Tour operators' price strategie in the Balearic Islands

In this paper we analyse the package tours prices from a sample of British and German tour operators. The offers correspond to one-week tourist packages in the Balearic Islands in a specific hotel establishment. The period studied comprises the 2002 and 2003 high seasons, what provides us with a dynamic perspective. The paper shows the existence of persistent differences in the mean prices from tour operators, as well as price distributions with different dispersion and shape among tour operators and markets. The time variation of these distributions seems to be linked to the market situation and structure. Although the paper is presented as an empirical investigation, the results can be interpreted in the context of theoretical literature on price dispersion.price dispersion, tour operators’ industry

Validating 10-joint juvenile arthritis disease activity score cut-offs for disease activity levels in non-systemic juvenile idiopathic arthritis

Objectives To validate cut-offs of the Juvenile Arthritis Disease Activity Score 10 (JADAS10) and clinical JADAS10 (cJADAS10) and to compare them with other patient cohorts. Methods In a national multicentre study, cross-sectional data on recent visits of 337 non-systemic patients with juvenile idiopathic arthritis (JIA) were collected from nine paediatric outpatient units. The cut-offs were tested with receiver operating characteristic curve-based methods, and too high, too low and correct classification rates (CCRs) were calculated. Results Our earlier presented JADAS10 cut-offs seemed feasible based on the CCRs, but the cut-off values between low disease activity (LDA) and moderate disease activity (MDA) were adjusted. When JADAS10 cut-offs for clinically inactive disease (CID) were increased to 1.5 for patients with oligoarticular disease and 2.7 for patients with polyarticular disease, as recently suggested in a large multinational register study, altogether 11 patients classified as CID by the cut-off had one active joint. We suggest JADAS10 cut-off values for oligoarticular/polyarticular disease to be in CID: 0.0-0.5/0.0-0.7, LDA: 0.6-3.8/0.8-5.1 and MDA: >3.8/5.1. Suitable cJADAS10 cut-offs are the same as JADAS10 cut-offs in oligoarticular disease. In polyarticular disease, cJADAS10 cut-offs are 0-0.7 for CID, 0.8-5.0 for LDA and > 5.0 for MDA. Conclusion I nternational consensus on JADAS cutoff values is needed, and such a cut-off for CID should preferably exclude patients with active joints in the CID group.Peer reviewe

Pain-coping scale for children and their parents : a cross-sectional study in children with musculoskeletal pain

BackgroundIn a chronic pain-causing disease such as juvenile idiopathic arthritis, the quality of coping with pain is crucial. Parents have a substantial influence on their children's pain-coping strategies. This study aimed to develop scales for assessing parents' strategies for coping with their children's pain and a shorter improved scale for children usable in clinical practice.MethodsThe number of items in the Finnish version of the pain-coping questionnaire for children was reduced from 39 to 20. A corresponding reduced scale was created for parental use. We recruited consecutive patients from nine hospitals evenly distributed throughout Finland, aged 8-16 years who visited a paediatric rheumatology outpatient clinic and reported musculoskeletal pain during the past week. The patients and parents rated the child's pain on a visual analogue scale from 0 to 100 and completed pain-coping questionnaires and depression inventories. The selection process of pain questionnaire items was performed using factor analyses.ResultsThe average (standard deviation) age of the 130 patients was 13.0 (2.3) years; 91 (70%) were girls. Four factors were retained in the new, improved Pain-Coping Scales for children and parents. Both scales had 15 items with 2-5 items/factor. The goodness-of-fit statistics and Cronbach's alpha reliability coefficients were satisfactory to good in both scaled. The criterion validity was acceptable as the demographic, disease related, and the depression and stress questionnaires correlated with the subscales.ConclusionsWe created a shorter, feasible pain-coping scale for children and a novel scale for caregivers. In clinical work, the pain coping scales may serve as a visualisation of different types of coping strategies for paediatric patients with pain and their parents and facilitate the identification of families in need of psychological support.Peer reviewe

Defining new clinically derived criteria for high disease activity in non-systemic juvenile idiopathic arthritis: a Finnish multicentre study

ObjectivesTo redefine criteria for high disease activity (HDA) in JIA, to establish HDA cut-off values for the 10-joint Juvenile Arthritis Disease Activity Score (JADAS10) and clinical JADAS10 (cJADAS10) and to describe the distribution of patients’ disease activity levels based on the JADAS cut-off values in the literature.MethodsData on 305 treatment-naïve JIA patients were collected from nine paediatric units treating JIA. The median parameters of the JADAS were proposed to be the clinical criteria for HDA. The cut-off values were assessed by using two receiver operating characteristics curve–based methods. The patients were divided into disease activity levels based on currently used JADAS cut-off values.ResultsWe proposed new criteria for HDA. At least three of the following criteria must be satisfied in both disease courses: in oligoarthritis, two or more active joints, ESR above normal, physician global assessment (PGA) of disease activity ≥2 and parent/patient global assessment (PtGA) of well-being ≥2; in polyarthritis, six or more active joints, ESR above normal, PGA of overall disease activity ≥4 and PtGA of well-being ≥2. The HDA cut-off values for JADAS10 (cJADAS) were ≥6.7 (6.7) for oligoarticular and ≥15.3 (14.1) for polyarticular disease. The distribution of the disease activity levels based on the JADAS cut-off values in the literature varied markedly based on which cut-offs were used.ConclusionNew clinically derived criteria for HDA in JIA and both JADAS and cJADAS cut-off values for HDA were proposed.</div

Validating 10-joint juvenile arthritis disease activity score cut-offs for disease activity levels in non-systemic juvenile idiopathic arthritis

Objectives To validate cut-offs of the Juvenile Arthritis Disease Activity Score 10 (JADAS10) and clinical JADAS10 (cJADAS10) and to compare them with other patient cohorts.Methods In a national multicentre study, cross-sectional data on recent visits of 337 non-systemic patients with juvenile idiopathic arthritis (JIA) were collected from nine paediatric outpatient units. The cut-offs were tested with receiver operating characteristic curve-based methods, and too high, too low and correct classification rates (CCRs) were calculated.Results Our earlier presented JADAS10 cut-offs seemed feasible based on the CCRs, but the cut-off values between low disease activity (LDA) and moderate disease activity (MDA) were adjusted. When JADAS10 cut-offs for clinically inactive disease (CID) were increased to 1.5 for patients with oligoarticular disease and 2.7 for patients with polyarticular disease, as recently suggested in a large multinational register study, altogether 11 patients classified as CID by the cut-off had one active joint. We suggest JADAS10 cut-off values for oligoarticular/polyarticular disease to be in CID: 0.0–0.5/0.0–0.7, LDA: 0.6–3.8/0.8–5.1 and MDA: >3.8/5.1. Suitable cJADAS10 cut-offs are the same as JADAS10 cut-offs in oligoarticular disease. In polyarticular disease, cJADAS10 cut-offs are 0–0.7 for CID, 0.8–5.0 for LDA and >5.0 for MDA.Conclusion International consensus on JADAS cut-off values is needed, and such a cut-off for CID should preferably exclude patients with active joints in the CID group.</div

El mercado de los tour operadores: implicaciones de un análisis de los precios de los paquetes turísticos para el turismo alemán y británico en Baleares

[spa] El proceso de comercialización de los destinos turísticos de sol y playa del Mediterráneo ha dependido tradicionalmente de los tour operadores, y esta dependencia plantea la necesidad de analizar el comportamiento de mercado de estos intermediarios turísticos. La presente tesis doctoral analiza los precios de los paquetes turísticos con el objetivo de obtener implicaciones sobre el comportamiento de mercado de los tour operadores des de un punto de vista de la economía industrial

Fenotipus, història natural, ús i seguretat de recursos sanitaris a la malaltia inflamatòria intestinal en pacients d'edat avançada

La malaltia inflamatòria intestinal (MII) es diagnostica a pacients de més de 60 anys en un 10-23% dels casos. Alguns estudis epidemiològics han suggerit que aquests pacients presenten unes característiques diferencials respecte als pacients que es diagnostiquen en edats més joves. Per altra banda, els pacients amb MII d’edat avançada tenen més comorbiditats, i per tant, un augment del risc de presentar efectes adversos dels principals fàrmacs utilitzats per tractar la malaltia com són les tiopurines i els agents biològics anti-TNF. No s’ha avaluat si existeixen diferències en la resposta a aquests tractaments en els pacients segons l’edat i sembla que, sobretot amb els agents biològics, hi ha més risc de presentar determinats efectes adversos (fonamentalment infeccions i neoplàsies), de manera que aquests factors podrien influenciar en el tractament que es prescriu en el pacients amb MII i edat avançada. Per tant, l’objectiu seria definir i avaluar, per un costat, les característiques específiques de la MII en edat avançada i, per un altre costat, establir l’eficàcia i seguretat dels diferents fàrmacs emprats, sobretot de les tiopurines, àmpliament utilitzades en la MII de cara a definir un algoritme de maneig. Per tot això, es realitzarà un primer estudi retrospectiu observacional de casos i controls i multicèntric. Es seleccionaran pacients de la base nacional de dades ENEIDA (Estudio Nacional en Enfermedad Inflamatoria Intestinal sobre Determinantes genéticos y Ambientales). S’avaluarà el fenotipus, ús i seguretat dels tractaments utilitzats, així com l’ús de recursos sanitaris en pacients diagnosticats de MII en edat avançada, comparant amb un grup control de MII diagnosticada en edat més jove. Posteriorment, es realitzarà un segon estudi retrospectiu i multicèntric, també a partir del registre ENEIDA que avaluarà específicament el perfil de seguretat de les tiopurines en comparació amb els pacients més joves. Els pacients s’agruparan en funció de l’edat de l’inici de la primera tiopurina, en majors de 60 anys o bé entre 18 i 50 anys. Finalment, d’aquesta cohort de pacients, es realitzarà un tercer estudi seleccionant aquells pacients que hagin presentat intolerància a una primera tiopurina i s’hagi iniciat una segona. S’avaluarà la tolerància a una segona tiopurina en aquest context i l’impacte de l’edat d’aquesta estratègia terapèutica.La enfermedad inflamatoria intestinal (EII) se diagnostica en pacientes de más de 60 años en un 10-23% de los casos. Algunos estudios epidemiológicos han sugerido que estos pacientes presentan unas características diferenciales respecto a los pacientes que se diagnostican en edades más jóvenes. Por otra parte, los pacientes con EII de edad avanzada tienen más comorbilidades, y por tanto, un aumento del riesgo de presentar efectos adversos de los principales fármacos utilizados para tratar la enfermedad como son las tiopurinas y los agentes biológicos anti-TNF. No se ha evaluado si existen diferencias en la respuesta a estos tratamientos en los pacientes según la edad y parece que, sobretodo con los agentes biológicos, hay más riesgo de presentar determinados efectos adversos (fundamentalmente infecciones y neoplasias), por lo que estos factores podrían influir en el tratamiento que se prescribe en el pacientes con EII y edad avanzada. Por tanto, el objetivo sería definir y evaluar, por un lado, las características específicas de la EII en edad avanzada y, por otro lado, establecer la eficacia y seguridad de los diferentes fármacos empleados, sobre todo de las tiopurinas, ampliamente utilizadas en la EII de cara a definir un algoritmo de manejo. Por todo ello, se realizará un primer estudio retrospectivo observacional de casos y controles y multicéntrico. Se seleccionarán pacientes de la base nacional de datos ENEIDA (Estudio Nacional en Enfermedad Inflamatoria Intestinal sobre Determinantes Genéticos y Ambientales). Se evaluará el fenotipo, uso y seguridad de los tratamientos utilizados, así como el uso de recursos sanitarios en pacientes diagnosticados de EII en edad avanzada, comparando con un grupo control de EII diagnosticada en edad más joven. Posteriormente, se realizará un segundo estudio retrospectivo y multicéntrico, a partir del registro ENEIDA que evaluará específicamente el perfil de seguridad de las tiopurinas en comparación con los pacientes más jóvenes. Los pacientes se agruparán en función de la edad del inicio de la primera tiopurina, en mayores de 60 años o bien entre 18 y 50 años. Finalmente, de esta cohorte de pacientes, se realizará un tercer estudio seleccionando aquellos pacientes que hayan presentado intolerancia a una primera tiopurina y se haya iniciado una segunda. Se evaluará la tolerancia a una segunda tiopurina en este contexto y el impacto de la edad en esta estrategia terapéutica.Inflammatory bowel disease (IBD) is diagnosed in patients over 65 years of age in 10-23% of cases. Epidemiological studies have shown that these patients have different characteristics than those diagnosed at younger ages. On the other hand, elderly IBD patients have more comorbidities and thus have an increased risk of developing adverse events from the main drugs used to treat the disease, such as thiopurines and biological anti-TNF agents. It has not been evaluated whether there are differences in the response to these treatments in patients by age and it seems that, especially with biological treatment, there is a greater risk of adverse events, so these factors could influence the treatment prescribed in elderly IBD patients. Our aim was to define and to evaluate the specific features of elderly patients with IBD and to establish the efficacy and safety of the different drugs, principally, the mainly used thiopurines, in order to define a management algorithm. We performed a first multicenter case-control retrospective study. Patients were selected from the national ENEIDA registry (Estudio Nacional en Enfermedad Inflamatoria Intestinal sobre Determinantes genéticos y Ambientales). The phenotype, the use and safety of the IBD treatments as well as the use of health resources in elderly patients with IBD will be evaluated by comparing them with younger IBD patients. A second retrospective multicenter study was performed in order to evaluate the thiopurine-related adverse events in elderly patients and to compare to younger patients. Patients were selected from the ENEIDA registry and were grouped in terms of age at the beginning of the thiopurine treatment. Finally, from this cohort of patients we performed a third study. We selected those patients who presented intolerance to a first thiopurine and switched to a second thiopurine compound. We evaluated the tolerance to a second thiopurine, and also the impact of the age.Universitat Autònoma de Barcelona. Programa de Doctorat en Medicin

Fenotipus, història natural, ús i seguretat de recursos sanitaris a la malaltia inflamatòria intestinal en pacients d'edat avançada

La malaltia inflamatòria intestinal (MII) es diagnostica a pacients de més de 60 anys en un 10-23% dels casos. Alguns estudis epidemiològics han suggerit que aquests pacients presenten unes característiques diferencials respecte als pacients que es diagnostiquen en edats més joves. Per altra banda, els pacients amb MII d'edat avançada tenen més comorbiditats, i per tant, un augment del risc de presentar efectes adversos dels principals fàrmacs utilitzats per tractar la malaltia com són les tiopurines i els agents biològics anti-TNF. No s'ha avaluat si existeixen diferències en la resposta a aquests tractaments en els pacients segons l'edat i sembla que, sobretot amb els agents biològics, hi ha més risc de presentar determinats efectes adversos (fonamentalment infeccions i neoplàsies), de manera que aquests factors podrien influenciar en el tractament que es prescriu en el pacients amb MII i edat avançada. Per tant, l'objectiu seria definir i avaluar, per un costat, les característiques específiques de la MII en edat avançada i, per un altre costat, establir l'eficàcia i seguretat dels diferents fàrmacs emprats, sobretot de les tiopurines, àmpliament utilitzades en la MII de cara a definir un algoritme de maneig. Per tot això, es realitzarà un primer estudi retrospectiu observacional de casos i controls i multicèntric. Es seleccionaran pacients de la base nacional de dades ENEIDA (Estudio Nacional en Enfermedad Inflamatoria Intestinal sobre Determinantes genéticos y Ambientales). S'avaluarà el fenotipus, ús i seguretat dels tractaments utilitzats, així com l'ús de recursos sanitaris en pacients diagnosticats de MII en edat avançada, comparant amb un grup control de MII diagnosticada en edat més jove. Posteriorment, es realitzarà un segon estudi retrospectiu i multicèntric, també a partir del registre ENEIDA que avaluarà específicament el perfil de seguretat de les tiopurines en comparació amb els pacients més joves. Els pacients s'agruparan en funció de l'edat de l'inici de la primera tiopurina, en majors de 60 anys o bé entre 18 i 50 anys. Finalment, d'aquesta cohort de pacients, es realitzarà un tercer estudi seleccionant aquells pacients que hagin presentat intolerància a una primera tiopurina i s'hagi iniciat una segona. S'avaluarà la tolerància a una segona tiopurina en aquest context i l'impacte de l'edat d'aquesta estratègia terapèutica.La enfermedad inflamatoria intestinal (EII) se diagnostica en pacientes de más de 60 años en un 10-23% de los casos. Algunos estudios epidemiológicos han sugerido que estos pacientes presentan unas características diferenciales respecto a los pacientes que se diagnostican en edades más jóvenes. Por otra parte, los pacientes con EII de edad avanzada tienen más comorbilidades, y por tanto, un aumento del riesgo de presentar efectos adversos de los principales fármacos utilizados para tratar la enfermedad como son las tiopurinas y los agentes biológicos anti-TNF. No se ha evaluado si existen diferencias en la respuesta a estos tratamientos en los pacientes según la edad y parece que, sobretodo con los agentes biológicos, hay más riesgo de presentar determinados efectos adversos (fundamentalmente infecciones y neoplasias), por lo que estos factores podrían influir en el tratamiento que se prescribe en el pacientes con EII y edad avanzada. Por tanto, el objetivo sería definir y evaluar, por un lado, las características específicas de la EII en edad avanzada y, por otro lado, establecer la eficacia y seguridad de los diferentes fármacos empleados, sobre todo de las tiopurinas, ampliamente utilizadas en la EII de cara a definir un algoritmo de manejo. Por todo ello, se realizará un primer estudio retrospectivo observacional de casos y controles y multicéntrico. Se seleccionarán pacientes de la base nacional de datos ENEIDA (Estudio Nacional en Enfermedad Inflamatoria Intestinal sobre Determinantes Genéticos y Ambientales). Se evaluará el fenotipo, uso y seguridad de los tratamientos utilizados, así como el uso de recursos sanitarios en pacientes diagnosticados de EII en edad avanzada, comparando con un grupo control de EII diagnosticada en edad más joven. Posteriormente, se realizará un segundo estudio retrospectivo y multicéntrico, a partir del registro ENEIDA que evaluará específicamente el perfil de seguridad de las tiopurinas en comparación con los pacientes más jóvenes. Los pacientes se agruparán en función de la edad del inicio de la primera tiopurina, en mayores de 60 años o bien entre 18 y 50 años. Finalmente, de esta cohorte de pacientes, se realizará un tercer estudio seleccionando aquellos pacientes que hayan presentado intolerancia a una primera tiopurina y se haya iniciado una segunda. Se evaluará la tolerancia a una segunda tiopurina en este contexto y el impacto de la edad en esta estrategia terapéutica.Inflammatory bowel disease (IBD) is diagnosed in patients over 65 years of age in 10-23% of cases. Epidemiological studies have shown that these patients have different characteristics than those diagnosed at younger ages. On the other hand, elderly IBD patients have more comorbidities and thus have an increased risk of developing adverse events from the main drugs used to treat the disease, such as thiopurines and biological anti-TNF agents. It has not been evaluated whether there are differences in the response to these treatments in patients by age and it seems that, especially with biological treatment, there is a greater risk of adverse events, so these factors could influence the treatment prescribed in elderly IBD patients. Our aim was to define and to evaluate the specific features of elderly patients with IBD and to establish the efficacy and safety of the different drugs, principally, the mainly used thiopurines, in order to define a management algorithm. We performed a first multicenter case-control retrospective study. Patients were selected from the national ENEIDA registry (Estudio Nacional en Enfermedad Inflamatoria Intestinal sobre Determinantes genéticos y Ambientales). The phenotype, the use and safety of the IBD treatments as well as the use of health resources in elderly patients with IBD will be evaluated by comparing them with younger IBD patients. A second retrospective multicenter study was performed in order to evaluate the thiopurine-related adverse events in elderly patients and to compare to younger patients. Patients were selected from the ENEIDA registry and were grouped in terms of age at the beginning of the thiopurine treatment. Finally, from this cohort of patients we performed a third study. We selected those patients who presented intolerance to a first thiopurine and switched to a second thiopurine compound. We evaluated the tolerance to a second thiopurine, and also the impact of the age

Economía Industrial (21209)(Cast)

abstract not availabl