Search

Se realiza en este trabajo un recorrido por restos industriales en desuso reconvertidos en hoteles, evidenciándose que la reutilización de estos viejos contenedores para nuevos usos turísticos ha servido por una parte para recuperar patrimonio, mientras por otra se logra una actuación sostenible que evita el despilfarro que supone la nueva construcción. No obstante, queda de relieve también la paradoja de actuaciones de rehabilitación, donde la reutilización puede conllevar un deterioro ambiental, pese a la recuperación patrimonial que en principio supone. This work includes a tour of disused industrial remains transformed into hotels, It is evident that the reuse of these old containers in order to new tourist uses has helped on the one hand to recover heritage, while on the other hand a sustainable action is achieved and it avoids the waste that implies the new construction. However, the paradox of rehabilitation actions is also highlighted, where reuse can lead to environmental deterioration, despite the recovery of heritage that initially it means.

Over recent years, online shopping has grown at a tremendous rate, reaching a worldwide online retail sales of 4.9 trillion USD in 2021. Moreover, forecasts predict a growth by 50% over the following four years, reaching 7.4 trillion USD in 2025 (Statista, 2022). Needless to say that it is crucial for retailers to optimally market their offerings online. This Research Topic aims at widening the knowledge on creating online multisensory customer experiences and comprises four empirical papers, one review on the on- and offline multisensory tasting experience, and one perspective on consumer consciousness in multisensory extended reality.

El Grupo de Investigación ARPACUR (Arte y Patrimonio Moderno y Contemporáneo), dirigido por la Doctora María del Mar Lozano Bartolozzi -en su constante apuesta por el análisis riguroso de sitios y patrimonios- ha sacado a la luz el volumen Paisajes culturales en la Extremadura meridional. Una visión desde el patrimonio. El libro, coordinado por Moisés Bazán de Huerta y Vicente Méndez Hernán, recoge resultados del Proyecto Nacional I+D+i homónimo, concedido por el Gobierno de España (HAR2017-87225-P). El volumen forma parte del programa de investigación que ARPACUR lleva desarrollando desde hace años, y que se había materializado hasta ahora en cuatro publicaciones: Paisajes modelados por el agua: entre el arte y la ingeniería; Patrimonio cultural vinculado con el agua. Paisaje, urbanismo, arte, ingeniería y turismo; Paisajes culturales del agua y en cuarto lugar: Paisajes culturales entre el Tajo y el Guadiana.

When consumers shop online, it is primarily their visual sense that is being triggered. With technology under development to also provide an experience in the olfactory, taste, and haptic sense, this paper investigates the added value of background music in the online store environment. In particular, a study is conducted with three conditions: a no music condition, a condition with music which is crossmodally incongruent with the online store environment, and a condition with music crossmodally congruent with the online store environment. Crossmodal congruency refers to the crossmodal correspondences (i.e., the tendency of one sensory attribute to be associated with an attribute in another sense) that are shared between the music and the online store environment. Although both musical pieces used were considered as pleasant, consumer reactions were not more positive when compared to the no music condition. Interestingly, the value of the money spent in the no music condition was significantly higher than in both musical conditions. The incongruent music condition, however, did lead to significantly lower consumer reactions for the other variables measured (i.e., pleasure, arousal, and store environment evaluation) when compared to the no music and congruent music condition.

Treatments for patients with sepsis with intermediate lactate values (≥2 and4 mmol/L) are poorly defined.To evaluate multicenter implementation of a treatment bundle (including timed intervals for antibiotics, repeat lactate testing, and intravenous fluids) for hemodynamically stable patients with sepsis and intermediate lactate values in the emergency department.We evaluated patients in annual intervals before and after bundle implementation in March 2013. We evaluated bundle compliance and compared outcome measures across groups with multivariable logistic regression. Because of their perceived risk for iatrogenic fluid overload, we also evaluated patients with a history of heart failure and/or chronic kidney disease.We identified 18,122 patients with sepsis and intermediate lactate values, including 36.1% treated after implementation. Full bundle compliance increased from 32.2% in 2011 to 44.9% after bundle implementation (P 0.01). Hospital mortality was 8.8% in 2011, 9.3% in 2012, and 7.9% in 2013 (P = 0.02). Treatment after bundle implementation was associated with an adjusted hospital mortality odds ratio of 0.81 (95% confidence interval, 0.66-0.99; P = 0.04). Decreased hospital mortality was observed primarily in patients with a heart failure and/or kidney disease history (P 0.01) compared with patients without this history (P 0.40). This corresponded to notable changes in the volume of fluid resuscitation in patients with heart failure and/or kidney disease after implementation.Multicenter implementation of a treatment bundle for patients with sepsis and intermediate lactate values improved bundle compliance and was associated with decreased hospital mortality. These decreases were mediated by improved mortality and increased fluid administration among patients with a history of heart failure and/or chronic kidney disease.

Retailers use atmospheric cues to trigger emotional reactions that enhance consumer behavior. However, introducing cues into a store environment may also trigger sensory overload, due to too much stimulation. This study aims to examine the effects of adding high arousal atmospheric cues in a store environment on affective reactions, approach behavior, and evaluations by making use of different methods (i.e., two lab experiments and one field experiment), by adding various types of atmospheric cues (i.e., cues processed in higher senses versus processed in lower senses), and by differentiating the order in which they are added. Results reveal that when a third high arousal cue is added sensory overload (i.e., rise in perceived arousal and decrease in perceived pleasantness) occurs under the condition that this third cue is processed by a higher sense (i.e. visual or auditory sense). Furthermore, a decrease in approach behavior and evaluations is also observed when these conditions are met. Mediation analyses indicate that this effect on evaluations is mediated by pleasure and approach behavior. The research presented extends previous findings by investigating possible predictors (i.e., number of cues as well as type of cues) of the momentum where sensory overload may take place.

This research studies the effect of scent expertise (laymen vs. novice experts vs. experts) on product and taste evaluations of three products that are (in)congruent with an ambient scent and examines whether this effect is mediated by these groups’ awareness of scents in their environment and by how well they are able to identify different scents. Results show that novice experts and experts evaluate an incongruent product less positively than laymen. Laymen score lower than novice experts and experts on odor identification, and lower than experts on odor awareness but not lower than novice experts. The differences in the evaluation between the scent expertise groups cannot be fully explained by differences in their level of odor identification or level of odor awareness.

Purpose The purpose of this article was to describe a quality improvement process on a diverse adult intensive care unit (ICU) population for a large healthcare organization for early detection of delirium. Background Delirium is often considered a common unpreventable problem in the ICU. A process for early detection of delirium allows the critical care team to evaluate the patient and intervene to improve or reverse the delirium. Description A business case was first developed, and then using performance improvement methodology combined with quality improvement methods and oversight from a Delirium/Sedation Workgroup, an implementation plan was developed. Intensive care clinical nurse specialists were educated; patients in the ICU were screened for delirium twice daily by bedside nurses using the Confusion Assessment Method. The clinical nurse specialist in each ICU was instrumental for driving the process of change and supporting the bedside nurse and physicians to discuss preventing, screening, and treating delirium. Outcome System-wide process implementation was completed in 1 year, 2011. In 2012, all medical centers had a program in place to decrease the use of benzodiazepines and improve communication in the multidisciplinary teams during daily rounds about the treatment and prevention of delirium. The process of performance improvement is ongoing with continual reassessment and feedback required to ensure sustainability. Conclusions/implications for practice Performance improvement involving 21 medical centers is a large-scale undertaking by an organization. It requires a systematic approach with key stakeholders and advanced practice nurses as subject matter experts involved throughout all phases of the implementation. Bedside clinicians assessing the patient must feel supported and valued members of the process. Challenges of all care providers need to be acknowledged and addressed.

Article-at-a-Glance Background In 2008, Kaiser Permanente Northern California implemented an initiative to improve sepsis care. Early detection and expedited implementation of sepsis treatment bundles that include early goal-directed therapy (EGDT) for patients with severe sepsis were implemented. Methods In a top-down, bottom-up approach to performance improvement, teams at 21 medical centers independently decided how to implement treatment bundles, using a "playbook" developed by rapid cycle pilot testing at two sites and endorsed by a sepsis steering committee of regional and medical center clinical leaders. The playbook contained treatment algorithms, standardized order sets and flow charts, best practice alerts, and chart abstraction tools. Regional mentors and improvement advisers within the medical centers supported team-building and rapid implementation. Timely and actionable data allowed ongoing identification of improvement opportunities. A consistent approach to performance improvement propelled local rapid improvement cycles and joint problem solving across facilities. Results The number of sepsis diagnoses per 1,000 admissions increased from a baseline value of 35.7 in July 2009 to 119.4 in May 2011. The percent of admitted patients who have blood cultures drawn who also have a serum lactate level drawn increased from a baseline of 27% to 97% in May 2011. The percent of patients receiving EGDT who had a second and lower lactate level within six hours increased from 52% at baseline to 92% in May 2011. Conclusion Twenty-one cross-functional frontline teams redesigned processes of care to provide regionally standardized, evidence-based treatment algorithms for sepsis, substantially increasing the identification and risk stratification of patients with suspected sepsis and the provision of a sepsis care bundle that included EGDT.

There is a new manner in the design of the tourist landscapes in rural Spain. The adoration for the popular, the traditional and the colorful are still popular nevertheless there are projects that look towards the future with respect for the environment thus creating projects with sustainable development.

Dentro de las últimas tendencias del arte chileno actual la opción pictórica continúa teniendo gran relevancia, lo que se explica por la pervivencia de una tradición, pero también por la atracción que para los más jóvenes supone la personalidad y relevancia internacional de Roberto Matta. No obstante, y pese a que esta preponderancia de la pintura sobre lienzo es un hecho, también lo es la existencia de artistas que han elegido otros medios de expresión que van desde la escultura hacia esos otros lenguajes más indefinibles dentro de la clasificación tradicional de las artes, como son las instalaciones o esas realizaciones que se incluyen dentro de ese cajón de sastre denominado Arte Visual.; Within the latest tendencies in Chilean art, painting still bears great relevance, a fact which is partly due to the maintenace of an established tradition, but also to the attraction which the personality and international relevance of Robeto Matta holds for the youngest. However, and despite the ruling of painting on canvas, there are also a number of artists who have chosen different means of self-expression, ranging form sculpture to other languages which seem difficult to define in traditional art classification, such as installations or the realisation included within the general category of Visual Art.