Transnational tourist destination management: a case study of the Baltic sea region

The issue of tourist destination management has been widely reflected in scientific literature. However, transnational destinations, i.e. those that are located on the territory of several countries, have not been given enough attention. The development of transnational destinations can occur provided there is close cooperation among key stakeholders. In the Baltic Sea Region (BSR) conditions for effective cooperation were created at the end of the 20th century when integration processes intensified. Currently, the BSR is the first macro-region of the European Union to implement a transnational strategy, in which tourism is recognised as a development priority. Creating an effective tourist destination management system has become a key challenge in this process. This article aims to identify and critically analyse the concept of transnational tourist destination management. Another goal is to identify the changing determinants of tourism management in the BSR and to explore relations between key stakeholders. To this end, we conducted a review of literature on destination management. We carried out a critical analysis of secondary sources (documents, information materials, the Internet resources) and supplemented the review with our insights from participatory observation. We also obtained additional information from interviews. Three models of destination management were identified: marketing-oriented, planning-oriented, and governance-oriented. Our research shows that the evolution of destination management is characterised by a gradual increase in the participation of public entities. This is related to the marginalisation of the tourism industry, which resulted in a systematic decrease in state funding for maintaining destination management structures. Acquiring the European Union funds from the European Territorial Cooperation Programs has become a partial but not entirely effective solution to this problem

‘You probably won’t notice any symptoms’ Blood pressure in pregnancy:discourses of contested expertise in an era of self-care and responsibilisation

Pregnancy is not a disease or illness, but requires clinical surveillance as life-threatening complications can develop. Preeclampsia, one such potentially serious complication, puts both mother and baby at risk. Self-monitoring blood pressure in the general population is well established, and its potential in pregnancy is currently being explored. In the context of self-monitoring, the information and guidance given to women regarding hypertension, and the literature they themselves seek out during pregnancy, are vital to perceptions of disease risk and subsequent responses to, and management of, any symptoms. Drawing on online, offline, official, and unofficial sources of information, discourses are examined to provide analysis of how self-responsibilization is reflected in contemporary information, advice, and guidance drawn from multiple sources. A paradox emerges between the paternalistic and lay discourses that seek to challenge and regain control. Findings are discussed in the context of Foucault’s governmentality and medical power

Ultrathin oxynitride films for CMOS technology, Journal of Telecommunications and Information Technology, 2004, nr 1

In this work, a review of possible methods of oxynitride film formation will be given. These are different combinations of methods applying high-temperature oxidation and nitridation, as well as ion implantation and deposition techniques. The layers obtained using these methods differ, among other aspects in: nitrogen content, its profile across the ultrathin layer, ... etc., which have considerable impact on device properties, such as leakage current, channel mobility, device stability and its reliability. Unlike high-temperature processes, which (understood as a single process step) usually do not allow the control of the nitrogen content at the silicon-oxynitride layer interface, different types of deposition techniques allow certain freedom in this respect. However, deposition techniques have been believed for many years not to be suitable for such a responsible task as the formation of gate dielectrics in MOS devices. Nowadays, this belief seems unjustied. On the contrary, these methods often allow the formation of the layers not only with a uniquely high content of nitrogen but also a very unusual nitrogen profile, both at exceptionally low temperatures. This advantage is invaluable in the times of tight restrictions imposed on the thermal budget (especially for high performance devices). Certain specific features of these methods also allow unique solutions in certain technologies (leading to simplifications of the manufacturing process and/or higher performance and reliability), such as dual gate technology for system-on-chip (SOC) manufacturing

A pharmacodynamic comparison of prasugrel vs. high-dose clopidogrel in patients with type 2 diabetes mellitus and coronary artery disease: results of the Optimizing anti-Platelet Therapy In diabetes MellitUS (OPTIMUS)-3 Trial

Aims: Patients with diabetes mellitus (DM) have increased platelet reactivity and reduced platelet response to clopidogrel compared with patients without DM. Prasugrel, a more potent antiplatelet agent, is associated with greater reductions in ischaemic events compared with clopidogrel, particularly in patients with DM. The aim of this study was to perform serial pharmacodynamic assessments of prasugrel with high-dose clopidogrel in patients with DM. Methods and results: Optimizing anti-Platelet Therapy In diabetes MellitUS (OPTIMUS)-3 was a prospective, randomized, double-blind, crossover study in patients with type 2 DM and coronary artery disease (CAD). Patients (n= 35) were randomly assigned to either prasugrel 60 mg loading dose (LD)/10 mg maintenance dose (MD) or clopidogrel 600 mg LD/150 mg MD over two 1-week treatment periods separated by a 2-week washout period. Platelet function was assessed by VerifyNow® P2Y12 assay, light transmission aggregometry, and vasodilator-stimulated phosphoprotein phosphorylation at 0, 1, 4, and 24 h and 7 days. Greater platelet inhibition by VerifyNow® P2Y12 was achieved by prasugrel compared with clopidogrel at 4 h post-LD (least squares mean, 89.3 vs. 27.7%, P< 0.0001; primary endpoint). The difference in platelet inhibition between prasugrel and clopidogrel was significant from 1 h through 7 days (P < 0.0001). Similar results were obtained using all other platelet function measures. Prasugrel resulted in fewer poor responders at all time points irrespective of definition used. Conclusion: In patients with type 2 DM and CAD, standard-dose prasugrel is associated with greater platelet inhibition and better response profiles during both the loading and maintenance periods when compared with double-dose clopidogrel

Superficial lymph nodes involved by lymphoma in modern gray-scale ultrasound imaging

Background: Clinical evaluation by palpation of superficial lymph nodes involved by lymphoproliferative process is not sufficient. Ultrasound is a useful method of the initial differential diagnosis of lymph nodes. The aim was to assess the spectrum of ultrasound features of superficial lymphomatous nodes and possible diagnostic pitfalls. Material/Methods: Fifty five lymph nodes in 55 patients were prospectively examined in ultrasound with application of blood flow imaging modes and modern imaging techniques. Only forty lymph nodes with histopathologically proven lymphoma were selected for this analysis (3 Hodgkin, 37 non-Hodgkin). Results: 27.5% of the examined lymph nodes were longitudinal; 42.5% had an oval or round shape; 30% were oval-lobulated or lobulated. 32.5% of the nodes did not show an echogenic hilum, 20% had a normal hilum, and 25% - evidently abnormal. 12.5% of the nodes were anechoic. The general ultrasound impression of a reactive lymph node was presented by 37.5% of the lymphomatous nodes; 45% were suspicious. Among 26 patients with non-Hodgkin lymphoma with multiple lymph nodes involved, in 15 (58%) lymph nodes were modeling on each other. Conclusions: Lymphomatous nodes reveal diverse ultrasound presentations: from appearances indistinguishable from benign reactive lymph nodes to features typical of metastases. Ultrasound internal structure of lymphomatous nodes may be anechoic, causing the possibility of confusion with a cyst, especially in case of a single lymphomatous node. Multiple lymphomatous nodes with non-Hodgkin lymphoma often model on each other assuming geometrical shapes

Effect of resonant magnetic perturbations on low collisionality discharges in MAST and a comparison with ASDEX Upgrade

Sustained ELM mitigation has been achieved on MAST and AUG using RMPs with a range of toroidal mode numbers over a wide region of low to medium collisionality discharges. The ELM energy loss and peak heat loads at the divertor targets have been reduced. The ELM mitigation phase is typically associated with a drop in plasma density and overall stored energy. In one particular scenario on MAST, by carefully adjusting the fuelling it has been possible to counteract the drop in density and to produce plasmas with mitigated ELMs, reduced peak divertor heat flux and with minimal degradation in pedestal height and confined energy. While the applied resonant magnetic perturbation field can be a good indicator for the onset of ELM mitigation on MAST and AUG there are some cases where this is not the case and which clearly emphasise the need to take into account the plasma response to the applied perturbations. The plasma response calculations show that the increase in ELM frequency is correlated with the size of the edge peeling-tearing like response of the plasma and the distortions of the plasma boundary in the X-point region.Comment: 31 pages, 28 figures. This is an author-created, un-copyedited version of an article submitted for publication in Nuclear Fusion. IoP Publishing Ltd is not responsible for any errors or omissions in this version of the manuscript or any version derived from i

Effects of technetium on marine micro-organisms

Eleven bacterial species have been isolated from the upper layer of intertidal sediments collected along the Belgian coast (Coxyde). Three of them (no. 1, 4 and 11) have been chosen for their halophilous character. One species has been identified as Flavobacterium halmephilum, the other two are being investigated. Effects of technetium (99Tc) have been studied on a mixed bacterial population isolated from sediments, as well as on the three halophilic species.At the concentrations utilized in this work (up to 100 microg ml-1), 99Tc has no evident effects on bacterial growth. Uptake of technetium (99Tc and/or 95mTc) has been investigated in the mixed bacterial population, in the three halophilic bacteria (including Flavobacterium halmephilum) and in the benthic ciliate Uronema marinum. It has been found that technetium is taken up by all these micro-organisms. However, the transfer factor (TF) in bacteria may vary considerably (from 0.5 to 200), but the cause of this variability is not known and deserves further study.The ciliate Uronema marinum, which feeds on living marine bacteria, was found to take up 95mTc added to the culture medium. However, the TF in this ciliate is rather low (from 1.4 to 5.5). Because it feeds on bacteria, Uronema marinum is supposed to take up technetium from water (direct contamination) as well as from contaminated bacteria (indirect contamination). Experiments with 95mTc-labeled bacterial cells might be useful, as they could indicate which form of contamination (direct or indirect) is prevailing