Development of Receptive Factors on the Principles of Sustainable Tourism Development - Budva Case

Sustainable tourism implies establishing a positive relationship and link between tourism development and environmental protection, i.e achieving a full harmony between economic and environmental interests. Tourism that is based on respect for ecological interests can ensure the constant maintenance of balance in the natural environment and tourism development. Building a private accommodation association, as one of the aspects of sustainable tourism, ensures the long-term sustainability that is needed for the destination of Budva, due to the large number of problems it encounters, starting from the gray business zone to the very poor quality private accommodation, which is higher than in basic accommodation, which should be the basis of tourism development. In view of the given problem, the subject of research of this paper is the direction in which the receptive factors in the destination of Budva should be developed, with reference to the basic and complementary accommodation units

Quantile regression in the consumption of luxury goods

The multiple linear regression estimates an average trend of the observed phenomena and so it does not provide a complete illustration of relations among phenomena, while the use of quantile regression gives this aspect. The quantile regression presents the evaluation of regression models of different parts, quantiles of the conditional distribution of some series. The quantile regression is widely used in social policy, in determination of maximal production, consumption analysis, etc. This thesis presents some basic principles and the quantile regression model, which is being estimated by minimization of total absolute deviations using linear programming algorithms. The aim of this thesis is to present how the use of quantile regression provides a more complete understanding of the moving of alcoholic beverages and tobacco consumption (i.e. consumption of luxury goods). The research subject of this thesis is the linear dependence between income and alcoholic beverages and tobacco consumption of 200 households, which were randomly selected from three territories: the city of Belgrade, Central Serbia and Vojvodina in 2010. Based on these data, we estimated simple linear regression and the quantile regression in order to compare their advantages and disadvantages. It was concluded that if the consumption of luxury goods is higher, household income has no effect on the decision about the level of spending

Morbidity of non-melanoma skin cancer

Introduction. The incidence of both non-melanoma (NMSC) has been increasing over the past decades worldwide. The objective of the paper was to determine incidence trend of NMSC in the Serbian population on the territory of Kosovo and Metohija in the period 2004-2013. Method. Descriptive epidemiological study was done. Data about incidence for NMSC were obtained from the record. Data about population originated from International Red Cross and UMNIK. Crude incidence rates were calculated per 100 000 inhabitans. Trend lines were estimated using linear regression. Results. During a 10-year period a total number of new NMSC cases was 304 (173(56,9%) in men and 131(43,1%) in women). Average crude annual incidence rate was 29,08/100 000. A significantly increasing incidence trend for NMSC in men (y=0,617x+24,29, R2=0,500) was determined. Conclusion. Our findings showed significantly increasing incidence trend of NMSC. Presented findings support the important role of primary prevention and early detection of NMSC in the earliest age. Screening of skin cancers may improve treatment and prognosis by earlier diagnosis

Does facial attractiveness influence perception of epilepsy diagnosis? An insight into stigma in epilepsy

Background: Using a group of young healthy individuals and patients with multiple sclerosis (pMS), we aimed to investigate whether the physical attractiveness judgment affects perception of epilepsy. We tested hypothesis that subjects, in the absence of relevant clues, would catch upon the facial attractiveness when asked to speculate which person suffers epilepsy and select less attractive choices. Method: Two photo-arrays (7 photos for each gender) selected from the Chicago Face Database (180 neutral faces of Caucasian volunteers with unknown medical status) were shown to study participants. Photos were evenly distributed along a continuum of attractiveness that was estimated by independent raters in prestudy stage. In each photo-array, three photos had rating 1-3 (unattractive), one photo had rating 4 (neutral), and three photos had rating 5-7 (attractive). High-quality printed photo-arrays were presented to test subjects, and they were asked to select one person from each photo-array "who has epilepsy". Finally, all subjects were asked to complete questionnaire of self-esteem and 19-item Scale of stereotypes toward people with epilepsy. Results: In total, 71 students of psychology, anthropology, or andragogy (mean age: 21.6 +/- 1.7 years; female: 85.9%) and 70 pMS (mean age: 37.9 +/- 8 years; female: 71.4%) were tested. Majority of students or pMS had no previous personal experience with individuals with epilepsy (63.4%; 47.1%, p=0.052). Male photo was selected as epileptic in the following proportions: students -84.5% unattractive, 8.5% neutral, and 7% attractive; pMS -62.9% unattractive, 8.6% neutral, and 28.6% attractive (p=0.003). Female photo was selected as epileptic in the following proportions: students -38% unattractive, 52.1% neutral, and 9.9% attractive; pMS -32.9% unattractive, 34.3% neutral, and 32.9% attractive (0.003). Both groups showed very low potential for stigmatization: significantly lower in pMS in 10 items. Patients with multiple sclerosis showed significantly higher self-esteem than students (p=0.007). Conclusion: Facial attractiveness influences the perception of diagnosis of epilepsy. Both students and pMS were less willing to attribute epilepsy to attractive person of both genders

Safety of primary anastomosis following emergency left sided colorectal resection: an international, multi-centre prospective audit.

This is the peer reviewed version of the following article: group, T. E. S. o. C. c. (2018). "Safety of primary anastomosis following emergency left sided colorectal resection: an international, multi-centre prospective audit." Colorectal Disease 20(S6): 47-57., which has been published in final form at https://doi.org/10.1111/codi.1437. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived VersionsINTRODUCTION: Some evidence suggests that primary anastomosis following left sided colorectal resection in the emergency setting may be safe in selected patients, and confer favourable outcomes to permanent enterostomy. The aim of this study was to compare the major postoperative complication rate in patients undergoing end stoma vs primary anastomosis following emergency left sided colorectal resection. METHODS: A pre-planned analysis of the European Society of Coloproctology 2017 audit. Adult patients (> 16 years) who underwent emergency (unplanned, within 24 h of hospital admission) left sided colonic or rectal resection were included. The primary endpoint was the 30-day major complication rate (Clavien-Dindo grade 3 to 5). RESULTS: From 591 patients, 455 (77%) received an end stoma, 103 a primary anastomosis (17%) and 33 primary anastomosis with defunctioning stoma (6%). In multivariable models, anastomosis was associated with a similar major complication rate to end stoma (adjusted odds ratio for end stoma 1.52, 95%CI 0.83-2.79, P = 0.173). Although a defunctioning stoma was not associated with reduced anastomotic leak (12% defunctioned [4/33] vs 13% not defunctioned [13/97], adjusted odds ratio 2.19, 95%CI 0.43-11.02, P = 0.343), it was associated with less severe complications (75% [3/4] with defunctioning stoma, 86.7% anastomosis only [13/15]), a lower mortality rate (0% [0/4] vs 20% [3/15]), and fewer reoperations (50% [2/4] vs 73% [11/15]) when a leak did occur. CONCLUSIONS: Primary anastomosis in selected patients appears safe after left sided emergency colorectal resection. A defunctioning stoma might mitigate against risk of subsequent complications

The impact of conversion on the risk of major complication following laparoscopic colonic surgery: an international, multicentre prospective audit.

This is the peer reviewed version of the following article: The and E. S. o. C. c. groups (2018). "The impact of conversion on the risk of major complication following laparoscopic colonic surgery: an international, multicentre prospective audit." Colorectal Disease 20(S6): 69-89., which has been published in final form at https://doi.org/10.1111/codi.14371. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.BACKGROUND: Laparoscopy has now been implemented as a standard of care for elective colonic resection around the world. During the adoption period, studies showed that conversion may be detrimental to patients, with poorer outcomes than both laparoscopic completed or planned open surgery. The primary aim of this study was to determine whether laparoscopic conversion was associated with a higher major complication rate than planned open surgery in contemporary, international practice. METHODS: Combined analysis of the European Society of Coloproctology 2017 and 2015 audits. Patients were included if they underwent elective resection of a colonic segment from the caecum to the rectosigmoid junction with primary anastomosis. The primary outcome measure was the 30-day major complication rate, defined as Clavien-Dindo grade III-V. RESULTS: Of 3980 patients, 64% (2561/3980) underwent laparoscopic surgery and a laparoscopic conversion rate of 14% (359/2561). The major complication rate was highest after open surgery (laparoscopic 7.4%, converted 9.7%, open 11.6%, P < 0.001). After case mix adjustment in a multilevel model, only planned open (and not laparoscopic converted) surgery was associated with increased major complications in comparison to laparoscopic surgery (OR 1.64, 1.27-2.11, P < 0.001). CONCLUSIONS: Appropriate laparoscopic conversion should not be considered a treatment failure in modern practice. Conversion does not appear to place patients at increased risk of complications vs planned open surgery, supporting broadening of selection criteria for attempted laparoscopy in elective colonic resection

An international multicentre prospective audit of elective rectal cancer surgery; operative approach versus outcome, including transanal total mesorectal excision (TaTME)

IntroductionTransanal total mesorectal excision (TaTME) has rapidly emerged as a novel approach for rectal cancer surgery. Safety profiles are still emerging and more comparative data is urgently needed. This study aimed to compare indications and short-term outcomes of TaTME, open, laparoscopic, and robotic TME internationally.MethodsA pre-planned analysis of the European Society of Coloproctology (ESCP) 2017 audit was performed. Patients undergoing elective total mesorectal excision (TME) for malignancy between 1 January 2017 and 15 March 2017 by any operative approach were included. The primary outcome measure was anastomotic leak.ResultsOf 2579 included patients, 76.2% (1966/2579) underwent TME with restorative anastomosis of which 19.9% (312/1966) had a minimally invasive approach (laparoscopic or robotic) which included a transanal component (TaTME). Overall, 9.0% (175/1951, 15 missing outcome data) of patients suffered an anastomotic leak. On univariate analysis both laparoscopic TaTME (OR 1.61, 1.02-2.48, P=0.04) and robotic TaTME (OR 3.05, 1.10-7.34, P=0.02) were associated with a higher risk of anastomotic leak than non-transanal laparoscopic TME. However this association was lost in the mixed-effects model controlling for patient and disease factors (OR 1.23, 0.77-1.97, P=0.39 and OR 2.11, 0.79-5.62, P=0.14 respectively), whilst low rectal anastomosis (OR 2.72, 1.55-4.77, P<0.001) and male gender (OR 2.29, 1.52-3.44, P<0.001) remained strongly associated. The overall positive circumferential margin resection rate was 4.0%, which varied between operative approaches: laparoscopic 3.2%, transanal 3.8%, open 4.7%, robotic 1%.ConclusionThis contemporaneous international snapshot shows that uptake of the TaTME approach is widespread and is associated with surgically and pathologically acceptable results