International experience in tourism as a model for comparison - Algeria and Tunisia -

تهدف هذه الدراسة الى وضعية قطاع السياحة في الجزائر مقارنة مع تونس ويكشف التفاوت الكبير في مداخيل هذا القطاع بين الجزائر وهذا البلد، مما يثبت عجز القطاع السياحي في الجزائر ، ولإدراك ذلك يستوجب الوقوف على مختلف مقومات هذا القطاع لاستجلاء ما أمكن من الحقائق حول واقع السياحة في هذه البلدان، وكيفية الاستثمار في هذا القطاع لتلبية حاجات التنمية الاقتصادية والاجتماعية والثقافية، باعتباره ركنا أساسيا في دعم ميزان المدفوعات، وتحسين المستوى المعيشي والثقافي للمواطنين، وإرساء ثقافة سياحية هادفة.This study aims to position the tourism sector in Algeria, compared to Tunisia and reveals the great disparity of income in this sector between Algeria and the country, which proves the deficit of the tourism sector in Algeria. To achieve this requires a position on the different elements of this sector in order to clarify as much as possible facts about the reality of tourism in these countries, and how to invest in this sector to meet economic and social development and cultural needs, as an essential element of the balance of payments, and to improve the standard of living and cultural citizens, and the establishment of a targeted tourism culture

Pulmonary Rehabilitation in Patients with Respiratory Disease

Background. Limited evidence suggests that pulmonary rehabilitation be included in the management of restrictive lung diseases. The purpose of this study was to document pulmonary rehabilitation outcomes in patients with respiratory diseases other than chronic obstructive pulmonary disease (COPD). Methods. Clinical outcomes of 31patients with respiratory diseases other than COPD and 190 patients with COPD, seen over a 35-month period, were reviewed retrospectively. Patients were evaluated for a 6-minute walk, arm curl strength, chair stand strength, the St. George’s Respiratory Questionnaire (SGRQ) total score, SGRQ symptom scores, SGRQ activity levels, and SGRQ impact of respiratory illness on the patient’s life. Outcome measures were obtained before the start of pulmonary rehabilitation and after a minimum of nine therapy visits. Results. Pre- and post-rehabilitation changes in the 6-minute walk, arm curl strength, chair stand strength, the St. George’s Respiratory Questionnaire (SGRQ) total score, SGRQ symptom scores, SGRQ activity levels, and SGRQ impact scores improved significantly for both groups. However, non-COPD patients achieved significantly higher mean SGRQ impact scores and arm curl strength than patients with COPD. Conclusions. Pulmonary rehabilitation should be recommended for all patients with respiratory disease, not only those with COPD

The Changing Landscape for Stroke\ua0Prevention in AF: Findings From the GLORIA-AF Registry Phase 2

Background GLORIA-AF (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients with Atrial Fibrillation) is a prospective, global registry program describing antithrombotic treatment patterns in patients with newly diagnosed nonvalvular atrial fibrillation at risk of stroke. Phase 2 began when dabigatran, the first non\u2013vitamin K antagonist oral anticoagulant (NOAC), became available. Objectives This study sought to describe phase 2 baseline data and compare these with the pre-NOAC era collected during phase 1. Methods During phase 2, 15,641 consenting patients were enrolled (November 2011 to December 2014); 15,092 were eligible. This pre-specified cross-sectional analysis describes eligible patients\u2019 baseline characteristics. Atrial fibrillation disease characteristics, medical outcomes, and concomitant diseases and medications were collected. Data were analyzed using descriptive statistics. Results Of the total patients, 45.5% were female; median age was 71 (interquartile range: 64, 78) years. Patients were from Europe (47.1%), North America (22.5%), Asia (20.3%), Latin America (6.0%), and the Middle East/Africa (4.0%). Most had high stroke risk (CHA2DS2-VASc [Congestive heart failure, Hypertension, Age  6575 years, Diabetes mellitus, previous Stroke, Vascular disease, Age 65 to 74 years, Sex category] score  652; 86.1%); 13.9% had moderate risk (CHA2DS2-VASc = 1). Overall, 79.9% received oral anticoagulants, of whom 47.6% received NOAC and 32.3% vitamin K antagonists (VKA); 12.1% received antiplatelet agents; 7.8% received no antithrombotic treatment. For comparison, the proportion of phase 1 patients (of N = 1,063 all eligible) prescribed VKA was 32.8%, acetylsalicylic acid 41.7%, and no therapy 20.2%. In Europe in phase 2, treatment with NOAC was more common than VKA (52.3% and 37.8%, respectively); 6.0% of patients received antiplatelet treatment; and 3.8% received no antithrombotic treatment. In North America, 52.1%, 26.2%, and 14.0% of patients received NOAC, VKA, and antiplatelet drugs, respectively; 7.5% received no antithrombotic treatment. NOAC use was less common in Asia (27.7%), where 27.5% of patients received VKA, 25.0% antiplatelet drugs, and 19.8% no antithrombotic treatment. Conclusions The baseline data from GLORIA-AF phase 2 demonstrate that in newly diagnosed nonvalvular atrial fibrillation patients, NOAC have been highly adopted into practice, becoming more frequently prescribed than VKA in Europe and North America. Worldwide, however, a large proportion of patients remain undertreated, particularly in Asia and North America. (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients With Atrial Fibrillation [GLORIA-AF]; NCT01468701