Reviewing Social Tourism for Future Research

The purpose of this work is to review the scientific literature (journal articles) that analyses social tourism, with the objective of identifying the evolution of the concept, the methodologies adopted and the main results of the empirical work in this field. The review of literature undertaken provides an analysis of the evolution of published research and also permits the identification of future research pathways

US Current Account Deficit and Exchange Rate Tax

We examine the relationship between the US current account deficit, the international value of the dollar, and the dollar reserves of foreign central banks. We find that the international value of the dollar impacts the US current account and also that dollar depreciations are accompanied by reductions in the inflow of foreign reserves. The inflow reductions are indicative that the US levies an exchange rate tax on foreigners because the foreign stock of reserves loses value.US current account; exchange rate tax

Cost-utility analysis of imaging for surveillance and diagnosis of hepatocellular carcinoma

Le carcinome hépatocellulaire (CHC) est une complication sérieuse associée aux maladies hépatiques chroniques. Les lignes directrices actuelles recommandent la surveillance du CHC par échographie tous les six mois. Cependant, la surveillance par échographie peut être difficile chez certains patients, notamment ceux atteints de cirrhose ou d'obésité. Autrement, la tomodensitométrie (TDM), l'imagerie par résonance magnétique (IRM) et l'IRM abrégée ont été explorées comme techniques d'imagerie alternatives et peuvent être utilisées chez les patients qui sont susceptibles d’avoir une échographie techniquement inadéquate. L’objectif de ce mémoire est d’évaluer l’impact économique de différentes stratégies de dépistage et de diagnostic basées sur l'imagerie chez des patients à risque de CHC, tout en tenant compte d'examens techniquement inadéquats et du taux de compliance des patients au programme de dépistage. Nous avons comparé sept stratégies de dépistage et diagnostic: stratégie A, échographie pour le dépistage et TDM pour le diagnostic; stratégie B, échographie pour le dépistage et IRM pour le diagnostic; stratégie C, échographie pour le dépistage et TDM pour une surveillance inadéquate ou positive; stratégie D, échographie pour le dépistage et IRM pour un dépistage inadéquat ou positif; stratégie E, dépistage et diagnostic par TDM suivis par une IRM en cas de dépistage inadéquat; stratégie F, dépistage et diagnostic avec IRM suivis par TDM pour un dépistage inadéquat; et stratégie G, dépistage avec IRM abrégée suivi par TDM pour un dépistage inadéquat ou IRM pour un dépistage positif. Deux scénarios de compliance au programme de surveillance ont été évalués: optimal et conservateur. Pour chaque scénario, la stratégie la plus coût-efficace reposait sur un seuil de propension à payer de Can$50,000 (dollars Canadiens) par année de vie ajustée en fonction de la qualité (AVAQ). Nous avons également effectué des analyses de sensibilité. Nos résultats ont démontré que la stratégie E était la stratégie la plus coût-efficace dans le scénario de compliance optimal (Can$13,631/AVAQ). Cependant, dans le scénario conservateur, la stratégie G constituait l'alternative la plus coût-efficace pour remplacer la pratique actuelle de surveillance par échographie (Can$39,681/AVAQ). Les analyses de sensibilité ont confirmé l'analyse de base dans le scénario de compliance optimal. Par contre, plusieurs paramètres ont modifié le rapport de coût-efficacité dans le scénario d’observance conservateur. En effectuant cette analyse économique, nous avons conclu qu'une approche individuelle, tenant compte des particularités cliniques des patients, est plus coût-efficace que la stratégie actuelle uniforme. Cependant, avant de mettre en place un programme de surveillance incorporant des modalités d'imagerie autres que l'échographie, les futures études devraient se concentrer sur le fardeau économique associé aux diagnostics faux positifs du CHC et sur la performance diagnostique d'examens d'IRM abrégés dans le scénario de surveillance.Hepatocellular carcinoma (HCC) is a serious complication associated with chronic liver disease. Current guidelines recommended HCC surveillance using ultrasound (US) every six months. However, US surveillance can be challenging for some patients, particularly those with cirrhosis or obesity. Alternately, computed tomography (CT), magnetic resonance imaging (MRI), and abbreviated MRI have been explored as alternative imaging modalities and may be used in selected patients who are likely to have experienced inadequate US examinations. In this thesis, we aimed to assess the cost-effectiveness of imaging-based surveillance and diagnostic strategies in patients at risk of HCC while taking into account technically inadequate examinations and patients’ compliance. We compared seven surveillance and diagnostic strategies: strategy A, US for surveillance and CT for diagnosis; strategy B, US for surveillance and MRI for diagnosis; strategy C, US for surveillance and CT for inadequate or positive surveillance; strategy D, US for surveillance and MRI for inadequate or positive surveillance; strategy E, surveillance and diagnosis with CT followed by MRI for inadequate surveillance; strategy F, surveillance and diagnosis with MRI followed by CT for inadequate surveillance; and strategy G, surveillance with abbreviated MRI followed by CT for inadequate surveillance or MRI for positive surveillance. Two compliance scenarios were evaluated: optimal and conservative. For each scenario, the most cost-effective strategy was based on a willingness-to-pay threshold of Can$50,000 (Canadian dollars) per quality-adjusted life year (QALY). We also performed sensitivity analyses. Our results demonstrated that strategy E was the most cost-effective strategy in scenarios with optimal patient compliance (Can$13,631/QALY). However, in scenarios with low patient compliance, strategy G was the most cost-effective alternative to the current US-surveillance practice (Can$39,681/QALY). Sensitivity analyses supported the base-case analysis in the optimal compliance scenario; however, several parameters altered the cost-effectiveness relationship in the conservative compliance scenario. By performing this economic analysis, we concluded that an individual approach, considering the clinical particularities of the patients, is more cost-effective than the current “one-size-fits-all” strategy. However, before implementing a surveillance program incorporating imaging modalities other than US, future studies should address the economic burden associated with false-positive HCC diagnoses and the accuracy of abbreviated MRI examinations in a surveillance setting

Post-surgical outcome of the ventral slot procedure for cervical intervertebral disc disease in dogs

Dissertação de Mestrado Integrado em Medicina VeterináriaThe medical records of 18 dogs, including 12 Chondrodystrophic breed dogs and 8 Non-Chondrodystrophic dogs with Cervical Intervertebral Disc Disease (CIVDD) that were submitted to Ventral Slot decompression surgery and posterior rehabilitation physiotherapy were analyzed. Patients were diagnosed using CT Myelography and subsequently classified as having either Hansen Type I or Hansen type II disc herniation. The most frequent clinical presentation was non-ambulatory tetraparesis (33%). The most frequently affected site for CIVDD were the vertebral segments C3-C4 for Hansen Type I (28%) and C4-C5 for Hansen type II (11%). The patient’s neurological status was graded using the Modified Frankel Scale and the difference between their pre-surgical and post-surgical neurological grading was calculated to determine the treatment outcome. The short term post-surgical outcome was positive in 100% of dogs, including 72% with an excellent outcome. A significant correlation was found between the site of lesion and the outcome. Hansen Type I CIVDD patients also showed a more favorable improvement compared to Hansen Type II patients.RESUMO - As histórias clínicas de 18 cães, incluindo 12 de raças condrodistróficas e 8 de raças não condrodistróficas com hérnia cervical da coluna vertebral que foram submetidos à técnica cirúrgica Ventral Slot e posterior fisioterapia de reabilitação foram analisados. Os pacientes foram diagnosticados através de TAC com mielografia e subsequentemente classificados como afetados por hérnia do disco hansen tipo I ou tipo II. A apresentação clinica mais frequente foi tetraparésia não-ambulatória (33%). O local mais afetado da coluna cervical foi o segmento C3-C4 nos casos de hérnia hansen tipo I (28%) e C4-C5 nos casos de hérnia hansen tipo II (11%). O estado neurológico dos pacientes foi classificado utilizando a escala de Frankel modificada, sendo que a diferença entre as classificações pré e pós-cirúrgicas foi comparada para determinar o outcome do tratamento. O outcome pós-cirúrgico a curto prazo foi positivo em todos os cães, incluindo 72% com um outcome excelente. Foi encontrada uma correlação significativa entre o segmento afetado e o outcome. Os pacientes com hérnia hansen tipo I mostraram uma melhoria mais favorável comparando com os que sofreram de hérnia hansen tipo II.N/

A Bayesian estimate of the CMB-large-scale structure cross-correlation

Evidences for late-time acceleration of the Universe are provided by multiple probes, such as Type Ia supernovae, the cosmic microwave background (CMB) and large-scale structure (LSS). In this work, we focus on the integrated Sachs--Wolfe (ISW) effect, i.e., secondary CMB fluctuations generated by evolving gravitational potentials due to the transition between, e.g., the matter and dark energy (DE) dominated phases. Therefore, assuming a flat universe, DE properties can be inferred from ISW detections. We present a Bayesian approach to compute the CMB--LSS cross-correlation signal. The method is based on the estimate of the likelihood for measuring a combined set consisting of a CMB temperature and a galaxy contrast maps, provided that we have some information on the statistical properties of the fluctuations affecting these maps. The likelihood is estimated by a sampling algorithm, therefore avoiding the computationally demanding techniques of direct evaluation in either pixel or harmonic space. As local tracers of the matter distribution at large scales, we used the Two Micron All Sky Survey (2MASS) galaxy catalog and, for the CMB temperature fluctuations, the ninth-year data release of the Wilkinson Microwave Anisotropy Probe (WMAP9). The results show a dominance of cosmic variance over the weak recovered signal, due mainly to the shallowness of the catalog used, with systematics associated with the sampling algorithm playing a secondary role as sources of uncertainty. When combined with other complementary probes, the method presented in this paper is expected to be a useful tool to late-time acceleration studies in cosmology.Comment: 21 pages, 15 figures, 4 tables. We extended the previous analyses including WMAP9 Q, V and W channels, besides the ILC map. Updated to match accepted ApJ versio

Fostering a sustained design capability in non-design-intensive organizations: a knowledge transfer perspective

Service designers have been increasingly involved in the transmission of design knowledge to enable non-professional designers to apply design skills and approaches in their work. However, the understanding of the factors that favor the effective transmission of design knowledge is limited, making the goal to achieve a sustainable capability in organizations a challenge. In this paper, the authors adopt a knowledge transfer lens to identify the key determinants in the transference of knowledge in organizations and conduct a preliminary review of how they have been addressed in design research literature. This review revealed an unbalanced interpretation with limited consideration of the knowledge senders’ characteristics and contextual factors affecting the dissemination of design knowledge. The paper, therefore, concludes with the proposal of an initial model where the four groups of determinants identified in the knowledge transfer literature (knowledge, receivers, senders, and context) could constitute the core elements for studying this phenomenon

MITO E RELIGIÃO EM GABRIEL GARCÍA MÁRQUEZ: UMA ANÁLISE DO CONTO “UM SENHOR MUITO VELHO COM UMAS ASAS ENORMES”

The present paper proposes an analysis of the short story A Very Old Man with Enormous Wings, by Gabriel García Márquez. This short story narrates the appearance of a supposed decrepit angel in the fictionalized seaside village where Pelayo, his wife, Elisenda, and their son lived. The narrative will center around the change in the routine of the poor and hitherto monotonous village after the appearance of the mythical figure. Our analysis is a bibliographical and theoretical one and will seek to elucidate how the subjects belonging to that daily life will deal with the destabilization caused by the appearance of a mythical figure who is divine but practically incapable. We will seek to establish relationships between narrative, myth, and religion, starting from the assumption that angels are predominantly biblical figures. Our analysis will focus on the betweenness of the human and the mythical to critically elucidate the narrative.O presente trabalho propõe uma análise do conto Um senhor muito velho com umas asas enormes, de Gabriel García Márquez. O conto narra a aparição de um suposto anjo decrépito no povoado litorâneo ficcionalizado, onde viviam Pelayo, sua mulher, Elisenda, e seu filho. A narrativa se concentrará em torno da mudança na rotina do pobre e até então monótono povoado a partir da aparição da referida figura mítica. Nossa análise, de cunho teórico e bibliográfico, buscará elucidar como os sujeitos pertencentes àquele cotidiano irão lidar com a desestabilização causada pelo surgimento de uma figura mítica divina, mas praticamente incapaz. Buscaremos estabelecer relações entre a narrativa, o mito e a religião, partindo do pressuposto de que anjos são figuras predominantemente bíblicas. Nossa análise irá focar no entrelugar do humano e do mítico para elucidar criticamente a narrativa