Comparison of screening for pre-eclampsia at 31-34 weeks' gestation by sFlt-1/PlGF ratio and a method combining maternal factors with sFlt-1 and PlGF

Objective: To estimate the patient-specific risk of preeclampsia (PE) at 31-34 weeks’ gestation by a combination of maternal characteristics and medical history with multiple of the median (MoM) values of serum placental growth factor (PLGF) and serum soluble fms-like tyrosine kinase-1 (sFLT-1) and compare the performance of screening to that achieved by the sFLT-1 to PLGF ratio. Methods: This was a prospective observational study in women attending for a third-trimester ultrasound scan at 31-34 weeks as part of routine pregnancy care. We estimated the performance of screening of PE with delivery within four weeks of assessment (PE at <4 weeks) and PE from four weeks after assessment and up to 40 weeks’ gestation (PE at 4w-40GW) in screening by the sFLT-1 to PLGF ratio and by a to PLGF ratio and by a method utilizing Bayes theorem to combine maternal factors and MoM values of sFLT-1 and PLGF. The significance of difference in performance of screening between the method utilising Bayes theorem and that of the sFLT-1 to PLGF ratio was assessed by comparison of the areas under the receiver operating characteristic curves (AUROC). Results: The study population of 8,063 singleton pregnancies included 231 (2.9%) that subsequently developed PE. In the prediction of delivery with PE at <4 weeks the performance of the method utilising Bayes theorem was similar to that of the sFLT-1 to PLGF (AUROC: 0.987, 95%CI 0.979-0.995 vs. 0.988, 95%CI: 0.981-0.994; p=0.961). and at fixed fixed screen positive rate (SPR) of 3.9% the detection rate (DR) was 87.1% for both methods. In contrast, the performance of screening for delivery with PE at 4w-40GW was better with the method utilising Bayes theorem than with the sFLT-1 to PLGF ratio (AUROC: 0.884, 95%CI 0.854-0.914 vs. 0.818, 95%CI: 0.775--0.860 ; p<0.0001) and at total fixed SPR of 25.7% the DRs were 84.4% vs. 73.0%. Conclusion: At 31-34 weeks’ gestation the performance of screening for PE at <4 weeks from assessment by the method utilising Bayes theorem is similar to that of the sFLT-1 to PLGF ratio, but the former is superior to the latter in prediction of PE >>4 weeks

Zorba the Greek’s tourism worldmaking: gendering Cretan place identity and Greek memory through film

Purpose Drawing on the discursive properties of placemaking theory, this paper discusses the development of film tourism in Crete from the release of the award-winning Zorba the Greek (dir. Michael Cacoyannis, ZG) to date. The approach is “genealogical,” seeking to explain how ZG-inspired tourism on Crete ended up being more than about the film itself owing to historical contingency

Towards reviving post-Olympic Athens as a cultural destination

This paper examines the effects of global change on the status and qualities of the Greek national capital, Athens, focusing on how they affect the development of cultural tourism in the city. Although Athens constituted one of the most significant destinations for Greek tourism in the past, in recent years it started to weaken. Athens is characterised by a series of problems, among them are the degradation of its environment and quality of life and traffic congestion. However, in terms of tourism development, the Olympic Games helped in re-imaging the city and upgrading its infrastructure. This study based on semi-structured interviews with top officials reveals how global change has affected Athens’ socio-cultural/economic status, identity and image. Despite the tourism policy/planning responses to global changes, Athens’ tourism continues to decline leaving unexplored potential such as its rich cultural heritage, new multicultural identity and the New Acropolis Museum. The paper suggests that cultural elements of capital cities must be multidimensional including a variety of attractions and amenities. The use of cultural heritage assets needs to be in line with global developments in order for cities to effectively leverage heritage for cultural tourism

Olympic legacy and cultural tourism: Exploring the facets of Athens' Olympic heritage

This study examines the effects of the Olympic Games on Athens’ cultural tourism and the city’s potential to leverage the Olympic legacy in synergy with its rich heritage in order to enhance its tourism product during the post-Games period. In doing so, a qualitative and interpretive approach was employed. This includes a literature review on Athens’ 2004 Olympics to identify the sport facilities and regeneration projects, which constitute the Olympic legacy and heritage. Based on that, an empirical analysis was undertaken, by collecting official documents about the 2004 Olympics, and conducting five semi-structured interviews with tourism/administrative officials. The findings indicate that the Olympiad contributed significantly to Athens’ built and human heritage, revealing the dimensions of new venues/facilities, infrastructure, transportation and aesthetic image of the city, and human capital enhancement. Hence, the Games affected to the multifaceted representation and reconstruction of the city’s identity and cultural heritage. However, the potential afforded from the post-Olympic Athens remains unrealised due to lack of strategic planning/management. The study concludes that there is a need to develop cross-leveraging synergies between the Olympic legacy and cultural tourism for the host city. Finally, a strategic planning framework for leveraging post-Games Olympic tourism is suggested in order to maximise the benefits of Olympic legacy and heritage in a host city’s tourism development

EECERA Children from refugee and migrant backgrounds

A research-informed play-based education toolkit which promotes inclusive education for Refugee and Migrant Children. A Resource for Early Childhood Education and Care Setting