Branding as an essential element in the creation process of the image of the brand in national tourism destinations

Purpose: Presentation of branding as an important element in the creation process of the brand image of national tourism destinations on the example of the operation of 39 National Tourism Organizations (NTOs) in Europe. Design/Methodology/Approach: For the selection of NTOs the following criteria were taken into account. 1. The functional criterion: the main functions attributed to NTOs were accepted as the grounds for the verification, firstly, it was considered whether the promotion of a given country on foreign markets is included among these tasks. 2. The economic criterion: possession of an autonomous financial budget by a given organization (regardless of the percentage share of funds from the budget of the state or from the private sector, or from any other sources) was accepted as the grounds for verification. 3. The organizational criterion: a separation of a given organization in the structure of a superior body was accepted as the grounds for verification. The research methods used include a method of diagnostic survey including a questionnaire technique, a direct interview and a statistical analysis. Findings: The analysis demonstrated among others that the vast majority of the NTOs examined (92.3%) implement the objectives of branding in practice. At the same time, a significant part of these organizations (86.1%) recognized the activities taken within branding to be very effective. Moreover, the vast majority of the NTOs analysed (91.7%) undertake the initiatives realized as part of branding on the global tourist market. Practical Implications: The conclusions following the study can be used by various entities which are responsible for an effective realization of the management process of the brand of tourism destinations on the different levels of administration. Originality/Value: The study constitutes an entirely new insight into the functioning of NTOs while presenting a substantially broader spectrum of the areas of interest for this type organizations as compared to those presented in the source literature till now.peer-reviewe

Superhydrophobic Surface by Replication of Laser Micromachined Pattern in Epoxy/Alumina Nanoparticle Composite

Superhydrophobic surfaces were obtained by superposition of microstructure—defined by replication of laser micromachined masters, with nanostructure—created by durable epoxy/γ-Al₂O₃ nanoparticle composite, used for replication. Hierarchical surface topography thus obtained consisted of hexagonally spaced microcavities and nanoparticle agglomerates, exposed on the replica surface by radio frequency (RF) air plasma etching. Surface topography was further enhanced by rims around the microcavity edges, resulting from nanosecond laser micromachining defects in aluminum masters. Subsequent wet chemical hydrophobization with 1H,1H,2H,2H-perfluorotetradecyltriethoxysilane (PFTDTES) provided superhydrophobic behavior in replicas with a microcavity spacing of 30 μm, as indicated by a water contact angle of 160° and a sliding angle of 8°. The preparation method is relatively simple, inexpensive, and potentially scalable.This work was supported by the National Science Centre of Poland through projects nos. 2011/03/N/ST8/05879 and UMO-2012/05/B/ST8/02876. The authors are grateful to Professor Weimin Liu and Professor Feng Zhou of the Lanzhou Institute of Chemical Physics, Chinese Academy of Science, for making the laser micromachining, JEOL SEM, and Drop Shape Analysis equipment available

Spatial diversity of tourist function development: the municipalities of Poland’s West Pomerania province

This article examines the spatial diversity of tourist function development using the example of one of Poland’s sixteen main administrative regions: the West Pomerania Province (Polish: Województwo zachodniopomorskie). The analysis was carried out based on the values of the Defert tourist function index, which is one of the basic indexes used in tourism geography. The analysis demonstrated significant differences between the individual municipalities in the region examined. This confirms the assumption that seaside municipalities have the highest tourist function development

Amyloidoza łańcuchów lekkich immunoglobulin z punktu widzenia kardiologa

Light-chain amyloidosis (amyloidosis AL) is diagnosed in approx. 70% of patients with cardiac amyloidosis. This type of amyloidosis has the worst prognosis, especially if the diagnosis is made in advanced stages. The majority of patients are referred to a cardiologist, but unfortunately only every fifth of them has the proper diagnosis. Therefore, strategies promoting early diagnosis are important. One of them is the measurement of serum free light chains concentration in every patient with heart failure with preserved ejection fraction. The acknowledgement of free light chains (FLCs) cardiotoxicity rendered the picture of AL amyloidosis from infiltrative cardiomyopathy into a toxic one. Best improvement in regard to heart failure is achieved upon hematological treatment resulting in decrease of FLCs concentration. Therefore, cardiological treatment is rather a supportive therapy. The role of cardiologist is the rapid diagnosis of the disease and referral of the patient to the hematologist. The standard heart failure treatment encompassing use of beta-blockers and angiotensin converting enzyme inhibitors aggravates orthostatic hypotension and congestion. Instead, up-to-date hematological treatment improves the prognosis of AL amyloidosis markedly, as long as early diagnosis is made.Amyloidozę łańcuchów lekkich (amyloidozę AL) rozpoznaje się u około 70% pacjentów z amyloidozą serca. Ta postać choroby wiąże się z najgorszym rokowaniem, szczególnie jeśli wykrywa się ją na zaawansowanym etapie. Kardiolog jest najczęściej odwiedzanym specjalistą przez pacjentów z amyloidozą AL. Niestety tylko u co piątego pacjenta jest stawiana właściwa diagnoza. Dlatego ważne jest, aby promować działania umożliwiające wczesne stwierdzenie choroby. Należy do nich oznaczanie wolnych łańcuchów lekkich (FLC) w surowicy u pacjentów z niewydolnością sercaz zachowaną frakcją wyrzutową. Wykazanie kardiotoksycznej roli FLC zmieniło postrzeganie amyloidozy AL jako choroby polegającej wyłącznie na pozakomórkowym gromadzeniu się nieprawidłowych złogów białkowych. Największą poprawę funkcji serca uzyskuje się, obniżając stężenie FLC w surowicy poprzez leczenie cytoredukcyjne. Leczenie kardiologiczne ma znaczenie uzupełniające. Rola kardiologa sprowadza się do jak najszybszego rozpoznania choroby i przekazania pacjenta do hematologa. Standardowa farmakoterapia niewydolności serca, obejmująca beta-adrenolityki i inhibitory konwertazy angiotensyny, u pacjentów z amyloidozą wywołuje nasilenie hipotensji ortostatycznej i objawów zastoinowych. Natomiast dzięki nowoczesnemu leczeniu cytoredukcyjnemu i antyamyloidowemu istotnie poprawiły się wyniki leczenia, pod warunkiem wczesnego rozpoznania amyloidozy AL

Mapping 123 million neonatal, infant and child deaths between 2000 and 2017

Since 2000, many countries have achieved considerable success in improving child survival, but localized progress remains unclear. To inform efforts towards United Nations Sustainable Development Goal 3.2—to end preventable child deaths by 2030—we need consistently estimated data at the subnational level regarding child mortality rates and trends. Here we quantified, for the period 2000–2017, the subnational variation in mortality rates and number of deaths of neonates, infants and children under 5 years of age within 99 low- and middle-income countries using a geostatistical survival model. We estimated that 32% of children under 5 in these countries lived in districts that had attained rates of 25 or fewer child deaths per 1,000 live births by 2017, and that 58% of child deaths between 2000 and 2017 in these countries could have been averted in the absence of geographical inequality. This study enables the identification of high-mortality clusters, patterns of progress and geographical inequalities to inform appropriate investments and implementations that will help to improve the health of all populations

Mapping child growth failure across low- and middle-income countries

Child growth failure (CGF), manifested as stunting, wasting, and underweight, is associated with high 5 mortality and increased risks of cognitive, physical, and metabolic impairments. Children in low- and middle-income countries (LMICs) face the highest levels of CGF globally. Here we illustrate national and subnational variation of under-5 CGF indicators across LMICs, providing 2000–2017 annual estimates mapped at a high spatial resolution and aggregated to policy-relevant administrative units and national levels. Despite remarkable declines over the study period, many LMICs remain far from the World Health 10 Organization’s ambitious Global Nutrition Targets to reduce stunting by 40% and wasting to less than 5% by 2025. Large disparities in prevalence and rates of progress exist across regions, countries, and within countries; our maps identify areas where high prevalence persists even within nations otherwise succeeding in reducing overall CGF prevalence. By highlighting where subnational disparities exist and the highest-need populations reside, these geospatial estimates can support policy-makers in planning locally 15 tailored interventions and efficient directing of resources to accelerate progress in reducing CGF and its health implications

Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016

As mortality rates decline, life expectancy increases, and populations age, non-fatal outcomes of diseases and injuries are becoming a larger component of the global burden of disease. The Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) provides a comprehensive assessment of prevalence, incidence, and years lived with disability (YLDs) for 328 causes in 195 countries and territories from 1990 to 2016

Global, regional, and national under-5 mortality, adult mortality, age-specific mortality, and life expectancy, 1970–2016: a systematic analysis for the Global Burden of Disease Study 2016

BACKGROUND: Detailed assessments of mortality patterns, particularly age-specific mortality, represent a crucial input that enables health systems to target interventions to specific populations. Understanding how all-cause mortality has changed with respect to development status can identify exemplars for best practice. To accomplish this, the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) estimated age-specific and sex-specific all-cause mortality between 1970 and 2016 for 195 countries and territories and at the subnational level for the five countries with a population greater than 200 million in 2016. METHODS: We have evaluated how well civil registration systems captured deaths using a set of demographic methods called death distribution methods for adults and from consideration of survey and census data for children younger than 5 years. We generated an overall assessment of completeness of registration of deaths by dividing registered deaths in each location-year by our estimate of all-age deaths generated from our overall estimation process. For 163 locations, including subnational units in countries with a population greater than 200 million with complete vital registration (VR) systems, our estimates were largely driven by the observed data, with corrections for small fluctuations in numbers and estimation for recent years where there were lags in data reporting (lags were variable by location, generally between 1 year and 6 years). For other locations, we took advantage of different data sources available to measure under-5 mortality rates (U5MR) using complete birth histories, summary birth histories, and incomplete VR with adjustments; we measured adult mortality rate (the probability of death in individuals aged 15-60 years) using adjusted incomplete VR, sibling histories, and household death recall. We used the U5MR and adult mortality rate, together with crude death rate due to HIV in the GBD model life table system, to estimate age-specific and sex-specific death rates for each location-year. Using various international databases, we identified fatal discontinuities, which we defined as increases in the death rate of more than one death per million, resulting from conflict and terrorism, natural disasters, major transport or technological accidents, and a subset of epidemic infectious diseases; these were added to estimates in the relevant years. In 47 countries with an identified peak adult prevalence for HIV/AIDS of more than 0·5% and where VR systems were less than 65% complete, we informed our estimates of age-sex-specific mortality using the Estimation and Projection Package (EPP)-Spectrum model fitted to national HIV/AIDS prevalence surveys and antenatal clinic serosurveillance systems. We estimated stillbirths, early neonatal, late neonatal, and childhood mortality using both survey and VR data in spatiotemporal Gaussian process regression models. We estimated abridged life tables for all location-years using age-specific death rates. We grouped locations into development quintiles based on the Socio-demographic Index (SDI) and analysed mortality trends by quintile. Using spline regression, we estimated the expected mortality rate for each age-sex group as a function of SDI. We identified countries with higher life expectancy than expected by comparing observed life expectancy to anticipated life expectancy on the basis of development status alone. FINDINGS: Completeness in the registration of deaths increased from 28% in 1970 to a peak of 45% in 2013; completeness was lower after 2013 because of lags in reporting. Total deaths in children younger than 5 years decreased from 1970 to 2016, and slower decreases occurred at ages 5-24 years. By contrast, numbers of adult deaths increased in each 5-year age bracket above the age of 25 years. The distribution of annualised rates of change in age-specific mortality rate differed over the period 2000 to 2016 compared with earlier decades: increasing annualised rates of change were less frequent, although rising annualised rates of change still occurred in some locations, particularly for adolescent and younger adult age groups. Rates of stillbirths and under-5 mortality both decreased globally from 1970. Evidence for global convergence of death rates was mixed; although the absolute difference between age-standardised death rates narrowed between countries at the lowest and highest levels of SDI, the ratio of these death rates-a measure of relative inequality-increased slightly. There was a strong shift between 1970 and 2016 toward higher life expectancy, most noticeably at higher levels of SDI. Among countries with populations greater than 1 million in 2016, life expectancy at birth was highest for women in Japan, at 86·9 years (95% UI 86·7-87·2), and for men in Singapore, at 81·3 years (78·8-83·7) in 2016. Male life expectancy was generally lower than female life expectancy between 1970 and 2016, an

Global, regional, and national disability-adjusted life-years (DALYs) for 333 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016

BACKGROUND: Measurement of changes in health across locations is useful to compare and contrast changing epidemiological patterns against health system performance and identify specific needs for resource allocation in research, policy development, and programme decision making. Using the Global Burden of Diseases, Injuries, and Risk Factors Study 2016, we drew from two widely used summary measures to monitor such changes in population health: disability-adjusted life-years (DALYs) and healthy life expectancy (HALE). We used these measures to track trends and benchmark progress compared with expected trends on the basis of the Socio-demographic Index (SDI). METHODS: We used results from the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 for all-cause mortality, cause-specific mortality, and non-fatal disease burden to derive HALE and DALYs by sex for 195 countries and territories from 1990 to 2016. We calculated DALYs by summing years of life lost and years of life lived with disability for each location, age group, sex, and year. We estimated HALE using age-specific death rates and years of life lived with disability per capita. We explored how DALYs and HALE differed from expected trends when compared with the SDI: the geometric mean of income per person, educational attainment in the population older than age 15 years, and total fertility rate. FINDINGS: The highest globally observed HALE at birth for both women and men was in Singapore, at 75·2 years (95% uncertainty interval 71·9-78·6) for females and 72·0 years (68·8-75·1) for males. The lowest for females was in the Central African Republic (45·6 years [42·0-49·5]) and for males was in Lesotho (41·5 years [39·0-44·0]). From 1990 to 2016, global HALE increased by an average of 6·24 years (5·97-6·48) for both sexes combined. Global HALE increased by 6·04 years (5·74-6·27) for males and 6·49 years (6·08-6·77) for females, whereas HALE at age 65 years increased by 1·78 years (1·61-1·93) for males and 1·96 years (1·69-2·13) for females. Total global DALYs remained largely unchanged from 1990 to 2016 (-2·3% [-5·9 to 0·9]), with decreases in communicable, maternal, neonatal, and nutritional (CMNN) disease DALYs offset by increased DALYs due to non-communicable diseases (NCDs). The exemplars, calculated as the five lowest ratios of observed to expected age-standardised DALY rates in 2016, were Nicaragua, Costa Rica, the Maldives, Peru, and Israel. The leading three causes of DALYs globally were ischaemic heart disease, cerebrovascular disease, and lower respiratory infections, comprising 16·1% of all DALYs. Total DALYs and age-standardised DALY rates due to most CMNN causes decreased from 1990 to 2016. Conversely, the total DALY burden rose for most NCDs; however, age-standardised DALY rates due to NCDs declined globally. INTERPRETATION: At a global level, DALYs and HALE continue to show improvements. At the same time, we observe that many populations are facing growing functional health loss. Rising SDI was associated with increases in cumulative years of life lived with disability and decreases in CMNN DALYs offset by increased NCD DALYs. Relative compression of morbidity highlights the importance of continued health interventions, which has changed in most locations in pace with the gross domestic product per person, education, and family planning. The analysis of DALYs and HALE and their relationship to SDI represents a robust framework with which to benchmark location-specific health performance. Country-specific drivers of disease burden, particularly for causes with higher-than-expected DALYs, should inform health policies, health system improvement initiatives, targeted prevention efforts, and development assistance for health, including financial and research investments for all countries, regardless of their level of sociodemographic development. The presence of countries that substantially outperform others suggests the need for increased scrutiny for proven examples of best practices, which can help to extend gains, whereas the presence of underperforming countries suggests the need for devotion of extra attention to health systems that need more robust support. FUNDING: Bill & Melinda Gates Foundation