Overtourism and the Policy Agenda: From Destinations to the European Union - Balancing Growth and Sustainability. Bruges Political Research Papers 83/2021.

For twenty years now, sustainable tourism has become a feature of tourism policy in Europe. However, in just a few years, the neologism “overtourism” has become a buzzword in the media, reflecting and encouraging an increasing politicisation of the issue. Some of the measures aimed at tackling the impacts of overtourism call into question the growth paradigm according to which tourism policies have been framed, and sometimes even create tensions with European single market law. This paper hypothesises a difficulty for overtourism to make it on the European policy agenda, given its antagonistic nature towards the growth paradigm on which tourism policy is based. It also hypothesises that the European institutions will nevertheless take up the matter, because of the political context and of pressure of various entrepreneurs. Building on a qualitative research methodology and on the results of semidirective interviews, this paper analyses the extent to which there is an awareness of the impacts of overtourism at the European level, looking through the lens of historical institutionalism, policy-cycle and governance theories. It concludes that despite a strong European dimension, reaching the European policy agenda has not been an easy task for overtourism, especially because of the centrality of the growth paradigm in tourism policy, which resulted in a pathdependency. Nonetheless, the fight against overtourism has both benefited from a relative window of opportunity and from a context favouring incremental change in the mindset of the institutions. The growing importance of the sustainability paradigm seems to have enabled the integration of this fight, through the pre-existing sustainable tourism framework, on the European policy agenda. Some questions remain, however, regarding the compatibility of the fight against overtourism with a still predominantly growth-based approach

Buying or Selling a Horse in France: An Introduction to the Legal Context Proposed to the Attention of U.S. Equine Lawyers

International audienc

The improved Clinical Global Impression Scale (iCGI): development and validation in depression

BACKGROUND: The Clinical Global Impression scale (CGI) is frequently used in medical care and clinical research because of its face validity and practicability. This study proposes to improve the reliability of the Clinical Global Impression (CGI) scale in depressive disorders by the use of a semi-standardized interview, a new response format, and a Delphi procedure. METHODS: Thirty patients hospitalised for a major depressive episode were filmed at T1 (first week in hospital) and at T2 (2 weeks later) during a 5' specific interview. The Hamilton Depressive Rating Scale and the Symptom Check List were also rated. Eleven psychiatrists rated these videos using either the usual CGI response format or an improved response format, with or without a Delphi procedure. RESULTS: The new response format slightly improved (but not significantly) the interrater agreement, the Delphi procedure did not. The best results were obtained when ratings by 4 independent raters were averaged. In this situation, intraclass correlation coefficients were about 0.9. CONCLUSION: The Clinical Global Impression is a useful approach in psychiatry since it apprehends patients in their entirety. This study shows that it is possible to quantify such impressions with a high level of interrater agreement

Assessing transplant representation: psychometric characteristics of the Transplanted Organ Questionnaire in an Italian sample of transplant recipients

Background: Organ transplantation may elicit several emotional responses, where the lack of psychological integration of the allograft can lead to up to out-to-out manifestations of psychopathological symptoms. As there are only a few studies which examined the impact of a successful psychological integration, it is mandatory to have a specific tool available. The aim of this study is to assess the factorial structure of the Italian translation of the Transplanted Organ Questionnaire (TOQ) and verify the association with its dimensions and psychopathology. Methods: The TOQ was translated from English into Italian using back-translation procedure, then it has been included in a survey with the Brief Symptoms Inventory in order to assess predictive validity with psychopathological symptoms. 117 Italian solid organ transplant recipients were enrolled via web and completed the survey. Results: Confirmatory factor analyses showed that the three-factor model had sufficient fit to the data obtained from the Italian sample, with the exclusion of five items for cultural and transplant-specific reasons. Predictive validity was partially confirmed, implying that the TOQ is significantly associated with mental health outcome measures. Conclusion: The Italian version of the TOQ represents a valid tool to explore the process of psychological integration of the transplanted organ and could improve the understanding about the role of psychological factors in post-transplant physiological recovery and duration of the graft. Clinicians and researchers in healthcare settings may take advantage of the TOQ to assess the changes experienced over time by transplant recipients and the resulting psychological implications on their global well-being

Study of the effective filtration method applicability for the control of composite materials stress-strain state

The paper presents the results of experimental studies on the possibility of applying the effective filtration principle in the developing non-destructive testing methods. The presented results make it possible to conclude that the optimal filtration principle can be applied in the further development of methods for determining the absolute values of the stress-strain state of similar objects. It is necessary for its implementation to have impulse responses of similar objects for given stress-strain state values

Adversarial Imitation Learning On Aggregated Data

Inverse Reinforcement Learning (IRL) learns an optimal policy, given some expert demonstrations, thus avoiding the need for the tedious process of specifying a suitable reward function. However, current methods are constrained by at least one of the following requirements. The first one is the need to fully solve a forward Reinforcement Learning (RL) problem in the inner loop of the algorithm, which might be prohibitively expensive in many complex environments. The second one is the need for full trajectories from the experts, which might not be easily available. The third one is the assumption that the expert data is homogeneous rather than a collection from various experts or possibly alternative solutions to the same task. Such constraints make IRL approaches either not scalable or not usable on certain existing systems. In this work we propose an approach which removes these requirements through a dynamic, adaptive method called Adversarial Imitation Learning on Aggregated Data (AILAD). It learns conjointly both a non linear reward function and the associated optimal policy using an adversarial framework. The reward learner only uses aggregated data. Moreover, it generates diverse behaviors producing a distribution over the aggregated data matching that of the experts

Le véritable et unique méthode de naviger par le quartier d'or laquelle est provvée d'une manière si facile et demontrée...

Copia digital. Madrid : Ministerio de Cultura. Subdirección General de Coordinación Bibliotecaria, 200

Antidepressants for insomnia in adults

Background Insomnia disorder is a subjective condition of unsatisfactory sleep (e.g. sleep onset, maintenance, early waking, impairment of daytime functioning). Insomnia disorder impairs quality of life and is associated with an increased risk of physical and mental health problems including anxiety, depression, drug and alcohol abuse, and increased health service use. hypnotic medications (e.g. benzodiazepines and 'Z' drugs) are licensed for sleep promotion, but can induce tolerance and dependence, although many people remain on long-term treatment. Antidepressant use for insomnia is widespread, but none is licensed for insomnia and the evidence for their efficacy is unclear. This use of unlicensed medications may be driven by concern over longer-term use of hypnotics and the limited availability of psychological treatments. Objectives To assess the effectiveness, safety and tolerability of antidepressants for insomnia in adults. Search methods This review incorporated the results of searches to July 2015 conducted on electronic bibliographic databases: the Cochrane Central Register of Controlled Trials (CENTRAL, 2015, Issue 6), MEDLINE (1950 to 2015), Embase (1980 to 2015) and PsycINFO (1806 to 2015). We updated the searches to December 2017, but these results have not yet been incorporated into the review. Selection criteria Randomised controlled trials (RCTs) of adults (aged 18 years or older) with a primary diagnosis of insomnia and all participant types including people with comorbidities. Any antidepressant as monotherapy at any dose whether compared with placebo, other medications for insomnia (e.g. benzodiazepines and 'Z' drugs), a different antidepressant, waiting list control or treatment as usual. Data collection and analysis Two review authors independently assessed trials for eligibility and extracted data using a data extraction form. A third review author resolved disagreements on inclusion or data extraction. Main results The search identified 23 RCTs (2806 participants). Selective serotonin reuptake inhibitors (SSRIs) compared with placebo: three studies (135 participants) compared SSRIs with placebo. Combining results was not possible. Two paroxetine studies showed significant improvements in subjective sleep measures at six (60 participants, P = 0.03) and 12 weeks (27 participants, P < 0.001). There was no difference in the fluoxetine study (low quality evidence). There were either no adverse events or they were not reported (very low quality evidence). Tricyclic antidepressants (TCA) compared with placebo: six studies (812 participants) compared TCA with placebo; five used doxepin and one used trimipramine. We found no studies of amitriptyline. Four studies (518 participants) could be pooled, showing a moderate improvement in subjective sleep quality over placebo (standardised mean difference (SMD) -0.39, 95% confidence interval (CI) -0.56 to -0.21) (moderate quality evidence). Moderate quality evidence suggested that TCAs possibly improved sleep efficiency (mean difference (MD) 6.29 percentage points, 95% CI 3.17 to 9.41; 4 studies; 510 participants) and increased sleep time (MD 22.88 minutes, 95% CI 13.17 to 32.59; 4 studies; 510 participants). There may have been little or no impact on sleep latency (MD -4.27 minutes, 95% CI -9.01 to 0.48; 4 studies; 510 participants). There may have been little or no difference in adverse events between TCAs and placebo (risk ratio (RR) 1.02, 95% CI 0.86 to 1.21; 6 studies; 812 participants) (low quality evidence). 'Other' antidepressants with placebo: eight studies compared other antidepressants with placebo (one used mianserin and seven used trazodone). Three studies (370 participants) of trazodone could be pooled, indicating a moderate improvement in subjective sleep outcomes over placebo (SMD -0.34, 95% CI -0.66 to -0.02). Two studies of trazodone measured polysomnography and found little or no difference in sleep efficiency (MD 1.38 percentage points, 95% CI -2.87 to 5.63; 169 participants) (low quality evidence). There was low quality evidence from two studies of more adverse effects with trazodone than placebo (i.e. morning grogginess, increased dry mouth and thirst). Authors' conclusions We identified relatively few, mostly small studies with short-term follow-up and design limitations. The effects of SSRIs compared with placebo are uncertain with too few studies to draw clear conclusions. There may be a small improvement in sleep quality with short-term use of low-dose doxepin and trazodone compared with placebo. The tolerability and safety of antidepressants for insomnia is uncertain due to limited reporting of adverse events. There was no evidence for amitriptyline (despite common use in clinical practice) or for long-term antidepressant use for insomnia. High-quality trials of antidepressants for insomnia are needed