Community-based tourism and networking: Viscri, Romania

This paper raises questions concerning the complexity of the term “community” when dealing with community-based tourism initiatives. It highlights the difficulty of translating into practice the paradigm of “community-based tourism”. Through a case study of tourism in the multi-ethnic village of Viscri, Romania, the paper discusses the operational role that a network of both internal and external actors may play in piloting tourism initiatives that produce benefits for communities that are unaccustomed to participatory development processes due to various barriers. The study highlights the key role played by a local leader and an external foundation in building a network that, thanks to the bonding and bridging relations activated, led the community towards a form of sustainable tourism development and a broader amelioration of the social conditions. The network described can be replicated in other geographical contexts, provided there is strong local leadership and also international interests and donors. In the long term, however, the network needs to be strengthened by involving other actors, above all local authorities. They are needed to assure the basis for long-term empowerment, participation in decision-making and progressive diversification of economic activities

Diaspora and tourism: Transylvanian Saxons visiting the homeland

This paper discusses visits to the homeland made by Transylvanian Saxons and their descendants, now mainly living in Germany, after their emigration from the former Saxon areas of Transylvania (Romania). The aim is to understand what compels those people to temporarily return to Transylvania, how the perception of the re-discovered places influences the sense of belonging, or not belonging, to the homeland, and the forms of connection that are re-established. Furthermore, the study aims at analysing the potential of diasporic-roots tourism for heritage protection and local development in this part of Romania. Study results revealed that the landscape re-visited over the journeys played an ambivalent role in the (re)definition of the meanings of home and homeland, reaffirming the sense of belonging to Transylvania and to Germany at the same time. Transylvanian Saxons pragmatically kept connections with the homeland both in Romania (visits, house properties, etc.) and away (associations, newspapers, social networks, etc.), without renouncing the new life found in Germany. Keeping house properties in the homeland was revealed to be a key feature for Saxons’ heritage protection and local development, especially when properties were turned into guesthouses for tourists

Evaluation of the accuracy of a patient-specific instrumentation

Patient-specific instruments (PSI) has been introduced with the aim to reduce the overall costs of the implants, minimizing the size and number of instruments required, and also reducing surgery time. The aim of this study was to perform a review of the current literature, as well as to report about our personal experience, to assess reliability and accuracy of patient specific instrument system in total knee arthroplasty (TKA). A literature review was conducted of PSI system reviewing articles related to coronal alignment, clinical knee and function scores, cost, patient satisfaction and complications. Studies have reported incidences of coronal alignment ≥3° from neutral in TKAs performed with patient-specific cutting guides ranging from 6% to 31%. PSI seem not to be able to result in the same degree of accuracy as for the CAS system, while comparing well with standard manual technique with respect to component positioning and overall lower axis, in particular in the sagittal plane. In cases in which custom-made cutting jigs were used, we recommend performing an accurate control of the alignment before and after any cuts and in any further step of the procedure, in order to avoid possible outliers

In-out versus out-in technique for ACL reconstruction. a prospective clinical and radiological comparison

Background: Several studies have recently shown better restoration of normal knee kinematics and improvement of rotator knee stability after reconstruction with higher femoral tunnel obliquity. The aim of this study is to evaluate tunnel obliquity, length, and posterior wall blowout in single-bundle anterior cruciate ligament (ACL) reconstruction, comparing the transtibial (TT) technique and the out–in (OI) technique. Materials and methods: Forty consecutive patients operated on for ACL reconstruction with hamstrings were randomly divided into two groups: group A underwent a TT technique, while group B underwent an OI technique. At mean follow-up of 10 months, clinical results and obliquity, length, and posterior wall blowout of femoral tunnels in sagittal and coronal planes using computed tomography (CT) scan were assessed. Results: In sagittal plane, femoral tunnel obliquity was 38.6 ± 10.2° in group A and 36.6 ± 11.8° in group B (p = 0.63). In coronal plane, femoral tunnel obliquity was 57.8 ± 5.8° in group A and 35.8 ± 8.2° in group B (p = 0.009). Mean tunnel length was 40.3 ± 1.2 mm in group A and 32.9 ± 2.3 mm in group B (p = 0.01). No cases of posterior wall compromise were observed in any patient of either group. Clinical results were not significantly different between the two groups. Conclusions: The OI technique provides greater obliquity of the femoral tunnel in coronal plane, along with satisfactory length of the tunnel and lack of posterior wall compromise. Level of evidence: II, prospective study

I musei di identità: un'opportunità per lo sviluppo locale e turistico delle aree marginali. Esperienze in Sardegna, Romania e Marocco

Riassunto: Questo studio analizza la relazione virtuosa che puo instaurarsi tra i musei di identita, il turismo culturale e lo sviluppo locale di comunita a economia debole. Vengono riportate le esperienze dei villaggi di Mamoiada (Italia), Sibiel (Romania) e Ait Iktel (Marocco), nei quali, di recente, sono stati istituiti dei musei che valorizzano il patrimonio locale, in specie legato alla cultura contadina. Per tutti e tre i casi analizzati, i risultati ottenuti testimoniano l'esistenza di processi di crescita del turismo culturale con implicazioni positive per lo sviluppo locale. In particolare, e emerso che, finora, le attivita svolte e promosse dai musei si sono inserite nel piu ampio sistema locale, aggiungendo valore alle risorse del territorio e alle capacita produttive delle comunita di riferimento. Parole chiave: musei di identita; turismo culturale; sviluppo locale; Mamoiada; Sibiel; Ait Iktel

Extra-articular tenodesis combined with an anterior cruciate ligament reconstruction in acute anterior cruciate ligament tear in elite female football players

PURPOSE: The growing popularity of elite soccer among female participants has led to increased incidents of anterior cruciate ligament (ACL) ruptures. Many authors underline a positive glide after ACL reconstruction (ACLR), especially in women. In fact, an isolated intra-articular ACLR may be inadequate to control rotational instability after a combined injury of the ACL and the peripheral structures of the knee. Extra-articular procedures are sometimes used in primary cases displaying excessive antero-lateral rotatory instability. The purpose of this case series was to report subjective and objective outcomes after combined ACL and lateral extra-articular tenodesis (LET) with a minimum 4-year follow-up in a selected high-risk population of elite female football players. METHODS: Between January 2007 and December 2010, 16 elite Italian female football players were included in the study. All patients underwent the same surgical technique: anatomical ACLR with autogenous semitendinosus and gracilis tendons. After the intra-articular reconstruction was performed, an additional extra-articular MacIntosh modified Coker-Arnold procedure was carried out. Patients were assessed pre- and post-operatively with the subjective and objective International Knee Documentation Committee (IKDC) evaluation form, Tegner activity scale (TAS) and Lysholm score. Joint laxity was assessed with KT-1000 by measuring the side-to-side (S/S) differences in displacement at manual maximum (mm) testing. RESULTS: At a mean follow-up of 72.6 ± 8.1 months, two independent examiners reviewed all players. All of the patients had a fully recovered range of motion. Lachman test was negative in all patients (100 %). The evaluation of joint laxity and clinical evaluation showed a statistically significant improvement. No patients experienced complication or a re-rupture. DISCUSSION: The rationale of combining extra-articular procedures with ACLR is to restrict the internal rotation of the reconstructed knee, taking advantage of its long lever arm and thus providing more stability in the rotational axis and preventing the ACL graft from undergoing further excessive strain. CONCLUSIONS: The combination of an LET with ACLR in elite female football players demonstrated excellent results in terms of subjective scales, post-operative residual laxity and re-rupture rate with no complication, and a complete return to sport activity

Alimentación del niño sano : trabajos prácticos guía C

120 p.Libro ElectrónicoEste documento surge de la necesidad como cátedra de poder acompañar los temas que componen la cursada de manera ordenada. Es importante aclarar que este documento no constituye un libro de texto, y mucho menos el único material que deberá ser consultado por el alumno. Cada capítulo está compuesto por una introducción teórica, que contiene lineamientos generales con las citas bibliográficas más relevantes y una guía de trabajos prácticos (Guía C) que tiene como finalidad ejercitar los temas planteados. Hay algunos temas que solo tienen abordaje teórico en la cursada, y es por eso que se han excluidos del presente texto, abordándose de manera completa y con información adicional durante el transcurso del ciclo lectivo. Asimismo, cuenta con la descripción de los talleres, en los cuales se lleva a la práctica los contenidos más relevantes de la cursada, como son el Taller de Antropometría, el de Lactancia, el de Formulas infantiles y el de Alimentación Complementaria. El libro contiene un apartado con preguntas de opción múltiple, de tipo verdadero o falso, de relación; con el objetivo de fijar y relacionar los conocimientos adquiridos en las clases teóricas; poniendo en práctica la modalidad de enunciados de los exámenes parciales y recuperatorios. Este tipo de actividades se irán resolviendo en las clases integradoras, que también serán pautadas con antelación a cargo de la titular de la cátedra.Introducción y Metodología de Trabajo 10 Trabajos prácticos .. 11 Evaluación Nutricional .. 12 Antropometría. 12 Crecimiento y Desarrollo . 14 Recomendaciones Nutricionales. 15 Lactancia Materna 19 TRABAJO PRÁCTICO N° 2: Lactancia Materna . 21 Código de Comercialización de Sucedáneos de la Leche Materna 24 Relactación y Carga Renal de Solutos . 26 TRABAJO PRÁCTICO Nº 3 Relactación y Carga Renal de Solutos . 27 Formulas Infantiles . 31 Formulas Infantiles . 32 TRABAJO PRÀCTICO Nº4: Formulas Infantiles. 34 Alimentación con Leche de Vaca Entera 35 TRABAJO PRÁCTICO N° 5 Adaptación de la leche de vaca 36 Digestión y absorción de Nutrientes.. 37 Alimentación Complementaria . 38 TRABAJO PRÁCTICO N° 6 Alimentación Complementaria.. 39 Actividades de Integración II . 40 Alimentación en el niño Preescolar y Escolar .. 42 TRABAJO PRÁCTICO N° 7 44 TRABAJO PRÁCTICO N° 7 Alimentación del niño preescolar. 45 TRABAJO PRÁCTICO N° 8 46 TRABAJO PRÁCTICO N° 8 Alimentación del niño escolar 47 Alimentación en el Adolescente .. 48 TRABAJO PRÁCTICO N° 9 50 TRABAJO PRÁCTICO N° 9 Alimentación en el Adolescente 51 Embarazo Adolescente 52 TRABAJO PRÁCTICO N° 10 Alimentación en la Adolescente Embarazada .. 53 Dietas Vegetarianas en Pediatría 54 TRABAJO PRÁCTICO N° 11 Dietas Vegetarianas en Pediatría 55 Preguntas de Integración III .. 56Anexo I - Talleres 59 Taller de Antropometría. 60 Taller de Lactancia Materna 61 Taller de Papillas .. 62 Para los 6 meses .. 63 Para los 7-8 meses .. 65 Para los 9-12 meses 67 TALLER DE FORMULAS INFANTILES Y LEV. 71 Anexo II Gráficos, Tablas, Información Nutricional .. 73 EVALUACIÓN NUTRICIONAL PEDIATRICA SEGÚN SAP (Población de referencia Nacional) . 74 EVALUACIÓN NUTRICIONAL PEDIATRICA SEGÚN MSN Algoritmos adaptados por MSN 2009 79 NECESIDADES NUTRICIONALES 80 REQUERIMIENTO PROTEICO 85 Cuadro de decimales del año 86 Velocidad de crecimiento niñas y niños 87 Tablas de Incremento de Peso . 91 Incremento de peso niñas y niños (graficas) . 95 Perímetro Cefálico niñas y niños de 0 a 18 meses. 97 Peso para la edad de niñas y niños 0 a 6 meses - de 0 a 24 meses y de 0 a 6 años 99 Longitud corporal/Talla de niñas y niños de 0 a 24 meses - de 0 a 6 años y de 0 a 19 años 105 Peso para la estatura de niñas y niños .. 111 IMC para niñas y niños de 1 a 6 años y de 5 a 19 años 113 CDC girls and boys .. 118 Tabla de composición Química y Formulas . 1201a ed

Zinc oxide nanoparticles as selective killers of proliferating cells

Background: It has recently been demonstrated that zinc oxide nanoparticles (ZnO NPs) induce death of cancerous cells whilst having no cytotoxic effect on normal cells. However, there are several issues which need to be resolved before translation of zinc oxide nanoparticles into medical use, including lack of suitable biocompatible dispersion protocols and a better understanding being needed of the mechanism of their selective cytotoxic action. Methods: Nanoparticle dose affecting cell viability was evaluated in a model of proliferating cells both experimentally and mathematically. The key issue of selective toxicity of ZnO NPs toward proliferating cells was addressed by experiments using a biological model of noncancerous cells, ie, mesenchymal stem cells before and after cell differentiation to the osteogenic lineage. Results: In this paper, we report a biocompatible protocol for preparation of stable aqueous solutions of monodispersed zinc oxide nanoparticles. We found that the threshold of intracellular ZnO NP concentration required to induce cell death in proliferating cells is 0.4 ± 0.02 mM. Finally, flow cytometry analysis revealed that the threshold dose of zinc oxide nanoparticles was lethal to proliferating pluripotent mesenchymal stem cells but exhibited negligible cytotoxic effects to osteogenically differentiated mesenchymal stem cells. Conclusion: Results confirm the ZnO NP selective cytotoxic action on rapidly proliferating cells, whether benign or malignant

Chest pain caused by multiple exostoses of the ribs: A case report and a review of literature

Abstract The aim of this paper is to report an exceptional case of multiple internal exostoses of the ribs in a young patient affected by multiple hereditary exostoses (MHE) coming to our observation for chest pain as the only symptom of an intra-thoracic localization. A 16 years old patient with familiar history of MHE came to our observation complaining a left-sided chest pain. This pain had increased in the last months with no correlation to a traumatic event. The computed tomography (CT) scan revealed the presence of three exostoses located on the left third, fourth and sixth ribs, all protruding into the thoracic cavity, directly in contact with visceral pleura. Moreover, the apex of the one located on the sixth rib revealed to be only 12 mm away from pericardium. Patient underwent video-assisted thoracoscopy with an additional 4-cm mini toracotomy approach. At the last 1-year followup, patient was very satisfied and no signs of recurrence or major complication had occured. In conclusion, chest pain could be the only symptom of an intra-thoracic exostoses localization, possibly leading to serious complications. Thoracic localization in MHE must be suspected when patients complain chest pain. A chest CT scan is indicated to confirm exostoses and to clarify relationship with surrounding structures. Video-assisted thoracoscopic surgery can be considered a valuable option for exostoses removal, alone or in addiction to a mini-thoracotomy approach, in order to reduce thoracotomy morbidity