more originary manner, as non-negative finitude, that affirms what is outside dialectical-speculative closure, what is to come. The notion of 'destinal' itself is thus transformed. No longer being merely a categorical grasp of "entities presently given", language is an originary exposure to the event of arrival in its lightning flash. Destiny appears as that of the messianic arrival of the 'not yet' which is not a telos that the immanent movement of historical reason reaches by an irresistible force of the negative. This essay reads Schelling, Heidegger and Kierkegaard to think language as a "place" of exposure to the non-teleological destiny that may erupt even today, here and now, without any given conditionality.Como nós podemos pensar o lugar destinal da linguagem na condição essencialmente histórica de nossa existência se tal historicidade não pode ser entendida com base apenas no trabalho da negatividade? Faz-se aqui a tentativa de pensar a linguagem de um modo mais originário, como finitude não negativa, que afirma o que se encontra fora do fechamento dialético-especulativo, o que está por vir. A própria noção de 'destinal' é então transformada. Não sendo mais apenas uma apreensão categorial de "entidades presentemente dadas", a linguagem é uma exposição originária ao evento da chegada em seu instante iluminador. O destino aparece como o da chegada messiânica do 'ainda não' que não é um telos que o movimento imanente da razão histórica atinge por meio de uma irresistível força do negativo. Este ensaio lê Schelling, Heidegger e Kierkegaard para pensar a linguagem como um "lugar" de exposição ao destino não teológico que pode irromper mesmo hoje, aqui e agora, sem
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Clitoral therapy device for treatment of sexual dysfunction in irradiated cervical cancer patients
International Nuclear Information System (INIS)
Schroder, MaryAnn; Mell, Loren K.; Hurteau, Jean A.; Collins, Yvonne C.; Rotmensch, Jacob; Waggoner, Steven E.; Yamada, S. Diane; Small, William; Mundt, Arno J.
2005-01-01
Purpose: The purpose of this pilot study was to evaluate the efficacy of the clitoral therapy device (Eros Therapy) in alleviating sexual dysfunction in irradiated cervical cancer patients. Methods and materials: Eligible patients had a history of cervical cancer treated with radiotherapy and self-reported sexual dysfunction of sexual arousal and/or orgasmic disorders. Patients used the noninvasive, nonpharmacologic clitoral therapy device using a hand-held, battery-powered vacuum to cause clitoral engorgement four times weekly for 3 months during foreplay and self-stimulation. Study instruments included the Female Sexual Function Index, Derogatis Interview for Sexual Functioning, and Dyadic Adjustment Scale. The outcome evaluation was performed at 3 months. Results: Between 2001 and 2002, 15 women were enrolled and 13 completed the study. The median patient age and radiotherapy-enrollment interval was 43.5 years and 2 years, respectively. At baseline, all patients reported symptoms of sexual arousal and/or orgasmic disorders, and some also had sexual desire and pain disorders. At 3 months, statistically significant improvements were seen in all domains tested, including sexual desire, arousal, lubrication, orgasm, sexual satisfaction, and reduced pain. The median Female Sexual Function Index total score increased from 17 to 29.4 (maximal score, 36; p <0.001). The median Derogatis Interview for Sexual Functioning total raw score increased from 46 to 95 (maximal score, 118; p <0.001). At baseline, the Derogatis Interview for Sexual Functioning total T-score corresponded to the bottom 10th percentile of normal sexual functioning. At 3 months, the total T-score placed the patients at the normalcy cutoff. Gynecologic examinations revealed improved mucosal color and moisture and vaginal elasticity and decreased bleeding and ulceration. Conclusion: Our results from this pilot study suggest that the clitoral therapy device may alleviate sexual dysfunction in irradiated
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APPROACHES IN INVESTIGATING ROMANIA’S IMAGE AS A TOURIST DESTINATION AMONG THE TURKISH STUDENTS
Directory of Open Access Journals (Sweden)
Olimpia BAN
2010-12-01
Full Text Available The image of the tourist destination plays an essential role in the decision making process regarding the choice of a holiday. Image has a crucial role in the success of the destination because it influences the consumers’ satisfaction and helps in drawing up a promotion strategy for the positioning/repositioning on a certain market, branding/rebranding the tourist destination. Information from different sources contribute to the formation of the image of a certain destination, information which can be distributed into: the promotion performed by the destination; the other’s opinions (direct or indirect; mass-media and the popular culture. We intended to investigate Romania’s image a a tourist destination among the Turkish students. The results showed that the students had very poor knowledge of our country.
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Tourism Destination Management (Case Study in Department of Culture and Tourism Pasuruan Regency
Directory of Open Access Journals (Sweden)
Sony Manggala Putra
2015-02-01
Full Text Available The tourism sector as one of the leading sectors in Pasuruan still faces many obstacles. The constraints associated with conditions that require improvement on tourist destination related to the presence of infrastructure, zoning, the gap between the tourism destination in the West and the East area, up to the level of visitation which has decreased from year to year. The aims of the studi were to describe and analyze Tourism Destination Management conducted by Department of Culture and Tourism Pasuruan at Banyu Biru and Ranu Grati object to become competitive and sustainable tourism destination. This study used a qualitative approach with a case study method locus in the Department of Culture and Tourism Pasuruan. The results of this study indicate that the tourism destination management of Banyu Biru and Ranu Grati when reviewed in terms of competitiveness, still needs a lot of improvement related to the presence of tourism facilities and the quality of employees as service providers. In terms of sustainability, it shows that the synergy between the regional government and tourism stakeholders need to be improved. The need for the establishment of cooperation with third parties in management of tourism destination in Banyu Biru and Ranu Grati, can be used to optimize the carrying capacity and tourist destination marketing system at Banyu Biru and Ranu Grati in order to compete in a competitive and sustainable way Keywords: tourism destination management, competitiveness, sustainability
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Destination Personality, Satisfaction, And Tourist Future Behavior: The Case Of North Cyprus
Rostampour, Mehrnoush
2013-01-01
ABSTRACT: Going through application of destination personality in North Cyprus and finding about the essence of its relation to tourist satisfaction, and tourist behavior, considering the moderating effect of tourist motivation on relation between destination personality and tourist satisfaction as the main aim of this study. This study focused on two aims: 1) the relationship between destination personality adopted from Aaker (1997) personality scale in tourism realm _ North Cyprus_ due ...
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Brand Equity of a Tourist Destination
Directory of Open Access Journals (Sweden)
Hwa-Kyung Kim
2018-02-01
Full Text Available In the current climate of severe competition among tourist destinations, the importance of brand equity in tourism marketing is increasing. This study looks at the impact of branding in relation to the largest group of inbound overseas tourists to South Korea, the Chinese. Data for the current study were obtained from a survey of tourists visiting Seoul from the Greater China region, including Mainland China, Hong Kong, Macao, Taiwan, and the Chinese living in Southeast Asia. The survey was conducted in popular sightseeing spots, four and five-star hotels in the Seoul Metropolitan Area, and the Incheon International Airport. The respondents were selected randomly, with effort expended to avoid any potential bias in the composition of the sample. Out of a total of 385 distributed questionnaires, 350 (China 191, Hong Kong 71, Taiwan 68, others 20 were selected as valid and finally used in the analysis. The results of this study suggest that price and word of mouth have beneficial effects on perceived quality, publicity, and brand awareness, and advertisement has beneficial effects on brand image. We also found that brand awareness and perceived quality have impacts on brand image, and brand image is related to brand loyalty. This is a pioneering study on the relationships between influencing factors, destination brand equity and its elements, and brand loyalty, with respect to Seoul, South Korea, as a tourism destination for tourists from China.
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Destinations matter: The association between where older adults live and their travel behavior.
Chudyk, Anna M; Winters, Meghan; Moniruzzaman, Md; Ashe, Maureen C; Gould, Joanie Sims; McKay, Heather
2015-03-01
The positive effect of physical activity in the prevention and treatment of many chronic diseases and age-related disabilities, such as mobility-disability, are widely accepted. Mobility is broadly defined as the ability of individuals to move themselves within community environments. These two concepts -physical activity and mobility - are closely linked and together contribute to older adults living healthy, independent lives. Neighborhood destinations may encourage mobility, as older adults typically leave their homes to travel to specific destinations. Thus, neighborhoods with a high prevalence of destinations may provide older adults an attractive opportunity to walk, instead of drive, and thereby obtain incidental physical activity. We know surprisingly little about the specific types of destinations older adults deem relevant and even less about destinations that support the mobility of older adults with low income. Accessible neighborhood destinations may be especially important to older adults with low income as they are more likely to walk as a primary travel mode. Conversely, this population may also be at increased risk of functional impairments that negatively affect their ability to walk. As a means to fill this information gap we aimed to better understand the mobility habits of older adults with low income. Thus, our specific objectives were to: (1) describe the types of destinations older adults with low income most commonly travel to in one week; and (2) determine the association between the prevalence of neighborhood destinations and the number of transportation walking trips these individuals make (average per day). We conducted a cross-sectional study of community-dwelling older adults with low income residing within Metro Vancouver, Canada. We assessed participant travel behavior (frequency, purpose, mode, destination) using seven-day travel diaries and measured the prevalence of neighborhood destinations using the Street Smart Walk Score. We
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Tourism experience, destination and event management
Directory of Open Access Journals (Sweden)
Vitić Andriela
2007-01-01
Full Text Available The paper tend to show some of the challenges of matured and world-known tourism destination, as well some of the modalities in keeping and increasing a level of Honolulu cluster's competitiveness. Accordingly, specific tourism experience as socio-cultural dimension of destination competitiveness was evaluated. A core of the paper is primary research of tourism event "Brunch on the Beach" Honolulu, Hawaii, that was done in 2004. Data for analysis were collected during the internship that author did in the City and Country - Honolulu. Internship was a part of JFDP scholarship received by the American Councils for International Educations (ACIE. George Washington University was the institution where the author completed the most of specialization and which gave a support for the internship organization. Questionnaire method was used for the research, while SPSS software was used for data analyses.
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The power of social media storytelling in destination branding.
Lund, Niels Frederik; Cohen, S.A.; Scarles, C.
2017-01-01
A large part of the global population is now connected in online social networks in social media where they share experiences and stories and consequently influence each other’s perceptions and buying behaviour. This poses a distinct challenge for destination management organisations, who must cope with a new reality where destination brands are increasingly the product of people’s shared tourism experiences and storytelling in social networks, rather than marketing strategies. This article s...
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Tourism Tax: Public Spending and Taxation in Tourism Destinations
Candela Guido; Castellani Massimiliano; Mussoni Maurizio
2013-01-01
In this paper we investigate the effects of a Keynesian policy in tourists destinations where tourism products are mainly sold through «direct sales» (decentralized solution) and the tourism market equilibrium is characterized by sticky prices and unemployment (coordination failure). A Keynesian demand policy is a Pareto improving solution with respect to the organization of sales by Tour operators or Destination managers (centralized solution), since tourism firms are not worse-off in terms ...
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Diabetic peripheral angiopathy treatment using a multi-laser therapy device
Zabulonov, Y.; Chukhraiyeva, O.; Vladimirov, A.; Chukhraiyev, M.; Zukow, W.
2015-01-01
Zabulonov Y., Chukhraiyeva O., Vladimirov A., Chukhraiyev M., Zukow W. Diabetic peripheral angiopathy treatment using a multi-laser therapy device. Journal of Education, Health and Sport. 2015;5(10):227-233. ISSN 2391-8306. DOI http://dx.doi.org/10.5281/zenodo.32801 http://ojs.ukw.edu.pl/index.php/johs/article/view/2015%3B5%2810%29%3A227-233 https://pbn.nauka.gov.pl/works/662978 Formerly Journal of Health Sciences. ISSN 1429-9623 / 2300-665X. Archives 2011–2014 http://journal.rsw....
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Diabetic peripheral angiopathy treatment using a multi-laser therapy device
Y. Zabulonov; O. Chukhraiyeva; A. Vladimirov; M. Chukhraiyev; W. Zukow
2015-01-01
Zabulonov Y., Chukhraiyeva O., Vladimirov A., Chukhraiyev M., Zukow W. Diabetic peripheral angiopathy treatment using a multi-laser therapy device. Journal of Education, Health and Sport. 2015;5(10):227-233. ISSN 2391-8306. DOIhttp://dx.doi.org/10.5281/zenodo.32801 http://ojs.ukw.edu.pl/index.php/johs/article/view/2015%3B5%2810%29%3A227-233 https://pbn.nauka.gov.pl/works/662978 Formerly Journal of Health Sciences. ISSN 1429-9623 / 2300-665X. Archives 2011–2014http://journal.rsw.ed...
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Evaluating Bloemfontein’s image as a tourist destination: A tour operator’s perspective
Directory of Open Access Journals (Sweden)
AJ Strydom
2014-07-01
Full Text Available Tour operators have been identified as vital information sources influencing the images and decision-making processes of tourists. Bloemfontein is situated in Central South Africa. Tourism marketers believe that the city is an ideal stopover destination for national tour operators en route to other destinations. Research was conducted among national tour operators in Johannesburg, Durban and Cape Town to determine their perceptions of Bloemfontein and whether they regard the city as a tourist or stopover destination. The research indicates that the city is not regarded as a tourist destination, but is seen as an ideal stopover destination which could be included in future tour itineraries. It is currently excluded because operators are unfamiliar with the tourism offering(s of Bloemfontein due to insufficient marketing by the tourism officials of the city.
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Aarts, M P J; Rosemann, A L P
2018-08-01
For treating affective disorders like SAD, light therapy is used although the underlying mechanism explaining this success remains unclear. To accelerate the research on defining the light characteristics responsible for inducing a specific effect a uniform manner for specifying the irradiance at the eye should be defined. This allows a genuine comparison between light-affect studies. An important factor impacting the irradiance at the eye are the radiant characteristics of the used light therapy device. In this study the radiant fluxes of five different light therapy devices were measured. The values were weighted against the spectral sensitivity of the five photopigments present in the human eye. A measurement was taken every five minutes to control for a potential stabilizing effect. The results show that all five devices show large differences in radiant flux. The devices equipped with blue LED lights have a much lower spectral radiant flux than the devices equipped with a fluorescent light source or a white LED. The devices with fluorescent lamps needed 30 min to stabilize to a constant radiant flux. In this study only five devices were measured. Radiant flux is just the first step to identify uniform specifications for light therapy devices. It is recommended to provide all five α-opic radiant fluxes. Preferably, the devices should come with a spectral power distribution of the radiant flux. For the devices equipped with a fluorescent lamp it is recommended to provide information on the stabilization time. Copyright © 2018 Elsevier B.V. All rights reserved.
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Marketing everything and theming sameness: Urban destination marketing in contemporary Europe
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Heeley John
2014-01-01
Full Text Available This paper reviews the academic and practitioner literature on urban destination marketing, suggesting that it contains within it a dominant paradigm which the author characterises as 'the theory of marketing competitive advantage'. As such, this theory requires towns and cities to differentiate themselves through the provision of unique products, based on which they subsequently undertake branding, market positioning, distribution and other activities through bespoke destination marketing organisations (DMOs. Practice is then contrasted with theory by reference to a discordant strad of the literature as well as the actual destination marketing currently being undertaken in 60 European towns and cities. The theory of marketing competitive advantage is shown to be an ideal which rarely translates into practice. Irrespective of whether or not a town or city possesses competitive advantage, DMO destination marketing gravitates almost inexorably towards a 'marketing of everything'. Such an approach, in turn, reduces to a bland and monolithic 'theming of urban sameness', all of which is diametrically opposite to what one would expect to be the case as per the theory of marketing competitive advantage. The author contends that this gap between theory and practice matters, necessitating a rethinking of how academics and practitioners should in future seek to explain or otherwise account for urban destination marketing.
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Creation of the competition's profile of Serbia as a tourism destination
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Ubavić Predrag
2015-01-01
Full Text Available During the last several decades tourism has more and more significant role in economic and social development of other countries, as well as in everyday life of a contemporary man. The Republic of Serbia, also, tends to use valorization of its touristic potentials to realize numerous objectives of its economic and general social development. Number of destinations that offer their tourist products on the tourist market increases, leading to intensified competition. Competitiveness is emphasized as a crucial issue in contemporary tourism, as destinations strive to be better than competitors. Observed from today's perspective we can come to a general conclusion that Serbia as a touristic destination, still hasn't taken adequate competitive position regarding other tourist destinations in the region. The aim of this paper is to point out the necessity of repositioning the present competitive position of Serbia to make it, within as short time period as possible, an attractive tourist destination on the regional and international tourist market. With adequate implementation of theoretical concepts and chosen research methods this paper is expected to enrich domestic professional literature from this field, also to point out new possibilities of Serbian tourism development to creators and those who carry out such economic and touristic politics.
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Consuming post-disaster destinations: The case of Sichuan, China
Biran, Avital; Liu, W.; Li, G.; Eichhorn, V.
2014-01-01
Addressing the call for a better understanding of tourist behavior in relation to post-disaster destinations, this study explores the motivations and intentions of potential domestic tourists (from non-hit areas) to visit Sichuan, China in the aftermath of an earthquake. Drawing on dark tourism theories, this study offers a more comprehensive insight into the consumption of post-disaster destinations, aiming to capture the impact of the changes to the destination’s attributes on tourist behav...
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Manuela Guerreiro
2015-06-01
Full Text Available The personality of a destination is vital to build a coherent destination brand and strengthen the place identity. Furthermore, brand personality appears in literature as a strategic axis that can be explored by tourist destinations in order to differentiate themselves from competitors. Since a brand encompasses not only functional but also symbolic elements, its image, as perceived by consumers, can be assessed with respect to both its functional and psychological components. Hence, this exploratory study investigates the brand personality of Portugal as a tourist destination, from the perspective of the Czech market, through a destination image approach. The online survey instrument included open-ended items to depict functional and psychological destination features and additional questions to characterize the profile of a sample of Czech university students. The main findings of this research highlight positive personality traits that are related to the brand of Portugal, which suggest its potential as a vacation destination for the Czech market under study.
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Good, Better, Best Practise – A Comparative Analysis of Official Destination Websites
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Candice Louw
2017-01-01
Full Text Available The uplifting financial impact that tourism may have on local and global economies of scale has resulted in tourists becoming a highly sought-after commodity capable of turning almost any tourism destination and its attractions into thriving exports. With the rapid evolution of Information and Communication Technologies (ICTs and the introduction of smart technologies in particular, however, tourism has become not only more accessible, but arguably also more competitive with an online, try-before-youbuy tourism experience now becoming a reality. Subsequently, the battle is no longer for top offline destination only, but also for online destination of choice. An opportunity thus exists for Official Destination Websites (ODWs to take advantage of these, and additional opportunities, to enhance a prospective tourist’s online, pre-tourism experience. By analysing seven of the world’s most popular destinations’ capital city ODWs, one comes to realise that ODWs have become an integrated, rather than independent, part of facilitating tourism. As such, the importance of developing, implementing and maintaining an ODW to increase the likelihood of a possible tourist conversion from mere browser to buyer is highlighted. Finally, the similarities and differences between the analysed ODWs are also listed in an attempt to guide prospective tourism destinations in their endeavour to establish a new ODW, as well as allowing destinations with an existing ODW to possibly implement improvements.
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Good, Better, Best Practise – A Comparative Analysis of Official Destination Websites
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Candice Louw
2017-12-01
Full Text Available The uplifting financial impact that tourism may have on local and global economies of scale has resulted in tourists becoming a highly sought-after commodity capable of turning almost any tourism destination and its attractions into thriving exports. With the rapid evolution of Information and Communication Technologies (ICTs and the introduction of smart technologies in particular, however, tourism has become not only more accessible, but arguably also more competitive with an online, try-before-you-buy tourism experience now becoming a reality. Subsequently, the battle is no longer for top offline destination only, but also for online destination of choice. An opportunity thus exists for Official Destination Websites (ODWs to take advantage of these, and additional opportunities, to enhance a prospective tourist’s online, pre-tourism experience. By analysing seven of the world’s most popular destinations’ capital city ODWs, one comes to realise that ODWs have become an integrated, rather than independent, part of facilitating tourism. As such, the importance of developing, implementing and maintaining an ODW to increase the likelihood of a possible tourist conversion from mere browser to buyer is highlighted. Finally, the similarities and differences between the analysed ODWs are also listed in an attempt to guide prospective tourism destinations in their endeavour to establish a new ODW, as well as allowing destinations with an existing ODW to possibly implement improvements.
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Personal values, subjective well-being and destination-loyalty intention of international students.
Jamaludin, N L; Sam, D L; Sandal, G M; Adam, A A
2016-01-01
What are the factors that predict international students' destination-loyalty intention? This is the main question this paper addresses, using an online survey among 396 (short-term, N = 182) and (long-term, N = 214) international students at a Norwegian university. Structural equation model-AMOS was conducted to examine relationships among personal values, subjective well-being and destination-loyalty intentions. The results showed that: (1) universalism was positively related to subjective well-being for short-term students; and (2) subjective well-being was positively related to destination-loyalty intention for all groups. We found that relatively stable and happy individuals might be important for ensuring destination-loyalty intentions. Results also indicated that personal values that emphasize justice and equity are also important for short-term international students' well-being.
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Laura CISMARU
2015-06-01
Full Text Available Within the most recent European Policy for Tourism, the competitiveness of the European tourism industry is directly linked to the image of Europe and to its perception, as a collection of sustainable and high-quality tourist destinations. In such context, improving the profile of the European tourist destinations has become a main target. During the last years, the European Commission focused on the sustainable development of tourist destinations. Several projects were developed, the most recent one introducing a practical tool - the European Tourism Indicators System (ETIS for the sustainable development of destinations. The present paper advances the idea that such tool can be successfully used in order to achieve the goal of improving the profile of the European tourist destinations.
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Management of antithrombotic therapy during cardiac implantable device surgery.
AlTurki, Ahmed; Proietti, Riccardo; Birnie, David H; Essebag, Vidal
2016-06-01
Anticoagulants are commonly used drugs that are frequently encountered during device placement. Deciding when to halt or continue the use of anticoagulants is a balance between the risks of thromboembolism versus bleeding. Patients taking warfarin with a high risk of thromboembolism should continue to take their warfarin without interruption during device placement while ensuring their international normalized ratio remains below 3. For patients who are taking warfarin and have low risk of thromboembolism, either interrupted or continued warfarin may be used, with no evidence to clearly support either strategy. There is little evidence to support continuing direct acting oral anticoagulants (DOACs) for device implantation. The timing of halting these medications depends largely on renal function. If bleeding occurs, warfarin׳s anticoagulation effect is reversible with vitamin K and activated prothrombin complex concentrate. There are no DOAC reversal agents currently available, but some are under development. Regarding antiplatelet agents, aspirin alone can be safely continued while clopidogrel alone may also be continued, but with a slightly higher bleeding risk. Dual antiplatelet therapy for bare-metal stent/drug-eluting stent implanted within 4 weeks/6 months, respectively, should be continued due to high risk of stent thrombosis; however, if they are implanted after this period, then clopidogrel can be halted 5 days before the procedure and resumed soon after, while aspirin is continued. If the patient is taking both aspirin and warfarin, aspirin should be halted 5 days prior to the procedure, while warfarin is continued.
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Sudden visual loss after cardiac resynchronization therapy device implantation.
De Vitis, Luigi A; Marchese, Alessandro; Giuffrè, Chiara; Carnevali, Adriano; Querques, Lea; Tomasso, Livia; Baldin, Giovanni; Maestranzi, Gisella; Lattanzio, Rosangela; Querques, Giuseppe; Bandello, Francesco
2017-03-10
To report a case of sudden decrease in visual acuity possibly due to a cardiogenic embolism in a patient who underwent cardiac resynchronization therapy (CRT) device implantation. A 62-year-old man with severe left ventricular systolic dysfunction and a left bundle branch block was referred to our department because of a sudden decrease in visual acuity. Nine days earlier, he had undergone cardiac transapical implantation of a CRT device, which was followed, 2 days later, by an inflammatory reaction. The patient underwent several general and ophthalmologic examinations, including multimodal imaging. At presentation, right eye (RE) best-corrected visual acuity (BCVA) was counting fingers and RE pupil was hyporeactive. Fundus examination revealed white-centered hemorrhagic dots suggestive of Roth spots. Fluorescein angiography showed delay in vascular perfusion during early stage, late hyperfluorescence of the macula and optic disk, and peripheral perivascular leakage. The first visual field test showed complete loss of vision RE and a normal left eye. Due to suspected giant cell arteritis, temporal artery biopsy was performed. Thirty minutes after the procedure, an ischemic stroke with right hemisyndrome and aphasia occurred. The RE BCVA worsened to hands motion. Four months later, RE BCVA did not improve, despite improvement in fluorescein angiography inflammatory sign. We report a possible cardiogenic embolism secondary to undiagnosed infective endocarditis causing monocular visual loss after CRT device implantation. It remains unclear how the embolus caused severe functional damage without altering the retinal anatomical structure.
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Diverging fortunes? Economic well-being of Latinos and African Americans in new rural destinations.
Crowley, Martha; Lichter, Daniel T; Turner, Richard N
2015-05-01
The geographic diffusion of Latinos from immigrant gateways to newly-emerging rural destinations is one of the most significant recent trends in U.S. population redistribution. Yet, few studies have explored how Latinos have fared in new destinations, and even fewer have examined economic implications for other minority workers and their families. We use county-level data from the 1990 and 2000 U.S. Census and the 2006-2010 American Community Survey to compare the changing economic circumstances (e.g., employment and unemployment, poverty, income, and homeownership) of Latinos and African Americans in new Latino boomtowns. We also evaluate the comparative economic trajectories of Latinos in new destinations and established gateways. During the 1990s, new rural destinations provided clear economic benefits to Latinos, even surpassing African Americans on some economic indicators. The 2000s, however, ushered in higher rates of Latino poverty; the economic circumstances of Latinos also deteriorated more rapidly in new vis-à-vis traditional destinations. By 2010, individual and family poverty rates in new destinations were significantly higher among Latinos than African Americans, despite higher labor force participation and lower levels of unemployment. Difference-in-difference models demonstrate that in both the 1990s and 2000s, economic trajectories of African Americans in new Latino destinations largely mirrored those observed in places without large Latino influxes. Any economic benefits for Latinos in new rural destinations thus have not come at the expense of African Americans. Published by Elsevier Inc.
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Development Strategies for Tourism Destinations: Tourism Sophistication vs. Resource Investments
Rainer Andergassen; Guido Candela
2010-01-01
This paper investigates the effectiveness of development strategies for tourism destinations. We argue that resource investments unambiguously increase tourism revenues and that increasing the degree of tourism sophistication, that is increasing the variety of tourism related goods and services, increases tourism activity and decreases the perceived quality of the destination's resource endowment, leading to an ambiguous effect on tourism revenues. We disentangle these two effects and charact...
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Long Journey Travel to Tourist Destination: A Review Paper
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Shahrin Norkamaliah
2014-01-01
Full Text Available Tourists are now more open in selecting tourist destination. The number of holiday trips were growing rapidly. There were various promotions available to attract tourists to travel either within or outside the country. Travel distance is not an obstacle for tourists to travel, regardless of local and foreign destination. This study will be conducted to identify the motivation of long journey travel that involves push and pull factors. The long journey involves distance, cost and the type of transportation used to get to the destination. For this purpose a comprehensive review and discussion on previous sources which involved a variety of secondary data sources will be used to meet every need of the study objectives. The finding showed that the travel distance was dependent on the motivation for tourists to travel and the type of transport they want to use. Mode of transport used has advantages and disadvantages for long journey travel depending on traveller choice.
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CONSIDERATIONS REGARDING THE DESIGN OF SPECIFIC TOURISM PRODUCTS FOR THE TOURISM DESTINATION ROMANIA
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MONICA PAULA RAŢIU
2011-01-01
Full Text Available Romania, as tourism destination with its component micro-destinations (Muntenia, Oltenia, Banat - Crişana, Transylvania, Bucovina, Maramureş, Moldavia and Dobrogea, possesses many tourism attractions and at the same time has a real tourism potential. The fact that it is not included among the Europe’s „valuable” destinations represents a loss both for its inhabitants and for Europeans in general, too. One of the reasons is the lack of an image consolidated by identity elements or / and simply the lack of image that would represent the starting point for development of appropriate tourism products (developing a strategy. This paper proposes, starting from the image perceived by the inhabitants about their own destination – based on the example of Transylvania – to emphasize the importance and also the role of the destination image in developing the main directions of actions and, especially, in developing the strategy for the specific tourism products.
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Grief Tourism on Destination Image Formation: Afyonkarahisar and Başkomutan National Historical Park
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Burhan KILIÇ
2011-06-01
Full Text Available The diversification of supply sources owned causes differences between destinations and special interest which is shaped for demand leads to become tourism widespread. In Turkey, there are many destinations where different features exist together. By means of alternative tourism types, various destinations and tourism types emerge. When all the events happened during the Independence War are considered in terms of national heritage, Afyonkarahisar is an important centre among grief tourism destinations. In research related to image components of Afyonkarahisar, confectionery, food products, and thermal tourism are the values of this destination that come to mind first. When the city is considered in terms of tourism, by highlighting the thermal tourism, the slogan “The Capital of Thermal Tourism” has been used. However it is hard to say that thermal tourism has a success taking the research into consideration. Therefore either other tourism values will be used to support the slogan available or with the work of a new image, a new image destination image will be created. The aim of this study is to eliminate the current negativity of Afyonkarahisar province’s destination image, strengthen the image and examine the availability of grief tourism which is one of the heritage tourism types so as to increase its market share
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S.C. Bagri
2015-10-01
Full Text Available Tourists’ satisfaction has been acknowledged as one of the most important elements of competitive advantage and formulating effective destination management strategies because it is a reliable standard to evaluate performance of tangible and intangible elements of tourism products and services. The purpose of this study is to investigate tourists’ satisfaction by examining the relationship between destination attribute importance and performance in a tourist destination. Trijuginarayan, an emerging spiritual and adventure tourist destination located in Garhwal Himalaya in Uttarakhand state of India was selected as the study area for this research. Importance-Performance Analysis was employed to examine the relationship between importance and performance of various destination attributes. Results revealed that attributes related to tourism product of spiritual and cultural nature, atmosphere and climate, a variety of tourist activities, hospitality and safety are significant factors in determining tourist satisfaction, whereas basic facilities such as accommodation, transportation, tourism infrastructure and hygiene and sanitation at destination are of significant importance in satisfaction evaluation. Findings also reveal that tourists were satisfied with the core products, but were dissatisfied with basic tourist facilities offered at the destination. The findings alert concerned tourism stakeholders for outlining effective strategies for holistic development and improving performance of attributes in a given destination.
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Diversity, Flexibility And Identity Mechanisms For Recycling Mature Tourist Destinations
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Biel Horrach Estarellas
2012-12-01
Full Text Available Globalizing dynamic sources are making of tourist destinations, spaces each time more homogeneous, unable to respond to the tourist’s new motivation and to the specific characteristics of the territory and the local landscape. Tourist space has gone through changes, resulting in conurbations without urban structure that require new planning patterns. Despite predictions, which determine a declining process or a post-stagnation, there is a high potential of reconversion of obsolete tourist destinations based on its typological characteristics and its interaction with the territory. The new challenges faced by tourist activity: diversity of tourist resources, travel flexibility and the differentiation of the destination from the rest by enhancing its identity, are methodologically tackled by testing regional tourist dynamics experimented in one of the most paradigmatic cases of tourist coastline development, Majorca Island.
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Designs for mechanical circulatory support device studies.
Neaton, James D; Normand, Sharon-Lise; Gelijns, Annetine; Starling, Randall C; Mann, Douglas L; Konstam, Marvin A
2007-02-01
There is increased interest in mechanical circulatory support devices (MCSDs), such as implantable left ventricular assist devices (LVADs), as "destination" therapy for patients with advanced heart failure. Because patient availability to evaluate these devices is limited and randomized trials have been slow in enrolling patients, a workshop was convened to consider designs for MCSD development including alternatives to randomized trials. A workshop was jointly planned by the Heart Failure Society of America and the US Food and Drug Administration and was convened in March 2006. One of the panels was asked to review different designs for evaluating new MCSDs. Randomized trials have many advantages over studies with no controls or with nonrandomized concurrent or historical controls. These advantages include the elimination of bias in the assignment of treatments and the balancing, on average, of known and unknown baseline covariates that influence response. These advantages of randomization are particularly important for studies in which the treatments may not differ from one another by a large amount (eg, a head-to-head study of an approved LVAD with a new LVAD). However, researchers have found it difficult to recruit patients to randomized studies because the number of clinical sites that can carry out the studies is not large. Also, there is a reluctance to randomize patients when the control device is considered technologically inferior. Thus ways of improving the design of randomized trials were discussed, and the advantages and disadvantages of alternative designs were considered. The panel concluded that designs should include a randomized component. Randomized designs might be improved by allowing the control device to be chosen before randomization, by first conducting smaller vanguard studies, and by allowing crossovers in trials with optimal medical management controls. With use of data from completed trials, other databases, and registries, alternative
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Dronkers, J.; Levels, M.; de Heus, M.
2014-01-01
Background Earlier studies using a double perspective (destination & origin) indicate that several macro-characteristics of both destination and origin countries affect the educational performance of migrant children. This paper explores the extent to which educational system features of destination
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El Haj, Mohamad; Gandolphe, Marie-Charlotte; Allain, Philippe; Fasotti, Luciano; Antoine, Pascal
2015-01-01
Destination memory is the ability to remember the receiver of transmitted information. By means of a destination memory directed forgetting task, we investigated whether participants with Alzheimer's Disease (AD) were able to suppress irrelevant information in destination memory. Twenty-six AD participants and 30 healthy elderly subjects were asked to tell 10 different proverbs to 10 different celebrities (List 1). Afterwards, half of the participants were instructed to forget the destinations (i.e., the celebrities) whereas the other half were asked to keep them in mind. After telling 10 other proverbs to 10 other celebrities (List 2), participants were asked to read numbers aloud. Subsequently, all the participants were asked to remember the destinations of List 1 and List 2, regardless of the forget or remember instructions. The results show similar destination memory in AD participants who were asked to forget the destinations of List 1 and those who were asked to retain them. These findings are attributed to inhibitory deficits, by which AD participants have difficulties to suppress irrelevant information in destination memory.
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Spoudeas HA
2014-09-01
Full Text Available Helen A Spoudeas,1 Priti Bajaj,2 Nathan Sommerford3 1London Centre for Paediatric Endocrinology, University College London, London, 2Ferring Pharmaceuticals, London, 3Health Informatics Research, Sciensus Ltd, Brighton, UK Purpose: Persistence and adherence with subcutaneous growth hormone (GH; somatropin therapy in children is widely acknowledged to be suboptimal. This study aimed to investigate how the use of a jet-delivery device, ZomaJet®, impacts on medication-taking behaviors compared to needle-based devices.Materials and methods: A retrospective cohort study of children aged ≤18 years was conducted using a UK-based, nationwide database of GH home-delivery schedules. Data were evaluated for the period between January 2010 and December 2012 for 6,061 children receiving either Zomacton® (somatropin via the ZomaJet jet-delivery device or one of six brands of GH all administered via needle-based devices. Persistence was analyzed for patients with appropriate data, measured as the time interval between first and last home deliveries. An analysis of adherence was conducted only for patients using ZomaJet who had appropriate data, measured by proportion of days covered. Brand switches were identified for all patients.Results: Persistence with GH therapy was significantly longer in patients using ZomaJet compared to needle-based devices (599 days versus 535 days, respectively, n=4,093; P<0.001; this association was observed in both sexes and across age subgroups (≤10 and 11–16 years. The majority (58% of patients using ZomaJet were classed as adherent (n=728. Only 297 patients (5% switched GH brand (n=6,061, and patients tended to use ZomaJet for longer than other devices before switching.Conclusion: It appears important that the choice of a jet-delivery device is offered to children prescribed daily GH therapy. These devices may represent a much-needed effective strategy for maintaining persistence with subcutaneous GH administration in
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City Image – As Tourism Destination
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Stanciulescu Gabriela Cecilia
2008-04-01
Full Text Available Tourism is a competitive industry, even on a global scale. If access to a destination or attraction is too complicated, time consuming, expensive or not providing adequate capacity, even the most spectacular attraction will remain a secret to most tourists, as they will prefer competitive alternatives” (Smiths, 2003. And to continue this, it is considered that „that cultural differences and uniqueness are important if one wants cultural products to become a commercial success” (Lindenberg, 2004. When cultural tourists are looking to experiment or to improve their knowledge, the question is: “Which are the best strategies and practices to market that experience and knowledge for the cultural tourists” (Kantanen, 2005. This paper will be dedicated to presenting city tourist destinations, their marketing and market positioning, also to analyze the way in which potential customers’ perception is built and how the process can be influenced, and to analyze the way the tourist product is assembled.
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Directory of Open Access Journals (Sweden)
Marković Ana Tripković
2016-12-01
Full Text Available There are various definitions of tourist destination. All of them define tourist destination as an area with specific tourist facilities and attractions, (primary and secondary elements which tourists choose as their journey goal. Budva individually represents the largest tourist destination due to number of arrivals and overnight stays. During its life cycle Budva has gone through different phases as a tourist destination. This thesis implies that it is not enough to use only common quantitative indicator of visitor number to define proper the position of tourist destination and predict further development. This text is based on a comparative analysis of the attitudes of tourists and local stakeholders in the three field researches, conducted in the period between 2015 and 2016. The thesis comes to the conclusion that the actual growth is based on meeting the needs of existing markets and tourists. On the other side, aspect of desired market position disagrees with scores of tourist offer elements- which should be input for improvement and preparation for the next stage in the destination development.
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Wondowossen, T.A.; Nakagoshi, N.; Yukio, Y.; Jongman, R.H.G.; Dawit, A.Z.
2014-01-01
Competitiveness can be applied to predict the economic sustainability of tourism in destinations which has been measured in terms of leakages and linkage related to employment and income generation opportunities to the destinations. This article examines destination competitiveness of Ethiopia based
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Continuous Intravenous Milrinone Therapy in Pediatric Outpatients
Curley, Michelle; Liebers, Jill; Maynard, Roy
2017-01-01
Milrinone is a phosphodiesterase 3 inhibitor with both positive inotropic and vasodilator properties. Administered as a continuous infusion, milrinone is indicated for the short-term treatment of patients with acute decompensated heart failure. Despite limited data supporting long-term milrinone therapy in adults with congestive heart failure, children managed as outpatients may benefit from continuous milrinone as a treatment for cardiac dysfunction, as a destination therapy for cardiac tran...
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Klara Trošt
2012-04-01
Full Text Available Events have become an increasingly significant component of destination branding. Many destinations throughout the world have developed events portfolios as a strategic initiative to attract tourists and to reinforce their brand. In this paper, the focus of research will be on tourist destination branding by means of events. The relationship between events and destination branding is examined through six phases of the process of building a destination brand identity with the use of events. When it comes to destination branding, a need for an analysis of strategic documents of destination development imposes because event tourism strategies help destinations plan how to use events in a tourism role. The purpose of this study is to examine which factors are of the top priorities when using events as a marketing approach. The method of case study will be used, by which two cultural events which take place in the Republic of Croatia will be analyzed, namely, “Špancirfest” in Varaždin and “Trka na prstenac” in Barban. Varaždin and Barban are on different levels in their branding work. The different sizes and locations of the destinations naturally affect the operating procedures. This article may be of interest to destination marketers and event organizers, especially in developing destinations which intend to differentiate themselves from the competitive market.
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Branding Prince Edward County as a Gastronomic Niche Tourism Destination: A Case Study
Geneviève Brisson; Rocci Luppicini
2015-01-01
Increasingly, gastronomy is playing a role in people's motivation for travel, and destinations are making food and beverages their main attraction. This study explored the growing field of gastronomic tourism, a type of niche tourism, through the theoretical framework of destination branding theory. Using a qualitative case study research design, this research examined the branding of the emergent region of Prince Edward County, Ontario, Canada as a gastronomic niche tourism destination from ...
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Maruyama, Atsushi; Shibata, Naoki; Murata, Yoshihiro; Yasumoto, Keiichi; Ito, Minoru
2004-01-01
We propose a personal navigation system (called PNS) which navigates a tourist through multiple destinations efficiently. In our PNS, a tourist can specify multiple destinations with desired arrival/stay time and preference degree. The system calculates the route including part of the destinations satisfying tourist's requirements and navigates him/her. For the above route search problem, we have developed an efficient route search algorithm using a genetic algorithm. We have designed and imp...
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Innovative Governance Strategies in Meetings Destination Networks
DEFF Research Database (Denmark)
Gyimóthy, Szilvia; Larson, Mia
2013-01-01
Innovative Governance Strategies in Meetings Destination Networks Introduction, problem statement and aims of the study Collaborative regional networks has been long considered as a must in successful tourism development (Dredge & Jenkins 2003) owing to benefits such as scale and scope economics......, as well as joint planning and coordination of supply facilities. However, the setting up and governance of destination networks is paved with managerial challenges, including, among others: the balancing of conflicting stakeholder interest (Wilkinson & March 2008), and bridging over the gap between...... the bureaucratic culture of public administration and the marketing culture adopted by private tourism firms (Palmer 1996). This regional coordinating role must be undertaken in spite of limited ownership, budget or power to control how individual firms deliver (D’Angella & Go 2007). Furthermore, various actors...
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Cognitive components of rural tourism destination images
DEFF Research Database (Denmark)
Kokkali, Panagiota; Koutsouris, Alex; Chrysochou, Polymeros
This paper aims at exploring issues related to rural tourism destination image focusing on TDI cognitive components. By means of empirical research addressing tourists visiting the Lake Plastiras area, Central Greece, the cognitive components of the area's TDI were identified along with their eff......This paper aims at exploring issues related to rural tourism destination image focusing on TDI cognitive components. By means of empirical research addressing tourists visiting the Lake Plastiras area, Central Greece, the cognitive components of the area's TDI were identified along......; (3) visitors can be classified in four clusters according the cognitive factors; (4) tourists' clusters differ in terms of age, education and income as well as number of visits and perception of the area's attractiveness. Such findings point towards the need of both a new strategy for the area...
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Medical Tourist’s Perception in Selecting their Destination: A Global Perspective
Sarwar, Abdullah AM; Manaf, Noorhazilah A; Omar, Azura
2012-01-01
Background: The need for better healthcare has grown significantly in recent years. In addition, the rising healthcare costs in the U.S. and in many European countries have forced many patients to seek medical treatment abroad, which has created the demand for medical tourism. With little yet known as to the perception of a medical tourist’s destination selection, this study aims to explore medical tourist’s perception in selecting their destination while going for medical treatment. Methods: Realizing the current need to examine closely the perception of medical tourists, this study had conducted a secondary study to collect data for assessing and identification of the key factors on patient’s perception and destination selection criteria. Results: The result confirms the existence of a very strong relationship between cost, service quality, treatment types and availability and marketing impact on the perception of the medical tourists’ in selecting their medical tourism destination. Conclusion: This study offers support for the proposed conceptual model and an empirical basis for comparison in future research. PMID:23113218
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Continuous Intravenous Milrinone Therapy in Pediatric Outpatients.
Curley, Michelle; Liebers, Jill; Maynard, Roy
Milrinone is a phosphodiesterase 3 inhibitor with both positive inotropic and vasodilator properties. Administered as a continuous infusion, milrinone is indicated for the short-term treatment of patients with acute decompensated heart failure. Despite limited data supporting long-term milrinone therapy in adults with congestive heart failure, children managed as outpatients may benefit from continuous milrinone as a treatment for cardiac dysfunction, as a destination therapy for cardiac transplant, or as palliative therapy for cardiomyopathy. The aim of this article is to review the medical literature and describe a home infusion company's experience with pediatric outpatient milrinone therapy.
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Furlanetto, Karina Couto; Pitta, Fabio
2017-02-01
Patients with hypoxemia and chronic respiratory failure may need to use oxygen therapy to correct hypoxemia and to use ventilatory support to augment alveolar ventilation, reverse abnormalities in blood gases (in particular hypercapnia) and reduce the work of breathing. Areas covered: This narrative review provides an overview on the use of oxygen therapy devices or portable ventilators for improved physical activity in daily life (PADL) as well as discusses the issue of lower mobility in daily life among stable patients with chronic respiratory disease who present indication for long-term oxygen therapy (LTOT) or home-based noninvasive ventilation (NIV). A literature review of these concepts was performed by using all related search terms. Expert commentary: Technological advances led to the development of light and small oxygen therapy devices and portable ventilators which aim to facilitate patients' mobility and ambulation. However, the day-by-day dependence of a device may reduce mobility and partially impair patients' PADL. Nocturnal NIV implementation in hypercapnic patients seems promising to improve PADL. The magnitude of their equipment-related physical inactivity is underexplored up to this moment and more long-term randomized clinical trials and meta-analysis examining the effects of ambulatory oxygen and NIV on PADL are required.
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The Sustainable Management of a Tourism Destination in Ireland: A Focus on County Clare
CONAGHAN, Aíne; HANRAHAN, James; McLOUGHLIN, Emmet
2015-01-01
Tourism destination management has significant importance in controlling many impacts of tourism, thus insuring its sustainability. Destination management requires the integration of different planning tools, approaches and concepts that help shape the management and daily operation of tourism related activities. This study examines the sustainable management of a tourism destination, focusing on County Clare, Ireland. Qualitative interviews were conducted with tourism stake...
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STARTING POINT FOR BRANDING SLAVONIA AS A TOURIST DESTINATION
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Berislav Bolfek
2012-12-01
Full Text Available Branding in tourism is a process that selects a particular destination by its characteristics, thus creating destination identity. The greatest success in this process is achieved by emphasizing authenticity, where Slavonia has great potential. By creating international recognisability of the region, a brand attracts investments and a skilled labour force, thus indirectly having a positive effect on export growth. Values that should draw the attention of both domestic and foreign tourists, i.e. values that are sufficiently attractive to bring tourists, are embedded in the brand. These values should be realistically based. Although Slavonia is an underdeveloped region in terms of tourism, it has a realistic perspective to become a desirable tourist destination. The paper provides analysis of the results of the conducted primary research about the perception that tourists have about Slavonia as a tourist destination. One of the goals was to determine the key components and areas that would be used in the future as a foundation for the definition of a unique brand identity of Slavonia and creation of a desirable tourist environment in this area. Based on the conducted research, clear indicators reflect the opinion of tourists which makes Slavonia unique and attractive, being at the same time elements of its unique brand identity. The results showed that the possible strong driving force of tourism development in Slavonia may include products such as rural tourism, thematic events, special interests (cycling, hiking, fishing and hunting, religious tourism, health and nautical tourism. Another conclusion that was made during the research is that Slavonia should aim at the target population. Thus, segmentation results in several target groups such as tourists with special interests, tourists preferring cultural heritage and other traditional values, nature lovers, recreational athletes and athletes. The aim was to gather data that could be used in the
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AN EXAMINATION OF COMPETITIVENESS OF RURAL DESTINATIONS FROM THE SUPPLY SIDE PERSPECTIVE
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Dunja Demirović
2016-12-01
Full Text Available Tourist destinations are now faced with increased competition at the market and holders of tourist policy and offers have realized that understanding the factors that contribute to a better positioning in the market place, and therefore the competitiveness, is of crucial importance for further development. The aim of this paper is to determine how much Vojvodina is competitive as a rural tourism destination, and to assess the current state of all the factors that affect/could affect the competitiveness of rural tourism destinations in Vojvodina Province (Northern Serbia. The total of 136 tourism experts were interviewed, and we concluded that the key resources and attraction of rural areas in Vojvodina are rated better than the macro and industry-related factors. This suggests that a rural development strategy should have a special bond with resources and attractions of the destination, that priority should be given to maintaining all aspects of safety and security, continuous improvement of services, diversity of culinary products, as well as the application of the principles of sustainability in environmental management. The work of national and provincial institutions should have the aim to ensure that the destination has a clear idea of where it is going and what it takes to become successful in the long term.
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Multi-Destination Cognitive Radio Relay Network with SWIPT and Multiple Primary Receivers
Al-Habob, Ahmed A.
2017-05-12
In this paper, we study the performance of simultaneous wireless information and power transfer (SWIPT) technique in a multi-destination dual-hop underlay cognitive relay network with multiple primary receivers. Information transmission from the secondary source to destinations is performed entirely via a decode- and-forward (DF) relay. The relay is assumed to have no embedded power source and to harvest energy from the source signal using a power splitting (PS) protocol and employing opportunistic scheduling to forward the information to the selected destination. We derive analytical expressions for the outage probability assuming Rayleigh fading channels and considering the energy harvesting efficiency at relay, the source maximum transmit power and primary receivers interference constraints. The system performance is also studied at high signal-to-noise ratio (SNR) values where approximate expressions for the outage probability are provided and analyzed in terms of diversity order and coding gain. Monte-Carlo simulations and some numerical examples are provided to validate the derived expressions and to illustrate the effect of various system parameters on the system performance. In contrast to their conventional counterparts where a multi- destination diversity is usually achieved, the results show that the multi-destination cognitive radio relay networks with the SWIPT technique achieve a constant diversity order of one.
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THE QUALITY OF THE TOURIST DESTINATIONS A KEY FACTOR FOR INCREASING THEIR ATTRACTIVENESS
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Daliborka Blazeska
2015-12-01
Full Text Available Taking into consideration that the tourism is extremely important for any country including Republic of Macedonia, it is necessary to pay attention to the quality of the tourist destinations and increasing of their attractiveness. So winners in the field of tourism will be those countries that have attractive tourist destination that will attract a lot of visitors. In this paper is defined the relationship between the factors of attractiveness of the destination and the achieving of competitiveness. In order to become competitive in the global market, the tourist destination has to be innovative and to continually search for new competitive advantages. Those kind of competitive advantages enable stable and long-term sustainable development of the tourist destination. In this paper special emphasis is put to the monitoring of the quality of the tourist destination with constant inquiries of the tourists (domestic and foreign regarding the most important segments of the quality of the tourist product which they are using, in order to perceive the satisfaction or the eventual dissatisfaction in order to be taken concrete strategies for the following period. The obtained results clearly confirm the dissatisfaction with the road infrastructure and signalization, the price of the services and the conditions for the stay, as well as the additional attractions that were expected to get.
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A Novel Evaluation Approach for Tourist Choice of Destination Based on Grey Relation Analysis
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Xudong Guo
2016-01-01
Full Text Available The decision-making process of choosing an ideal tourism destination is influenced by a number of psychological and nonpsychological variables. Tourists need a method to quickly and easily select a suitable destination. Driven by this practical decision issue, a novel approach of tourist destination evaluation, grey relation analysis (GRA, is developed and applied to the ranking evaluation of Taiwan tourism destinations in China. In the evaluating process, we apply entropy to calculate the weight of each index, which is a more objective method of calculating weights. The results of the study indicate that although the same size is small and the distribution of data is unknown, GRA can still be successfully used in evaluating tourist destinations. In addition, we compare the GRA results with the Technique for Order Preference by Similarity to Ideal Solution (TOPSIS and show that more accurate ranking results can be obtained.
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78 FR 48046 - Safety Zone; Kuoni Destination Management Fireworks; San Diego, CA
2013-08-07
...-AA00 Safety Zone; Kuoni Destination Management Fireworks; San Diego, CA AGENCY: Coast Guard, DHS... waters of the San Diego Bay in support of the Kuoni Destination Management Fireworks Display on August 6... Guard's ability to protect the public from the potential hazards associated with fireworks displays...
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Destination memory in schizophrenia: "Did I told Elvis Presley about the thief?"
El Haj, Mohamad; Altman, Rosalie; Bortolon, Catherine; Capdevielle, Delphine; Raffard, Stéphane
2017-02-01
Destination memory refers to the ability to remember to whom a piece of information was previously transmitted. Our paper assessed this ability in schizophrenia. Twenty-five patients with schizophrenia and 25 control participants told proverbs (e.g., "send a thief to catch a thief") to pictures of celebrities (e.g., Elvis Presley). Afterward, participants had to indicate to which celebrity they had previously said the proverbs. Participants also completed a binding task in which they were required to associate letters with their corresponding context (i.e., location). Analysis revealed worse destination memory and binding in patients with schizophrenia than in controls. In both populations, destination memory was significantly correlated with performances on the binding task. Our findings suggest difficulty in the ability to attribute information to its appropriate destination in schizophrenia. This difficulty may be related to compromise in binding separate cues together to form a coherent representation of an event in memory. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
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BRAND EQUITY OF LAHORE FORT AS A TOURISM DESTINATION BRAND
KASHIF, MUHAMMAD; SAMSI, SITI ZAKIAH MELATU; SARIFUDDIN, SYAMSULANG
2015-01-01
ABSTRACTStudies that measure the brand equity of destination brands by using the Customer-Based Brand Equity (CBBE) model in a developing country context are scarce. The present study investigates the destination brand equity of the Lahore Fort by employing the CBBE model in a developing country context of Pakistan. Following the positivist tradition, we adopted a survey-based approach to collect data from 237 tourists visiting the Lahore Fort. Data were collected through a questionnaire deve...
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The allure of new immigrant destinations and the Great Recession in the United States.
Ellis, Mark; Wright, Richard; Townley, Matthew
2014-01-01
In the 1990s, the immigrant population in the United States dispersed to non-traditional settlement locations (what have become known as "new immigrant destinations"). This paper examines whether the allure of new destinations persisted in the 2000s with a particular focus on the internal migration of the foreign born during the recent deep recessionary period and its aftermath. Three specific questions motivate the analysis. First, are immigrants, much like the US-born population, becoming less migratory within the country over time? Second, is immigrant dispersal from traditional gateways via internal migration continuing despite considerable economic contraction in many new destination metropolitan areas? Third, is immigration from aboard a substitute for what appears to be declining immigrant internal migration to new destinations? The findings reveal a close correlation between the declining internal migration propensity of the US-born and immigrants in the last two decades. We also observe parallels between the geographies of migration of native- and foreign-born populations with both groups moving to similar metropolitan areas in the 1990s. This redistributive association, however, weakened in the subsequent decade as new destination metropolitan areas lost their appeal for both groups, especially immigrants. There is no evidence to suggest that immigration from abroad is substituting for the decline in immigrant redistribution through internal migration to new destinations. Across destination types the relationship between immigration from abroad and the internal migration of the foreign born remained the same before, during, and after the Great Recession.
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The Impact of the Hotel Industry on the Competitiveness of Tourism Destinations in Hungary
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Albert Tóth Attila
2016-12-01
Full Text Available This paper focuses on a complex question from the perspective of the hotel industry. It tries to draw attention to the importance of hotels, enhancing it on the basis of the tourism destination competitiveness models and introducing the role and place of the hotel industry in the most important models. The hotel industry research evaluates the most important tourism destinations of Hungary on the micro-regional level that justifies the importance and contribution of the hotels and accommodations to competitiveness and success of tourism destinations with exact results. As a result of the research, the micro-regional destinations can be ranged within three groups in Hungary. In the first group of the most developed and most competitive tourism destinations, the hotel industry plays a very important role. In these regions, the hotel industry has a significant effect not only on competitiveness of tourism but also on general development of the regions. In the second group, which can be still called tourism destination, tourism and the hotel industry both play a significant role, but only the competitiveness of tourism can be considered good, the effects of the tourism on general development of the region can be proved only to a lesser extent. In the third group, the effects of tourism and the hotel industry can only be experienced to a lesser extent. The majority of these regions are not considered to be attractive tourism destinations for tourists any more.
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Ivan Gerasimovich Aghajanyan
2016-04-01
Full Text Available Background: The most common types of non-malignant prostate diseases are benign prostatic hyperplasia (BPH and chronic prostatitis (CP. The aim of this study was to find out whether thermobalancing therapy with a physiotherapeutic device is effective for BPH and CP. Methods: During a 2.5-year period, 124 men with BPH over the age of 55 were investigated. Clinical parameters were tested twice: via the International Prostate Symptom Score (IPSS and via ultrasound measurement of prostate volume (PV and uroflowmetry maximum flow rate (Qmax, before and after six months of therapy. In 45 men with CP under the age of 55, the dynamics of the National Institute of Health Chronic Prostatitis Symptom Index (NIH-CPSI were studied. Results: The results of the investigated index tests in men with BPH confirmed a decrease in IPSS (p < 0.001, a reduction in PV (p < 0.001, an increase in Qmax (p < 0.001, and an improvement of quality of life (QoL (p < 0.001. NIH-CPSI scores in men with CP indicated positive dynamics. Conclusions: The observed positive changes in IPSS, PV, and Qmax in men with BPH and the improvement in NIH-CPSI-QoL in patients with CP after using a physiotherapeutic device for six months as mono-therapy, support the view that thermobalancing therapy with the device can be recommended for these patients. Furthermore, the therapeutic device is free of side effects.
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El Haj, Mohamad; Gandolphe, Marie-Charlotte; Allain, Philippe; Fasotti, Luciano; Antoine, Pascal
2015-01-01
Destination memory is the ability to remember the receiver of transmitted information. By means of a destination memory directed forgetting task, we investigated whether participants with Alzheimer's Disease (AD) were able to suppress irrelevant information in destination memory. Twenty-six AD participants and 30 healthy elderly subjects were asked to tell 10 different proverbs to 10 different celebrities (List 1). Afterwards, half of the participants were instructed to forget the destinations (i.e., the celebrities) whereas the other half were asked to keep them in mind. After telling 10 other proverbs to 10 other celebrities (List 2), participants were asked to read numbers aloud. Subsequently, all the participants were asked to remember the destinations of List 1 and List 2, regardless of the forget or remember instructions. The results show similar destination memory in AD participants who were asked to forget the destinations of List 1 and those who were asked to retain them. These findings are attributed to inhibitory deficits, by which AD participants have difficulties to suppress irrelevant information in destination memory. PMID:25918456
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Kalinina, Anastasia
2013-01-01
The object of the study was to investigate the opportunity of destination brand-ing through the tool of its gastronomy. In order to render concrete to the topic I chose a popular destination – Sicily and Sicilian gastronomy. It is a fact that the theme of gastronomic direction in tourism and the role of gastronomy in des-tination branding is not developed at all. Besides, personally I have been always attracted by gastronomic experiences in tourism. So it was a challenge for my-self to explor...
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The Sustainable Management of a Tourism Destination in Ireland: A Focus on County Clare
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Aine CONAGHAN
2015-06-01
Full Text Available Tourism destination management has significant importance in controlling many impacts of tourism, thus insuring its sustainability. Destination management requires the integration of different planning tools, approaches and concepts that help shape the management and daily operation of tourism related activities. This study examines the sustainable management of a tourism destination, focusing on County Clare, Ireland. Qualitative interviews were conducted with tourism stakeholders. Additionally a theoretical framework incorporating the various elements that emerged from the theory was also utilised to examine existing tourism strategies and plans. Stakeholders all agreed it would be an advantage to have a Destination Management Office (DMO lead that would coordinate destination management. However, it was found many tourism visions lack consistency and a timeframe with only a few addressing sustainability itself. Also the multiple regulations and guidelines identified by the framework were not communicated effectively to both stakeholders and policy makers when managing tourism in County Clare.
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Sustainability as an Identity Factor of Tourist Destinations at Websites:Does the Consumer Care?
Francisco Vicente Sales Melo; Salomão Alencar de Farias
2014-01-01
When choosing a vacation destination, consumers consider various factors, such as culture, natural attractions, history and points of interest, among others. In this article we analyze whether the question of sustainability is a determining factor in the choice of tourist destinations. Therefore, the article investigates the relationship of the identity of tourist destinations, as presented at their official websites, according to sustainability characteristics, the evaluation of the destinat...
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TOURIST MOTIVATION FOR RURAL DESTINATIONS
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Angela BOTEZATU
2014-04-01
Full Text Available City daily overexertion impels tourists wish to travel. Rural tourism behavior is determined by a set of motivational factors that makes him appreciate favorable tourist destinations. In order to analyze and assess the opinions and attitudes of tourists in rural areas we realized a market survey, the results being presented in the article below. Future trends, the growth rate of market depend largely on the wishes and intentions of goods or services consumers. This study involves the engagement of a number of 658 respondents, which were interviewed to determine the basic motivations in choosing countryside. The working methods used were analysis, synthesis and questionnaire survey as a research method. Results refer to the following: about 59 percent, spend up to 10% of annual income for vacations and travel, for rural tourism this amount is much lower; the association of the term „rural tourism” in the local tourist mind, oscillates among „a villa” in rural areas or „active vacation” (biking, hiking, riding, swimming or hunting; customer loyalty is one of the goals of marketing activities undertaken in hostels or other travel service providers. In conclusion, we mention that the variety of motivational factors in choosing tourist destinations in rural areas drive this type of tourism.
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El Haj, M.; Gandolphe, M.C.; Allain, P.; Fasotti, L.; Antoine, P.
2015-01-01
Destination memory is the ability to remember the receiver of transmitted information. By means of a destination memory directed forgetting task, we investigated whether participants with Alzheimer's Disease (AD) were able to suppress irrelevant information in destination memory. Twenty-six AD
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CAPITAL FLOWS AND THEIR SECTORAL DESTINATIONS
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Petris Sorina
2012-07-01
Full Text Available Since 2003, New European Union Member States have made large capital inflows, which led to a credit crunch and recession. Whether they are foreign direct investment, or banking flows, capital inflows ultimately affect GDP, depending on how they are invested. In the specialty literature, analysis of capital flows was done especially in terms of their structure, with a lack of analysis in terms of final destination of capital inflows. Therefore, we analyzed the effect of capital inflows on GDP in the New Member States of the European Union (Bulgaria, Czech Republic, Estonia, Hungary, Latvia, Lithuania, Poland, Romania and Slovakia over the last economic cycle. Based on experiences of the new Member States during the recent boom and crisis, the paper studies the impact of capital inflows on GDP growth, inflows channeled to economic sectors, such as real estate and corporate investment sector. The results of this research tries to highlight the extent to which the final destination of capital flows is important for the evolution of GDP.
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The Determinants of Tourist Use of Public Transport at the Destination
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Aaron Gutiérrez
2016-09-01
Full Text Available Of all the activities associated with tourism, transport is the one that creates most pollution. However, the mobility of tourists at their destination is an activity that has so far received very little attention from researchers in comparison with that afforded to the transport mode used to travel from their point of origin to their destination. This paper provides new evidence about the use of public transport by tourists at their final destination. The study is based on data obtained from a survey conducted with tourists (N = 4336 on the Costa Daurada (Catalonia, a Mediterranean sun and beach resort. The empirical analysis is based on estimations made using a multinomial model of the transport mode chosen by tourists to travel to the Costa Daurada combined with another model that estimated the probability of them using public transport during their stay. The results show that the tourists who arrived by private car were the ones who least used public transport at the destination. This was despite the fact that these tourists had the profile that made them most likely to use this type of transportation. On the other hand, although the tourists who arrived by plane had the profile that made them least likely to use public transport, they were the ones who used it most. It is, therefore, possible to conclude that, in addition to tourist profile, another key factor in deciding whether tourists will use public transport at their destination is whether they will take their own car.
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Youth destinations associated with objective measures of physical activity in adolescents.
Cradock, Angie L; Melly, Steven J; Allen, Joseph G; Morris, Jeffrey S; Gortmaker, Steven L
2009-09-01
Limited availability of desirable destinations within walkable distances and unsuitable weather may adversely affect physical activity among adolescents on weekends. This study examines evidence for associations between objective measures of local environment and physical activity levels of adolescents. Students (n=152, 59% male; mean age, 13.7 years) from 10 neighborhoods with schools in four communities wore TriTrac-R3D accelerometers recording physical movements on weekends. Minute-by-minute data were summed over 15-minute intervals providing estimates of proportion of time spent in moderate and vigorous physical activity (MVPA) and (log) mean physical activity levels on weekends (n=7,506 intervals). Objective measures of neighborhood characteristics were calculated using geographic information systems including average daily traffic, housing density, open space, and density of employees per square kilometer in youth destinations. Linear mixed models were fit examining associations between neighborhood environmental variables and accelerometer measures of physical activity, controlling for time, day, age, body mass index, gender of respondent, race/ethnicity, precipitation, and temperature deviation. On weekends, the presence of greater densities of employees in neighborhood destinations serving youth (beta=3.96, p=0.050) was directly associated with MVPA, independent of student characteristics. Young people attending schools in neighborhoods characterized by greater densities of employees in destinations for youth are more physically active on weekends. Compared with neighborhoods with lower densities, attending a school in neighborhoods with higher densities of employees in potential destinations for youth may contribute to participation in an additional 30 minutes of MVPA per day on weekends.
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El Haj, Mohamad; Omigie, Diana; Samson, Séverine
2015-06-01
Familiarity is assumed to exert a beneficial effect on memory in older adults. Our paper investigated this issue specifically for destination memory, that is, memory of the destination of previously relayed information. Young and older adults were told familiar (Experiment 1) and unfamiliar (Experiment 2) proverbs associated with pictures depicting faces of celebrities (e.g., Elvis Presley) or unknown people, with a specific proverb assigned to each face. In a later recognition task, participants were presented with the previously exposed proverb-face pairs and for each pair had to decide whether they had previously relayed the given proverb to the given face. In general, destination performance was found to be higher for familiar than for unfamiliar faces. However while there was no difference between the two groups when the proverbs being relayed were unfamiliar, the advantage of face familiarity on destination memory was present only for older adults when the proverbs being relayed were familiar. Our results show that destination memory in older adults is sensitive to familiarity of both destination and output information.
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Detecting cavitation in vivo from shock-wave therapy devices
Matula, Thomas J.; Yu, Jinfei; Bailey, Michael R.
2005-04-01
Extracorporeal shock-wave therapy (ESWT) has been used as a treatment for plantar faciitis, lateral epicondylitis, shoulder tendonitis, non-unions, and other indications where conservative treatments have been unsuccessful. However, in many areas, the efficacy of SW treatment has not been well established, and the mechanism of action, particularly the role of cavitation, is not well understood. Research indicates cavitation plays an important role in other ultrasound therapies, such as lithotripsy and focused ultrasound surgery, and in some instances, cavitation has been used as a means to monitor or detect a biological effect. Although ESWT can generate cavitation easily in vitro, it is unknown whether or not cavitation is a significant factor in vivo. The purpose of this investigation is to use diagnostic ultrasound to detect and monitor cavitation generated by ESWT devices in vivo. Diagnostic images are collected at various times during and after treatment. The images are then post-processed with image-processing algorithms to enhance the contrast between bubbles and surrounding tissue. The ultimate goal of this research is to utilize cavitation as a means for optimizing shock wave parameters such as amplitude and pulse repetition frequency. [Work supported by APL internal funds and NIH DK43881 and DK55674.
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Tourist Profile and Destination Brand Perception: The Case of Cape Town, South Africa
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Ikechukwu O. Ezeuduji
2016-08-01
Full Text Available Tourists pay for destination brands. This study checked for the relationships between tourists’ profile and how they perceived the destination brand of Cape Town. A questionnaire survey of 220 tourists visiting Cape Town was done. This study found that repeat visit, age of tourist, length of stay, and tourist origin, have significant influences on how tourists visiting Cape Town perceived the destination. The top three destination attributes of Cape Town (cognitive images, which enhance visitor experience satisfaction are (1 the overall level of service quality at facilities in Cape Town, (2 the city being one of the best places the tourists have visited, and (3 the destination’s good value for money. The top three emotional valuations of destination attributes (affective images which enhance visitor experience satisfaction in Cape Town include (1 memorable visit, (2 valuable visit, and (3 friendly and hospitable population. It is therefore recommended that tourism businesses in Cape Town develop relationship marketing tools to attract and retain its tourists segments of loyal, advanced in age, long-staying and domestic tourists. Results from this research could be compared with related findings in the international arena and have related implications, especially for developing economies
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Destination memory and deception: when I lie to Barack Obama about the moon.
Haj, Mohamad El; Saloppé, Xavier; Nandrino, Jean Louis
2018-05-01
This study investigates whether deceivers demonstrate high memory of the person to whom lies have been told (i.e., high destination memory). Participants were asked to tell true information (e.g., the heart is a vital organ) and false information (e.g., the moon is bigger than the sun) to pictures of famous people (e.g., Barack Obama) and, in a subsequent recognition test, they had to remember to whom each type of information had previously been told. Participants were also assessed on a deception scale to divide them into two populations (i.e., those with high vs. those with low deception). Participants with high tendency to deceive demonstrated similar destination memory for both false and true information, whereas those with low deception demonstrated higher destination memory for lies than for true information. Individuals with a high tendency to deceive seem to keep track of the destination of both true information and lies to be consistent in their future social interactions, and thus to avoid discovery of their deception. However, the inconsistency between deceiving and the moral standard of individuals with a low tendency to deceive may result in high destination memory in these individuals.
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Bucharest: Analysis of an ‘old’ destination with a new tourism identity
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Aurelia-Felicia Stăncioiu
2011-11-01
Full Text Available To be able to promote itself efficiently on the market, a destination, given the marketing perspective – has to be aware about the authentic and crucial elements of its own identity as being the only way to transfer, virtually and materially, of what it has best – the social-cultural and artistic identity (which, from a tourist perspective, represents its perceived image, along with psychological and artistic image of the destination. Hence without a detailed knowledge of this aspect, the promotion leads to a presentation of a distorted image of the destination which, in time, can distort the socio-cultural identity of the inhabitants of that region. To build the image of a destination (a notoriously long and complex process, begins with the need to profoundly understand tourists’ complexity of expectations (both functional and psychological and, on their basis, to use these as attributes of the destination in order to improve attractiveness. In Romania’s case such an aspect gains more importance due to the fact that, after the 1989, young generation, an important population segment, seem to register a continuous and dangerous process of “identity erosion”, which over time could result into disconnecting from the essence of the Romanian spirit, not being able to understand or even ignoring sense of belonging, sense of identity, heritage and “tourism heritage”.
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Good, Better, Best Practise – A Comparative Analysis of Official Destination Websites
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Candice Louw
2017-01-01
Full Text Available The uplifting financial impact that tourism may have on local and global economies of scale has resulted in tourists becoming a highly sought-after commodity capable of turning almost any tourism destination and its attractions into thriving exports. With the rapid evolution of Information and Communication Technologies (ICTs and the introduction of smart technologies in particular, however, tourism has become not only more accessible, but arguably also more competitive with an online, try-before-you-buy tourism experience now becoming a reality. Subsequently, the battle is no longer for top offline\tdestination only, but also for online destination of choice. An opportunity thus exists for Official Destination Websites (ODWs to take advantage of these, and additional opportunities, to enhance a\tprospective tourist’s online, pre-tourism experience. By analysing seven of the world’s most popular destinations’ capital city ODWs, one comes to realise that ODWs have become an integrated, rather than independent, part of facilitating tourism. As such, the importance of developing, implementing and maintaining an ODW to increase the likelihood of a possible tourist conversion from mere browser to buyer is highlighted. Finally, the similarities and differences between the analysed ODWs are also listed in an attempt to guide prospective tourism destinations in their endeavour to establish a new ODW, as well as allowing destinations with an existing ODW to possibly implement improvements.
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Directory of Open Access Journals (Sweden)
Vahid Qaemi
2012-10-01
Full Text Available Tourism destination brand equity is defined as all assets (or debts of brands provided with name and symbol of tourism destination to make changes in value services of experiences. In many cases, brand equity is more than physical assets. This survey performs an investigation to identify effective factors in tourism destination equity, cause and affects relationships, and proposes a model for perceived value of tourism destination. The proposed study is performed in one of free islands named Gheshm. The preliminary results indicate that there is a positive relationship between tourism destination brand awareness and destination brand equity, tourism destination brand image, destination brand equity and tourism destination brand loyalty.
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Jano Jiménez-Barreto
2018-03-01
Full Text Available Purpose - An official destination website (ODW is a key component for tourist’s decision-making processes. ODW acts as a direct channel where users may share experiences and opinions about previous or future travels. At the same time, it drives user participation in destination branding activities. In this context, it is crucial to identify how the destination website, using Web 2.0 technologies, could motivate user’s participation with the brand. The purpose of this paper is to propose and evaluate a model that posits the destination website quality as a determinant factor to predict users’ attitudes toward the website and their willingness to participate in co-creation experiences. Design/methodology/approach - Using a combined qualitative and quantitative method, this paper provides an exploratory research that examines the role of destination website quality on attitudes toward the website and the willingness to participate in online co-creation experiences. Findings - Findings confirm that there is a direct and significant relationship between website quality, attitudes toward the website and willingness to participate in online co-creation experiences. Moreover, attitudes toward the website partially mediate relationships between destination website quality and willingness to participate in online co-creation experiences. Originality/value - The literature of value co-creation is trying to identify which factors drive consumer’s participation with brands across different consumption contexts. This study provides evidence that confirms, from a tourism destination website point of view, that website quality is one of these key factors that motives user’s co-creation with a destination.
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FACTORS AFFECTING CITY DESTINATION CHOICE AMONG YOUNG PEOPLE IN SERBIA
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Nemanja Tomić
2015-07-01
Full Text Available The main goal of this study is to explore factors which influence city destination choice among young people in Serbia. In order to achieve this we conducted a survey consisting of 20 different items influencing the choice of city destination. Afterwards the principal component exploratory factor analysis (EFA was carried out in order to extract factors. T-test and ANOVA test were also used to determine if there is a difference between different gender and age groups in terms of which factors influence their choice of a city destination. The results indicate four motivating factors extracted by factor analysis, from which Good hospitality and restaurant service seems to be the major motivating factor. The results also show that respondents belonging to the age group of under 25 give more importance to Information and promotion as well as to Good hospitality and restaurant service than those belonging to older age groups. The same two factors are also more important to females than males.
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Clinical manifestations and management of left ventricular assist device-associated infections.
Nienaber, Juhsien Jodi C; Kusne, Shimon; Riaz, Talha; Walker, Randall C; Baddour, Larry M; Wright, Alan J; Park, Soon J; Vikram, Holenarasipur R; Keating, Michael R; Arabia, Francisco A; Lahr, Brian D; Sohail, M Rizwan
2013-11-01
Infection is a serious complication of left ventricular assist device (LVAD) therapy. Published data regarding LVAD-associated infections (LVADIs) are limited by single-center experiences and use of nonstandardized definitions. We retrospectively reviewed 247 patients who underwent continuous-flow LVAD implantation from January 2005 to December 2011 at Mayo Clinic campuses in Minnesota, Arizona, and Florida. LVADIs were defined using the International Society for Heart and Lung Transplantation criteria. We identified 101 episodes of LVADI in 78 patients (32%) from this cohort. Mean age (± standard deviation [SD]) was 57±15 years. The majority (94%) underwent Heartmate II implantation, with 62% LVADs placed as destination therapy. The most common type of LVADIs were driveline infections (47%), followed by bloodstream infections (24% VAD related, and 22% non-VAD related). The most common causative pathogens included gram-positive cocci (45%), predominantly staphylococci, and nosocomial gram-negative bacilli (27%). Almost half (42%) of the patients were managed by chronic suppressive antimicrobial therapy. While 14% of the patients had intraoperative debridement, only 3 underwent complete LVAD removal. The average duration (±SD) of LVAD support was 1.5±1.0 years. At year 2 of follow-up, the cumulative incidence of all-cause mortality was estimated to be 43%. Clinical manifestations of LVADI vary on the basis of the type of infection and the causative pathogen. Mortality remained high despite combined medical and surgical intervention and chronic suppressive antimicrobial therapy. Based on clinical experiences, a management algorithm for LVADI is proposed to assist in the decision-making process.
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Sarvari, Neda Gholizadeh
2012-01-01
ABSTRACT: This study revisits the previous studies carried out by several researchers on Customer – Based Brand Equity with an intension to further investigate the applications and testing of the Customer-Based Brand Equity (CBBE) model in relation to destination branding. The study specifically examines the effects of Brand Equity Dimensions (Brand Awareness, Brand Loyalty, Brand Value, Brand Quality and Brand Image) on Tourists Satisfaction and ultimately on Future Behaviours that result i...
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Bennett, Rachel; Hosegood, Victoria; Newell, Marie-Louise; McGrath, Nuala
2015-05-01
Despite the removal of restrictions on movement and increasing female participation in migration, only a minority of migrant parents in South Africa include their children in their destination household. Quantitative analyses of the circumstances in which children accompany a migrant parent have been limited by the lack of available data that document family arrangements from the perspective of more than one household. This paper uses data about members of rural households in a demographic surveillance population in KwaZulu-Natal and a linked sample survey of adult migrants to examine factors associated with children's inclusion in the destination household of migrant parents, analyse the timing and sequence of children's moves to parental destination households, and describe the composition of parental origin and destination households. The findings confirm that in contemporary South Africa, only a small percentage (14%) of migrants' children who are members of the parental origin household are also members of the parental destination household. Membership of the parental destination household is associated with parental characteristics and the child's age, but not measures of socio-economic status, and children most commonly migrate several years after their migrant parent. Children included in the destination household of migrant fathers frequently live in small households, which also include their mother, whereas children included in the destination household of migrant mothers live in larger households. This study contributes to understanding the contexts of children's inclusion in parental destination households in South Africa and demonstrates the potential of data collected in migrants' origin and destination households.
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The relation between personality traits and psychographic positions of travel destinations
Ismailov, Amet
2017-01-01
Master's thesis in International hotel and tourism management Understanding potential visitors is one of the fundamental tasks for researchers and businesses, destination marketing organizations as well as many other stakeholders in tourism domain. Despite the fact that Internet has become one of the major marketing channels for hospitality and tourism, researchers indicate that there is a notable gap in understanding how to effectively use social media in travel destination marketing. The...
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Medical Tourism Destination SWOT Analysis: A Case Study of Malaysia, Thailand, Singapore and India
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Wong Kee Mun
2014-01-01
Full Text Available The growth of global medical tourism in the recent years had spurred the interest of many governments to join in the bandwagon, particularly from Asia. Using the SWOT analytical model, this paper provides pertinent comparative analysis of the medical tourism destinations here being Malaysia, Thailand, Singapore and India. Each destination possesses its own value propositions to convince the demands of medical tourists. Malaysia and Thailand have a good mixture of elements (medical, tourism and wellness to be an excellent medical tourism destination while Singapore and India need further development in some of these elements. Meeting or exceeding the medical tourists’ expectations and requirements are the priority of medical tourism destination marketers in ensuring a successful medical tourism industry development.
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International Nuclear Information System (INIS)
Mizoguchi, Asumi; Arimura, Hidetaka; Shioyama, Yoshiyuki
2013-01-01
We are developing a method to evaluate four-dimensional radiation dose distribution in a patient body based upon the animated image of EPID (electronic portal imaging device) which is an image of beam-direction at the irradiation. In the first place, we have obtained the image of the dose which is emitted from patient body at therapy planning using therapy planning CT image and dose evaluation algorism. In the second place, we have estimated the emission dose image at the irradiation using EPID animated image which is obtained at the irradiation. In the third place, we have got an affine transformation matrix including respiratory movement in the body by performing linear registration on the emission dose image at therapy planning to get the one at the irradiation. In the fourth place, we have applied the affine transformation matrix on the therapy planning CT image and estimated the CT image 'at irradiation'. Finally we have evaluated four-dimensional dose distribution by calculating dose distribution in the CT image 'at irradiation' which has been estimated for each frame of the EPID animated-image. This scheme may be useful for evaluating therapy results and risk management. (author)
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Directory of Open Access Journals (Sweden)
Roxana - Andreea SARAGEA
2011-12-01
Full Text Available In the context of increased competition on the international tourism market, the assessment of destination image has become a research subject for both managers aiming to improve destination positioning and academic researchers. In order to obtain a competitive advantage, every tourist destination must identify, maintain and reinforce, through appropriate marketing policies, unique items that form and build over time "the destination' s image". Accordingly, the ultimate target of the tourist destinations' promoters should be to achieve a high level of coincidence between the promoted or projected image and the perceived image of the destination, held by potential and actual tourists. Therefore, the aim of this paper is to illustrate promotional techniques and methods used by the authorities of the Canary Islands over the years (projected image, and to identify, through a survey among the citizens of Braşov, the image that they have of the Canary Islands (perceived image.
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Ala-Lahti, Erkka
2016-01-01
The aim of this bachelor's thesis was to provide points of development for the subject company Kyrö Distillery Company in the developing of a gastronomic tourism destination. The subject company mainly operates as a distillery, but it has promising tourism potential in the field of gastronomic tourism. The company and the restaurant located in the destination, Kyrönmaan matkailunedistämiskeskus, also operate as a tourism destination providing tours and tastings of the company. The objecti...
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Mihaela Jucan; Cornel Jucan; Ilie Rotariu
2013-01-01
The paper deals with the most important changes that have occurred in business because of social media and its impact on organisations and leadership in recent years. It seeks to synthesize existing research, theories and concepts, in order to understand "social destinations", and to provide a bridge from past research to future success. Becoming a "social destination" is a strategic and tactical leadership and management issue and the paper will present the importance of destination leadersh...
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Ecotourism Destinations in Romania
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Iuliana Ioana Merce
2014-05-01
Full Text Available Romania has about 800 protected areas, which now covers about 5% of the country. Most ecotourism destinations are located within or adjacent to these protected areas such as Danube Delta Biosphere Reserve, northern communities National Park, Yosemite National Park, Apuseni Natural Park. In Romania there are still non-fragmented forest, and over a third of the population of bears, wolves and lynx in Europe, unique paradise of birds in the Danube Delta, more than 12 000 caves and, not least, full of authentic local traditions. Ecotourism allows recovery and conservation of the country's natural capital.
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THE FESTIVALS AS A TOOL ON OHRID TOURISM DESTINATION BRANDING
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Zoran Strezovski
2013-12-01
Full Text Available The main aim of the paper is about festivals in the southern west city in the Republic of Macedonia – Ohrid, empirical research of influence of the Ohrid summer festival on Ohrid tourism destination branding. Its strength to attract foreign tourist and the role of Ohrid municipality and tourism stockholders to use festival as a tool to attract more foreign tourist and branding Ohrid as a tourism destination. Nowadays, many tourist organization develop strategy for creating or support festivals on their destination. The festivals have strong influence of the destination attracting many foreign tourist. Some cities are branding as a festival cities, attract over million visitors per year. Ohrid summer festival as a member of European festival association, is the most important festival in Ohrid city but also in the country. The festival has the role to promote and present culture achievements from the country but also it is attractive factor for foreign tourist to visit Ohrid city and the region in the summer period. It is held from 12 of July until 20 of August each year. Ohrid municipality should incorporate Ohrid summer festival and other festivals in general promotion on Ohrid city. It should support and create new festivals.This paper presents an action research conducted on a sample of 150 foreign visitors on Ohrid summer festival during the festival from 12 July till 20 august 2010.
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Role of destination management in strengthening the competitiveness of Croatian tourism
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Irena Bosnić
2014-10-01
Full Text Available Tourism today is marked by various social-economic trends. Croatia as a tourist destination is present on the networked international tourism market, which imposes daily adjustments to varying conditions on the market, primarily through improvement of the competitiveness of its own tourism offer. An important precondition for forming such an offer is an effective system for managing a tourist destination or destination management. With its accession to the European Union, Croatia has become a part of the European tourist market, which is a boost for tourism but also challenging, as it needs to stay true to its identity and maintain its uniqueness. Due to Croatia’s new macroenvironment, conditions and rapidly changing consumer requirements on the global tourism market, as well as global economic and political instability, which has not left the European Union unscathed, strategic operational planning and clear guidance for the future development of tourism in Croatia are essential. Thus, the goal of this paper is to emphasize the importance and functionality of destination management for the development of competitiveness of Croatian tourism, with emphasis on strategic managing of its development and review the challenges and adaptations to the conditions on the European tourism market.
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[Innovation of characteristic medicinal cupping devices].
Li, Jianping; Zhang, Hui; Yang, Jianmei; Xu, Xinchun; Niu, Yanxia; Cai, Jun
2015-08-01
To compare the differences in the characteristic medicinal cupping therapy between the traditional cupping device and the innovated cupping device. Fifty patients of neck and low back pain were selected. The self-comparison was adopted. The cupping therapy was applied to the acupoints located on the left or right side with the traditional cupping device and the innovated cupping device. The cupping sites were centered at bilateral Quyuan (SI 13) and Dachangshu (BL 25). The cups were retained for 10 min. The traditional cupping device was the glass with smooth border, 100mL. The innovated cupping device was the vacuum-sucking cup. The operative time, medicinal leakage, comfort and cupping marks were observed for the two different cupping devices. The operative time with the innovated medicinal cupping device was shorter obviously compared with the traditional one at Quyuan (SI 13) and Dachangshu (BL 25, both Pcupping device was remarkably improved as compared with the traditional one at the two acupoints (both Pcupping operation (both P>0. 05). The cupping marks with the innovated medicinal cupping device were much deeper than those with the traditional one after cupping therapy. The innovated cupping device is more convenent and comfortable in operation during the characteristic medicinal cupping therapy.
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Factors Influencing Perceived Crowding of Tourists and Sustainable Tourism Destination Management
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Qian Jin
2016-09-01
Full Text Available Studies on tourists crowding are developed to explore the perception of crowding, and these studies indicate crowding influence on sustainable development of tourist destinations. This study aims to reveal the influential factors of tourists’ perceived crowding. We obtained data from interviewing over 400 tourists and five senior tourism officials in Xi’an, China. This study firstly applies factor analysis to identify the constructed variables of tourists’ motivations from the principle component analysis. It then examines the correlation between nationality and perceived crowding. Consequently, a multiple regression is used to identify the connection between motivations and perceived crowding. The results of the study indicate nationality and motivation as two significant influential factors to perceived crowding management. This study also shows that management in tourist destinations would benefit from provision of the authentic travel experience integrated with zoning the travel destination.
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Characterisation of a CMOS charge transfer device for TDI imaging
International Nuclear Information System (INIS)
Rushton, J.; Holland, A.; Stefanov, K.; Mayer, F.
2015-01-01
The performance of a prototype true charge transfer imaging sensor in CMOS is investigated. The finished device is destined for use in TDI applications, especially Earth-observation, and to this end radiation tolerance must be investigated. Before this, complete characterisation is required. This work starts by looking at charge transfer inefficiency and then investigates responsivity using mean-variance techniques
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Vacation Behaviour: Frequency, Destination Choice and Expenditures
Rouwendal, J.; van Loon, R.R.
2013-01-01
The authors study the probability of taking a vacation, foreign or domestic, and the expenditures of Dutch households on vacations. The paper first provides a brief review of Dutch vacation behaviour over the past 30 years. It then presents the results of statistical models for destination choice
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Destination Marketing through a Utility Business Model: The Case of Cyprus
Machlouzarides, Haris
2009-01-01
Traditional business models that used to govern the operations of travel and tourism businesses defined in a rigid way their functional areas and the relationships among them. The advent of Information and Communication Technologies (ICT) has driven the transformation of these business models into novel destination marketing models. The Cyprus Tourism Organisation (CTO) recognising the need of establishing an explicit model for managing the process of destination marketing has developed an in...
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Successful heart transplant after 1374 days living with a total artificial heart.
Gerosa, Gino; Gallo, Michele; Bottio, Tomaso; Tarzia, Vincenzo
2016-04-01
The CardioWest Total Artificial Heart (CW-TAH) has been approved as a temporary device for bridge to cardiac transplantation and is under investigation for destination therapy by US Food and Drug Administration (FDA). We herein report the longest worldwide survival out of hospital (1374 days) of a patient supported with Cardio West Total Artificial Heart (CW-TAH). This experience is intended as a proof of concept of using CW-TAH as the destination therapy in patients with biventricular failure. © The Author 2016. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.
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A Common Probe Design for Multiple Planetary Destinations
Hwang, H. H.; Allen, G. A., Jr.; Alunni, A. I.; Amato, M. J.; Atkinson, D. H.; Bienstock, B. J.; Cruz, J. R.; Dillman, R. A.; Cianciolo, A. D.; Elliott, J. O.;
2018-01-01
Atmospheric probes have been successfully flown to planets and moons in the solar system to conduct in situ measurements. They include the Pioneer Venus multi-probes, the Galileo Jupiter probe, and Huygens probe. Probe mission concepts to five destinations, including Venus, Jupiter, Saturn, Uranus, and Neptune, have all utilized similar-shaped aeroshells and concept of operations, namely a 45-degree sphere cone shape with high density heatshield material and parachute system for extracting the descent vehicle from the aeroshell. Each concept designed its probe to meet specific mission requirements and to optimize mass, volume, and cost. At the 2017 International Planetary Probe Workshop (IPPW), NASA Headquarters postulated that a common aeroshell design could be used successfully for multiple destinations and missions. This "common probe"� design could even be assembled with multiple copies, properly stored, and made available for future NASA missions, potentially realizing savings in cost and schedule and reducing the risk of losing technologies and skills difficult to sustain over decades. Thus the NASA Planetary Science Division funded a study to investigate whether a common probe design could meet most, if not all, mission needs to the five planetary destinations with extreme entry environments. The Common Probe study involved four NASA Centers and addressed these issues, including constraints and inefficiencies that occur in specifying a common design. Study methodology: First, a notional payload of instruments for each destination was defined based on priority measurements from the Planetary Science Decadal Survey. Steep and shallow entry flight path angles (EFPA) were defined for each planet based on qualification and operational g-load limits for current, state-of-the-art instruments. Interplanetary trajectories were then identified for a bounding range of EFPA. Next, 3-degrees-of-freedom simulations for entry trajectories were run using the entry state
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How did Malaysia Manage its Position as Top 10 World Tourist Destinations in UNWTO Ranking in 2012?
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Nor’Ain Othman
2014-03-01
Full Text Available There are many reasons contributing to the achievement of Malaysia for being rank as top 10 most visited destinations in the world for the last four years. Among the factors are structures, resources, strategy, policy and leadership. In order to identify how Malaysia manage to be at this rank, a study was carried out on destination branding of Malaysian tourism from destination marketers’ perspectives. The objectives are to identify tourism marketing messages that influence international tourists desire to visit Malaysia and to examine destination marketing agencies attitude towards building “Brand Malaysia” in tourism products. The subject of this research is the most recent promotion involving a new brand entitled “Malaysia Truly Asia” and examines the initiative within the framework of the country’s destination branding and destination image development strategies. An assessment of the part played by destination branding in Malaysian tourism industry at large forms the wider context for the study and conclusions of more general relevance are drawn from the particularities of the case. A quantitative research method is used to examine the attitude of destination marketers towards the awareness on marketing mix used in creating “Brand Malaysia” tourism branding. A total of 300 questionnaires were distributed to travel agencies based on purposive convenient sampling.
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ROMANIA AS TOURISM DESTINATION – AN EXTERNAL PERSPECTIVE
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Carmen Emilia CHASOVSCHI
2008-06-01
Full Text Available Only few steps have already been pointed towards bringing Romania at its proper place on the European tourism market. And big challenges are still there, outside, waiting to be settled. Tourism is indeed a very nice sector, but, if we all consider ourselves tourists, it doesn’t, necessary, mean that we all know tourism is done. The present paper offers an outside perspective of Romanian tourism; a perspective based on a research done among the German tour operators and reveals some strengths and weaknesses of Romania, as a tourism destination. These points are delivering an original view, through the eyes of foreign tour operators or tourists that visited the country or the destinations within.
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Ito, Mikako; Ohno, Kinji
2018-02-20
Endplate acetylcholinesterase (AChE) deficiency is a form of congenital myasthenic syndrome (CMS) caused by mutations in COLQ, which encodes collagen Q (ColQ). ColQ is an extracellular matrix (ECM) protein that anchors AChE to the synaptic basal lamina. Biglycan, encoded by BGN, is another ECM protein that binds to the dystrophin-associated protein complex (DAPC) on skeletal muscle, which links the actin cytoskeleton and ECM proteins to stabilize the sarcolemma during repeated muscle contractions. Upregulation of biglycan stabilizes the DPAC. Gene therapy can potentially ameliorate any disease that can be recapitulated in cultured cells. However, the difficulty of tissue-specific and developmental stage-specific regulated expression of transgenes, as well as the difficulty of introducing a transgene into all cells in a specific tissue, prevents us from successfully applying gene therapy to many human diseases. In contrast to intracellular proteins, an ECM protein is anchored to the target tissue via its specific binding affinity for protein(s) expressed on the cell surface within the target tissue. Exploiting this unique feature of ECM proteins, we developed protein-anchoring therapy in which a transgene product expressed even in remote tissues can be delivered and anchored to a target tissue using specific binding signals. We demonstrate the application of protein-anchoring therapy to two disease models. First, intravenous administration of adeno-associated virus (AAV) serotype 8-COLQ to Colq-deficient mice, resulting in specific anchoring of ectopically expressed ColQ-AChE at the NMJ, markedly improved motor functions, synaptic transmission, and the ultrastructure of the neuromuscular junction (NMJ). In the second example, Mdx mice, a model for Duchenne muscular dystrophy, were intravenously injected with AAV8-BGN. The treatment ameliorated motor deficits, mitigated muscle histopathologies, decreased plasma creatine kinase activities, and upregulated expression
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SULTANA, Seyama; HAQUE, Ahasanul; MOMEN, Abdul; YASMIN, Farzana
2014-01-01
Abstract Background In this edge, medical tourism is not a new idea. Medical treatment is one of the essential demands of human beings and it requires high quality and intensive care. Beside western world, few developing countries are playing key roles as medical tourism destinations. India is one of the leading names among these countries. The purpose of the paper is to find the factors influencing the attractiveness of India as a health tourism destination. Methods The study has found the major contributing factors and their relative importance in the attractiveness of the health tourism destination that is India from consumers’ perspectives by conducting survey with an application of structural equation modelling approach. Results In Indian context, medical tourists consider service quality and cost mostly to select any medical destination. In addition they also give value to the destination competitiveness but tourist attitude is less important in comparison with other factors affecting their destination choice. Since the study has used structural equation modelling approach to test the hypothesis and figure out the relative importance of the factors, the fundamental indices such as Normed Chi square(less than 3), RMSEA (less than 0.08) and CFI (more than 0.90) values show the overall model fit of the proposed model. Conclusion In order to transform a country such as India as an attractive and competitive medical tourist destination in this time of globalization, a step should be taken to control cost ensuring the quality of services. PMID:25909055
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Sultana, Seyama; Haque, Ahasanul; Momen, Abdul; Yasmin, Farzana
2014-07-01
In this edge, medical tourism is not a new idea. Medical treatment is one of the essential demands of human beings and it requires high quality and intensive care. Beside western world, few developing countries are playing key roles as medical tourism destinations. India is one of the leading names among these countries. The purpose of the paper is to find the factors influencing the attractiveness of India as a health tourism destination. The study has found the major contributing factors and their relative importance in the attractiveness of the health tourism destination that is India from consumers' perspectives by conducting survey with an application of structural equation modelling approach. In Indian context, medical tourists consider service quality and cost mostly to select any medical destination. In addition they also give value to the destination competitiveness but tourist attitude is less important in comparison with other factors affecting their destination choice. Since the study has used structural equation modelling approach to test the hypothesis and figure out the relative importance of the factors, the fundamental indices such as Normed Chi square(less than 3), RMSEA (less than 0.08) and CFI (more than 0.90) values show the overall model fit of the proposed model. In order to transform a country such as India as an attractive and competitive medical tourist destination in this time of globalization, a step should be taken to control cost ensuring the quality of services.
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Loforte, Antonio; Montalto, Andrea; Musumeci, Francesco; Amarelli, Cristiano; Mariani, Carlo; Polizzi, Vincenzo; Lilla Della Monica, Paola; Grigioni, Francesco; Di Bartolomeo, Roberto; Marinelli, Giuseppe
2018-05-08
Right ventricular failure after continuous-flow left ventricular assist device (LVAD) implantation is still an unsolved issue and remains a life-threatening event for patients. We undertook this study to determine predictors of the patients who are candidates for isolated LVAD therapy as opposed to biventricular support (BVAD). We reviewed demographic, echocardiographic, hemodynamic, and laboratory variables for 258 patients who underwent both isolated LVAD implantation and unplanned BVAD because of early right ventricular failure after LVAD insertion, between 2006 and 2017 (LVAD = 170 and BVAD = 88). The final study patients were randomly divided into derivation (79.8%, n = 206) and validation (20.1%, n = 52) cohorts. Fifty-seven preoperative risk factors were compared between patients who were successfully managed with an LVAD and those who required a BVAD. Nineteen variables demonstrated statistical significance on univariable analysis. Multivariable logistic regression analysis identified destination therapy (odds ratio [OR] 2.0 [1.7-3.9], p = 0.003), a pulmonary artery pulsatility index right ventricle/left ventricle end-diastolic diameter ratio >0.75 (OR 2.7 [1.5-5.5], p = 0.001), an right ventricle stroke work index 17 (OR 3.5 [1.9-6.9], p the major predictors of the need for BVAD. Using these data, we propose a simple risk calculator to determine the suitability of patients for isolated LVAD support in the era of continuous-flow mechanical circulatory support devices.
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Price, Louise
2016-04-01
"While we teach, we learn" (Roman philosopher Seneca) One of the most beneficial ways to remember a theory or concept is to explain it to someone else. The offer of fieldwork and visits to exciting destinations is arguably the easiest way to spark a students' interest in any subject. Geology at A-Level (age 16-18) in the United Kingdom incorporates significant elements of field studies into the curriculum with many students choosing the subject on this basis and it being a key factor in consolidating student knowledge and understanding. Geology maintains a healthy annual enrollment with interest in the subject increasing in recent years. However, it is important for educators not to loose sight of the importance of recruitment and retention of students. Recent flexibility in the subject content of the UK curriculum in secondary schools has provided an opportunity to teach the basic principles of the subject to our younger students and fieldwork provides a valuable opportunity to engage with these students in the promotion of the subject. Promotion of the subject is typically devolved to senior students at Hessle High School and Sixth Form College, drawing on their personal experiences to engage younger students. Prospective students are excited to learn from a guest speaker, so why not use our most senior students to engage and promote the subject rather than their normal subject teacher? A-Level geology students embarking on fieldwork abroad, understand their additional responsibility to promote the subject and share their understanding of the field visit. They will typically produce a series of lessons and activities for younger students using their newly acquired knowledge. Senior students also present to whole year groups in seminars, sharing knowledge of the location's geology and raising awareness of the exciting destinations offered by geology. Geology fieldwork is always planned, organised and led by the member of staff to keep costs low, with recent visits
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Practical approaches to commencing device-assisted therapies for Parkinson disease in Australia.
Williams, David R; Evans, Andrew H; Fung, Victor S C; Hayes, Michael; Iansek, Robert; Kimber, Thomas; O'Sullivan, John D; Sue, Carolyn M
2017-10-01
In Australia 1% of individuals aged over 50 years have Parkinson disease (PD). Guidance for commencing device-assisted therapies (DAT) for PD in Australia was developed based on a review of European recommendations and their relevance to the local clinical setting. An online survey and teleconference discussions were held by a group of eight local movement disorder experts to develop consensus. Referral to a movement disorder specialist and consideration of DAT is appropriate when motor fluctuations cause disability or reduced quality of life, response to treatment is inconsistent or motor fluctuations and dyskinesias require frequent treatment adjustment without apparent benefit and levodopa is required four or more times daily. Three types of DAT are available in Australia for patients with PD: continuous subcutaneous apomorphine; continuous levodopa-carbidopa intestinal gel infusion; and deep brain stimulation. All improve consistency of motor response. The most important aspects when considering which DAT to use are the preferences of the patient and their carers, patient comorbidities, age, cognitive function and neuropsychiatric status. Patients and their families need to be provided with treatment options that are suitable to them, with adequate explanations regarding the recommendations and comparison of potential device-related complications. DAT are best managed, where possible, in a specialist centre with experience in all three types of therapy. Proactive and early management of symptoms during disease progression is essential to maintain optimally motor responses and quality of life in patients with PD. © 2017 Royal Australasian College of Physicians.
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Christian, Hayley E; Klinker, Charlotte D; Villanueva, Karen; Knuiman, Matthew W; Foster, Sarah A; Zubrick, Stephan R; Divitini, Mark; Wood, Lisa; Giles-Corti, Billie
2015-06-16
Relationships between context-specific measures of the physical and social environment and children's independent mobility to neighborhood destination types were examined. Parents in RESIDE's fourth survey reported whether their child (8-15 years; n = 181) was allowed to travel without an adult to school, friend's house, park and local shop. Objective physical environment measures were matched to each of these destinations. Social environment measures included neighborhood perceptions and items specific to local independent mobility. Independent mobility to local destinations ranged from 30% to 48%. Independent mobility to a local park was less likely as the distance to the closest park (small and large size) increased and less likely with additional school grounds (P dependent upon the specific destination being visited and the impact of neighborhood features varies according to the destination examined. Findings highlight the importance of access to different types and sizes of urban green space for children's independent mobility to parks.
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Nemoto, Yuki; Maruo, Takuya; Fukuyama, Yasuhiro; Kawarai, Shinpei; Shida, Takuo; Nakayama, Tomohiro
2015-01-01
Repeatable head immobilization is important for minimizing positioning error during radiation therapy for veterinary patients with head neoplasms. The purpose of this retrospective cross-sectional study was to describe a novel technique for head immobilization (Device II) and compare this technique with a previously described technique (Device I). Device II provided additional support by incorporating three teeth (vs. two teeth with Device I). Between 2011 and 2013, both devices were applied in clinically affected cats (Device I, n = 17; Device II, n = 11) and dogs (Device I, n = 85; Device II, n = 22) of various breeds and sizes. The following data were recorded for each included patient: variability in the angle of the skull (roll, yaw, and pitch), coordinates of the isocenter, and distance from the reference mark to the tumor. Devices I and II differed for skull angle variability during the treatment of dogs (roll, P = 0.0007; yaw, P = 0.0018; pitch, P = 0.0384) and for yaw of during the treatment of cats (P patients. © 2015 American College of Veterinary Radiology.
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THE PERCEPTION OF ROMANIA AS A TOURIST DESTINATION INTO SUSTAINABLE DEVELOPMENT
Directory of Open Access Journals (Sweden)
MAZILU MIRELA
2015-06-01
Full Text Available Motto: "Ecological and economic deficits are now shaping not only our future, but our present. The future is here." Lester R. Brown (World on the Edge After 50 years of communism, of values destruction, of chaotic real estate evolution, of a kitsch tourist image perceived by those visiting our country, of values reversal, of values dilution, all of us who love our country and tourism wonder what and how to do to transform Romania into an attractive destination. We all know that we have marvelous places, we know that they are not promoted, but why those authorized to do so, don't do it, we don't know! Recently, the ones from National Geographic Traveler (the travelling publication with the widest audience, having over 8.5 million readers have given us a ball of oxygen, have shown us a ray of hope by classifying Maramures in the Top 20 mandatory tourist destinations for 2015, summing up a series of criteria: authenticity, sustainability, cultural richness, etc. Maramures has all these qualities. But it remains a micro region, and the rest of the country (with small exceptions has not attracted attention or tourists... The perception of Romania as a tourist destination is unclear; it has not got a good reputation as a bona fide destination for occasional tourists. This is caused partly by: deficiencies in the destination marketing, the absence of governmental support in tourism, the unprofessional practices in the business tourism sector, the low standards of the services for the visitors, the deficient infrastructure, improper facilities and pass-time activities, etc. The re-launching of tourism from Romania, of the tourist destinations and the attraction of a larger number of foreign tourists could bring supplementary benefits, but with many necessary changes, in the tourism managers’ opinion. “Two elements are essential in the tourism industry system: how to make use environmentally, sustainably of the tourism potential of the landscape and
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BRAND EQUITY OF LAHORE FORT AS A TOURISM DESTINATION BRAND
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Muhammad Kashif
2015-06-01
Full Text Available Studies that measure the brand equity of destination brands by using the Customer-Based Brand Equity (CBBE model in a developing country context are scarce. The present study investigates the destination brand equity of the Lahore Fort by employing the CBBE model in a developing country context of Pakistan. Following the positivist tradition, we adopted a survey-based approach to collect data from 237 tourists visiting the Lahore Fort. Data were collected through a questionnaire developed to explain the relationship of brand awareness, brand image, brand association, and brand loyalty with Lahore Fort’s overall brand equity. We used various robust statistical techniques such as correlation, regression and confirmatory factor analysis (using PLS method to reach meaningful conclusions and found that brand image and brand associations positively contribute to brand loyalty. Furthermore, brand loyalty significantly contributes towards overall brand equity. Pragmatically, this study measures the customer based brand equity of the Lahore Fort, a destination brand. The results are useful as they suggest a few strategies that can help policy makers to enhance Lahore Fort’s brand performance.
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Gas and LNG trading hubs, hub indexation and destination flexibility in East Asia
International Nuclear Information System (INIS)
Shi, Xunpeng; Padinjare Variam, Hari Malamakkavu
2016-01-01
In the East Asian gas markets, issues like gas trading hubs, hub indexed pricing, and destination flexibility are being debated. This paper examines the impact of a change in East Asia's pricing benchmark and contract flexibility on the regional and global gas markets. The paper uses the Nexant World Gas Model, a linear program with global cost minimization as the objective. To our knowledge, this study on hub competition, price benchmark change and contract flexibility improvement in East Asia will be the first in the literature and have real policy relevance. The results show that both price benchmark change and contract flexibility improvements will create an overall benefit for the world and East Asia importers, but the impacts are different among exporters and importers. However, there is no evidence of competition among different benchmark hubs and no evidence that destination restrictions cause the “Asia Premium”. It implies that removal of destination clauses has higher priority than the change to hub indexation for Japan, Korea and Chinese Taipei, but both should be treated equally in China. The study also suggests that East Asian importers should cooperate among themselves and with exporters to facilitate the hub creation and contract changes in East Asia. - Highlights: •Gas trading hubs in Japan and China are not mutually exclusive. •Both price benchmark changes and contract flexibility improvements are beneficial. •The “Asian Premium” is not caused by destination restriction. •Destination flexibility is much more important than hub indexation in East Asia except China. •Hub indexation is as important as destination flexibility in China due to pipeline imports.
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Von Ruden, Serena A S; Murray, Margaret A; Grice, Jennifer L; Proebstle, Amy K; Kopacek, Karen J
2012-04-01
Advances in mechanical circulatory support, such as the use of ventricular assist devices (VADs), have become a means for prolonging survival in end-stage heart failure (HF). VADs decrease the symptoms of HF and improve quality of life by replacing some of the work of a failing heart. They unload the ventricle to provide improved cardiac output and end-organ perfusion, resulting in improvement in cardiorenal syndromes and New York Heart Association functional class rating. VADs are currently used asa bridge to heart transplantation, a bridge to recovery of cardiac function, or as destination therapy. Complications of VAD include bleeding, infections, arrhythmias, multiple organ failure, right ventricular failure, and neurological dysfunction. Patients with VAD have unique pharmacotherapeutic requirements in terms of anticoagulation, appropriate antibiotic selection, and continuation of HF medications. Pharmacists in acute care and community settings are well prepared to care for the patient with VAD. These patients require thorough counseling and follow-up with regard to prevention and treatment of infections, appropriate levels of anticoagulation, and maintenance of fluid balance. A basic understanding of this unique therapy can assist pharmacists in attending to the needs of patients with VAD.
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Directory of Open Access Journals (Sweden)
Edriana Pangestuti
2017-06-01
Full Text Available This study sought to understand the relationship between destination competitiveness factors (such as the tourist’s image, service quality, satisfaction and behavioral intention. Little empirical research has explored these relationships from the heritage tourist’s perspective. A mixed method was used to achieve the study’s objectives and test the conceptual model. Twelve in-depth interviews and 400 questionnaire surveys (international and domestic were conducted using purposive technique sampling. A structural equation modeling (SEM technique was applied to identify, evaluate and develop the dimensions and test the relationship between these dimensions simultaneously. The final model showed that service quality has a significant relationship with satisfaction but an insignificant relationship with behavioral intention. In addition, this study provided new insights, determining that destination image and service quality factors influence destination competitiveness via the mediating of tourists’ satisfaction in a heritage tourism context. This shows the importance of destination image and service quality for measuring competitiveness. This present model will be useful as a guide for future research for measuring destination competitiveness in the heritage tourism context. Understanding destination competitiveness factors will help marketers predict future travel behavior and develop effective strategies in order to compete with other destinations. Keywords: destination image, satisfaction, service quality, behavioral intention and destination competitiveness ABSTRAK Penelitian ini berusaha memahami hubungan antara faktor daya saing destinasi (seperti citra destinasi, kualitas layanan, kepuasan dan niat perilaku. Beberapa penelitian serupa telah dilakukan dengan melihat dari perspektif wisatawan. Metode kualitatif dan kuantitatif (Mix method digunakan untuk menguji model konseptual. Dua belas narasumber dan 400 kuesioner (wisatawan
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Impact of an iDevice application on student learning in an occupational therapy kinesiology course.
Hughes, Jason K; Kearney, Pamalyn
2017-01-01
As technology continues to evolve, and information is increasingly accessed through smartphones and tablets, it is essential for university faculty to reassess teaching methodologies. This study explored how use of an iDevice application (app) by participants enrolled in an entry-level occupational therapy kinesiology course affected student learning in the course. This iDevice app was developed through a collaboration between the lead author and the Department of Technology Enhanced Learning and Innovation at Augusta University. The iDevice app was released to the public via the Apple ® App Store at the midpoint of the kinesiology course. All students were invited to use the app. Focus groups were conducted with 19 students recruited from the first year cohort of occupational therapy graduate students. These focus groups were conducted at the end of the semester once grades had been submitted. Thematic analysis of focus group transcripts revealed three themes reflecting how participants perceived app use impacting their learning. Participants report the app facilitated learning through provision of visual content, serving as a reliable source of information, and generally supporting the learning process. The Kinesiology Pro Consult App provided on demand learning, allowing students to be more autonomous with their learning and take advantage of opportunities to learn anywhere and anytime. Finally, participants reported the app allowed them to be more efficient in their learning, possibly allowing more time for other courses. Mobile device apps that support student learning in specific content areas may provide positive benefits to student learning both in the specific course related to the app but also in other courses as a result of increased efficiency in learning.
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Predictors of trips to food destinations
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Kerr Jacqueline
2012-05-01
Full Text Available Abstract Background Food environment studies have focused on ethnic and income disparities in food access. Few studies have investigated distance travelled for food and did not aim to inform the geographic scales at which to study the relationship between food environments and obesity. Further, studies have not considered neighborhood design as a predictor of food purchasing behavior. Methods Atlanta residents (N = 4800 who completed a travel diary and reported purchasing or consuming food at one of five food locations were included in the analyses. A total of 11,995 food-related trips were reported. Using mixed modeling to adjust for clustering of trips by participants and households, person-level variables (e.g. demographics, neighborhood-level urban form measures, created in GIS, and trip characteristics (e.g. time of day, origin and destination were investigated as correlates of distance travelled for food and frequency of grocery store and fast food outlet trips. Results Mean travel distance for food ranged from 4.5 miles for coffee shops to 6.3 miles for superstores. Type of store, urban form, type of tour, day of the week and ethnicity were all significantly related to distance travelled for food. Origin and destination environment, type of tour, day of week, age, gender, income, ethnicity, vehicle access and obesity status were all significantly related to visiting a grocery store. Home neighborhood environment, day of week, type of tour, gender, income, education level, age, and obesity status were all significantly related to likelihood of visiting a fastfood outlet. Conclusions The present study demonstrated that people travel sizeable distances for food and this distance is related to urban. Results suggest that researchers need to employ different methods to characterize food environments than have been used to assess urban form in studies of physical activity. Food is most often purchased while traveling from locations other
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A Model of Market Positioning of Destinations Based on Online Customer Reviews of Lodgings
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Manuel Rodríguez-Díaz
2017-12-01
Full Text Available The aim of this study is to develop a methodology to determine the competitive online positioning of lodging companies in different tourist destinations. The rise of the digital age has allowed many customers to share their opinions through specialized websites, providing a dynamic and constantly updated evaluation of the market. In this context, competitiveness is an essential factor in the economic sustainability of destinations. The competitive positioning of destinations is determined by the scale of variables used by Booking.com. The price and lodging category variables are also used, as well as three new variables derived from the initial scale: the quality average, value and added value. This methodology provides a tool to determine the level of competitiveness of the lodging offered in tourist destinations, based on which, actions can be taken to improve destinations’ positioning.
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Sustainable Coastal Destination Development: Fostering Green Practices of Restaurateurs
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Timo Derriks
2015-12-01
Full Text Available Coastal tourism destinations are reinventing themselves, concentrating on product improvement and image enhancement. Reinventing sustainably is key and restaurants are an important factor. Research upon the processes of change in the industry seems to be fragmented and undefined in its conclusions. Knowledge is lacking on what specifically drives innovation in the hospitality industry. Since restaurants seem to be focusing more than ever on implementing green strategies, incorporating sustainability into restaurant practices is not an unexplored area. However, the how and why it is incorporated or not, can be different per restaurant. The objective of this study is to identify possibilities of change in restaurateur practices, which can lead to interventions that will foster sustainable destination development in Vrouwenpolder; a coastal destination within the Netherlands. For the identification of interventions that could advance the sustainability enacted in restaurateur practices, a qualitative research was conducted. Practices of restaurateurs in Vrouwenpolder are identified and compared to perceived-to-be ideal practices. Analysis of data collection draws on practice theory, and resulted into recommendations for advancing the sustainability enacted in restaurateur practices. It seems to be that primarily the meaning within a practice is decisive in whether sustainability is integrated or not.
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DEFF Research Database (Denmark)
Christensen, Arne; Christrup, Lona Louring; Fabricius, Paul Erik
2010-01-01
. In the first half of the study, patients using the device reported 91% compliance versus 85% in the control group. This difference diminished after crossover (88 versus 86%). BP was not affected. Electronic monitoring data on compliance revealed taking, dosing and timing compliance between 45 and 52% in study...... to be effective in improving patient compliance to some extent, but the combined effect has not been documented. OBJECTIVE: To assess the impact of an electronic reminder and monitoring device on patient compliance and BP control. METHODS: All patients received medical treatment with telmisartan once daily...... and were randomized to either electronic compliance monitoring with a reminder and monitoring device or standard therapy for 6 months. Both groups were crossed over after 6 months. Intervention effectiveness was assessed using self-reported compliance and BP. RESULTS: Data from 398 patients were analysed...
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Yoon, Yooshik
2002-01-01
This study was conducted to theoretically develop and empirically test a structural equation model of tourism destination competitiveness from the tourism stakeholders'perspective. The proposed hypotheses that attempted to identify the structural relationships among the five constructs in the model were examined through a series of analyses in LISREL: 1) perceived tourism development impacts, 2) environmental attitudes, 3) place attachment, 4) development preferences about destination attract...
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Does tourism destination competitiveness lead to performance? A case of ASEAN region
Hafiz Hanafiah, Mohd; Hemdi, Mohamad Abdullah; Ahmad, Ismail
2016-01-01
The main purpose of this paper is to identify the causes of ASEAN tourism performance. This paper empirically examines the role of tourism destination competitiveness on tourism performance among the ASEAN countries. This study employed the Travel and Tourism Competitiveness Index (TTCI) to assess tourism performance of the ASEAN countries. More specifically, this paper explores whether tourism's core resources, complementary resources, destination management, tourism prices and globalisation...
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Consumer satisfaction and dissatisfaction in tourism as related to destination image perception
Chon, Kye-Sung
1990-01-01
The primary objective of this study was to investigate the relationship between travel destination image and the tourist satisfaction/dissatisfaction. Using the evaluative congruity theory framework, this study focused on the role of destination images in tourism with regard to consumer satisfaction/ dissatisfaction (CS/D) from the stand point of: (1) the functional congruency between the tourist's expectations and his/her perceptions of specific utilitarian (functional) ...
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Assessing the Level of Popularity of European Stag Tourism Destinations
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Iwanicki Grzegorz
2016-09-01
Full Text Available The primary objective of this article is to determine the degree of popularity of stag tourism destinations in Europe. Research was based on the search engine method, involving an analysis of the highest positioned offers of travel agencies in the most commonly used search engines in Europe (Google, Bing, Yahoo. The analysis divided the studied cities into four categories in terms of popularity. Conducting the said analysis is strongly justified, because academic publications have so far not provided studies which have determined the degree of popularity of stag destinations on a continental scale.
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DESTINATION MARKETING STRATEGY IN BALI THROUGH OPTIMIZING THE POTENTIAL OF LOCAL PRODUCTS
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I Gusti Ayu Oka Suryawardani
2014-03-01
Full Text Available This study was designed to study destination marketing strategy in Bali through optimizing the potential of local products. Seventy nine of hotel managers were interviewed based on cluster sampling method to gain their point of view. The results show that destination must build their images around unique attributes that provide them sustainable competitive advantage including its attraction which should be designed to meet the needs of the target market and should be served by local products. The results also show that hotel managers thought that foreign tourists always preferred imported products, meanwhile previous statistical results indicate that foreign tourists significantly look for local products. There is a need to encourage hotel managers to change their perception and attitude about local and imported products. In fact, hoteliers expressed willingness to use local products as long as these meet the quality standard. As tourism involves four types of activities, namely something to see, something to do, something to buy, something to learn, destination product development could be focused in the above activities through offering foreign tourist, such as to stay in hotels, homestays or villas owned by Balinese; to eat in restaurants owned by Balinese by choosing the authentic local foods that are using local meat, seafood and vegetables, exotic local fruits and beverages; and to buy products that are produced by the Balinese. By promoting vacation on the real Balinese atmosphere such as stay in accommodations owned by the Balinese supported by the authenticity of local Balinese foods, fruits and beverages, these will strengthen the local economy, so the benefit of tourism development can be more beneficial to the local Balinese. The results suggests that destination management related to improvement of service and hospitality are really important through improvement of human resource by giving training to their employees, educate
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Image of Finland as a Destination for the Mainland Chinese Tourist
Aihaiti, Maierhaba
2014-01-01
China is one of the biggest countries in the world which has a population of nearly 1.4 million people. With help of a steady growth economy, the outbound tourism of China has dramatically increased. Finland as gateway for Chinese tourists to Europe has become a unique destination for them. However, Finland is still relatively unknown and mysterious for most of the Chinese tourists. The aims of this study were to examing how the destination image affects the decision making of mainland Chines...
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McKellar, Stephen H; Deo, Salil; Daly, Richard C; Durham, Lucian A; Joyce, Lyle D; Stulak, John M; Park, Soon J
2014-01-01
A competent aortic valve is essential to providing effective left ventricular assist device support. We have adopted a practice of central aortic valve closure by placing a simple coaptation stitch at left ventricular assist device implantation in patients with significant aortic insufficiency. We conducted a follow-up study to evaluate the efficacy and durability of this procedure. The study included patients who had undergone continuous flow left ventricular assist device implantation. The patients were divided into 2 groups, those who did not require any aortic procedure because the valve was competent and those who underwent central aortic valve closure for mild or greater aortic regurgitation. The clinical endpoints were mortality, progression or recurrence of aortic insufficiency, and reoperation for aortic valve pathologic features. Aortic insufficiency was measured qualitatively from mild to severe on a scale of 0 to 5. A total of 123 patients received continuous flow left ventricular assist devices from February 2007 to August 2011. Of those, 18 (15%) underwent central aortic valve closure at left ventricular assist device implantation because of significant aortic insufficiency (1.8 ± 1.4) and 105 who did not (competent aortic valve, 0.15 ± 0.43; P assist device-supported patients, with follow-up extending into 2 years. Although aortic insufficiency progressed over time in those with minimal native valve regurgitation initially, no such progression was noted in those with central aortic valve closure. Additional investigation is needed to evaluate whether prophylactic central aortic valve closure should be performed at left ventricular assist device implantation to avoid problematic aortic regurgitation developing over time, in particular in patients undergoing left ventricular assist device implantation for life-long (destination therapy) support. Copyright © 2014 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights
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Yachin, Jonathan Moshe
2013-01-01
In the contemporary tourism industry, the competitive game is between destinations. Tourism operations struggle to remain competitive on the international market and their success depends to a large extent on other complementary and competing tourism organizations at the destination. It is the sum of the total tourism offerings at the destination which determines its attractiveness. This research explores tourism collaboration process as a means of generating destination competitiveness. The ...
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Fujiwara, Atsushi; Komasawa, Nobuyasu; Minami, Toshiaki
2014-01-01
A 71-year-old man was scheduled to undergo cardiac resynchronization therapy device (CRTD) implantation. He was combined with severe chronic heart failure due to ischemic heart disease. NYHA class was 3 to 4 and electrocardiogram showed non-sustained ventricular. Ejection fraction was about 20% revealed by transthoracic echocardiogram. He was also on several anticoagulation medications. We planned to implant the device under the greater pectoral muscle. As general anesthesia was considered risky, monitored anesthesia care utilizing peripheral nerve block and slight sedation was scheduled. Pectoral nerves (PECS) block and intercostal block was performed under ultrasonography with ropivacaine. For sedation during the procedure, continuous infusion of dexmedetomidine without a loading dose was performed. The procedure lasted about 3 hours, but the patient showed no pain or restlessness. Combination of PECS block and intercostal block may provide effective analgesia for CRTD implantation.
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Urban tourism destinations in South Africa: Divergent trajectories 2001–2012
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Christian M. Rogerson
2014-07-01
Full Text Available Cities are growing tourism destinations in both developed and developing countries. For policymakers in many cities the promotion of tourism is a vital issue. The phenomenon of urban tourism has emerged as a significant research topic in tourism and urban studies. The South African experience has been one of the most well documented cases in urban tourism in the developing world. Most existing research is focussed on supply-side issues of the establishment of new tourism products in cities or of the impacts of growing urban tourism. This article examines urban tourism from a demand-side perspective and interrogates the performance of South Africa’s eight metropolitan areas as tourism destinations over the period 2001-2012.The analysis reveals that the metropolitan areas as a group are expanding in significance as tourism destinations. Divergent pathways or trajectories of development are apparent in terms of unpacking the performance of the eight different areas.
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Smart Card Data Mining of Public Transport Destination: A Literature Review
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Tian Li
2018-01-01
Full Text Available Smart card data is increasingly used to investigate passenger behavior and the demand characteristics of public transport. The destination estimation of public transport is one of the major concerns for the implementation of smart card data. In recent years, numerous studies concerning destination estimation have been carried out—most automatic fare collection (AFC systems only record boarding information but not passenger alighting information. This study provides a comprehensive review of the practice of using smart card data for destination estimation. The results show that the land use factor is not discussed in more than three quarters of papers and sensitivity analysis is not applied in two thirds of papers. In addition, the results are not validated in half the relevant studies. In the future, more research should be done to improve the current model, such as considering additional factors or making sensitivity analysis of parameters as well as validating the results with multi-source data and new methods.
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Personal values, subjective well-being and destination-loyalty intention of international students
Jamaludin, N. L.; Sam, D. L.; Sandal, G. M.; Adam, A. A.
2016-01-01
What are the factors that predict international students? destination-loyalty intention? This is the main question this paper addresses, using an online survey among 396 (short-term, N?=?182) and (long-term, N?=?214) international students at a Norwegian university. Structural equation model-AMOS was conducted to examine relationships among personal values, subjective well-being and destination-loyalty intentions. The results showed that: (1) universalism was positively related to subjective ...
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The allure of new immigrant destinations and the Great Recession in the United States
Ellis, Mark; Wright, Richard; Townley, Matthew
2013-01-01
In the 1990s, the immigrant population in the United States dispersed to non-traditional settlement locations (what have become known as “new immigrant destinations”). This paper examines whether the allure of new destinations persisted in the 2000s with a particular focus on the internal migration of the foreign born during the recent deep recessionary period and its aftermath. Three specific questions motivate the analysis. First, are immigrants, much like the US-born population, becoming less migratory within the country over time? Second, is immigrant dispersal from traditional gateways via internal migration continuing despite considerable economic contraction in many new destination metropolitan areas? Third, is immigration from aboard a substitute for what appears to be declining immigrant internal migration to new destinations? The findings reveal a close correlation between the declining internal migration propensity of the US-born and immigrants in the last two decades. We also observe parallels between the geographies of migration of native- and foreign-born populations with both groups moving to similar metropolitan areas in the 1990s. This redistributive association, however, weakened in the subsequent decade as new destination metropolitan areas lost their appeal for both groups, especially immigrants. There is no evidence to suggest that immigration from abroad is substituting for the decline in immigrant redistribution through internal migration to new destinations. Across destination types the relationship between immigration from abroad and the internal migration of the foreign born remained the same before, during, and after the Great Recession. PMID:24791036
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QUALITY FROM THE VIEWPOINT OF TOURISM DESTINATION
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Liliana ELMAZI
2008-06-01
Full Text Available Service quality initiatives are high priorities in many tourist destinations, with expenditure seen as long-term investment for future growth and profitability. My study’s goal is to explain the quality dimensions from the viewpoint of tourism destination. When we start to discuss about tourism quality supply, the main problem we have to consider is the structure of tourism supply as a complex of tangible and intangible elements. Analysis of the quality problem, their measuring and monitoring and marketing strategies based on quality, needs to be built on the specificity of tourist offer, regarding the level of goods and services. Because of this, the level of quality and customer satisfaction of quality is very hard to measure and to control. The first major feature of quality programs development is typically, to identify the key components or dimensions of quality from customer and employee research, i.e. their needs and expectations.
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IPTV inter-destination synchronization: A network-based approach
Stokking, H.M.; Deventer, M.O. van; Niamut, O.A.; Walraven, F.A.; Mekuria, R.N.
2010-01-01
This paper introduces a novel network-based approach to inter-destination media synchronization. The approach meets the need for synchronization in advanced TV concepts like social TV and offers high scalability, unlike conventional end-point based approaches. The solution for interdestination media
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Directory of Open Access Journals (Sweden)
Pavković Vladimir
2015-01-01
Full Text Available This paper analyses different film genres and their role as a media communications instrument for the tourist destination promotion strategy. The general objective of the paper is to point to the significance of film for the tourist destination recognisability as well as its perception in the public eye. The specific objectives of the paper are directed at the analysis of individual roles that different film genres have in the tourist destination promotion strategy. The research methods employed in the paper entail film identification and its role in media communications, the identification both of different film genres and their specific features, then, the observation of their application in the tourist destination promotion strategy, and eventually, the identification of their significance in the process of raising the public's awareness of the destination itself as well as the creation of positive perception of the destination with the targeted audience. In this regard, the paper focuses on the following: feature films, documentary films, tourist-related report, promotional tourist films, messages conveyed through films to the targeted audience as well as the strategies and methods employed in the film as a promotional tool. One of the key findings of the paper is to highlight the significance of each film genre in the process of tourist destination promotion, whereas their combination represents an important segment of media strategies in the field of tourism, and is a prerequisite for the desired positioning in the contemporary tourism market.
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Destination Brand Personality of Portugal for the Russian-Speaking Market
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Taisiya Chaykina
2014-03-01
Full Text Available Nowadays brand personality is admitted to be one of the essential parts of brand strategy. It has also become a popular aspect of destination branding due to the fact that destinations are constantly competing for visitors attention in various ways. The term of branding has been first applied to marketing of services or places since the 1990’s. Later on it was broadened and utilized by specialists in the field of tourism marketing. Tourism brand personality is a relatively new one and there are only few works devoted to brand personality of countries as tourism destinations. Keeping in mind the novelty of the research area, this study was planned as exploratory in nature. The stated goal of the research is: to identify the brand personality attributes ascribed to Portugal by the Russian-speaking market and compare the possible existing differences of attributes among the subgroups of the study (actual visitors and possible future visitors. The results of this research might be interesting to the local officials and to business representatives as it highlights the main attributes of Portugal brand personality from the Russian speaking people’s point of view.
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Law, Sabrina P; Oron, Assaf P; Kemna, Mariska S; Albers, Erin L; McMullan, D Michael; Chen, Jonathan M; Law, Yuk M
2018-05-01
Ventricular assist devices have gained popularity in the management of refractory heart failure in children listed for heart transplantation. Our primary aim was to compare the composite endpoint of all-cause pretransplant mortality and loss of transplant eligibility in children who were treated with a ventricular assist device versus a medically managed cohort. This was a retrospective cohort analysis. Data were obtained from the Scientific Registry of Transplant Recipients. The at-risk population (n = 1,380) was less than 18 years old, either on a ventricular assist device (605 cases) or an equivalent-severity, intensively medically treated group (referred to as MED, 775 cases). None. The impact of ventricular assist devices was estimated via Cox proportional hazards regression (hazard ratio), dichotomizing 1-year outcomes to "poor" (22%: 193 deaths, 114 too sick) versus all others (940 successful transplants, 41 too healthy, 90 censored), while adjusting for conventional risk factors. Among children 0-12 months old, ventricular assist device was associated with a higher risk of poor outcomes (hazard ratio, 2.1; 95% CI, 1.5-3.0; p comparative study of ventricular assist devices versus medical therapy in children. Age is a significant modulator of waitlist outcomes for children with end-stage heart failure supported by ventricular assist device, with the impact of ventricular assist devices being more beneficial in adolescents.
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Falchook, Aaron D; Tracton, Gregg; Stravers, Lori; Fleming, Mary E; Snavely, Anna C; Noe, Jeanne F; Hayes, David N; Grilley-Olson, Juneko E; Weiss, Jared M; Reeve, Bryce B; Basch, Ethan M; Chera, Bhishamjit S
2016-01-01
Accurate assessment of toxicity allows for timely delivery of supportive measures during radiation therapy for head and neck cancer. The current paradigm requires weekly evaluation of patients by a provider. The purpose of this study is to evaluate the feasibility of monitoring patient reported symptoms via mobile devices. We developed a mobile application for patients to report symptoms in 5 domains using validated questions. Patients were asked to report symptoms using a mobile device once daily during treatment or more often as needed. Clinicians reviewed patient-reported symptoms during weekly symptom management visits and patients completed surveys regarding perceptions of the utility of the mobile application. The primary outcome measure was patient compliance with mobile device reporting. Compliance is defined as number of days with a symptom report divided by number of days on study. There were 921 symptom reports collected from 22 patients during treatment. Median reporting compliance was 71% (interquartile range, 45%-80%). Median number of reports submitted per patient was 34 (interquartile range, 21-53). Median number of reports submitted by patients per week was similar throughout radiation therapy and there was significant reporting during nonclinic hours. Patients reported high satisfaction with the use of mobile devices to report symptoms. A substantial percentage of patients used mobile devices to continuously report symptoms throughout a course of radiation therapy for head and neck cancer. Future studies should evaluate the impact of mobile device symptom reporting on improving patient outcomes.
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The Role of Marketing Mix Components in Destination Choices of Visitors and the Case of Dalyan
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Özgür ÖZER
2012-03-01
Full Text Available This study investigated the impact of the eight components of the marketing mix, as being product, price, distribution, promotion, person, partnership, program and package, upon choice of a destination.For this research purpose, data was collected by face-to-face interviews and survey from 260 foreign tourists visiting the region of Dalyan. First, the marketing mix components were classified according to their importance determined by the arithmetic averages. Then, multiple regression analysis was performed to determine whether the marketing mix components had an effect on the destination choice. The analysis found that the variables of ‘product’ and ‘person’ had an effect on the Dalyan destination choice. This result shows that the ’product’ is an influencial factor, as expected, on the choice of the Dalyan destination, within the scope of ecotourism, visited by the tourists. In addition, ‘person’ is also important factor on the destination choice for the Dalyan region.
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van der Waerden, P.J.H.J.; Timmermans, H.J.P.; de Bruin - Verhoeven, M.
2017-01-01
In this paper the relationship between car drivers’ personal and trip characteristics and the maximum distance car drivers are willing to walk between a parking facility and the final destination(s) will be discussed. The willingness to walk is investigated in the context of four different trip
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Wolff, Katharina; Larsen, Svein
2016-12-01
The present investigation is a cross-sectional, multi-national, quantitative, and quasi-experimental comparison of tourists' risk perceptions regarding different destinations throughout the past decade. Over 10,000 tourists to Norway from 89 different countries filled in a questionnaire rating the perceived risk for various destinations. Data were collected during 2004, 2010, 2011, 2012, 2013 and 2015 and allow for a comparison of perceived risk across time, place and nationality. Results show that while absolute risk judgments for different destinations fluctuate somewhat over the years, relative risk judgments remain constant. Findings also reveal a "home-is-safer-then-abroad-bias" with tourists consistently perceiving their home country among the safest destinations. The current investigation is rare because it looks at more than one destination at a time. Insights gained from the present findings diverge from what would have been concluded from employing case studies, that is, looking at one destination at a time. © 2016 The Authors. Scandinavian Journal of Psychology published by Scandinavian Psychological Associations and John Wiley & Sons Ltd.
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Directory of Open Access Journals (Sweden)
Setyo Ferry Wibowo
2016-04-01
Full Text Available The purpose of this research are: 1 To find out the description of destination image, tourist satisfaction, and revisit intention of Betawi cultural village Setu Babakan, 2 test empirically the influence of destination image toward revisit intention of Betawi cultural village Setu Babakan, 3 test empirically the influence of tourist satisfaction toward revisit intention of Betawi cultural village Setu Babakan, 4 test empirically the influence of destination image toward revisit intention of Betawi cultural village Setu Babakan. The object of this research was 200 respondents who have ever visit to Betawi cultural village Setu Babakan at one time. The results of descriptive test explained that the destination image provided is good according to the tourist, so that the tourist is satisfied and want to revisit intention of Betawi cultural village Setu Babakan. The hypothesis test shows: 1 the influence of destination image toward revisit intention by -30%, 2 the influence of tourist satisfaction toward revisit intention by 118%, 3 the influence of destination image toward tourist satisfaction by 92%.
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General and acute care surgical procedures in patients with left ventricular assist devices.
Arnaoutakis, George J; Bittle, Gregory J; Allen, Jeremiah G; Weiss, Eric S; Alejo, Jennifer; Baumgartner, William A; Shah, Ashish S; Wolfgang, Christopher L; Efron, David T; Conte, John V
2014-04-01
Left ventricular assist devices (LVADs) have become common as a bridge to heart transplant as well as destination therapy. Acute care surgical (ACS) problems in this population are prevalent but remain ill-defined. Therefore, we reviewed our experience with ACS interventions in LVAD patients. A total of 173 patients who received HeartMate(®) XVE or HeartMate(®) II (HMII) LVADs between December 2001 and March 2010 were studied. Patient demographics, presentation of ACS problem, operative intervention, co-morbidities, transplantation, complications, and survival were analyzed. A total of 47 (27 %) patients underwent 67 ACS procedures at a median of 38 days after device implant (interquartile range 15-110), with a peri-operative mortality rate of 5 % (N = 3). Demographics, device type, and acuity were comparable between the ACS and non-ACS groups. A total of 21 ACS procedures were performed emergently, eight were urgent, and 38 were elective. Of 29 urgent and emergent procedures, 28 were for abdominal pathology. In eight patients, the cause of the ACS problem was related to LVADs or anticoagulation. Cumulative survival estimates revealed no survival differences if patients underwent ACS procedures (p = 0.17). Among HMII patients, transplantation rates were unaffected by an ACS intervention (p = 0.2). ACS problems occur frequently in LVAD patients and are not associated with adverse outcomes in HMII patients. The acute care surgeon is an integral member of a comprehensive approach to effective LVAD management.
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The Role of Entrepreneurship and Longlife Learning in Branding of Tourism Destination
Gregorić, Marina; Skendrović, Ljiljana
2012-01-01
Branding of tourism destination can’t be seen without cooperation between private and public sector, entrepreneurship and government. Lifelong learning is an important element of increased awareness about the market and advantages of tourism destination as well as its market value. Definition of brand which starts from the needs of consumers is one that should lead in contemporary market environment where customers and market determine the value of the product or services. To achieve successf...
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DIFFERENCES BETWEEN PLACE BRANDING AND DESTINATION BRANDING FOR LOCAL BRAND STRATEGY DEVELOPMENT
Victor-Alexandru BRICIU
2013-01-01
To highlight the principles used in the design and development of a regional brand strategy we need to identify the disciplinary and the theoretical referential that would best fit the branding approach. This paper will address the main forms of branding: place branding, location branding and destination branding, as a specialized form of destination marketing. From the theoretical point of view, by identifying the fundamental and the management brand model, the regional tourism brand conc...
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Conference communication. Managing change in tourism destinations: Key issues and current trends.
Mariani, M.M.; Buhalis, Dimitrios; Longhi, C.; Vitouladiti, O.
2013-01-01
This conference communication illustrates the major outcomes emerging from the EIASM Conference on Tourism Management and Tourism Related Issues held in Nice (France), September 20-21, 2012. While a number of managerial issues pertaining to the tourism field were dealt with, this communication covers three specific areas of interest for destination management and marketing: (1) the increasing competition among tourism destinations and the rise and consolidation of BRIC countries as outbound t...
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Usability evaluation of a locomotor therapy device considering different strategies
Directory of Open Access Journals (Sweden)
Langthaler Sonja
2016-09-01
Full Text Available Usability of medical devices is one of the main determining factors in preventing use errors in treatment and strongly correlates to patient safety and quality of treatment. This thesis demonstrates the usability testing and evaluation of a prototype for locomotor therapy of infants. Therefore, based on the normative requirements of the EN 62366, a concept combined of evaluation procedures and assessing methods was created to enable extensive testing and analysis of the different aspects of usability. On the basis of gathered information weak points were identified and appropriate measures were presented to increase the usability and operating safety of the locomotor prototype. The overall outcome showed an usability value of 77.4% and an evaluation score of 6.99, which can be interpreted as “satisfactory”.
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Heatley, Gerald; Sood, Poornima; Goldstein, Daniel; Uriel, Nir; Cleveland, Joseph; Middlebrook, Don; Mehra, Mandeep R
2016-04-01
The HeartMate 3 left ventricular assist system (LVAS; St. Jude Medical, Inc., formerly Thoratec Corporation, Pleasanton, CA) was recently introduced into clinical trials for durable circulatory support in patients with medically refractory advanced-stage heart failure. This centrifugal, fully magnetically levitated, continuous-flow pump is engineered with the intent to enhance hemocompatibility and reduce shear stress on blood elements, while also possessing intrinsic pulsatility. Although bridge-to-transplant (BTT) and destination therapy (DT) are established dichotomous indications for durable left ventricular assist device (LVAD) support, clinical practice has challenged the appropriateness of these designations. The introduction of novel LVAD technology allows for the development of clinical trial designs to keep pace with current practices. The prospective, randomized Multicenter Study of MagLev Technology in Patients Undergoing Mechanical Circulatory Support Therapy With HeartMate 3 (MOMENTUM 3) clinical trial aims to evaluate the safety and effectiveness of the HeartMate 3 LVAS by demonstrating non-inferiority to the HeartMate II LVAS (also St. Jude Medical, Inc.). The innovative trial design includes patients enrolled under a single inclusion and exclusion criteria , regardless of the intended use of the device, with outcomes ascertained in the short term (ST, at 6 months) and long term (LT, at 2 years). This adaptive trial design includes a pre-specified safety phase (n = 30) analysis. The ST cohort includes the first 294 patients and the LT cohort includes the first 366 patients for evaluation of the composite primary end-point of survival to transplant, recovery or LVAD support free of debilitating stroke (modified Rankin score >3), or re-operation to replace the pump. As part of the adaptive design, an analysis by an independent statistician will determine whether sample size adjustment is required at pre-specified times during the study. A further 662
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Ages of origin and destination for a difference in life expectancy
Directory of Open Access Journals (Sweden)
Elwood Carlson
2006-03-01
Full Text Available Decomposition of a difference in life expectancies may identify ages at which the difference originates in mortality differences, or may identify age at which the difference results in different values of person-years lived (life table population. This study shows that the two approaches are orthogonally related to each other, and derives an origin-destination decomposition matrix in which summing in one direction produces Andreev's origin-decomposition results, while summing in the other direction produces destination-decomposition corresponding to directly-observed differences in nLx values.
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Challenges Facing Customer Patronage of Tourism Destinations in ...
African Journals Online (AJOL)
Prof
Although there are two categories of tourism destination - recreation/attractions and hospitality, this study ... The first Property Management Systems (Fidelio and Hogatex) appear in the tourism market. ..... In most cases, foreigners are hired to manage and offer consultancy ..... Marketing concepts and strategies in tourism.
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Directory of Open Access Journals (Sweden)
Aaron D. Falchook, MD
2016-04-01
Conclusions: A substantial percentage of patients used mobile devices to continuously report symptoms throughout a course of radiation therapy for head and neck cancer. Future studies should evaluate the impact of mobile device symptom reporting on improving patient outcomes.
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Kelly, Joseph
2006-01-01
The goal of this dissertation is to develop a conceptual framework and associated methods for evaluating alternative tourism planning strategies in terms of dematerialization and acceptability amongst tourists. Its objectives are to (1) examine the technical potential of dematerialization planning options in tourism destinations, (2) investigate tourist perspectives concerning destination planning alternatives that promote dematerialization, (3) assess the travel market responses and demateri...
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Destination Branding Kota Jember Pada Pemberitaan Jember Fashion Carnaval 2016 di Media Online
Directory of Open Access Journals (Sweden)
Muntadliroh Muntadliroh
2016-12-01
Full Text Available Jember Fashion Carnaval (JFC 2016 telah banyak diberitakan di media online selama bulan Agustus – September 2016. Karnaval tahunan ini memberikan implikasi pada upaya destination branding Kota Jember. Penelitian ini bertujuan menganalisis isi pemberitaan JFC 2016 di media online selama bulan Agustus – September 2016. Fokus penelitian ini adalah pemaknaan teks/pesan pemberitaan JFC 2016 yang membentuk destination branding Kota Jember. Metode yang digunakan adalah content analysis dengan pendekatan kuantitatif deskriptif. Hasil penelitian menunjukkan bahwa pemberitaan JFC 2016 merepresentasikan tahapan pembangunan destination branding Kota Jember dengan sumber informasi terbanyak dari birokrat (39%, konten berita terbesar berisi topik review JFC 2016 dan penyelenggaraan JFC 2016 masing-masing sebanyak (20%, kategori berita terbanyak bertema lifestyle (40%, dan didominasi tone berita positif (70%.
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Koohsari, Mohammad Javad; Owen, Neville; Cole, Rachel; Mavoa, Suzanne; Oka, Koichiro; Hanibuchi, Tomoya; Sugiyama, Takemi
2017-03-01
Street layout is consistently associated with adults' travel behaviors, however factors influencing this association are unclear. We examined associations of street layout with travel behaviors: walking for transport (WT) and car use; and, the extent to which these relationships may be accounted for by availability of local destinations. A 24-h travel diary was completed in 2009 by 16,345 adult participants of the South-East Queensland Household Travel Survey, Australia. Three travel-behavior outcomes were derived: any home-based WT; over 30min of home-based WT; and, over 60min of car use. For street layout, a space syntax measure of street integration was calculated for each Statistical Area 1 (SA1, the smallest geographic unit in Australia). An objective measure of availability of destinations - Walk Score - was also derived for each SA1. Logistic regression examined associations of street layout with travel behaviors. Mediation analyses examined to what extent availability of destinations explained the associations. Street integration was significantly associated with travel behaviors. Each one-decile increment in street integration was associated with an 18% (95%CI: 1.15, 1.21) higher odds of any home-based WT; a 10% (95%CI: 1.06, 1.15) higher odds of over 30min of home-based WT; and a 5% (95%CI: 0.94, 0.96) lower odds of using a car over 60min. Local destinations partially mediated the effects of street layout on travel behaviors. Well-connected street layout contributes to active travel partially through availability of more local destinations. Urban design strategies need to address street layout and destinations to promote active travel among residents. Copyright © 2016 Elsevier Inc. All rights reserved.
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NASA Technology Area 07: Human Exploration Destination Systems Roadmap
Kennedy, Kriss J.; Alexander, Leslie; Landis, Rob; Linne, Diane; Mclemore, Carole; Santiago-Maldonado, Edgardo; Brown, David L.
2011-01-01
This paper gives an overview of the National Aeronautics and Space Administration (NASA) Office of Chief Technologist (OCT) led Space Technology Roadmap definition efforts. This paper will given an executive summary of the technology area 07 (TA07) Human Exploration Destination Systems (HEDS). These are draft roadmaps being reviewed and updated by the National Research Council. Deep-space human exploration missions will require many game changing technologies to enable safe missions, become more independent, and enable intelligent autonomous operations and take advantage of the local resources to become self-sufficient thereby meeting the goal of sustained human presence in space. Taking advantage of in-situ resources enhances and enables revolutionary robotic and human missions beyond the traditional mission architectures and launch vehicle capabilities. Mobility systems will include in-space flying, surface roving, and Extra-vehicular Activity/Extravehicular Robotics (EVA/EVR) mobility. These push missions will take advantage of sustainability and supportability technologies that will allow mission independence to conduct human mission operations either on or near the Earth, in deep space, in the vicinity of Mars, or on the Martian surface while opening up commercialization opportunities in low Earth orbit (LEO) for research, industrial development, academia, and entertainment space industries. The Human Exploration Destination Systems (HEDS) Technology Area (TA) 7 Team has been chartered by the Office of the Chief Technologist (OCT) to strategically roadmap technology investments that will enable sustained human exploration and support NASA s missions and goals for at least the next 25 years. HEDS technologies will enable a sustained human presence for exploring destinations such as remote sites on Earth and beyond including, but not limited to, LaGrange points, low Earth orbit (LEO), high Earth orbit (HEO), geosynchronous orbit (GEO), the Moon, near
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Directory of Open Access Journals (Sweden)
Iuliia Murava
2016-04-01
Full Text Available The aim of the study is to identify waste generated within the territories of tourist destinations in Carpathian Mountains in Ukraine and to classify it for the use of effective waste management methods. The dynamics of municipal waste generation in tourist destinations in Carpathian region has been analyzed. The sources of waste generation in tourist activities have been identified and classified by the criterion of their further use. The methods of waste management within the tourist destinations in Carpathian region have been proposed. The problem of tourist destinations waste has been identified as one of the significant environmental aspects of tourism industry. Recommendations for implementation of the waste management methods can form the basis of waste management programs within the tourist destinations in the Carpathians. To achieve the goal and to solve the identified tasks a range of research methods have been used in the study: praximetric method (analysis of research experience and summarizing the information of printed sources on environmental aspects of the tourism industry and the problems of waste management within tourist destinations; comparative analysis has been used for identification of quantitative indicators and dynamics of municipal waste generation; specific search method has been used for identifying, selecting, theoretical analysis, classification of the waste generated in tourist destinations and calculation of their generated amount.
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Titan: a distant but enticing destination for human visitors.
Nott, Julian
2009-10-01
Until recently, very little was known about Saturn's largest satellite, Titan. But that has changed dramatically since the Cassini spacecraft started orbiting in the Saturn system in 2004. Larger than Mercury and with a dense atmosphere, Titan has many of the characteristics of a planet. Indeed, many scientists now see it as the most interesting place in the Solar System for robotic exploration, with many unique features and even the possibility of exotic forms of life. This paper points out that Titan is also a potential destination for humans. With its predominantly nitrogen atmosphere, moderate gravity, and available water and oxygen, it also appears that, once it becomes possible to travel there, it will prove to be much more hospitable for human visitors than any other destination in the Solar System.
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From smart city to smart destination. The case of three Canadian cities
Directory of Open Access Journals (Sweden)
François Bédard
2018-03-01
Full Text Available Several cities around the world are self-proclaimed "smart" by integrating, in varying degrees, new technologies in the different spheres of the city. Nevertheless, despite this effervescence around the smart city, the concept requires more conceptualization from the researchers. This is even more important when it comes time to distinguishing between smart city and smart destination. The relationship between these two concepts is blurred and the transition from the smart city to the smart destination is not automatic. This situation is explained by the fact that the intrinsic characteristics of their respective target populations, being the citizens and the tourists, are different. This article compares three Canadian cities in the province of Quebec with the aim of demonstrating that the realization of a smart destination project requires the adaptation of governance structure and the involvement of all the stakeholders and more particularly in tourism.
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A Critical Analysis on Evolution of Branding Destination in Langkawi Island
Directory of Open Access Journals (Sweden)
Mohd Yusof Mohd Fadil
2014-01-01
Full Text Available The purpose of this paper is to highlight the branding efforts by Langkawi Island based on various slogans and taglines used from 1974 until present. Secondary sources such as government reports, destination marketing organization websites, brochures and previous studies were referred to identify those slogans. This paper argues that destination branding process is not as easy as most destination marketing thought. The process is complex and it may need involvement from various stakeholders such as local population and tourism operators. Based on the various slogans identified, this paper argues that too many slogans and taglines are used and thus they may create confusion among host population, tourism operators as well as the tourists in terms of what are the actual core values of the island. The paper concludes with a suggestion that an empirical research is needed to confirm whether all these slogans or brands used are endorsed and supported by the internal stakeholders (e.g. host community, tourism operators as well as in agreement with what as being perceived by the tourists.
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The impact of factors influencing destination quality on overall customer satisfaction
Directory of Open Access Journals (Sweden)
Ida Vajčnerová
2013-01-01
Full Text Available The paper deals with problems concerning tourist destination quality and the impact of individual factors on the overall satisfaction of a customer – a visitor to a destination. The methodology is based on the evaluation of individual factors that were identified on the basis of previously conducted researches and that consider all attributes of a destination which visitors are able to evaluate on the basis of their experience and consequent satisfaction. The used data were obtained by a questionnaire surveys, the evaluation is qualitative, and the ten-degree Likert scale is used. The practical part of the paper will focus on creating a multidimensional regression model for overall customer satisfaction for evaluating individual quality factors. The objective of the paper is to identify factors that influence overall customer satisfaction the most; this will be done on the basis of the statistical importance of individual regression parameters. The analysis will be conducted for the data from the regions of Lednice-Valtice Area and Znojemsko and Podyjí; subsequently these two regions will be compared.
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Neuts, B.; Romao, J.; van Leeuwen, E.S.; Nijkamp, P.
2013-01-01
As a result of advances in ICT services, transportation and local development, among others, more destinations are competing to attract both national and international visitors. Globalization requires destinations to increase their competitiveness or risk losing out on tourist revenues. While the
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Pavković Vladimir; Filipović Vinka; Vlastelica-Bakić Tamara
2015-01-01
This paper analyses different film genres and their role as a media communications instrument for the tourist destination promotion strategy. The general objective of the paper is to point to the significance of film for the tourist destination recognisability as well as its perception in the public eye. The specific objectives of the paper are directed at the analysis of individual roles that different film genres have in the tourist destination promotion strategy. The research methods emplo...
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Criteria for the Selection of Tourism Destinations by Students from Different Countries
Directory of Open Access Journals (Sweden)
Dębski Maciej
2017-12-01
Full Text Available The objective of this paper is to identify selected aspects of the management of information about prospective tourist destinations by young people (students from Canada, Poland, and Trinidad and Tobago. On the basis of a questionnaire study, the ranking of preferences of respondents (i.e., the main criteria of destination choice has been presented. Students were selected as respondents - as a “convenient sample” - in this privately funded study. A variety of aspects related to comfort (and convenience and attractiveness have been identified as most important to the choice of destination. These are also leading motives that may form a platform for advertising campaigns and suggestions for regional development. This examination has been done mainly with the use of analysis of averages, Spearman correlation coefficients, and various approaches to factor analysis. It turns out that despite very different characteristics of respondents from the three countries, both their preferences and motives for promotion of the destination are very similar. Conclusions can be helpful for travel agencies and those responsible for the development of tourism infrastructure, as well as for the organization of further studies on the subject. The combination of various statistical tools used when examining the subject and the finding - that is, the similarity of preferences between travelers - can be regarded as new value when examining the subject.
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Verma, Sean; Bassily, Emmanuel; Leighton, Shane; Mhaskar, Rahul; Sunjic, Igor; Martin, Angel; Rihana, Nancy; Jarmi, Tambi; Bassil, Claude
2017-07-01
Left ventricular assist device (LVAD) and inotrope therapy serve as a bridge to transplant (BTT) or as destination therapy in patients who are not heart transplant candidates. End-stage heart failure patients often have impaired renal function, and renal outcomes after LVAD therapy versus inotrope therapy have not been evaluated. In this study, 169 patients with continuous flow LVAD therapy and 20 patients with continuous intravenous inotrope therapy were analyzed. The two groups were evaluated at baseline and at 3 and 6 months after LVAD or inotrope therapy was started. The incidence of acute kidney injury (AKI), need for renal replacement therapy (RRT), BTT rate, and mortality for 6 months following LVAD or inotrope therapy were studied. Results between the groups were compared using Mann-Whitney U test and Chi-square with continuity correction or Fischer's exact at the significance level of 0.05. Mean glomerular filtration rate (GFR) was not statistically different between the two groups, with P = 0.471, 0.429, and 0.847 at baseline, 3 and 6 months, respectively. The incidence of AKI, RRT, and BTT was not statistically different. Mortality was less in the inotrope group (P < 0.001). Intravenous inotrope therapy in end-stage heart failure patients is non-inferior for mortality, incidence of AKI, need for RRT, and renal function for 6-month follow-up when compared to LVAD therapy. Further studies are needed to compare the effectiveness of inotropes versus LVAD implantation on renal function and outcomes over a longer time period.
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Destination discount : A sensible road for national brands?
Deleersnyder, B.; Koll, O.
2012-01-01
Purpose – This paper aims to study the consequences of listing national brands in discounters. Is the discount channel a promising outlet for manufacturer brands? Is it an effective means to attract new buyers? Which combination of brand and discount destination at which price is best suited for
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DEFF Research Database (Denmark)
Brambini, Annalisa; Vang, Jan
2013-01-01
-located places. Based on regional innovation systems and place branding research the paper develops policy measures adapted to the specific challenges a shadow destination faces. Empirically, the appropriateness of the policy measures is demonstrated through applying it to a paradigmatic shadow destination......Tourism has often been hyped as an engine of regional growth and development but often failed to deliver the expected results. This is especially the case in shadow destinations. The concept of a shadow destination refers to a region whose relative attractioness is significantly lower than co...
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Directory of Open Access Journals (Sweden)
G. Dinis
2015-11-01
Full Text Available In a sector strongly dependent on information as is the case of tourism, the timely knowledge of consumer behaviour enables making well-considered decisions and less uncertainty. Nowadays, the act of searching on the Internet about a particular subject before decision-making is part of the individuals’ daily lives. The Google Trends tool provides real time aggregated data on the online individuals’ interest based on the carried out search queries on Google. The objective of this paper is to show that Google Trends can provide comparative information about the individuals’ interest in relation to Portugal tourism regional areas and in particular, on the tourist destination "Algarve", and also between its competing tourist destinations. The results show that the tool can contribute to the knowledge of the individuals’ interests in relation to regional tourist destinations, information considered of great interest for Destination Management Organizations.
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Directory of Open Access Journals (Sweden)
Pieter Burghouwt
2015-10-01
Full Text Available Network-based detection of botnet Command and Control communication is a difficult task if the traffic has a relatively low volume and if popular protocols, such as HTTP, are used to resemble normal traffic. We present a new network-based detection approach that is capable of detecting this type of Command and Control traffic in an enterprise network by estimating the trustworthiness of the traffic destinations. If the destination identifier of a traffic flow origins directly from: human input, prior traffic from a trusted destination, or a defined set of legitimate applications, the destination is trusted and its associated traffic is classified as normal. Advantages of this approach are: the ability of zero day malicious traffic detection, low exposure to malware by passive host-external traffic monitoring, and the applicability for real-time filtering. Experimental evaluation demonstrates successful detection of diverse types of Command and Control Traffic.
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Identifying factors affecting destination choice of medical tourists: a ...
African Journals Online (AJOL)
medical tourism”, has emerged as a new source of competitive advantage all over the world. The present study seeks to identify the factors that affect destination choice of medical tourists. Methods: We systematically searched relevant databases ...
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PESTEL analysis of tourism destinations in the perspective of business tourism (MICE)
Marina Gregorić
2014-01-01
Purpose of this research is to apply PESTEL analysis on two different destinations (Croatia and Qatar) in order to find our their specific attributes as well as to analyse weather we can learn from their advantages and disadvantages due to the fact that one is rich on natural attractions while other one is mostly characterised by humand made attractions. Design is done by using the core of PESTEL analysis where each destination is analysed according to political, economical, socio-cultural, t...
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Using portable negative pressure wound therapy devices in the home care setting
Directory of Open Access Journals (Sweden)
Burke JR
2014-12-01
Full Text Available Joshua R Burke, Rachael Morley, Mustafa Khanbhai Academic Surgery Unit, Education and Research Centre, University Hospital of South Manchester, Manchester, UK Abstract: Negative pressure wound therapy (NPWT is the continuous or intermittent application of subatmospheric pressure to the surface of a wound that improves the wound environment, accelerates healing, and reduces wound closure time. Since its first documented use, this technology has lent itself to a number of adaptations, most notably, the development of portable devices facilitating treatment in the home care setting. With advancing surgical standards, wound healing is an important rate-limiting factor in early patient discharge and often a major cost of inpatient treatment. The efficacy of NPWT in the home care setting has been investigated through rate of wound closure, time in care, and patient experience. Rate of wound closure is the most appropriate primary end point. Much can be gleaned from patient experience, but the future success of portable NPWT will be measured on time in care and therefore cost effectiveness. However, there is a lack of level 1a evidence demonstrating increased efficacy of portable over inpatient NPWT. The development of portable NPWT is an encouraging innovation in wound care technology, and extending the benefits to the home care setting is both possible and potentially more beneficial. Keywords: portable, negative pressure wound therapy, vacuum-assisted closure, topical negative pressure therapy
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Directory of Open Access Journals (Sweden)
Robert Robinson
2016-02-01
Full Text Available Laboratory-based testing does not allow for the sufficiently rapid return of data to enable optimal therapeutic monitoring of patients with metabolic diseases such as phenylketonuria (PKU. The typical turn-around time of several days for current laboratory-based testing is too slow to be practically useful for effective monitoring or optimizing therapy. This report describes the development of a rapid, paper-based, point-of-care device for phenylalanine detection using a small volume (40 μL of whole blood. The quantitative resolution and reproducibility of this device with instrumented readout are described, together with the potential use of this device for point-of-care monitoring by PKU patients.
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Cerin, Ester; Lee, Ka-yiu; Barnett, Anthony; Sit, Cindy H P; Cheung, Man-chin; Chan, Wai-man; Johnston, Janice M
2013-06-20
Walking for transport can contribute to the accrual of health-enhancing levels of physical activity in elders. Identifying destinations and environmental conditions that facilitate this type of walking has public health significance. However, most findings are limited to Western, low-density locations, while a larger proportion of the global population resides in ultra-dense Asian metropolises. We investigated relationships of within-neighborhood objectively-measured destination categories and environmental attributes with walking for transport in 484 elders from an ultra-dense metropolis (Hong Kong). We estimated relationships of diversity (number of different types) and prevalence of within-neighborhood destination categories (environmental audits of 400 m buffers surrounding residential addresses) with transport-related walking (interviewer-administered questionnaire) in 484 Chinese-speaking elders able to walk unassisted and living in 32 neighborhoods stratified by socio-economic status and transport-related walkability. We examined the moderating effects of safety and pedestrian infrastructure-related neighborhood attributes on destination-walking associations. Participants reported on average 569 and 254 min/week of overall and within-neighborhood walking for transport, respectively. The prevalence of public transit points and diversity of recreational destinations were positively related to overall walking for transport. The presence of a health clinic/service and place of worship, higher diversity in recreational destinations, and greater prevalence of non-food retails and services, food/grocery stores, and restaurants in the neighborhood were predictive of more within-neighborhood walking for transport. Neighborhood safety-related aspects moderated the relationship of overall walking for transport with the prevalence of public transit points, this being positive only in safe locations. Similar moderating effects of safety-related attributes were observed
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Positioning of Serbia as a tourism destination on the international tourist market
Directory of Open Access Journals (Sweden)
Ubavić Predrag
2016-01-01
Full Text Available In this paper an analysis was conducted of the existing touristic position of Serbia as a destination on the international toursitic market. Almost all countries worldwide tend to valorise their touristic potentials by offering various touristic products/services on touristic markets in order to realize numerous objectives of its economic and general social development. The Republic of Serbia also classified the development of touristic activity into priorities of its actual economic politics and developing strategy. Observing from today's perspective one can conclude that Serbia still hasn't taken an adequate competing position regarding other toursitic destinations, not only in the region but in the world as well. The aim of this paper is to point out the main causes of the present market position of Serbia and the necessity of its repositioning, so that it can become attractive and respectable touristic destination as soon as possible both in regional and international touristic market.
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The influence of education level on choosing coastal regions as tourist destinations
Directory of Open Access Journals (Sweden)
Đeri Lukrecija
2017-01-01
Full Text Available The main aim of the paper is to investigate the influence of formal education level on decision-making process when choosing a tourist destination based on multivariate analysis of variance (MANOVA. The survey was conducted on the sample of 252 respondents from Bačka region (Vojvodina/Serbia. Also, this study strives to examine the influence of education level on decision-making process including all five phases of decision-making process: need awareness, information search, alternatives estimation, purchase and purchase evaluation, applied to the process of choosing coastal regions as tourist destinations. The study shows that education level is related to four out of five phases of decision-making process (only in case of need awareness there is no statistically significant difference. This is especially important for creation of a marketing platform with promotional activities adjusted to different market segments differentiated by education level. Moreover, the study discusses differences in behaviour of different educational groups while choosing travel destinations.
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marketing destination information in a tourism driven economy
African Journals Online (AJOL)
PROF. BARTH EKWEME
This paper studies the destination information marketing as an aid to the Cross River Tourism bid. A questionnaire was designed to elicit responses from the stakeholders in the tourism industry. Out of 69 ... State were tourist guide books, internet and the Tourism Bureau. ... beauty are appreciated by all normal human.
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Social Trust, Safety and the Choice of Tourist Destination
DEFF Research Database (Denmark)
Jensen, Susanne; Svendsen, Gert Tinggaard
2016-01-01
Does social trust influence safety and tourists’ destination choice? Our claim is that the roots of safety may take two forms: either formal institutions or informal institutions. Formal institutions concern how society can build up control mechanisms through the legal system, police authority...... and military. The problem is that high visibility of police and military in public spaces may give the tourist the impression of an unsafe and insecure destination. Instead, social trust through self-enforcements of social norms for behaviour may be important because the informal institutions guarantee...... the safety of tourists (and locals) without signalling a problem with safety. Building social trust may further enhance the feeling of safety and thereby attract even more tourists. Thus, our trust-safety theory may guide the active use of social trust by tourist officials and policy makers....
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Research of consumer motives and attitudes about tourist destinations
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Stanković Ljiljana
2012-01-01
Full Text Available The research on consumer behavior and the consumption system is one of the crucial tasks for destination marketing. The information on consumers' needs, priorities in satisfying them, motives, their solvency and the degree of realized satisfaction represent the basis for the development of marketing strategies and value creation. It is of special importance to identify and clarify the factors that determine consumers' preferences in the process of different options evaluation and the choice of a tourist destination. Consumer behavior and the consumption system are determined by the influence of a large number of factors: geographical, economic, demographic, social, psychological, etc. Only through simultaneous interaction of these factors, the complex processes of translating stimuli in the minds of consumers into their certain reactions in the process of purchasing and using the products could be understood.
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Blazquez-Resino, Juan J.; Muro-Rodriguez, Ana I.; Perez-Jimenez, Israel R.
2016-01-01
In this paper, a study of the perceived destination image created by promotional Web Pages is expounded in an attempt to identify their differences as generators of destination image in the consumers' mind. Specifically, it seeks to analyse whether the web sites of different Spanish regions improve the image that consumers have of the destination, identifying their main dimensions and analysing its effect on satisfaction and intentions of the future behavior of potential visitors. To achieve these objectives and verify the hypotheses, a laboratory experiment was performed, where it was determined what changes are produced in the tourist's previous image after browsing the tourist webs of three different regions. Moreover, it analyses the differences in the effect of the perceived image on satisfaction and potential visitors' future behavioral intentions. The results obtained enable us to identify differences in the composition of the perceived image according to the destination, while confirming the significant effect of different perceived image dimensions regarding satisfaction. The results allow managers to gain a better understanding of the effectiveness of their sites from a consumer perspective as well as suggestions to follow in order to achieve greater efficiency in their communication actions in order to improve the motivation of visitors to go to the destination. PMID:27933027
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Directory of Open Access Journals (Sweden)
Juan Jose Blazquez-Resino
2016-11-01
Full Text Available In this paper, a study of the perceived destination image created by promotional Web Pages is expounded in an attempt to identify their differences as generators of destination image in the consumers’ mind. Specifically, it seeks to analyse whether the web sites of different Spanish regions improve the image that consumers have of the destination, identifying their main dimensions and analysing its effect on satisfaction and intentions of the future behaviour of potential visitors. To achieve these objectives and verify the hypotheses, a laboratory experiment was performed, where it was determined what changes are produced in the tourist´s previous image after browsing the tourist webs of three different regions. Moreover, it analyses the differences in the effect of the perceived image on satisfaction and potential visitors´ future behavioural intentions. The results obtained enable us to identify differences in the composition of the perceived image according to the destination, while confirming the significant effect of different perceived image dimensions regarding satisfaction. The results allow managers to gain a better understanding of the effectiveness of their sites from a consumer perspective as well as suggestions to follow in order to achieve greater efficiency in their communication actions in order to improve the motivation of visitors to go to the destination.
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STRATEGY FOR THE DESTINATIONAL E-MARKETING & SALES
Zlatko Sehanovic; Giorgio Cadum; Igor Sehanovic
2010-01-01
Every tourist destination should make and implement a destination’s marketing and sales strategy. A very important part of destination’s sales and marketing strategy is the e-marketing and sales strategy. The cooperation of specialized regional development agencies, regional tourist board, local (city and county) tourist boards, hoteliers, tourist agencies, conservators, entertainment and cultural program developers, private accommodation owners and others involved in creation of destination’...
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Wibowo, Setyo Ferry; Sazali, Adnan; Kresnamurti R. P., Agung
2016-01-01
The purpose of this research are: 1) To find out the description of destination image, tourist satisfaction, and revisit intention of Betawi cultural village Setu Babakan, 2) test empirically the influence of destination image toward revisit intention of Betawi cultural village Setu Babakan, 3) test empirically the influence of tourist satisfaction toward revisit intention of Betawi cultural village Setu Babakan, 4) test empirically the influence of destination image toward revisit intention ...
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Cardiac transplantation after bridged therapy with continuous flow left ventricular assist devices.
Deo, Salil V; Sung, Kiick; Daly, Richard C; Shah, Ishan K; Altarabsheh, Salah E; Stulak, John M; Joyce, Lyle D; Boilson, Barry A; Kushwaha, Sudhir S; Park, Soon J
2014-03-01
Cardiac transplantation is an effective surgical therapy for end-stage heart failure. Patients (pts) may need to be bridged with a continuous flow left ventricular assist device (CF-LVAD) while on the transplant list as logistic factors like organ availability are unknown. Cardiac transplantation post-LVAD can be a surgically challenging procedure and outcome in these pts is perceived to be poorer based on experience with earlier generation pulsatile flow pumps. Data from a single institution comparing these pts with those undergoing direct transplantation in the present era of continuous flow device therapy are limited. Evaluate results of cardiac transplantation in pts bridged with a CF-LVAD (BTx) and compare outcomes with pts undergoing direct transplantation (Tx) in a single institution. From June 2007 till January 2012, 106 pts underwent cardiac transplantation. Among these, 37 (35%) pts (51±11 years; 85% male) were bridged with a CF-LVAD (BTx), while 70 (65%) comprised the Tx group (53±12 years; 72% males). The median duration of LVAD support was 227 (153,327) days. During the period of LVAD support, 10/37 (27%) pts were upgraded to status 1A and all were successfully transplanted. Median hospital stay in the BTx (14 days) was slightly longer than the Tx group (12 days) but not statistically significant (p=0.21). In-hospital mortality in the BTx (5%) and Tx (1%) were comparable (p=0.25). Estimated late survival in the BTx cohort was 94±7, 90±10 and 83±16% at the end of one, two and three years, respectively which was comparable to 97±4%, 93±6% and 89±9% for the Tx group (p=0.50). Cardiac transplantation after LVAD implant can be performed with excellent results. Patients can be supported on the left ventricular assist device even for periods close to a year with good outcome after cardiac transplantation. Copyright © 2013 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand
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INCREDIBLE !NDIA CAMPAIGN : Destination Marketing and the role of Social Media
Bafna, Sanjana
2015-01-01
Tourism is an important aspect of a country's domestic economy and helps in generating valuable employment and foreign exchange. Tourists get attracted to a particular destination because they are excited about the destination and because there are no safety concerns about the destination. Destination branding is a concept that encompasses the enhancement of the 'image' tourists have about a particular destination. This research explores the destination bra...
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Inter-Destination Media Synchronization, now standardized by ETSI TISPAN
Deventer, M.O. van; Stokking, H.M.; Niamut, O.M.; Walraven, F.A.
2010-01-01
nter-Destination Media Synchronization (IDMS) is een reeks van technologieën voor de synchronisatie van mediacontent op meerdere televisies. Sociale televisie is een belangrijke toepassing van IDMS. Sociale televisie stelt vrienden in staat om een televisieprogramma samen te bekijken vanaf
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Destination image and crime in Mexico: An analysis of foreign government travel advice
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J. Carlos Monterrubio
2013-01-01
Full Text Available Destination image has been recognised as an influential component of travel decision processes. Although organic sources of information play an important role in shaping destination image, researchers have often ignored the types of sources and the information they deliver. In particular, official websites where government travel advice is given, especially in relation to crime, have been widely excluded from scholarly research. This paper analyses the relationship between crime-related travel advice given by foreign governments and Mexico’s destination image. Qualitative content analysis of official websites from the US, Canada, the UK and Spain reveals that the travel advice given relates largely to the violence and insecurity that Mexico is currently experiencing. “No advisory in effect”, “Exercise caution” and “Defer non-essential travel” are messages commonly found in the governments’ travel advice about Mexico.
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COMPETITIVENESS THROUGH SUSTAINABILITY AND FINANCIAL EFFICIENCY OF SPA TOURIST DESTINATIONS
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Anis Cecilia
2010-12-01
Full Text Available In the specific literature, success may be achieved by two important attributes: competitiveness and sustainability. Competitive advantage represents an essential criterion for surviving on the tourist market and defines the ability of one destination to use these resources effectively and in the long term. The paper work continue a study begun last year by the same authors about tourist perception of attractiveness of the two tourist SPA destinations (Buziaş and Băile Felix on a different market segment (18-35 years old people. This time, we undertake an analysis on SC Turism Felix SA in order to determine and underline the tourist competitiveness through sustainability and financial efficiency (tourism performance indicators evolution, market share, turnover, investment volume, financial returns and costs.
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A STRUCTURAL EQUATION MODEL: GREECE’S TOURISM DEMAND FOR TOURIST DESTINATION
Chaitip, Prasert; Chaiboonsri, Chukiat; Kovacs, Sandor; Balogh, Peter
2010-01-01
Structural equation model (LISREL 8) was applied to test the causal relationships between tourist travel motivations and tourist destination. A survey containing Likert scale questions was conducted to collect data from 100 tourists who had travelled to Greece’s tourist destination. With the help of factor analysis, four dimensions were identified for scales used in the study: travel cost satisfaction, tourism product, tourism product attributes, and tourism product management. Results indi...
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Ekiz, Erdogan H.; Khoo-Lattimore, Catheryn
2014-01-01
The recent discourse of tourism development among officials within the Government of India has included the state of Goa, mainly because it has consistently witnessed positive economic impacts from tourism. However, in view of competition from other destinations, Goan tourism planners will need to identify important attributes of Goa that will positively affect tourists' destination loyalty. This study examines the correlation between five attributes of Goa and tourists' loyalty to Goa. Famil...
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Vilanova, Larissa Soares Reis; Gonçalves, Thais Marques Simek Vega; Pimentel, Marcele Jardim; Bavia, Paula Furlan; Rodrigues Garcia, Renata Cunha Matheus
2014-12-01
Patients with myofascial pain experience impaired mastication, which might also interfere with their sleep quality. The purpose of this study was to evaluate the jaw motion and sleep quality of patients with myofascial pain and the impact of a stabilization device therapy on both parameters. Fifty women diagnosed with myofascial pain by the Research Diagnostic Criteria were enrolled. Pain levels (visual analog scale), jaw movements (kinesiography), and sleep quality (Epworth Sleepiness Scale; Pittsburgh Sleep Quality Index) were evaluated before (control) and after stabilization device use. Range of motion (maximum opening, right and left excursions, and protrusion) and masticatory movements during Optosil mastication (opening, closing, and total cycle time; opening and closing angles; and maximum velocity) also were evaluated. Repeated-measures analysis of variance in a generalized linear mixed models procedure was used for statistical analysis (α=.05). At baseline, participants with myofascial pain showed a reduced range of jaw motion and poorer sleep quality. Treatment with a stabilization device reduced pain (Pmastication increased, and improvements in sleep scores for the Pittsburgh Sleep Quality Index (P<.001) and Epworth Sleepiness Scale (P=.04) were found. Myofascial pain impairs jaw motion and quality of sleep; the reduction of pain after the use of a stabilization device improves the range of motion and sleep parameters. Copyright © 2014 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.
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R.N. Mekuria (Rufael); H.M. Stokking (Hans); M.O. van Deventer (Oskar)
2011-01-01
htmlabstractInter-destination media (play-out) synchronization for social TV has gained attention from research and industry in recent years.Applications include social TV and interactive game shows. To motivate further research of inter-destination synchronization technologies, pilot
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Potential of Congress Tourism in the Republic of Croatia in Comparison to Neighboring Destinations
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Gregorić Marina
2016-12-01
Full Text Available The phenomenon of globalization has led to the development of various selective forms of tourism. One of them is MICE tourism known in Croatia as a business form of tourism. Business tourism is still a relatively new concept and covers all aspects of business travel. The development of business travel has led to the development of congress tourism as a separate form of business tourism which is the focus of this paper. Congress tourism is a lucrative segment of the tourist offer that often takes place out of the tourist season. It requires quality congress facilities which can meet the needs of the participants and organizers of the congress. The main role of congress tourism is to gather participants from different countries and promote different products, services, training, education and many other fields of business while at the same time it promotes the hosting destination and its tourism attractions. The aim of this paper is to research and determine the current situation, supply and demand of the Croatian meetings and congress industry in comparison with the neighbouring destinations, the Republic of Slovenia and the Republic of Serbia. The study and comparison between three destinations imply changes that need to take place to improve the congress offer, to detect what the competitive position of the Republic of Croatia is, which marketing activities to improve so that the Republic of Croatia can become a competitive destination in the region and Europe. Congress tourism as a form of business tourism in Croatia is growing. The most prominent cities in this form of tourism are Zagreb, Dubrovnik and Opatija. The objectives pursued in Croatian congress offer are: the number of participants in congresses, strengthening the quality of congress offer and infrastructure, ensuring coordinated actions of stakeholders and increasing the recognition and awareness of Croatia as a congress destination. Since joining the EU, Slovenia has become an
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Mayrovitz, Harvey N; Partsch, Hugo; Vanscheidt, Wolfgang
2015-01-01
To characterize and compare interface pressure profiles of an adaptive compression therapy (ACT) device and a traditional 4-layer bandage (4LB) system. A prospective, randomized, open-label, 1-arm, active controlled study. The sample comprised 12 healthy volunteers. Subjects wore both devices for 8 hours on 3 consecutive days. Treatments were randomized to left and right legs. One clinician performed all applications and was experienced in the clinical use of both devices. Pressures were measured in seated and standing positions at the lower, mid, and upper calf immediately post application and after 1, 4, and 8 hours. Pressures achieved with the ACT were closer to targeted 40/30/20 mmHg graduated pressure values and were significantly less than the 4LB for corresponding sites/postures (P pressures (mean ± SD) for the ACT were 36.9 ± 4.9, 30.5 ± 4.5, and 21.0 ± 3.6 mmHg. Corresponding interface pressures for the 4LB were 52.5 ± 8.4, 57.5 ± 10.3, and 53.5 ± 12.9 mmHg. In the standing position, initial interface pressures for the ACT were 40.7 ± 4.8, 35.6 ± 4.5, and 21.1 ± 4.6 compared to 54.6 ± 12.5, 64.4 ± 10.9, and 53.7 ± 14.3 for the 4LB. At 1, 4, and 8 hours after application, the 4LB showed a significant progressive decline in interface pressure in both seated and standing positions (P pressures than the 4LB and the pressures achieved were consistent with contemporary venous ulcer therapy standards.
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Architecture as a Tool for Branding in Rural Istrian Tourism Destination
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Ivana Medica
2010-06-01
Full Text Available Natural and protected environments with authentic widespread traditional construction have become one of the fundamental touristic resources. Traditional architecture is a very crucial part of collective cultural heritage. Although it is ample and widespread, only since recent times it has been given its economical value as well as it has been included in tourism. According to the context above, authors have come up with a hypothesis stating that with implying branding of traditional architectural heritage, a positive influence on enrichment of touristic offerings of certain destination will be achieved. The authors defend and fulfill their hypothesis by analyzing different research on the example of rural destinations in Istria.
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DIFFERENCES BETWEEN PLACE BRANDING AND DESTINATION BRANDING FOR LOCAL BRAND STRATEGY DEVELOPMENT
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Victor-Alexandru BRICIU
2013-07-01
Full Text Available To highlight the principles used in the design and development of a regional brand strategy we need to identify the disciplinary and the theoretical referential that would best fit the branding approach. This paper will address the main forms of branding: place branding, location branding and destination branding, as a specialized form of destination marketing. From the theoretical point of view, by identifying the fundamental and the management brand model, the regional tourism brand concept is regarded by positioning it in the category (the most general one of place branding.
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Social media storytelling alliances and destination branding.
Lund, Niels Frederik
2018-01-01
The emergence of social media necessitates a fundamental rethink of marketing practises as brands are now co-created with social media users. Destination management organisations (DMOs) therefore need to develop new social media strategies. This thesis suggests that DMOs ought to strengthen their storytelling capabilities as it is an essential tool in increasing social media engagement. A conceptual framework is therefore developed drawing on four particular sociological concepts: storytellin...
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Perioperative Care of the Patient With the Total Artificial Heart.
Yaung, Jill; Arabia, Francisco A; Nurok, Michael
2017-05-01
Advanced heart failure continues to be a leading cause of morbidity and mortality despite improvements in pharmacologic therapy. High demand for cardiac transplantation and shortage of donor organs have led to an increase in the utilization of mechanical circulatory support devices. The total artificial heart is an effective biventricular assist device that may be used as a bridge to transplant and that is being studied for destination therapy. This review discusses the history, indications, and perioperative management of the total artificial heart with emphasis on the postoperative concerns.
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Mekuria, R.N.; Stokking, H.M.; Deventer, M.O. van
2011-01-01
Inter-destination media (play-out) synchronization for social TV has gained attention from research and industry in recent years. Applications include social TV and interactive game shows. To motivate further research of inter-destination synchronization technologies, pilot measurements of play-out
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Jeuring, Jelmer; Haartsen, Tialda
2017-01-01
The importance of residents’ communication about their home region as tourist destination is increasingly acknowledged in the place branding process. However, the extent to which residents feel responsible for communicating Destination Images (DIs), and how these attributions affect word-of-mouth
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Umakanthan, Ramanan; Haglund, Nicholas A; Stulak, John M; Joyce, Lyle D; Ahmad, Rashid; Keebler, Mary E; Maltais, Simon
2013-01-01
Advances in mechanical circulatory support have been critical in bridging patients awaiting heart transplantation. In addition, improvement in device durability has enabled left ventricular assist device therapy to be applied as destination therapy in those not felt to be transplant candidate. Because of the increasing complexity of patients, there continues to be a need for alternative strategies for device implantation to bridge high-risk patients awaiting heart transplantation, wherein the risks of numerous previous sternotomies may be prohibitive. We present a unique technique for placement of the HeartWare ventricular assist device via left anterior thoracotomy to the descending aorta in a patient awaiting heart transplantation with a history of multiple previous sternotomies.
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Humidifiers for oxygen therapy: what risk for reusable and disposable devices?
La Fauci, V; Costa, G B; Facciolà, A; Conti, A; Riso, R; Squeri, R
2017-06-01
Nosocomial pneumonia accounts for the vast majority of healthcare-associated infections (HAI). Although numerous medical devices have been discussed as potential vehicles for microorganisms, very little is known about the role played by oxygen humidifiers as potential sources of nosocomial pathogens. The purpose of this research was to evaluate the safety of the reuse of humidifiers by analysing the rate of microbial contamination in reusable and disposable oxygen humidifiers used during therapy, and then discuss their potential role in the transmission of respiratory pathogens. Water samples from reusable and disposable oxygen humidifiers were collected from different wards of the University Hospital of Messina, Italy, where nosocomial pneumonia has a higher incidence rate due to the "critical" clinical conditions of inpatients. In particular, we monitored the Internal Medicine and Pulmonology wards for the medical area; the General Surgery and Thoracic and Cardiovascular Surgery wards for the surgical area and the Intensive Care Unit and Neonatal Intensive Care Unit for the emergency area. The samples were always collected after a period of 5 days from initial use for both types of humidifiers. Samples were processed using standard bacteriological techniques and microbial colonies were identified using manual and automated methods. High rates of microbial contamination were observed in samples from reusable oxygen humidifiers employed in medical (83%), surgical (77%) and emergency (50%) areas. The most relevant pathogens were Pseudomonas aeruginosa, amongst the Gram-negative bacteria, and Staphylococcus aureus, amongst the Gram-positive bacteria. Other pathogens were detected in lower percentage. The disposable oxygen humidifier samples showed no contamination. This research presents evidence of the high rate and type of microbial contamination of reusable humidifiers employed for oxygen therapy. These devices may thus be involved in the transmission of potential
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Tourism Destination Benchmarking: Evaluation and Selection of the Benchmarking Partners
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Luštický Martin
2012-03-01
Full Text Available Tourism development has an irreplaceable role in regional policy of almost all countries. This is due to its undeniable benefits for the local population with regards to the economic, social and environmental sphere. Tourist destinations compete for visitors at tourism market and subsequently get into a relatively sharp competitive struggle. The main goal of regional governments and destination management institutions is to succeed in this struggle by increasing the competitiveness of their destination. The quality of strategic planning and final strategies is a key factor of competitiveness. Even though the tourism sector is not the typical field where the benchmarking methods are widely used, such approaches could be successfully applied. The paper focuses on key phases of the benchmarking process which lies in the search for suitable referencing partners. The partners are consequently selected to meet general requirements to ensure the quality if strategies. Following from this, some specific characteristics are developed according to the SMART approach. The paper tests this procedure with an expert evaluation of eight selected regional tourism strategies of regions in the Czech Republic, Slovakia and Great Britain. In this way it validates the selected criteria in the frame of the international environment. Hence, it makes it possible to find strengths and weaknesses of selected strategies and at the same time facilitates the discovery of suitable benchmarking partners.
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Community crosstalk: An exploratory analysis of destination and festival eWOM on Twitter
Williams, Nigel; Inversini, Alessandro; Buhalis, Dimitrios; Ferdinand, Nicole
2015-01-01
Research suggests that festivals can promote a destination via online word-of-mouth (eWOM) on socialmedia, even though the nature of this effect is not yet fully understood. Using a combination of Social Network Analysis and text analysis (qualitative and quantitative), this article examines eWOM at a tourism destination (Bournemouth) when a festival (Bournemouth Air Show 2013) is staged. The Communities of Interest of eWOM interactions on Twitter were captured and analysed to understand the ...
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Community crosstalk: an exploratory analysis of destination and festival eWOM on Twitter
Williams, Nigel L.; Inversini, Alessandro; Buhalis, Dimitrios; Ferdinand, Nicole
2015-01-01
Research suggests that festivals can promote a destination via online word-of-mouth (eWOM) on social media, even though the nature of this effect is not yet fully understood. Using a combination of Social Network Analysis and text analysis (qualitative and quantitative), this article examines eWOM at a tourism destination (Bournemouth) when a festival (Bournemouth Air Show 2013) is staged. The Communities of Interest of eWOM interactions on Twitter were captured and analysed to understand the...
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Usability testing of an mHealth device for swallowing therapy in head and neck cancer survivors.
Constantinescu, Gabriela; Kuffel, Kristina; King, Ben; Hodgetts, William; Rieger, Jana
2018-04-01
The objective of this study was to conduct the first patient usability testing of a mobile health (mHealth) system for in-home swallowing therapy. Five participants with a history of head and neck cancer evaluated the mHealth system. After completing an in-application (app) tutorial with the clinician, participants were asked to independently complete five tasks: pair the device to the smartphone, place the device correctly, exercise, interpret progress displays, and close the system. Quantitative and qualitative methods were used to evaluate the effectiveness, efficiency, and satisfaction with the system. Critical changes to the app were found in three of the tasks, resulting in recommendations for the next iteration. These issues were related to ease of Bluetooth pairing, placement of device, and interpretation of statistics. Usability testing with patients identified issues that were essential to address prior to implementing the mHealth system in subsequent clinical trials. Of the usability methods used, video observation (synced screen capture with videoed gestures) revealed the most information.
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Destination Development for Rural Tourism Area in Wanayasa, Puwakarta, West Java, Indonesia
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Jajang Gunawijaya
2016-10-01
Full Text Available This purpose of this paper is to elaborate the understanding of destination development of rural tourism in Wanayasa, Purwakarta, Jawa Barat. It has a rich potential for the rural tourism prosperity. Then author incorporates destination development through Butler‘s Area Life Cycle. Research was conducted in August 2015 with qualitative approaches i.e. interview and focus group discussion to 120 respondents which comprises representation from several different group. In addition, some of data also produced from secondary sources such as government regulation and official website. Findings show that Wanayasa possessed their ability in developing aspect of internal factors, attractions and accommodation facilities. Apart from that quality, it is obvious that their rural tourism development is lack of destination management and chaotic strategy marketing formulation as a result of disorganized planning processes. With those conditions, it will be tough for them to formulate the true competitive advantage as a basic foundation of their tourism development. This paper illustrates a detailed analysis of the destination‘s strengths and weaknesses, and a more distinctive understanding of what facilitates a destination‘s competitive position.
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Lane, Courtney R; Sutton, Brett; Valcanis, Mary; Kirk, Martyn; Walker, Cathryn; Lalor, Karin; Stephens, Nicola
2016-03-15
Knowledge of relationships between antibiotic susceptibility of Shigella isolates and travel destination or other risk factors can assist clinicians in determining appropriate antibiotic therapy prior to susceptibility testing. We describe relationships between resistance patterns and risk factors for acquisition in Shigella isolates using routinely collected data for notified cases of shigellosis between 2008 and 2012 in Victoria, Australia. We included all shigellosis patients notified during the study period, where Shigella isolates were tested for antimicrobial sensitivity using Clinical and Laboratory Standards Institute breakpoints. Cases were interviewed to collect data on risk factors, including recent travel. Data were analyzed using Stata 13.1 to examine associations between risk factors and resistant strains. Of the 500 cases of shigellosis, 249 were associated with overseas travel and 210 were locally acquired. Forty-six of 51 isolates of Indian origin displayed decreased susceptibility or resistance to ciprofloxacin. All isolates of Indonesian origin were susceptible to ciprofloxacin. Twenty-six travel-related isolates were resistant to all tested oral antimicrobials. Male-to-male sexual contact was the primary risk factor for 80% (120/150) of locally acquired infections among adult males, characterized by distinct periodic Shigella sonnei outbreaks. Clinicians should consider travel destination as a marker for resistance to common antimicrobials in returning travelers, where severe disease requires empirical treatment prior to receipt of individual sensitivity testing results. Repeated outbreaks of locally acquired shigellosis among men who have sex with men highlight the importance of prevention and control measures in this high-risk group. © The Author 2015. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.
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Yen, Irene H; Leung, Cindy W; Lan, Mars; Sarrafzadeh, Majid; Kayekjian, Karen C; Duru, O Kenrik
2015-04-01
Some studies indicate that older adults lead active lives and travel to many destinations including those not in their immediate residential neighborhoods. We used global positioning system (GPS) devices to track the travel patterns of 40 older adults (mean age: 69) in San Francisco and Los Angeles. Study participants wore the GPS devices for 7 days in fall 2010 and winter 2011. We collected survey responses concurrently about travel patterns. GPS data showed a mean of four trips/day, and a mean trip distance of 7.6 km. Survey data indicated that older adults commonly made trips for four activities (e.g., volunteering, work, visiting friends) at least once each week. Older adults regularly travel outside their residential neighborhoods. GPS can document the mode of travel, the path of travel, and the destinations. Surveys can document the purpose of the travel and the impressions or experiences in the specific locations. © The Author(s) 2013.
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Going Round in Circles: Mobility, Destination and Experience
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Alan Clarke
2011-10-01
Full Text Available This paper addresses the changing approaches to transport in urban tourism as seen through the move from functional sectoral accounts towards a perspective informed by the experience economy. By reviewing the traditional service offers, it is possible to unpack what lies within the service dominant logics that lead to co-creation of value and the realisation of quality tourism experiences. The paper then considers the adoption and adaptation of traditional forms of transport within the value proposition in urban tourism. Mobility in tourism is a strangely new focus of attention, strangely because without it there would be no tourism to speak of. However mobility requires a framework of civil and legal entitlements that allow people to move and a transport infrastructure that allows those rights to be realised in both working and leisure time situations. This article will address the construction of the tourism transport infrastructure by examining the ways in which the transportation elements in mobility have been re-thought within tourism. The first part of the paper will re-construct an account of transport and mobility which deals with it in terms of the functions and logistics of delivery, both between points of origin and destinations, and within destinations. These perspectives can be seen in the texts which shape the basic tourism curriculum (Cooper et al, 2008; Page, 2009 and explain how tourism and transport have developed over the years by integrating the opportunities provided by the new technologies – motorised vehicles (both cars and coaches, trains, ships and aeroplanes – to allow for the development of a range of destinations. Lumsdon and Page (2004 introduced a new approach to transport and tourism by distinguishing between transport for tourism and transport as tourism, which provides a linkage between the first and second parts of this article. The second part will develop an account of mobility in tourism that demonstrates
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Going round in circles: mobility, destination and experience
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Alan Clarke
2010-10-01
Full Text Available This paper addresses the changing approaches to transport in urban tourism as seen through the move from functional sectoral accounts towards a perspective informed by the experience economy. By reviewing the traditional service offers, it is possible to unpack what lies within the service dominant logics that lead to co-creation of value and the realisation of quality tourism experiences. The paper then considers the adoption and adaptation of traditional forms of transport within the value proposition in urban tourism. Mobility in tourism is a strangely new focus of attention, strangely because without it there would be no tourism to speak of. However mobility requires a framework of civil and legal entitlements that allow people to move and a transport infrastructure that allows those rights to be realised in both working and leisure time situations. This article will address the construction of the tourism transport infrastructure by examining the ways in which the transportation elements in mobility have been re-thought within tourism. The first part of the paper will re-construct an account of transport and mobility which deals with it in terms of the functions and logistics of delivery, both between points of origin and destinations, and within destinations. These perspectives can be seen in the texts which shape the basic tourism curriculum and explain how tourism and transport have developed over the years by integrating the opportunities provided by the new technologies – motorised vehicles (both cars and coaches, trains, ships and aeroplanes – to allow for the development of a range of destinations. Lumsdon and Page (2004 introduced a new approach to transport and tourism by distinguishing between transport for tourism and transport as tourism, which provides a linkage between the first and second parts of this article. The second part will develop an account of mobility in tourism that demonstrates how their uniqueness derives
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Connecting the Members of Generation Y to Destination Brands: A Case Study of the CUBIS Project
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Ralf Bochert
2017-07-01
Full Text Available There is direct correlation between building powerful destination brands and the degree to which tourists and locals share the brands values. The massive penetration of the active population by Generation Y has generated a major shift in tourism marketing, based on the profile of this cohort. The members of Generation Y are very different from previous generations. The so-called “digital natives” share high technological proficiency; they like to share their skills; they are disloyal consumers; and they are affected by trends. In order to connect with members of Generation Y and to actively involve them into the life of tourist destinations, viral, participative, interactive, networked and versatile marketing techniques should be employed. This article introduces the Intelligent Solution for Brand Culturalization (CUBIS Project, which is a collaborative research initiative that offers to Destination Management Organizations an innovative idea of how to connect the members of Generation Y with destination brands using information and communication technologies (ICT. The CUBIS Project aims to create emotional attachment with the brand values and supports the adoption of the brand by young locals and tourists. The CUBIS idea is flexible and highly adaptable to other destinations. The article uses exploratory qualitative research in the form of a case study.
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Belgaid, Djouhar Roufeida; Khan, Zara; Zaidi, Mariam; Hobbs, Adrian
2016-09-15
Assessing the safety and effectiveness of left atrial appendage (LAA) (pouch found in the upper chambers of the heart) occlusion, using the Watchman device compared to long term warfarin therapy (drug that reduces clot formation), in preventing the risk of stroke in patients with atrial fibrillation (most common type of irregular heart beat). 90% of strokes in atrial fibrillation arise from clots forming in this pouch. By mechanically blocking it using the device less clots are suggested to be formed. This is an alternative to taking warfarin especially in patients who cannot take it. 50 sites in the United States enrolled 407 participants. After being randomly allocated, the device group had 269 participants and warfarin group (comparator)had 138 participants. Patients with atrial fibrillation and at high risk of stroke were randomly allocated a group after they were deemed eligible. Patients in the device group had to take warfarin and aspirin for 45days till the complete closure of the LAA. The oral anticoagulant was followed by dual antiplatelet therapy until 6months and then ASA. Patients in the warfarin group have to take it for life and were continually monitored. The study ran for 26months. The trial assessed the rate of adverse events using three endpoints: The PREVAIL trial was not designed to show superiority, but non-inferiority. It met the safety endpoint and one efficacy endpoint for the watchman device compared to long term warfarin for overall efficacy of the device. The results established that LAA occlusion is not worse than warfarin intake for the prevention of stroke more than 1week after randomization. Compared to previous trials, the safety of the device has also improved. LAA occlusion is a reasonable alternative to chronic warfarin therapy in stroke prevention for patients with atrial fibrillation. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
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A model of destination image promotion with a case study of Nanjing, P. R. China
Xiang Li; Hans Vogelsong
2003-01-01
Destination image has long been a popular research topic in tourism studies. However, methods used to integrate image in real marketing practice and evaluating the market performance in a systematic way are still puzzling to practitioners. A destination image promotion model is proposed in this paper as an effort to solve the problem. The roles of some major factors...
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Directory of Open Access Journals (Sweden)
Jelica J. MARKOVIĆ
2015-10-01
Full Text Available The purpose of this study is to determine the dimensions of the lakeside tourist destinations quality through the cases of Lake Palić and Lake Srebrno (Serbia, by interviewing daily visitors and tourists and to determine which dimensions of quality have a crucial impact on the overall satisfaction of daily visitors and tourists. Various models have been developed to measure quality. In this paper, the quality is measured by the model that is appropriate for lakeside tourist destinations, developed by Ryan, Huimin, and Chon (2010. Five dimensions of quality were identified and named as: additional tourist infrastructure, lake water quality, natural environment, hospitality and cleanness of the place. The results showed that the measured quality model largely predicts overall satisfaction of daily visitors and tourists on the destination. The dimension lake water quality has the most effects on the overall satisfaction. Further research could use this research by adding some other quality dimensions into consideration (e.g. quality of service, situational conditions, destination management in examining the effect of destination’s quality on satisfaction of daily visitors and tourists. The research is important to managers of lakeside tourist destinations who tend to have highly satisfied guests and who work on promotion and improvement of destination quality.
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Context-aware recommender system based on ontology for recommending tourist destinations at Bandung
Rizaldy Hafid Arigi, L.; Abdurahman Baizal, Z. K.; Herdiani, Anisa
2018-03-01
Recommender System is software that is able to provide personalized recommendation suits users’ needs. Recommender System has been widely implemented in various domains, including tourism. One approach that can be done for more personalized recommendations is the use of contextual information. This paper proposes a context aware recommender based ontology system in the tourism domain. The system is capable of recommending tourist destinations by using user preferences of the categories of tourism and contextual information such as user locations, weather around tourist destinations and close time of destination. Based on the evaluation, the system has accuracy of of 0.94 (item recommendation precision evaluated by expert) and 0.58 (implicitly from system-end user interaction). Based on the evaluation of user satisfaction, the system provides a satisfaction level of more than 0.7 (scale 0 to 1) for speed factors for providing liked recommendations (PE), informative description of recommendations (INF) and user trust (TR).
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Directory of Open Access Journals (Sweden)
Nur Shuhadah Mohd
2015-09-01
Full Text Available The formation of tourism experience frequently subjected to complexity of individual tourist psycho-graphical factor, which leads to vast difference in the end experience formed among the respective tourist. However, the fact that travelling is highly subjected to environmental fuzziness and the issue of geographical consciousness may interfere the emotion of tourist and influence the formation of this experience. The evolution and advancement of mobile technologies had been optimized in improving the way human interact with the surrounding environment. Within this context, mobile augmented reality (AR technology is perceived as capable in narrowing the gap between the formation of pleasant experience and the issue of geographical consciousness, thus transform the way tourist interact with the destination. Pertaining to this situation, this conceptual paper is attempted to understand the effectiveness of mobile augmented reality in enhancing tourist travel experience on the tourism destination. In relation to this aim, this study is directed to clarify the mechanism and usability of mobile augmented reality in relation to its capability in improving tourism interpretation and to discover the influence of utilization of this technology towards tourism experience. Critical review of existing literature that relevant to the research area was done in understanding on the extensiveness of impact of mobile AR on tourist and experience formation. Findings revealed the capability of AR in merging virtual information with the real world environment through the platform of mobile device able to create a more dynamic interaction between tourist and surrounding environment.
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Language, Colonial Attitude and War in Emecheta's Destination Biafra
African Journals Online (AJOL)
This study aims at examining the relevance of Sociolinguistic Functional Stylistics (SFS) in supplying a methodical structure upon which Emecheta's Destination Biafra can be appreciated. Much of the critical attention on Emecheta has been centred on issues of gender and sexuality to the extent that ideological implications ...
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Directory of Open Access Journals (Sweden)
Stanislav Mokrý
2013-01-01
Full Text Available The aim of this article is to introduce results of research of perceptual carrying capacity of selected area. Concept of perceptual tourist carrying capacity aims to find the number of visitors of tourist destination that the visitor is willing to accept before deciding to prefer travelling to another tourist destination. In order to determine the perceptual carrying capacity the visual method is used. The photos of destination that depict different level of visitors are presented to respondents when using this method. The primary research method used in this investigation was the questionnaire survey which was conducted via online questionnaires. The questionnaire used computer-generated images that depict different number of visitors of the particular destination – nature trail around the church of St. John of Nepomuk in Žďár nad Sázavou (UNESCO monument. The questionnaire also contained samples of photos taken from photo gallery section of CzechTourism agency (photo.czechtourism.com, which were used to determine the preferred destination for recreation. The survey was conducted within the period from May 2012 to July 2012 on a sample of 736 respondents from The Czech Republic.
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Update on Renal Replacement Therapy: Implantable Artificial Devices and Bioengineered Organs.
Attanasio, Chiara; Latancia, Marcela T; Otterbein, Leo E; Netti, Paolo A
2016-08-01
Recent advances in the fields of artificial organs and regenerative medicine are now joining forces in the areas of organ transplantation and bioengineering to solve continued challenges for patients with end-stage renal disease. The waiting lists for those needing a transplant continue to exceed demand. Dialysis, while effective, brings different challenges, including quality of life and susceptibility to infection. Unfortunately, the majority of research outputs are far from delivering satisfactory solutions. Current efforts are focused on providing a self-standing device able to recapitulate kidney function. In this review, we focus on two remarkable innovations that may offer significant clinical impact in the field of renal replacement therapy: the implantable artificial renal assist device (RAD) and the transplantable bioengineered kidney. The artificial RAD strategy utilizes micromachining techniques to fabricate a biohybrid system able to mimic renal morphology and function. The current trend in kidney bioengineering exploits the structure of the native organ to produce a kidney that is ready to be transplanted. Although these two systems stem from different technological approaches, they are both designed to be implantable, long lasting, and free standing to allow patients with kidney failure to be autonomous. However, for both of them, there are relevant issues that must be addressed before translation into clinical use and these are discussed in this review.
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Directory of Open Access Journals (Sweden)
Fitri Abdillah
2016-10-01
Full Text Available The community in the tourism destination is one of the key elements to ensure the sustainability of the tourism destination itself. The objective of this study was to determine if the development of tourism contributes to the involvement and the level of quality of life of the local community in Pangandaran and Palabuhanratu. A total of 279 samples were obtained from two locations. Data were analyzed by using descriptive methods to determine the phase of the development of destinations, the community involvement, and the level of quality of life The results showed that (1 Pangandaran has a better destination performance than Palabuhanratu, (2 Pangandaran is in the growth phase and Palabuhanratu is in the consolidation phase, (3 Increase in the number of tourist arrivals in destinations within the growth phase is more influential than that in the consolidation phase, and (4 Among the four components of quality of life, the material aspect has the highest value, followed by the spiritual, social and personal aspects. The development of tourism destinations significantly affected the level of community involvement and the level of quality of life.
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Medical Tourism Destination SWOT Analysis: A Case Study of Malaysia, Thailand, Singapore and India
Wong Kee Mun; Velasamy Peramarajan; Tengku Arshad Tengku Nuraina
2014-01-01
The growth of global medical tourism in the recent years had spurred the interest of many governments to join in the bandwagon, particularly from Asia. Using the SWOT analytical model, this paper provides pertinent comparative analysis of the medical tourism destinations here being Malaysia, Thailand, Singapore and India. Each destination possesses its own value propositions to convince the demands of medical tourists. Malaysia and Thailand have a good mixture of elements (medical, tourism an...
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Kemp, Steven; Madden, Gary; Simpson, Michael
1998-01-01
Isolates factors influencing choice of Australia as a preferred destination for international students in emerging regional markets. Uses data obtained from a survey of students in Indonesia and Taiwan to estimate a U.S./Australia and rest-of-world/Australia discrete destination-choice model. This model identifies key factors determining country…
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Xue, Huaju; Fang, Chengjiang
2018-02-01
It is vital to assess the regional tourist supply capability by suppliers and demand groups. The supply side’s evaluation of the regional supply capacity determines the direction of the supply investment in future, the demand side’s evaluation indicates their satisfaction degree of the destination supply and also effects their revisit the tourism destination. Therefore, the assessment of the supply and demand sides is an important reference for the reform of destination supply side, which helps us find the shortage of the destination supply factors and optimize tourism destination supply promptly. This paper through investigating tourism supply and demand groups in Shanghai, used the survey data and constructed tourism supply optimization model, analyzed the current situation of tourism supply factors in Shanghai. Results showed that the environment of Shanghai should be improved first, including improving urban air and water quality, up-grading public sanitation and increasing urban green coverage. Other supply factors improved priority were information and marketing, we should improve the information consultation of scenic spots, increase the intensity of tourism promotion and provide more free travel publicity brochures.
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Destination Marketing Organizations and Climate Change—The Need for Leadership and Education
Directory of Open Access Journals (Sweden)
Rachel Dodds
2010-11-01
Full Text Available Destination Marketing Organizations (DMOs operate at many levels ranging from the national to the municipal and have evolved over the years to respond to the geographical and political realities that are associated with tourism supply. Alongside providing information to potential visitors, DMOs work to make a destination attractive by showcasing its unique aspects and attractions. As the appeal of destinations, cost of doing business and the destination brand may be affected by the possible effects of climate change, this study aims to identify opportunities and threats to municipal and provincial/territorial DMOs and their members as well as identify measures they are undertaking to address the potential impacts. A study conducted of Canada’s provincial and municipal large DMOs was conducted in 2009. This research found that awareness of climate change in Canada’s tourism industry is increasing, but more efforts must be undertaken to mitigate climate change. To address climate change and tourism, this paper suggests doing three things: (a DMOs need to demonstrate leadership about climate change education and mitigation to all their members; (b government policy and action are needed to provide incentives for industry to address climate change; and (c industry members require further education to take the steps necessary mitigate risk and to adapt. The internet has changed the DMOs’ roles and how they provide information to the consumer; as such, they have been presented with an opportunity to take on new roles as educational and marketing providers. This paper will outline in the current shifts among Canadian DMOs and will discuss the key issues that are applicable to DMOs worldwide.
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Diaspora engagement of African migrant health workers - examples from five destination countries.
Wojczewski, Silvia; Poppe, Annelien; Hoffmann, Kathryn; Peersman, Wim; Nkomazana, Oathokwa; Pentz, Stephen; Kutalek, Ruth
2015-01-01
Migrant health workers fill care gaps in their destination countries, but they also actively engage in improving living conditions for people of their countries of origin through expatriate professional networks. This paper aims to explore the professional links that migrant health workers from sub-Saharan African countries living in five African and European destinations (Botswana, South Africa, Belgium, Austria, and the United Kingdom) have to their countries of origin. Qualitative interviews were conducted with migrant doctors, nurses, and midwives from sub-Saharan Africa (N=66). A qualitative content analysis of the material was performed using the software ATLAS.ti. Almost all migrant health workers have professional ties with their countries of origin supporting health, education, and social structures. They work with non-governmental organizations, universities, or hospitals and travel back and forth between their destination country and country of origin. For a few respondents, professional engagement or even maintaining private contacts in their country of origin is difficult due to the political situation at home. The results show that African migrant health workers are actively engaged in improving living conditions not only for their family members but also for the population in general in their countries of origin. Our respondents are mediators and active networkers in a globalized and transnationally connected world. The research suggests that the governments of these countries of origin could strategically use their migrant health workforce for improving education and population health in sub-Saharan Africa. Destination countries should be reminded of their need to comply with the WHO Global Code of Practice for the international recruitment of health professionals.
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Directory of Open Access Journals (Sweden)
Menara Simanjuntak
2012-09-01
Full Text Available This study aimed to provide inputs for local government of Toba Samosir (Tobasa in preparing strategic development plan of tourist destinations in District Tobasa. This study is a qualitative approach through in-depth interviews and feedback from forum discussion groups with participants representing community leaders, indigenous peoples, governments and travel business. Total participants are 15 people collected on June 1, 2012 at Balige government office. Discussion forums formulated nine locations of tourist destination spread in Toba Samosir. As result this research, we formulated four strategic plans with tactical plans; (1 specifying and establish the location of tourist destinations in the District Tobasa; (2 submitting plans to the government budget or through the budget of Tobasa district in five years starting in 2014 to follow; (3 conducting government financing for infrastructure development and tourism industry participation; (4 doing tourism and cultural promotion. We found limitations for the plan. Some of them were: the low budget provided by the District government so that we expected supports from domestic investors to accelerate tourism development in the area. Most activities were proposed under the action plan of both Tobasa District government and North Sumatra Government.
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Travel and biologic therapy: travel-related infection risk, vaccine response and recommendations.
Hall, Victoria; Johnson, Douglas; Torresi, Joseph
2018-01-01
Biologic therapy has revolutionized the management of refractory chronic autoimmune and auto-inflammatory disease, as well as several malignancies, providing rapid symptomatic relief and/or disease remission. Patients receiving biologic therapies have an improved quality of life, facilitating travel to exotic destinations and potentially placing them at risk of a range of infections. For each biologic agent, we review associated travel-related infection risk and expected travel vaccine response and effectiveness. A PUBMED search [vaccination OR vaccine] AND/OR ['specific vaccine'] AND/OR [immunology OR immune response OR response] AND [biologic OR biological OR biologic agent] was performed. A review of the literature was performed in order to develop recommendations on vaccination for patients in receipt of biologic therapy travelling to high-risk travel destinations. There is a paucity of literature in this area, however, it is apparent that travel-related infection risk is increased in patients on biologic therapy and when illness occurs they are at a higher risk of complication and hospitalization. Patients in receipt of biologic agents are deemed as having a high level of immunosuppression-live vaccines, including the yellow fever vaccine, are contraindicated. Inactivated vaccines are considered safe; however, vaccine response can be attenuated by the patient's biologic therapy, thereby resulting in reduced vaccine effectiveness and protection. Best practice requires a collaborative approach between the patient's primary healthcare physician, relevant specialist and travel medicine expert, who should all be familiar with the immunosuppressive and immunomodulatory effects resulting from the biologic therapies. Timing of vaccines should be carefully planned, and if possible, vaccination provided well before established immunosuppression.
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Destination brand equity research from 2001 to 2012
Kladou, Stella; Giannopoulos, Antonios A.; Mavragani, Eleni
2015-01-01
The present study delves into a review of the destination brand equity literature published since 2001, aiming to offer tourism researchers a reference guide to the general context, corresponding methods,and focus of previous works. A multisource search resulted in the identification of 64 relevant papers. Content analysis using multiple classifier variables provides further insights into specific geographical, conceptual, and methodological aspects. Conclusions pertain to the multidimensiona...
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Energy costs of manual therapy: effects of plinth height and an assistive device.
O'Connell, D G; Holmes, C F; Santos, J L; Jordan, E; Acosta, F
1994-01-01
The purpose of this investigation was to examine the metabolic and cardiopulmonary responses of an experienced therapist (8 years experience) performing manual therapy at standard (S) plinth height (31 in), elevated (E) plinth height (38 in), and standard (SMTH) and elevated (EMTH) plinth height wearing a manual therapy harness (MTH). The MTH, developed by one of the investigators (J.L.S.), is a vestlike device worn by the therapist, which, when attached to the patient, can be used to distract articular surfaces. The MTH allows the therapist more freedom of hand movement and use of body weight to help provide joint distraction. Inferior glide (Grade 3-Maitland) was provided to the lift hip of 12 individuals at a rate of 20 oscillations per minute for 4 minutes, continuously, so that steady-rate metabolic conditions could be established. Mean body mass and height for the 12 individuals was 70±10.5 kg and 174.5±13 cm, respectively. The therapist's heart rate returned to resting levels between each of the randomly assigned treatments. One subject was treated daily. The therapist (age 32) was chosen because of his clinical experience, similar height (172 em) and weight (73 kg) to the average adult American male, and excellent intra- and interday (5%≤ METs, 5%≤ HR) reproducibility. Metabolic equivalents (METs), heart rate (HR), and rate of perceived exertion (RPE) were measured and averaged for the last 2 minutes of each treatment condition. The therapist was unaware of day-to-day test results except for RPE. Mean METs were 3. 7,3.2,2.6, and 2.4 for S, E, SMTH, and EMTH, respectively. Mean HRs were .117, 110, 104, and 93 beats/min for S, E, SMTH, and EMTH, respectively. RPE was 11. 0,8.7, 7.9, and 7.3jorS, E, SMTH, and EMTH, respectively. Repeated-measures analysis of variance (Scheffé F-test) revealed that SMTH and EMTH METs were similar, and significantly different (p≤0.05) from Sand E. METs for E were significantly different and lower than for S. HRs were
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Directory of Open Access Journals (Sweden)
Asunción Beerli-Palacio
2017-07-01
Full Text Available Purpose - The purpose of this paper is to analyse the influence of the confirmation of the motivations of tourists in changing image of a tourist destination pre- and post-visit. That is, considering whether once the tourist has made the trip, depending on whether their expectations have been met and confirmed motivations, will have a more or less image gap. Design/methodology/approach - The authors conducted an empirical study with a representative sample of leisure tourists to Tenerife (Canary Islands, Spain of both sexes, 16 or more years of age, and visiting the island of Tenerife for the first time from abroad and from the rest of Spain. The final sample was 411 participants. Findings - The results verify that the confirmation of the intellectual and escape motivations influences directly and positively change cognitive image pre- and post-visit. The fact that the affiliation motivations do not influence the cognitive image gap may be due to that tourists who visit a destination stay with friends or family and for this they interact less with the destination, which will imply that the cognitive image pre- and post-visit do not vary. Originality/value - This research has sought to contribute towards a better understanding of the area, which is concerned, with the image of destinations and, more specifically, the concept of how the image changes after a visit to the destination. In this sense, and given the of lack empirical evidence about how confirmation of motivations influences on destination image gap, this research aims to contribute to the improvement of knowledge about the personal factors that influence the change of the pre- and post-visit destination image.
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Nazem, Mohsen; Trépanier, Martin; Morency, Catherine
2015-01-01
An Enhanced Intervening Opportunities Model (EIOM) is developed for Public Transit (PT). This is a distribution supply dependent model, with single constraints on trip production for work trips during morning peak hours (6:00 a.m.-9:00 a.m.) within the Island of Montreal, Canada. Different data sets, including the 2008 Origin-Destination (OD) survey of the Greater Montreal Area, the 2006 Census of Canada, GTFS network data, along with the geographical data of the study area, are used. EIOM is a nonlinear model composed of socio-demographics, PT supply data and work location attributes. An enhanced destination ranking procedure is used to calculate the number of spatially cumulative opportunities, the basic variable of EIOM. For comparison, a Basic Intervening Opportunities Model (BIOM) is developed by using the basic destination ranking procedure. The main difference between EIOM and BIOM is in the destination ranking procedure: EIOM considers the maximization of a utility function composed of PT Level Of Service and number of opportunities at the destination, along with the OD trip duration, whereas BIOM is based on a destination ranking derived only from OD trip durations. Analysis confirmed that EIOM is more accurate than BIOM. This study presents a new tool for PT analysts, planners and policy makers to study the potential changes in PT trip patterns due to changes in socio-demographic characteristics, PT supply, and other factors. Also it opens new opportunities for the development of more accurate PT demand models with new emergent data such as smart card validations.
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Directory of Open Access Journals (Sweden)
Ida Vajčnerová
2016-01-01
Full Text Available The objective of the paper is to explore possibilities of evaluating the quality of a tourist destination by means of the principal components analysis (PCA and the cluster analysis. In the paper both types of analysis are compared on the basis of the results they provide. The aim is to identify advantage and limits of both methods and provide methodological suggestion for their further use in the tourism research. The analyses is based on the primary data from the customers’ satisfaction survey with the key quality factors of a destination. As output of the two statistical methods is creation of groups or cluster of quality factors that are similar in terms of respondents’ evaluations, in order to facilitate the evaluation of the quality of tourist destinations. Results shows the possibility to use both tested methods. The paper is elaborated in the frame of wider research project aimed to develop a methodology for the quality evaluation of tourist destinations, especially in the context of customer satisfaction and loyalty.
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Directory of Open Access Journals (Sweden)
Jun Li
2015-01-01
Full Text Available The transportation infrastructure always plays an important role in the development of the local tourism. A system dynamics method incorporated with a destination choice model is proposed in this paper to analyze the dynamic impacts of transportation infrastructure on the tourism development, where multiple tourism destinations share a common market. Tourists’ destination choice behaviors are characterized by a multinomial logit choice model based on the utility of destinations, which depends heavily on the accessibility of destinations that the local administration has strong willingness to improve. The system dynamics method is used to model dynamic interactions among destinations and to simulate the dynamic evolution of the competition on the tourism market. A case study of the World Cultural Heritage Sites, Xidi and Hongcun villages, shows the competition for road infrastructure investment can produce a win-win situation and bring the cooperation on investment due to the positive externality of transport infrastructure and two villages show a tendency to merge into one bigger destination. Finally, the tourism development strategies for two villages are discussed based on the scenario analysis.
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THE REVIVAL OF TOURISM IN MEHEDINTI COUNTY - CASE STUDY: THE DANUBE BEND TOURIST DESTINATION
Directory of Open Access Journals (Sweden)
Mirela MAZILU
2009-06-01
Full Text Available The sustainable management of the destinations is essential for the development of tourism, especially through the planning of the efficient usage of the space and of the land, as well as through the control of the development and through the decisions to invest in infrastructure and services. Granting the fact that the new development of tourism is, as a scale and a type, adequate for the needs of the local community and for the natural environment, the sustainable development can consolidate the economic performances and the competitive position of a destination on a long term. This needs a support frame which implicates all the interested parties at regional and local levels, as well as an efficient structure which facilitates the efficient partnership and management. A basic request for the quality existence and perenniality of the tourist destinations from Romania is to remain competitive. The actions undertaken for this purpose should be considered as a part of the process of creation of a sustainable character, which represents one of the most important advantages in the competition. Thus, in order to ensure competitiveness, viability and prosperity on a long term, the tourist destinations should emphasize the full integration of the preoccupations regarding the sustainability within the decisional process and within their management practices and instruments.
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Sultana, Razia; Christ, Andreas; Meyrueis, Patrick
2014-05-01
The improvements in the hardware and software of communication devices have allowed running Virtual Reality (VR) and Augmented Reality (AR) applications on those. Nowadays, it is possible to overlay synthetic information on real images, or even to play 3D on-line games on smart phones or some other mobile devices. Hence the use of 3D data for business and specially for education purposes is ubiquitous. Due to always available at hand and always ready to use properties of mobile phones, those are considered as most potential communication devices. The total numbers of mobile phone users are increasing all over the world every day and that makes mobile phones the most suitable device to reach a huge number of end clients either for education or for business purposes. There are different standards, protocols and specifications to establish the communication among different communication devices but there is no initiative taken so far to make it sure that the send data through this communication process will be understood and used by the destination device. Since all the devices are not able to deal with all kind of 3D data formats and it is also not realistic to have different version of the same data to make it compatible with the destination device, it is necessary to have a prevalent solution. The proposed architecture in this paper describes a device and purpose independent 3D data visibility any time anywhere to the right person in suitable format. There is no solution without limitation. The architecture is implemented in a prototype to make an experimental validation of the architecture which also shows the difference between theory and practice.
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Exploring tourists push and pull motivations to visit Mauritius as a tourist destination
Directory of Open Access Journals (Sweden)
Hemant Kassean
2013-01-01
Full Text Available This study examines the motivational push and pull-factors that affect tourists’ decision in their choice of a holiday destination. 200 questionnaires were completed using a face to face interview among specific groups of travellers to Mauritius (English, French, German, Italian and South African tourists at various points on the island. The findings demonstrate that rest and relaxation are the most compelling push motivation forces followed by nostalgia, escape, novelty and social interaction. The key pull based motives were found to be the special climate and weather of Mauritius, the exquisite landscape and scenery, unique flora and fauna, exotic beaches, the exotic ambience and atmosphere, the welcoming nature of Mauritian hospitality and the authentic Mauritian culture. The Push and pull factors between first time visitors and repeat visitors are discussed in this article and the study essentially contributes to our overall understanding of why holiday makers take travel decisions to opt for long- haul destinations like Mauritius, and can therefore help destination marketers develop better marketing programmes to meet the specific needs of their customers.
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Drivers of the formation of e-loyalty towards tourism destinations
Directory of Open Access Journals (Sweden)
Eduardo Parra-Lopez
2018-03-01
Full Text Available Purpose - The purpose of this paper is to determine the drivers of the formation of e-loyalty in a tourist destination, providing a model composed of variables that are under the control of the firm along with others that are not fully controllable by professionals. Design/methodology/approach - The study was carried out with a sample of 497 subjects, university students and online consumers, and with the use of structural equations (partial least squares. Findings - Results show that young people give a high valuation to all the variables used in the research. These results contribute to the literature on e-loyalty in tourism destinations and improve tourism loyalty in this population segment. Research limitations/implications - The main limitation of this research has been related to the number of variables and measurement indicators that, according to the literature review, influence e-loyalty. Finally, a balanced and statistically significant model has been developed that has practical utility and analyzes online purchase of tourism products from a process perspective that includes variables that are internal and external to the firm. Practical implications - The study suggests that young people have a favourable attitude and predisposition towards e-commerce, which, in turn, favours firms’ efforts to promote consumption and loyalty within the framework of the model’s variables. Originality/value - This research paper has important value by analysing the initiating variables to determine how e-loyalty can be managed in tourist destinations, in addition to analysing an important segment for future tourism development.
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Moldovan Perception of Greece as a Tourism Destination
Stela Cazacu
2017-01-01
Purpose: This research study analyzes Moldovans' intentions to visit Greece, and their perceptions of Greece's image as a tourism destination, according to the following dimensions: (1) environmental beauty and convenience, (2) country's citizens, (3) place and architectural structure, (4) shopping and tourist accommodation and (5) similarity of the local culture and cuisine with the Moldovan one. The goal is split into four objectives. Design/methodology/approach: For attaining the goal,...
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THE SUSTAINABILITY OF SURFING TOURISM AT REMOTE DESTINATIONS
Hugues Dit Ciles, Emily Kate
2009-01-01
Surfing is an increasing component of the adventure tourism sector. Growth in surfing as a lifestyle, sporting activity and industry has generated a surge of exploration and intrusion by surfing tourism into remote and vulnerable destinations worldwide in the "search" for uncrowded waves at uncharted locations. Consequendy, there have been concerns at the impacts of surfing tourism on coastal, island and marine areas, often characterised by fragile environments and host communi...
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Bidwell, Julie T; Lyons, Karen S; Mudd, James O; Gelow, Jill M; Chien, Christopher V; Hiatt, Shirin O; Grady, Kathleen L; Lee, Christopher S
Patients who receive ventricular assist device (VAD) therapy typically rely on informal caregivers (family members or friends) to assist them in managing their device. The purpose of this study is to characterize changes in person-oriented outcomes (quality of life [QOL], depression, and anxiety) for VAD patients and their caregivers together from pre-implantation to 3 months post-implantation. This was a formal interim analysis from an ongoing prospective study of VAD patients and caregivers (n = 41 dyads). Data on person-oriented outcomes (QOL: EuroQol 5 Dimensions Visual Analog Scale; depression: Patient Health Questionnaire-8; anxiety: Brief Symptom Inventory) were collected at 3 time points (just prior to implantation and at 1 and 3 months post-implantation). Trajectories of change for patients and caregivers on each measure were estimated using latent growth modeling with parallel processes. Patients' QOL improved significantly over time, whereas caregiver QOL worsened. Depression and anxiety also improved significantly among patients but did not change among caregivers. There was substantial variability in change on all outcomes for both patients and their caregivers. This is the first quantitative study of VAD patient-caregiver dyads in modern devices that describes change in person-oriented outcomes from pre-implantation to post-implantation. This work supports the need for future studies that account for the inherent relationships between patient and caregiver outcomes and examine variability in patient and caregiver responses to VAD therapy.
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Coupling mode-destination accessibility with seismic risk assessment to identify at-risk communities
International Nuclear Information System (INIS)
Miller, Mahalia; Baker, Jack W.
2016-01-01
In this paper, we develop a framework for coupling mode-destination accessibility with quantitative seismic risk assessment to identify communities at high risk for travel disruptions after an earthquake. Mode-destination accessibility measures the ability of people to reach destinations they desire. We use a probabilistic seismic risk assessment procedure, including a stochastic set of earthquake events, ground-motion intensity maps, damage maps, and realizations of traffic and accessibility impacts. For a case study of the San Francisco Bay Area, we couple our seismic risk framework with a practical activity-based traffic model. As a result, we quantify accessibility risk probabilistically by community and household type. We find that accessibility varies more strongly as a function of travelers' geographic location than as a function of their income class, and we identify particularly at-risk communities. We also observe that communities more conducive to local trips by foot or bike are predicted to be less impacted by losses in accessibility. This work shows the potential to link quantitative risk assessment methodologies with high-resolution travel models used by transportation planners. Quantitative risk metrics of this type should have great utility for planners working to reduce risk to a region's infrastructure systems. - Highlights: • We couple mode-destination accessibility with probabilistic seismic risk assessment. • Results identify communities at high risk for post-earthquake travel disruptions. • Accessibility varies more as a function of home location than by income. • Our model predicts reduced accessibility risk for more walking-friendly communities.
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Negative pressure wound therapy and external fixation device: a simple way to seal the dressing.
Bulla, Antonio; Farace, Francesco; Uzel, André-Pierre; Casoli, Vincent
2014-07-01
Negative pressure therapy is widely applied to treat lower limb trauma. However, sealing a negative pressure dressing in the presence of an external fixation device may be difficult and time consuming. Therefore, screws, pins, wires, etc, may preclude the vacuum, preventing the plastic drape to perfectly adhere to the foam. To maintain the vacuum, we tried to prevent air leaking around the screws putting bone wax at the junction between the pins and the plastic drape. This solution, in our hands, avoids air leakage and helps maintain vacuum in a fast and inexpensive way.
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What Determines the Choice of Tourist Destination? The Case of Denmark
DEFF Research Database (Denmark)
Jensen, Susanne; Svendsen, Gert Tinggaard
2017-01-01
What determines the choice of tourist destination? Based on the comprehensive tourist surveys by VisitDenmark in 2004, 2008 and 2011, we find that both Danes and tourists from countries close to Denmark attach great importance to safety, but it is also important for nationalities such as American...... and Japanese. Furthermore, tourists staying at hotels and youth hostels ascribe less weight to safety than tourists using other accommodation forms. Finally, returning tourists ascribe more weight to safety than first-time tourists.......What determines the choice of tourist destination? Based on the comprehensive tourist surveys by VisitDenmark in 2004, 2008 and 2011, we find that both Danes and tourists from countries close to Denmark attach great importance to safety, but it is also important for nationalities such as Americans...
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Mobile Social Computing for Destination Marketing: Valuing Territoriality and Social Contagion
DEFF Research Database (Denmark)
Tussyadiah, Iis
of influence enablers that leads to social contagion and stimulate territorial behavior that drives and changes people’s mobility within tourism destinations. It was identified in this study that locative media encourage the expansion of experience territory by presenting new approaches to territorial......Mobile social computing has become an important platform for daily experiences and has caused a tremendous impact on people’s interaction with and interpretation of objects, materials, and images of tourist places. This study explores how locative media shapes tourist behavior and how destination...... marketers should respond to this behavior with appropriate marketing strategies. This study identifies that locative media provide tourists with the playfulness of pursuing rewards and competing (as well as staying connected) with their social network while traveling. Locative media function as a platform...
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DEFF Research Database (Denmark)
Hartl, Ann
by viewing them as cooperative customers. Thus the DMO needs to apply the principles of marketing to the development process of the strategy itself, and therefore to view the strategic plan as a product of the DMO, which needs to be marketed. The theoretical analysis shows that DMOs cannot control all......This thesis concentrates on the subject of destination marketing with a specific focus on the process of developing strategies through a Destination Marketing Organisation (DMO) for a peripheral area, illustrated by a case study from the Danish island of Bornholm. It investigates the theoretical...... foundations for destination marketing, concluding that there should be a shift in focus from general marketing theory to a broader application of organisational theories and associated fields, enabling the DMO to improve performance. The specific conditions for and structures of peripheral areas indicate...
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Predicting discharge destination after stroke: A systematic review.
Mees, Margot; Klein, Jelle; Yperzeele, Laetitia; Vanacker, Peter; Cras, Patrick
2016-03-01
Different factors have been studied and proven to significantly influence discharge destination of acute stroke patients after hospitalization. Few reviews have been published combining the results of these studies. Therefore we aim to present an overview of the studies conducted regarding these predicting factors. Through conducting a systematic review we aimed to study the different predictive factors influencing discharge destination of acute stroke patients after hospitalization. Nineteen articles were selected in accordance with the research question and inclusion criteria. The factors found were, according to their significance in the articles, subcategorized in age, gender, functional status, cognitive status, race and ethnicity, co morbidities, education, stroke characteristics, social and living situation. The main factors significantly associated with other than home discharge were functional dependence/comorbidities, neurocognitive dysfunction and previous living circumstances/marital status. A medium or large infarct is associated with institutionalization. The stroke volume is not associated with home discharge. The effect of other factors remain controversial and results differ between studies. These include: age, gender, race, affected hemisphere and availability of a caregiver not living at home. Factors such as education, hospital complications, geographic location and FIM progression during hospitalization have not been studied sufficiently. Copyright © 2016 Elsevier B.V. All rights reserved.
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Case Studies Approach in Tourism Destination Branding Research
Directory of Open Access Journals (Sweden)
Adeyinka-Ojo S.F.
2014-01-01
Full Text Available A review of literature indicates that there are different types of qualitative research methods such as action research, content analysis, ethnography, grounded theory, historical analysis, phenomenology and case study. However, which approach is to be used depends on several factors such as the nature and objectives of the research. The aim of this paper is to focus on the research methodology aspects of applying case study as a research approach and its relevance in tourism destination branding research specifically on a single case study (SCS context. There are arguments that the SCS is a weak research strategy. Some of the potentials or shortcomings highlighted in the literature include the primitive nature of SCS, flexibility of sample technique, data collection method and data analysis. Others include lack of rigour, reliability, validity, credibility of findings and generalisation. This paper has adopted content analysis of the literature on tourism destination branding. Findings indicate that the quality of SCS can be verified using specific case study tactics for four design tests such as validity (construct, internal and external; and reliability using the case study protocol. Theoretical implication suggests that SCS is an empirical enquiry use to understand complex phenomena and favoured by practitioners.
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Directory of Open Access Journals (Sweden)
Olga González-Morales
2016-11-01
Full Text Available This paper reflects on governance, corporate social responsibility (CSR and public-private cooperation in sustainable tourist destinations. The empirical analysis focuses on the island of Fuerteventura (the Canary Islands, where a process of coordinated decision making has begun, as well as putting in place plans to modernize the destination. Those responsible for tourism hotel and non-hotel accommodation were surveyed to assess the importance given to CSR in their companies. In particular, CSR’s environmental dimension and its relation with the public sector and other socio-economic factors, bearing in mind that Fuerteventura is a tourist destination in a Biosphere Reserve.
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Directory of Open Access Journals (Sweden)
Yanli Wang
2016-01-01
Full Text Available Joint destination-mode travel choice models are developed for intercity long-distance travel among sixteen cities in Yangtze River Delta Megaregion of China. The model is developed for all the trips in the sample and also by two different trip purposes, work-related business and personal business trips, to accommodate different time values and attraction factors. A nested logit modeling framework is applied to model trip destination and mode choices in two different levels, where the lower level is a mode choice model and the upper level is a destination choice model. The utility values from various travel modes in the lower level are summarized into a composite utility, which is then specified into the destination choice model as an intercity impedance factor. The model is then applied to predict the change in passenger number from Shanghai to Yangzhou between scenarios with and without high-speed rail service to demonstrate the applicability. It is helpful for understanding and modeling megaregional travel destination and mode choice behaviors in the context of developing country.
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Iconic Destination: a Snapshot of Sustainable Tourism in Pisa
Directory of Open Access Journals (Sweden)
Silvia Sarti
2015-12-01
Full Text Available Tourism is one of the world's fastest growing industries. According to the World Tourism Organization, Italy is the fifth most visited country in the world, with more than 47.7 million tourists a year (2013. At the same time, the increasing number of studies focused on sustainable tourism demonstrates a growing interest about the topic. In addition, practitioners’ attitude is changing and the most important actors of the market are acting in a more sustainable way and developing reports on their eco-friendly performances. Nowadays, the entire supply chain maybe environmentally sustainable. From the reservation to the post-holiday phase, it is possible to select the more eco-friendly suppliers. The main companies operating in the different stages of the process are demonstrating a concrete interest on sustainable development. This new challenge is generated through the information flow between local authorities, private firms and final customers. We propose to make a reflection based on the latter actors’ attitude. Our research aims to investigate the level of sensitivity of tourists about environmental sustainability from two different perspectives: self-evaluation and real purchasing behavior. We conducted a face-to-face survey among tourists in Pisa, in Piazza dei Miracoli, during May 2015. By using a structured questionnaire, we gathered primary data from a sample of 406 respondents. We selected respondents randomly. Pisa is the perfect location to obtain information from several typologies of tourists, with different levels of awareness of sustainable issues. Itis one of the most important tourist destination in Italy and it is an iconic destination recognized worldwide thanks to the attractiveness of the leading tower. The results of our study is a snapshot of the current level of awareness among tourists. The analysis of the questionnaires revealed tourist profiles, their eco-friendly behaviors, their concerns about sustainability
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Directory of Open Access Journals (Sweden)
Tarcan Ertugrul
2015-01-01
Full Text Available This study based on literature review aims to evaluate and emphasize the affect of the strategic facility management (SFM on choice of medical tourism destination. Medical Tourism, which ranges from the health care services involving a cure to the wellness services involving no specific health trouble to pleasure and amusement services, is one of the most growing sectors in the world. Cost and quality of medical services are among the main reasons for the choice of destination. Strategic facility management has a positive correlation on the levels of quality, cost and customer satisfaction. Thus medical tourism and destination managers should take into account of the potential advantages of value creation offered through SFM in order to be chosen by customers (stakeholders.
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International Nuclear Information System (INIS)
Hekkenberg, R T; Richards, A; Beissner, K; Zeqiri, B; Prout, G; Cantrall, Ch; Bezemer, R A; Koch, Ch; Hodnett, M
2004-01-01
Physical therapy ultrasound is widely applied to patients. However, many devices do not comply with the relevant standard stating that the actual power output shall be within ±20% of the device indication. Extreme cases have been reported: from delivering effectively no ultrasound or operating at maximum power at all powers indicated. This can potentially lead to patient injury as well as mistreatment. The present European (EC) project is an ongoing attempt to improve the quality of the treatment of patients being treated with ultrasonic physical-therapy. A Portable ultrasound Power Standard (PPS) is being developed and accurately calibrated. The PPS includes: Ultrasound transducers (including one exhibiting an unusual output) and a driver for the ultrasound transducers that has calibration and proficiency test functions. Also included with the PPS is a Cavitation Detector to determine the onset of cavitation occurring within the propagation medium. The PPS will be suitable for conducting in-the-field accreditation (proficiency testing and calibration). In order to be accredited it will be important to be able to show traceability of the calibration, the calibration process and qualification of testing staff. The clinical user will benefit from traceability because treatments will be performed more reliably
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Jensen, Alexandra D; Winter, Marcus; Kuhn, Sabine P; Debus, Jürgen; Nairz, Olaf; Münter, Marc W
2012-03-29
To investigate repositioning accuracy in particle radiotherapy in 6 degrees of freedom (DOF) and intensity-modulated radiotherapy (IMRT, 3 DOF) for two immobilization devices (Scotchcast masks vs thermoplastic head masks) currently in use at our institution for fractionated radiation therapy in head and neck cancer patients. Position verifications in patients treated with carbon ion therapy and IMRT for head and neck malignancies were evaluated. Most patients received combined treatment regimen (IMRT plus carbon ion boost), immobilization was achieved with either Scotchcast or thermoplastic head masks. Position corrections in robotic-based carbon ion therapy allowing 6 DOF were compared to IMRT allowing corrections in 3 DOF for two standard immobilization devices. In total, 838 set-up controls of 38 patients were analyzed. Robotic-based position correction including correction of rotations was well tolerated and without discomfort. Standard deviations of translational components were between 0.5 and 0.8 mm for Scotchcast and 0.7 and 1.3 mm for thermoplastic masks in 6 DOF and 1.2-1.4 mm and 1.0-1.1 mm in 3 DOF respectively. Mean overall displacement vectors were between 2.1 mm (Scotchcast) and 2.9 mm (thermoplastic masks) in 6 DOF and 3.9-3.0 mm in 3 DOF respectively. Displacement vectors were lower when correction in 6 DOF was allowed as opposed to 3 DOF only, which was maintained at the traditional action level of >3 mm for position correction in the pre-on-board imaging era. Setup accuracy for both systems was within the expected range. Smaller shifts were required when 6 DOF were available for correction as opposed to 3 DOF. Where highest possible positioning accuracy is required, frequent image guidance is mandatory to achieve best possible plan delivery and maintenance of sharp gradients and optimal normal tissue sparing inherent in carbon ion therapy.
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Salvage therapy for CLL and the role of stem cell transplantation.
Gribben, John G
2005-01-01
Chronic lymphocytic leukaemia (CLL) remains an incurable disease and, notwithstanding the excellent remission rates now achieved with purine analogs and monoclonal antibodies, the vast majority of patients with CLL are destined to relapse after primary treatment. The management of relapsed CLL patients is then dependent upon a number of factors, most importantly age, performance status, previous therapy administered, the response and duration of response to such therapy, and time from last therapy. Although prior therapy and response to such therapy are important factors in determining next therapy, it is often difficult to determine their importance from published studies. Furthermore, the goal of therapy, whether palliative or aggressive, must also be weighed into the decision when deciding on the next line of treatment. With many potential treatments available, the sequence of treatments and the timing of procedures such as stem cell transplantation remain controversial and are the focus of ongoing clinical trials.
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Device therapy in pediatric and congenital heart disease patients
Directory of Open Access Journals (Sweden)
Naokata Sumitomo, MD, PhD
2014-12-01
Conclusions: Despite the limited experience, limitations of device implantations owing to the size of the devices, and necessity for nonendocardial electrode placement, device implantations are required in more pediatric and CHD patients than expected.
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International Nuclear Information System (INIS)
Munera, Ana G; Restrepo, Gustavo; Duque, Mauricio; Cubides, Carlos; Uribe, William; Medina, Eduardo; Marin, Jorge; Gil, Efrain; Aristizabal, Dagnovar
2007-01-01
In patients with advanced heart failure, functional class lll-IV, mortality reaches 50% at one year and 80% at two years. Some remain asymptomatic and have a poor functional state, regardless of the pharmacologic treatment. Heart resynchronization therapy is a therapeutic alternative that improves hemodynamic and symptoms in these patients. The objective is to analyze the experience in the management of heart failure with heart resynchronization therapy devices with or without cardio defibrillator. Methodological design: an intervention study without aleatory patients assignment, with evaluation before and after the intervention. Results: the cohort was constituted by 82 patients. 73% were men. Mean age was 65.4+/- 11.9 years. The etiology was non-ischemic in 50 patients and ischemic in 32. Mean initial ejection fraction was 19.4% +/- 11.7%. Initial functional class was class lll - IV in 85% of cases and all patients received optimal medical treatment. During the follow-up, it was observed improvement of functional class, diastolic function, diastolic diameter of left ventricle, ejection fraction, mitral insufficiency, left atrial area, systolic lung pressure, synchrony parameters and myocardial function index with statistical significant difference in relation to the initial value (p<0.05). Survival at 44 months was 72%. Conclusion: the experience with heart resynchronization therapy and clinical and echocardiographic follow-up of the studied patients is similar to that found in other studies described in the literature
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Fitri Abdillah
2016-01-01
The community in the tourism destination is one of the key elements to ensure the sustainability of the tourism destination itself. The objective of this study was to determine if the development of tourism contributes to the involvement and the level of quality of life of the local community in Pangandaran and Palabuhanratu. A total of 279 samples were obtained from two locations. Data were analyzed by using descriptive methods to determine the phase of the development of destinations, the c...
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Tweets and Facebook Posts, the Novelty Techniques in the Creation of Origin-Destination Models
Malema, H. K.; Musakwa, W.
2016-06-01
Social media and big data have emerged to be a useful source of information that can be used for planning purposes, particularly transportation planning and trip-distribution studies. Cities in developing countries such as South Africa often struggle with out-dated, unreliable and cumbersome techniques such as traffic counts and household surveys to conduct origin and destination studies. The emergence of ubiquitous crowd sourced data, big data, social media and geolocation based services has shown huge potential in providing useful information for origin and destination studies. Perhaps such information can be utilised to determine the origin and destination of commuters using the Gautrain, a high-speed railway in Gauteng province South Africa. To date little is known about the origins and destinations of Gautrain commuters. Accordingly, this study assesses the viability of using geolocation-based services namely Facebook and Twitter in mapping out the network movements of Gautrain commuters. Explorative Spatial Data Analysis (ESDA), Echo-social and ArcGis software were used to extract social media data, i.e. tweets and Facebook posts as well as to visualize the concentration of Gautrain commuters. The results demonstrate that big data and geolocation based services have the significant potential to predict movement network patterns of commuters and this information can thus, be used to inform and improve transportation planning. Nevertheless use of crowd sourced data and big data has privacy concerns that still need to be addressed.
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TWEETS AND FACEBOOK POSTS, THE NOVELTY TECHNIQUES IN THE CREATION OF ORIGIN-DESTINATION MODELS
Directory of Open Access Journals (Sweden)
H. K. Malema
2016-06-01
Full Text Available Social media and big data have emerged to be a useful source of information that can be used for planning purposes, particularly transportation planning and trip-distribution studies. Cities in developing countries such as South Africa often struggle with out-dated, unreliable and cumbersome techniques such as traffic counts and household surveys to conduct origin and destination studies. The emergence of ubiquitous crowd sourced data, big data, social media and geolocation based services has shown huge potential in providing useful information for origin and destination studies. Perhaps such information can be utilised to determine the origin and destination of commuters using the Gautrain, a high-speed railway in Gauteng province South Africa. To date little is known about the origins and destinations of Gautrain commuters. Accordingly, this study assesses the viability of using geolocation-based services namely Facebook and Twitter in mapping out the network movements of Gautrain commuters. Explorative Spatial Data Analysis (ESDA, Echo-social and ArcGis software were used to extract social media data, i.e. tweets and Facebook posts as well as to visualize the concentration of Gautrain commuters. The results demonstrate that big data and geolocation based services have the significant potential to predict movement network patterns of commuters and this information can thus, be used to inform and improve transportation planning. Nevertheless use of crowd sourced data and big data has privacy concerns that still need to be addressed.
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15 CFR 30.36 - Exemption for shipments destined to Canada.
2010-01-01
... 15 Commerce and Foreign Trade 1 2010-01-01 2010-01-01 false Exemption for shipments destined to Canada. 30.36 Section 30.36 Commerce and Foreign Trade Regulations Relating to Commerce and Foreign Trade BUREAU OF THE CENSUS, DEPARTMENT OF COMMERCE FOREIGN TRADE REGULATIONS Exemptions From the Requirements...
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New Trends in Tourism Destination Branding by Means of Digital Marketing
Directory of Open Access Journals (Sweden)
Parlov Natalija
2016-12-01
Full Text Available Contemporary business is largely based on digital information. Traditional media forms lose battle in a new global surrounding. Therefore, knowing specific terminology and postulates of new conditions in the digital information market is essential. Globalization is an inevitable process overtaking all economic activities, including tourism sector intertwined with various advertising activities in order to place and sell its products and services. Digital marketing is thus more and more used. In that context, world tourism organizations and national tourist agencies play a role of communicator, trying to create desired mental image of a specific country as a tourism destination in the minds of final consumers. They use branding to make one country uniquely recognizable in the market. The aim of this paper is to present new trends in tourism destination branding process by using the means of digital marketing. The main purpose of this research was to analyse marketing activities and communication strategies of European countries, perceived as the largest tourism market, and compare them with the tourism promotion of Croatia in various markets. The results of the analysis of Croatian activities in promoting its tourism destinations imply there is still a large potential to improve implementation of digital marketing means by preparing the strategy of integrated market communication. The analysis of marketing activities of tourism developed countries shows trends in digital marketing that can serve as a model for development of Croatian tourism brand in global digital surrounding.
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A smart spirometry device for asthma diagnosis.
Kassem, A; Hamad, M; El Moucary, C
2015-08-01
In this paper an innovative prototype for smart asthma spirometry device to be used by doctors and asthma patients is presented. The novelty in this prototype relies in the fact that it is destined to subtend not only adults but offers an efficient and attractive manner to accommodate children patients as well thus, making it efficient for doctors, patients and parents to detect and monitor such intricate cases at stages as early as six years old. Moreover, the apparatus used enables us to integrate a vital parameter representing the Forced Expiratory Volume to the final diagnosis. Besides, the presented device will automatically diagnose those patients, assess their asthma condition, and schedule their medication process without excessive visits to medical centers whilst providing doctors with accurate and pertinent and comprehensive medical data in a chronological fashion. Zooming into under the hood of the device, a fully reliable hardware digital system lies along with a flowmeter detector and a Bluetooth emitter to interface with a user-friendly GUI-based application installed on smartphones which incorporates appealing animated graphics to encourage children to take the test. Furthermore, the device offers the capability of storing chronological data and a relevant resourceful display for accurate tracking of patients' medical record, the evolvement of their asthma condition, and the administered medication. Finally, the entire device is aligned with the medical requirements as per doctors' and telemedicine specialists' recommendations; the experiments carried out demonstrated the effectiveness and sustainable use of such device.
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Directory of Open Access Journals (Sweden)
Maja PULIC
2015-10-01
Full Text Available The newest member joined the European Union (EU with a well-conceived destination branding strategy. Croatia is becoming more and more identifiable world-wide by creating a distinctive brand in order to maintain a solid positioning as a destination place. As competition is becoming more intense, an increasing number of countries struggle to make themselves visible in the global tourism market. Tourism dominates the Croatian service sector, where the bulk of the tourist industry is concentrated along the Adriatic Sea coast. Although not very successful in public diplomacy, a complex system of coordinated activities that Croatia implemented resulted in strengthening the perception and image of the overall destination brand. This research aims at exploring the Croatian destination branding strategy as a potential model for its closest neighboring country, Bosnia and Herzegovina (BIH. Sharing a common history, borders and people, BIH and Croatia represent a unique comparative case study for regional spill-over development between the EU and non-EU countries. Therefore, this study takes into account what has been done so far on both sides regarding destination branding strategy, thus exploring what lessons could be learned from Croatia and what is the best future regional approach for creating a BIH’s destination brand.
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Directory of Open Access Journals (Sweden)
Olivera Blagojevic Popovic
2018-03-01
Full Text Available In the hotel industry, it is a well-known fact that, despite of quality and variety of services provided, there is a low probability that the guests will return. This research is focused on identifying the basic factors of the hotel offer, which could determine the influence on the correlation between the guests’ satisfaction and the probability of their return. The objective of the article is to explore the relationship between the guests’ satisfaction with the quality hotel services in total (including the tourist offer of the place and the probability of his return to the same destination. The questionnaire method was applied in the survey, and the data were analysed based on factor analysis. Thereafter, the model for forecasting the probability of the guests returning to the destination was established, by using the example of Montenegrin tourism. The model represents a defined framework for the guest’s decision-making process. It identifies two main characteristics of guest experiences: satisfaction and rated quality (of the destination’s overall hotel service and tourist offer. The same model evaluates the impact of the above factors on the probability of the guests’ returning to the same destination. The starting hypothesis was the existence of a high degree of correlation between the guests’ satisfaction (with the destination’s hotel services and tourist offer and the probability of returning to the selected Montenegrin destinations. The research confirmed the above-mentioned hypothesis. The results have revealed that there are significant differences in perceived quality, i.e. satisfaction between the target groups of Eastern and Western European tourists
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Diaspora engagement of African migrant health workers – examples from five destination countries
Wojczewski, Silvia; Poppe, Annelien; Hoffmann, Kathryn; Peersman, Wim; Nkomazana, Oathokwa; Pentz, Stephen; Kutalek, Ruth
2015-01-01
Background Migrant health workers fill care gaps in their destination countries, but they also actively engage in improving living conditions for people of their countries of origin through expatriate professional networks. This paper aims to explore the professional links that migrant health workers from sub-Saharan African countries living in five African and European destinations (Botswana, South Africa, Belgium, Austria, and the United Kingdom) have to their countries of origin. Design Qualitative interviews were conducted with migrant doctors, nurses, and midwives from sub-Saharan Africa (N=66). A qualitative content analysis of the material was performed using the software ATLAS.ti. Results Almost all migrant health workers have professional ties with their countries of origin supporting health, education, and social structures. They work with non-governmental organizations, universities, or hospitals and travel back and forth between their destination country and country of origin. For a few respondents, professional engagement or even maintaining private contacts in their country of origin is difficult due to the political situation at home. Conclusions The results show that African migrant health workers are actively engaged in improving living conditions not only for their family members but also for the population in general in their countries of origin. Our respondents are mediators and active networkers in a globalized and transnationally connected world. The research suggests that the governments of these countries of origin could strategically use their migrant health workforce for improving education and population health in sub-Saharan Africa. Destination countries should be reminded of their need to comply with the WHO Global Code of Practice for the international recruitment of health professionals. PMID:26652910
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Directory of Open Access Journals (Sweden)
de Fátima Guerreiro Godoy, Maria
2010-01-01
Full Text Available The aim of this study was to evaluate the reduction in volume of arm lymphedema secondary to breast cancer therapy utilizing an exercise facilitating device. Twenty-one women with arm lymphedema resulting from the surgical and radiotherapeutic treatment of breast cancer were randomly selected. Evaluation was made by water-displacement volumetry before and after each session. The patients were submitted to a series of active exercises using a facilitating device for four 12-minute sessions with intervals of 3 minutes between sessions in the sitting position with alignment of the spinal column. The lymphedematous arm was maintained under compression using a cotton-polyester sleeve. The active exercising device used was a mobile flexion bar fixed on a metal base at a height of 30 cm from the tabletop and at a distance of 10 cm from the patient’s body. The paired t-test was utilized for statistical analysis with an alpha error of 5% (p-value ≤0.05 being considered significant. The initial mean volume of the arms was 2,089.9 and the final volume was 2,023.0 mL with a mean loss of 66.9 mL (p-value <0.001. In conclusion, active exercises utilizing facilitating devices can contribute to a reduction in size of lymphedematous limbs.
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Boyd Sun Fatt; Johnny Cindy; Bakansing Shirley M.
2014-01-01
Sabah is blessed with natural forest habitats and rich with floras and faunas. Amongst its’ attraction is wildlife endemism. Lok Kawi Wildlife Park was established to provide an alternative wildlife tourism destination with its inhabitants from the wildlife species of Borneo. Since its opening in 2007, multitudes of tourists have visited the park. However, there has been no study to identify the visitor’s perspective on Lok Kawi Wildlife Park as man-made wildlife tourism destination. The stud...
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Poland as a(n) (un)attractive destination for Belarusian labour migrants: CARIM-East research report
Brunarska, Zuzanna; Lesińska, Magdalena
2014-01-01
Poland, due to its geographical and cultural proximity as well as stable economic growth in recent years, may be a natural destination country for labour migrants from Belarus. The statistics related to their residence and employment show that the numbers of Belarusians working in Poland are smaller than it could be expected, in particular, relatively smaller comparing to Ukrainians. The text analyzes the causes of the limited attractiveness of Poland as a destination country for labour migra...
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Directory of Open Access Journals (Sweden)
Tu Han-Chun
2014-01-01
Full Text Available Tourist destination image is important for strategic marketing and tourist choice. While many studies focus on images and their influencing factors, images are wrongly considered only for sale, compromising local authenticity and local life. With a critical review of development plans and the results of a questionnaire survey, this paper argues that images often stereotype and misplace tourist destination, in particularly for images brought about by structural forces. Islands are lands surrounded by ocean and often taken as full of marine and coastal resources and sceneries. In Penghu archipelago, marine environment is important for local livelihood and tourist destination. However, with the case of Erkan, we realize that, along with the evidence from interviews and surveys, most Erkan tourists do not come for its marine or natural resources. Erkan, as a fishing village, was turned into a tourism destination for tis vernacular architecture and folklore products irrelevant to its marine environment. With structural endeavours and official makeover of places, places are stereotyped and often become out of place.
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Directory of Open Access Journals (Sweden)
Dirceu Tornavoi de Carvalho
2016-03-01
Full Text Available The research aims to verify if the experience with country brands website influences the image and attractiveness of a touristic destination in the consumers’ minds as also in their intention to visit the destination. A pre-test/post-test pre-experimental study with a 30 undergraduate students sample in a university of São Paulo was conducted. The treatment consisted of exposing the subjects to the Iceland official touristic site. The dependent variables were the touristic attractiveness perception and the intention to visit Iceland. The evaluation of the browsing experience was measured using scales of online consumer behavior literature. The two hypotheses were: (1 that positive online experience positively influences the destination image formation and (2 positively influences the intention of visit, were supported by statistical means comparison tests before and after treatment. The content analysis of the open question, performed after treatment, showed the effect that the knowledge acquired by pleasurable navigation have in shaping the image and increasing the intention of visiting a touristic destination.
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Atar, İlyas; Karaçağlar, Emir; Özçalık, Emre; Özin, Bülent; Müderrisoğlu, Haldun
2015-06-01
Presence of a persistent left superior vena cava (PLSVC) is generally clinically asymptomatic and discovered incidentally during central venous catheterization. However, PLSVC may cause technical difficulties during cardiac device implantation. An 82-year-old man with heart failure symptoms and an ejection fraction (EF) of 20% was scheduled for resynchronization therapy-defibrillator device (CRT-D) implantation. A PLSVC draining via a dilated coronary sinus into an enlarged right atrium was diagnosed. First, an active-fixation right ventricular lead was inserted into the right atrium through the PLSVC. The stylet was preshaped to facilitate its passage to the right ventricular apex. An atrial lead was positioned on the right atrium free wall, and an over-the-wire coronary sinus lead deployed to a stable position. CRT-D implantation procedure was successfully completed.
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WHY CHINESE TOURISTS CHOOSE FINLAND AS TRAVEL DESTINATION
Zheng, Qiaoyin
2016-01-01
The purpose of this thesis is to find out the reasons why Chinese tourists choose Finland as travel destination. In this study, the author gives general view of Chinese outbound tourism and comes up with some reasonable recommendations for attracting more Chinese tourists to travel to Finland. Also the aim is to help readers to make improvements for increasing the competitiveness of Finland in the Chinese tourism market. The theoretical framework consist of the theory based on consumer b...
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Case Studies Approach in Tourism Destination Branding Research
Adeyinka-Ojo S.F.; Nair V.; Khoo-Lattimore C.
2014-01-01
A review of literature indicates that there are different types of qualitative research methods such as action research, content analysis, ethnography, grounded theory, historical analysis, phenomenology and case study. However, which approach is to be used depends on several factors such as the nature and objectives of the research. The aim of this paper is to focus on the research methodology aspects of applying case study as a research approach and its relevance in tourism destination bran...
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Physiotherapy devices able to generate ethical dilemmas
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Roman Nadinne
2017-01-01
Full Text Available Physical therapy is a medical specialty where the professionals help restore movement and function when someone is affected by injury, illness or disability. This paper wishes to establish the connection between ethics, physiotherapy and bioengineering. The research method was achieved using academic database searches based on specific keywords. A SWOT analysis of the physiotherapy devices utilization and design was made, for extracting ethical considerations. The main results suggest that physiotherapy devices are able to generate ethical dilemmas, classified in 4 main items: (1 Bioengineering in physical therapy, ethical and clinical standards for manufacturers; (2 Social impact of physical therapy devices and ethical issues; (3 Inter-professional lack of communication and ethical concerns; (4 Bioengineering ethical research and education. As conclusions, for the physical therapy or electrotherapy research equipment development, a multidisciplinary team is needed. The equipment used in rehabilitation must fulfil specific technical and scientific requirements drafted by the professionals.
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SAME-DAY TRIPS: A CHANCE OF URBAN DESTINATION DEVELOPMENT
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Dario Simicevic
2011-12-01
Full Text Available The global economic crisis, the decline of standard and climatic factors influence the allocation of tourism trends at the global level. Certain types of tourist movements start up and develop; they have been present, but not sufficiently studied by authors. They also include a short trip or visit to a particular destination. Considering their characteristics, they do not require a lot of money and they make an increasingly important segment of the tourism market. Therefore, the importance of same-day trips should not be neglected on today's tourism market. Although in practice this part of the tourist offers and demand has not often been attached enough importance, same day trip can achieve a very significant inflow of funds and encourage the development of many potential tourist destinations. For all the reasons mentioned above, and because of its importance, the organization of same day-trips should be the fundamental basis and essential focus for tourism development. Taking into consideration that inbound tourist agencies show special interest for same-day trips, we have tried to give a starting point for further research in this part of the tourism market.