This book reviews the cultural tourism market in Europe from a survey carried out in 1997. It analyzes the way in which cultural attractions are produced for, and used by, cultural tourists and how such cultural attractions as museums, art galleries, monuments and heritage attractions are marketed.
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BACKGROUND. Appropriate critical care admissions are an important component of surgical care. However, there are few data describing postoperative critical care admission in resource-limited low- and middle-income countries. OBJECTIVE. To describe the demographics, organ failures, organ support and outcomes of non-cardiac surgical patients admitted to critical care units in South Africa (SA). METHODS. The SA Surgical Outcomes Study (SASOS) was a 7-day national, multicentre, prospective, observational cohort study of all patients ≥16 years of age undergoing inpatient non-cardiac surgery between 19 and 26 May 2014 at 50 government-funded hospitals. All patients admitted to critical care units during this study were included for analysis. RESULTS. Of the 3 927 SASOS patients, 255 (6.5%) were admitted to critical care units; of these admissions, 144 (56.5%) were planned, and 111 (43.5%) unplanned. The incidence of confirmed or strongly suspected infection at the time of admission was 35.4%, with a significantly higher incidence in unplanned admissions (49.1 v. 24.8%, p<0.001). Unplanned admission cases were more frequently hypovolaemic, had septic shock, and required significantly more inotropic, ventilatory and renal support in the first 48 hours after admission. Overall mortality was 22.4%, with unplanned admissions having a significantly longer critical care length of stay and overall mortality (33.3 v. 13.9%, p<0.001). CONCLUSION. The outcome of patients admitted to public sector critical care units in SA is strongly associated with unplanned admissions. Adequate 'high care-dependency units' for postoperative care of elective surgical patients could potentially decrease the burden on critical care resources in SA by 23%. This study was registered on ClinicalTrials.gov (NCT02141867). ; SASA and the Vascular Association of SA (VASSA). ; http://www.samj.org.za ; am2017 ; Surgery
In 1985 the French government created a unique circuit for the dissemination of doctoral theses: References went to a national database "Téléthèses" whereas the documents were distributed to the university libraries in microform. In the era of the electronic document this French network of deposit of and access to doctoral theses is changing. How do you discover and locate a French thesis today, how do you get hold of a paper copy and how do you access the full electronic text? What are the catalogues and databases referencing theses since the disappearance of "Téléthèses"? Where are the archives, and are they open? What is the legal environment that rules the emerging structures and tools? This paper presents national plans on referencing and archiving doctoral theses coordinated by the government as well as some initiatives for creating full text archives. These initiatives come from universities as well as from research institutions and learned societies. "Téléthèses" records have been integrated in a union catalogue of French university libraries SUDOC. University of Lyon-2 and INSA Lyon developed procedures and tools covering the entire production chain from writing to the final access in an archive: "Cyberthèses" and "Cither". The CNRS Centre for Direct Scientific Communication at Lyon (CCSD) maintains an archive ("TEL") with about 2000 theses in all disciplines. Another repository for theses in engineering, economics and management called "Pastel" is proposed by the Paris Institute of Technology (ParisTech), a consortium of 10 engineering and commercial schools of the Paris region.