Valor añadido, autenticidad y lealtad en el Xacobeo 2010: una evaluación del evento a partir de las percepciones de los visitantes

The tourist attractiveness of Santiago de Compostela is mainly based on the historic, cultural and artistic heritage. This heritage is in part a consequence of Santiago’s origins around the shrine of St. James. The city is the final destination of an ancient pilgrimage road and celebrates a «Jubilee or Holy Year Privilege» from 1119. From 1993, the tourist attractiveness of the city has been reinforced with the celebration of a cultural, religious and social event, worldwide promoted: the Xacobeo. From then on, the number of pilgrims and hotel guest in the city has substantially increased and official sources talk about record in the number of attendants any time the event takes place. This study goes beyond the ever discussed number of visitants and examines the success of the event itself in terms of the added value and authenticity perceived by the visitors and their intention to «revisit» and/or to recommend the event to relative and friends.El atractivo turístico de Santiago de Compostela se basa en gran medida en su patrimonio histórico, cultural y artístico. Este patrimonio es en parte una consecuencia de los orígenes de la ciudad en torno al santuario del apóstol Santiago. La ciudad es el destino final de un camino de peregrinación y celebra el «Jubileo o el privilegio del Año Santo» desde 1119. Desde el año 1993, el atractivo turístico de la ciudad se ha visto reforzado con la celebración de un evento cultural, religioso y social, promocionado a nivel mundial: el Xacobeo. Desde ese momento, las cifras de peregrinos y turistas que visitan la ciudad han aumentado considerablemente y las fuentes oficiales hablan de records en el número de visitantes cada vez que el evento tiene lugar. Este estudio va más allá del siempre discutido número de visitantes y examina el éxito del evento en sí mismo, en términos del valor añadido y la autenticidad percibida por los visitantes, así como su intención de «revisitar» y/o recomendar el evento a familiares y amigos

Disparidades en el bienestar económico regional: el caso de las regiones españolas e italianas objetivo 1

Texto dispoñible en galego e españolEste traballo parte dunha visión revisada do benestar económico rexional para analizar as disparidades económicas entre trinta e oito rexións españolas e italianas e comparalas coas que se obteñen a partir do PIB per cápita (PIBpc). Para iso proponse un indicador sintético de benestar rexional baseado nas catro compoñentes do benestar económico suxeridas por Osberg (1985): capacidade de consumo, acumulación, desigualdade e inseguridade económica. Estes aspectos son integrados nun único índice a través do enfoque “beneficio da dúbida”, unha variante da Análise Envolvente de Datos para a construción de indicadores sintéticos. Os resultados amosan como as rexións con menor produto por habitante (Obxectivo 1 da Unión Europea) son tamén as de menor nivel de benestar económico e, ademais, que as disparidades son maiores en termos deste último. En xeral, as rexións italianas rexistran un nivel de benestar económico superior ao que se desprende do seu PIBpc, mentres que no caso español ocorre precisamente o contrario. Este comportamento só ten tres excepcións no caso español, entre as que se atopa precisamente Galicia, cun nivel de benestar económico por riba do que cabería esperar do seu PIBpcEste trabajo parte de una visión revisada del bienestar económico regional para analizar las disparidades económicas entre treinta y ocho regiones españolas e italianas y compararlas con las que se obtienen a partir del PIB per cápita (PIBpc). Para eso se propone un indicador sintético de bienestar regional basado en las cuatro componentes del bienestar económico sugeridas por Osberg (1985): capacidad de consumo, acumulación, desigualdad e inseguridad económica. Estos aspectos son integrados en un único índice a través del enfoque “beneficio de la duda”, una variante del Análisis Envolvente de Datos para la construcción de indicadores sintéticos. Los resultados muestran como las regiones con menor producto por habitante (Objetivo 1 de la Unión Europea) son también las de menor nivel de bienestar económico y, además, que las disparidades son mayores en términos de este último. En general, las regiones italianas registran un nivel de bienestar económico superior a lo que se desprende de su PIBpc, mientras que en el caso español ocurre precisamente lo contrario. Este comportamiento tiene solamente tres excepciones en el caso español, entre las que se encuentra precisamente Galicia, con un nivel de bienestar económico por encima del que cabría esperar de su PIBpcMoving beyond a traditional view of economic wellbeing, this paper analyzes economic well-being disparities between 38 Spanish and Italian regions and compares them with those derived from the traditional GDP per capita indicator. The paper suggests a synthetic indicator of regional economic wellbeing based on Osberg’s (1985) four components: consumption capacity, accumulation, inequality, and economic insecurity. These aspects are integrated in an single index by using the “Benefit-of-the-doubt” approach, a Data Envelopment Analysis model. The results show that the regions with less per capita GDP (EO Objective 1) are also those with lower levels of economic wellbeing. Yet, differences in terms of wellbeing are larger than those in terms of GDP per capita. Nevertheless, “poor” Italian regions have a better behaviour on economic wellbeing terms than “poor” Spanish ones. Galicia is among the few exceptions, enjoying an economic wellbeing larger that would be expected from its per capita productS

An Analysis of Tourism Loyalty: The Case of Santiago de Compostela

Texto dispoñible en galego e españolNos últimos anos no ámbito turístico, ao igual que no conxunto da economía, produciuse un cambio de paradigma na xestión das empresas e a medición da satisfacción dos clientes foi desprazada polo concepto de lealdade, ao consideralo un mellor indicador do seu comportamento real. Neste artigo proponse un enfoque integrado para tratar de comprender a lealdade do turismo co destino Santiago de Compostela, á vez que se examinan as relacións teóricas e empíricas acerca dos vínculos entre a satisfacción turística, tanto global como por atributos, e a lealdade co destino. Os resultados do traballo permitirán coñecer os factores sobre os que os responsables, tanto públicos como privados, da xestión do destino deberán incidir para xerar lealdade nos turistas. Un turista leal seguramente repetirá a visita e moi probablemente a recomendará a outras persoas. A celebración do Xacobeo no ano 2010 traerá a Santiago de Compostela –e a Galicia no seu conxunto– un importante volume de turistas, oportunidade que debería ser aproveitada para xerar fluxos turísticos nos próximos anosEn los últimos años en el ámbito turístico, al igual que en el conjunto de la economía, se ha producido un cambio de paradigma en la gestión de las empresas y la medición de la satisfacción los clientes ha sido desplazada por el concepto de lealtad, al considerarlo un mejor indicador de su comportamiento real. En este artículo se propone un enfoque integrado para tratar de comprender la lealtad del turismo con el destino Santiago de Compostela, a la vez que se examinan las relaciones teóricas y empíricas acerca de los vínculos entre la satisfacción turística, tanto global como por atributos, y la lealtad con el destino. Los resultados del trabajo permitirán conocer los factores sobre los que los responsables, tanto públicos como privados, de la gestión del destino deberán incidir para generar lealtad en los turistas. Un turista leal seguramente repetirá la visita y muy probablemente la recomendará a otras personas. La celebración del Xacobeo en el año 2010 traerá a Santiago de Compostela –y a Galicia en su conjunto– un importante volumen de turistas, oportunidad que debería ser aprovechada para generar flujos turísticos en los próximos añosThis paper analyses the loyalty of tourists to the destination Santiago de Compostela. Using structural equation modeling (SEM), it examines the theoretical relations between tourist satisfaction, overall and by attributes, and loyalty to the destiny. The results show that loyalty is strongly influenced by tourists’ satisfaction with the various elements that make up the destination (accommodation, catering, cultural and natural heritage, security, etc.), whereas tourists’ overall satisfaction does not seem to have an impact on tourists’ loyalty. The conclusions derived from work can be used by public and private institutions responsible for the managing the city of Santiago de CompostelaS

Can the Arrow of Time be understood from Quantum Cosmology?

I address the question whether the origin of the observed arrow of time can be derived from quantum cosmology. After a general discussion of entropy in cosmology and some numerical estimates, I give a brief introduction into quantum geometrodynamics and argue that this may provide a sufficient framework for studying this question. I then show that a natural boundary condition of low initial entropy can be imposed on the universal wave function. The arrow of time is then correlated with the size of the Universe and emerges from an increasing amount of decoherence due to entanglement with unobserved degrees of freedom. Remarks are also made concerning the arrow of time in multiverse pictures and scenarios motivated by dark energy.Comment: 14 pages, to appear in "The Arrow of Time", ed. by L. Mersini-Houghton and R. Vaa

Laparoscopic Right Colectomy. Intracorporeal Anastomosis Is Associated with Better Outcome

Colon cancer is the third most common cancer in man and woman in the developed world. Laparoscopic right colectomy is the standard of care for right colon cancer. Since the first report on laparoscopic approach in 1991, the surgical technique has been improved and currently all procedure is performed intracorporeally. The ileo-colic anastomosis can be performed either intracorporeal and extracorporeal: the differences in clinical outcome, complications rate, hospital stay and quality of life between that two techniques are not still clear and a large number of studies has been published about that. According to most recent meta-analysis, intracorporeal anastomosis have showed better outcome in anastomotic leakage rate, surgical site infection rate, development of incisional hernia, postoperative pain and recovery of gastrointestinal function

The impact of COVID-19 on myocardial infarctions, strokes and out-of-hospital cardiopulmonary arrests: an observational retrospective study on time-sensitive disorders in the Friuli Venezia Giulia region (Italy)

The COVID-19 global pandemic has changed considerably the way time-sensitive disorders are treated. Home isolation, people's fear of contracting the virus and hospital reorganisation have led to a significant decrease in contacts between citizens and the healthcare system, with an expected decrease in calls to the Emergency Medical Services (EMS) of the Friuli-Venezia Giulia (FVG) region. However, mortality in clinical emergencies like acute ST-elevation myocardial infarction (STEMI), stroke and out-of-hospital cardiopulmonary arrest (OHCA) remained high. An observational retrospective cross-sectional study was carried out in FVG, taking into account the period between March 1, 2020, and May 31, 2020, the first wave of the COVID-19 pandemic, and comparing it with the same period in 2019. The flow of calls to the EMS was analysed and COVID-19 impact on time-sensitive disorders (STEMIs, ischemic strokes and OHCPAs) was measured in terms of hospitalisation, treatment and mortality. Despite a -8.01% decrease (p value ˂0.001) in emergency response, a 10.89% increase in calls to the EMS was observed. A lower number of advanced cardiopulmonary resuscitations (CPR) (75.8 vs 45.2%, p=0.000021 in April) and ROSC (39.1 vs 11.6%, p=0.0001 in April) was remarked, and survival rate dropped from 8.5 to 5%. There were less strokes (-27.5%, p value=0.002) despite a more severe onset of symptoms at hospitalisation with NHISS˃10 in 38.47% of cases. Acute myocardial infarctions decreased as well (-20%, p value=0.05), but statistical significances were not determined in the variables considered and in mortality. Despite a lower number of emergency responses, the number of calls to the EMS was considerably higher. The number of cardiac arrests treated with advanced CPR (ALS) was lower, but mortality was higher. The number of strokes decreased as well, but at the time of hospitalisation the clinical picture of the patient was more severe, thus affecting the outcome when the patient was discharged. Finally, STEMI patients decreased; however, no critical issues were observed in the variables taken into account, neither in terms of response times nor in terms of treatment times

Stroke management during the coronavirus disease 2019 (COVID-19) pandemic: experience from three regions of the north east of Italy (Veneto, Friuli-Venezia-Giulia, Trentino-Alto-Adige)

Background: Efficiency of care chain response and hospital reactivity were and are challenged for stroke acute care management during the pandemic period of coronavirus disease 2019 (COVID-19) in North-Eastern Italy (Veneto, Friuli-Venezia-Giulia, Trentino-Alto-Adige), counting 7,193,880 inhabitants (ISTAT), with consequences in acute treatment for patients with ischemic stroke. Methods: We conducted a retrospective data collection of patients admitted to stroke units eventually treated with thrombolysis and thrombectomy, ranging from January to May 2020 from the beginning to the end of the main first pandemic period of COVID-19 in Italy. The primary endpoint was the number of patients arriving to these stroke units, and secondary endpoints were the number of thrombolysis and/or thrombectomy. Chi-square analysis was used on all patients; furthermore, patients were divided into two cohorts (pre-lockdown and lockdown periods) and the Kruskal-Wallis test was used to test differences on admission and reperfusive therapies. Results: In total, 2536 patients were included in 22 centers. There was a significant decrease of admissions in April compared to January. Furthermore, we observed a significant decrease of thrombectomy during the lockdown period, while thrombolysis rate was unaffected in the same interval across all centers. Conclusions: Our study confirmed a decrease in admission rate of stroke patients in a large area of northern Italy during the lockdown period, especially during the first dramatic phase. Overall, there was no decrease in thrombolysis rate, confirming an effect of emergency care system for stroke patients. Instead, the significant decrease in thrombectomy rate during lockdown addresses some considerations of local and regional stroke networks during COVID-19 pandemic evolution

Recommendations for Implementing Lung Cancer Screening with Low-Dose Computed Tomography in Europe.

Lung cancer screening (LCS) with low-dose computed tomography (LDCT) was demonstrated in the National Lung Screening Trial (NLST) to reduce mortality from the disease. European mortality data has recently become available from the Nelson randomised controlled trial, which confirmed lung cancer mortality reductions by 26% in men and 39-61% in women. Recent studies in Europe and the USA also showed positive results in screening workers exposed to asbestos. All European experts attending the "Initiative for European Lung Screening (IELS)"-a large international group of physicians and other experts concerned with lung cancer-agreed that LDCT-LCS should be implemented in Europe. However, the economic impact of LDCT-LCS and guidelines for its effective and safe implementation still need to be formulated. To this purpose, the IELS was asked to prepare recommendations to implement LCS and examine outstanding issues. A subgroup carried out a comprehensive literature review on LDCT-LCS and presented findings at a meeting held in Milan in November 2018. The present recommendations reflect that consensus was reached