Process orientation of the world heritage city management system

Purpose This article aims to explain how the world heritage city management system may be improved, and the structure of its processes enhanced by including relevant stakeholders to reach better results, i.e. outputs and outcomes. With this aim, process-based orientation is proposed as a new management approach. Design/methodology The article is divided into two parts. In the first part, theoretical background of the world heritage city management system is given, and process orientation of heritage city management explained. In the second part theoretical concepts were applied to the cases of the world heritage cities (sites) of Split (Croatia) and Venice (Italy). A brief description of the basic characteristics (elements, processes) and of the main problems related to the results (outputs and outcomes) is followed by the application of the Unified Modelling Language as the method. The process architecture of the new management meta-model is presented, processes designed and documented, and activities and responsibilities among stakeholders, both existing as well as potential, within the proposed hierarchical structure shared. Findings By proposing the process-oriented approach to the management of world heritage cities, the paper sets out to contribute to the growing body of knowledge related to cultural heritage management (especially world heritage cities). By applying knowledge from different theories into a process-based approach to the management of world heritage cities, it enables UNESCO's directives to be implemented into the actual managerial system of a World Heritage Site (WHS). We find it potentially useful not only to WHS managers, but also to scholars and other experts who have managerial responsibilities but limited knowledge in this area

Toerisme en Erfgoed. Zijn er Grenzen aan Toeristische Ontwikkeling?

The patient context is important when commenting on or interpreting the ECG.Pulmonary embolism needs to be considered in any patient presenting with chest pain or haemodynamic instability, especially if the ECG does not show typical acute myocardial ischaemia or infarction. A multitude of ECG abnormalities, singly usually non-specific, strengthens the case for pulmonary embolism. A normal ECG does not exclude pulmonary embolism

From Urban Systems to Sustainable Competitive Metropolitan Regions

Una raccolta di essay sullo sviluppo della' citta' che illustra come le citta' si sono sviluppate per affrontare meglio le questioni di competitivita' e di sostenibilita'.Alla base della raccolta le ricerche di EURICUR dell'Erasmus University Rotterdam

Tracking the sea-level signature of the 8.2 ka cooling event: New constraints from the Mississippi Delta

The ever increasing need for accurate predictions of global environmental change under greenhouse conditions has sparked immense interest in an abrupt, century‐scale cooling around 8200 years ago, with a focal point in the North Atlantic and with hemispheric teleconnections. Despite considerable progress in the unraveling of this striking feature, including a conceivable driving mechanism (rapid drainage of proglacial Lake Agassiz/Ojibway and a resulting reduced strength of North Atlantic thermohaline circulation), several key questions remain unanswered. One salient aspect concerns the total amount of freshwater released during this catastrophic event, likely echoed by a near‐instantaneous eustatic sea‐level rise. So far, no attempts have been made to perform high‐resolution sea‐level studies that explicitly focus on this critical time interval. Here, we present new data from the Mississippi Delta suggestive of abrupt sea‐level rise associated with the 8.2 ka event. However, the amount of sea‐level rise was likely less than ∼1.2 m, corresponding to a meltwater volume of less than ∼4.3 1014 m3; values lower than estimates used by several recent studies

Pulmonary diffusing capacity disturbances are related to nailfold capillary changes in patients with Raynaud's phenomenon with and without an underlying connective tissue disease

PURPOSE: The aim of this study was to evaluate whether pulmonary microvascular damage is part of a more generalized involvement of the microvasculature in the spectrum of scleroderma (Scl)-like syndromes. PATIENTS AND METHODS: We studied four groups of patients, all with Raynaud's phenomenon (RP), distinguished by the extent and nature of their underlying connective tissue disease. Twenty-two patients had primary RP (pRP), another 22 patients had RP and an undifferentiated connective tissue disease (uCTD), 15 patients had Scl, and eight patients had the CREST syndrome (CREST). Pulmonary vascular damage in these groups was assessed by measuring the pulmonary diffusing capacity (T1,CO) and its components: the diffusing capacity of the alveolocapillary membrane (Dm) and the pulmonary capillary blood volume (Vc). Results were compared with morphologic abnormalities of the nailfold capillaries, as determined by nailfold capillary microscopy, and related to the presence of antinuclear antibodies. RESULTS: Vc was below normal in 38% and 43% of patients with pRP and uCTD, respectively (versus 52% in patients with Scl or CREST combined). In contrast, Dm was below normal in only 5% and 26% of patients with pRP and uCTD, respectively (versus 61% in patients with Scl or CREST combined). In patients with Scl and CREST, Dm was significantly decreased as compared with the former groups (p less than 0.01). Dm was also the pulmonary function parameter that correlated most strongly with both nailfold capillary abnormalities and the presence of antinuclear antibodies, whereas Vc did not. CONCLUSION: Early pulmonary involvement in Scl syndromes is functionally characterized by a lowered Dm, correlating with morphologic changes of the nailfold capillaries. Decreased Vc is probably a reflection of RP of the pulmonary vasculature

The influence of sexual arousal on subjective pain intensity during a cold pressor test in women

Background & objectives Pain can be significantly lessened by sex/orgasm, likely due to the release of endorphins during sex, considered potent analgesics. The evidence suggests that endorphins are also present during sexual arousal (that is, prior to sex/orgasm). It follows then that pain can be modulated during sexual arousal, independent of sex/orgasm, too. Accordingly, sexual arousal induced by erotic slides has been demonstrated to lessen pain in men, but not in women. One explanation could be that for women, the erotic slides were not potent enough to elicit a lasting primed state of sexual arousal by the time pain was induced. Thus, the current study aims to optimize the means of inducing a potent state of sexual arousal and subsequently examine the potentially analgesic influence of sexual arousal on pain in women. As a subsidiary aim, the study also assesses whether the anticipated analgesic effect of sexual arousal would be stronger than that of distraction or generalized (non-sexual) arousal. Methods Female participants (N = 151) were randomly distributed across four conditions: sexual arousal, generalized arousal, distraction, neutral. Mild pain was induced using a cold pressor while participants were concurrently exposed to film stimuli (pornographic, exciting, distracting, neutral) to induce the targeted emotional states. A visual analogue scale was utilized to measure the subjective level of pain perceived by the participants. Results Sexual arousal did not reduce subjective pain. Generalized arousal and distraction did not result in stronger analgesic effects than the neutral condition. Conclusion The present findings do not support the hypothesis that sexual arousal alone modulates subjective pain in women. This might be due to the possibility that genital stimulation and/or orgasm are key in pain reduction, or, that feelings of disgust may inadvertently have been induced by the pornographic stimulus and interfered with sexual arousal in influencing pain