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Tourism is one of the most important and rapidly growing sectors for economic, cultural and global development of a country. Competition between tourist destinations is increasingly intense and is played internationally in a globalized scenario, where each destination competes with new and different competing destinations. In view of this, the tourism sector has had to equip itself with appropriate decision-making tools for studying and analyzing the competitiveness of the destinations. This chapter focuses on its analysis on the countries bordering on the Mediterranean Sea, one of the areas with the greatest worldwide attractiveness to tourists, characterized by different levels and models of tourism development. There are areas traditionally dedicated to hospitality, considered world leaders (such as France, Spain and Italy) and countries that have grown rapidly in their wake (Croatia and Greece), and on the other, more recently emerged destinations (Egypt, Morocco and Tunisia) that compete very well, focussing on an ‘exotic’ seaside offer accessible to all. The aim of this chapter is to carry out a research on the tourism competitiveness of Mediterranean countries. The analysis is based on the 14 pillars described in the Travel & Tourism Competitiveness Report 2019. In order to see how the 14 pillars of the competitiveness index are grouping on the countries, we applied the principal component analysis and hierarchical cluster analysis.

Clustering financial time series is a recent topic of statistical literature with important fields of applications, in particular portfolio composition and risk evaluation. The risk is generally linked to the volatility of the asset, but its level of predictability also plays a basic role in investment decisions. In particular, the classification of a certain asset could be linked to its dependence on the volatility of a dominant market: movements in the volatility of the dominant market can provide similar movements in the volatility of the asset and its predictability would depend on the strength of this dependence. Working in a model based framework, we base the classification of the volatility of an asset not only on its volatility level, but also on the presence of spillover effects from a dominant market, such as the US one, and on the similarity of the dynamics of the asset and the dominant market. The method is carried out using an extended version of the Multiplicative Error Model and is applied to a set of European assets, also performing a historical simulation experiment.

Resistin and adiponectin are two adipokines involved in the regulation of insulin sensitivity, and have been suggested as mediators of adult metabolic syndrome. Aim The aim of this study was to investigate cord blood levels of resistin, and their postnatal changes in full-term appropriate for gestational age (AGA) neonates. Interrelations between resistin, adiponectin, and insulin, and between resistin and neonatal and maternal anthropometric parameters were also assessed. Design Blood samples were obtained from 30 full term AGA neonates at birth and on the 4th day of life. Anthropometric variables studied included birth weight, length, body mass index (BMI), neonatal weight loss, and mother's BMI. Resistin and adiponectin were determined by ELISA, and insulin by radioimmunoassay method. Data were analyzed using Wilcoxon test and Spearman's correlation coefficient. Results Resistin levels were high at birth and did not change on the 4th day of life. Resistin levels were not correlated to insulin, nor adiponectin levels, nor any anthropometric parameter of neonates or their mothers. Instead, adiponectin levels increased on the 4th day of life, and were correlated to insulin levels. Conclusion High levels of resistin in full-term AGA neonates suggest that this hormone may play a role in maintenance of metabolic neonatal homeostasis, but its physiological significance needs further investigation.

Background The aim of this study was to verify if hospital policies and practices, independently of main maternal sociodemographic determinants, influence initiation and duration of breastfeeding. Methods The study was carried out at the Immunization Centre of Messina where all infants born in the four maternity wards of Messina are vaccinated, using a structured questionnaire, constructed in conformity with the methodology suggested by the WHO. Results Data analysis, performed by non-parametric and multivariate analysis of variance and by Kaplan–Meier curves, showed that the highest probability rate (P

The aim of this prospective study was to verify normal serum AFP (alpha-fetoprotein) levels in jaundiced breastfed infants with indirect hyperbilirubinemia.The study was conducted in clinically jaundiced breastfed infants, 20, or more, days old, referred to our outpatient ambulatory. Inclusion criteria were: birth at term after a physiologic pregnancy, with an Apgar score7 at 1 and 5 min, no evidence of congenital anomalies or diseases, direct bilirubin1 mg/dl, normal values of alpha-1-antitrypsin, glucose-6-phosphate dehydrogenase, thyroid stimulating hormone, triiodothyronine, tyroxine, and normal growth. 30 non-jaundiced breastfed infants age-weight-matched, were used as control group.98 jaundiced breastfed infants satisfied inclusion criteria. Their mean serum concentration of AFP was significantly higher than control infants (3548 vs 1095 ng/ml, p0.001). Serum AFP levels of jaundiced infants were directly associated with serum indirect bilirubin and gamma-glutamyltranspeptidase concentrations.The most probable explanation of elevated AFP in jaundiced breastfed infants may be the presence in human milk of one or more factors which affect hepatocyte growth and/or function. Based on our finding we demonstrated that in jaundiced breastfed infants normal range of serum AFP levels are higher than previously published data for healthy infants. Our data can be useful for a right interpretation of AFP levels in breastfed infants with prolonged jaundiced and may be used to avoid unnecessary investigations.

Clustering financial time series is a recent topic of statistical literature with important fields of applications, in particular portfolio composition and risk evaluation. The risk is generally linked to the volatility of the asset, but its level of predictability also plays a basic role in investment decisions. In particular, the classification of a certain asset could be linked to its dependence on the volatility of a dominant market: movements in the volatility of the dominant market can provide similar movements in the volatility of the asset and its predictability would depend on the strength of this dependence. Working in a model based framework, we base the classification of the volatility of an asset not only on its volatility level, but also on the presence of spillover effects from a dominant market, such as the U.S. one, and on the similarity of the dynamics of the asset and the dominant market. The method is carried out using an extended version of the Multiplicative Error Model and is applied to a set of European assets.

Most outcomes do not deeply express the degree of disability in patients with respiratory failure (RF) following inpatient pulmonary rehabilitation (IPR). The aim of our study was to evaluate the efficacy of an IPR in patients with confirmed COPD and RF using functional independence measure (FIM) that determines the degree of disability experienced by patients and the progress they make during rehabilitation. This scale includes several items: self care, mobility, locomotion, communication and social recognition. Twenty-two patients (age 70+/-2 years, PO(2) 58.18+/-7.63mmHg, PCO(2) 46.82+/-9.11mmHg) were prospectively observed and studied. IPR included respiratory and peripheral muscle training, mucus evacuation techniques, and energy conservation techniques. FIM, Medical Research Council dyspnoea scale (MRC), St. George's Respiratory Questionnaire (SGRQ), and 6-min walking distance (6-MWD) were assessed on admission (pre) and discharge (post) from IPR. After IPR there was a statistically significant improvement (p

Elevated breast milk (BM) Na concentration is regarded as responsible for elevated Na intake. To verify the clinical significance of milk Na concentration, we studied the relationship between BM Na+ concentration and infants' daily Na+ intake, infants' daily BM intake (DBMI) and percentage weight loss (%WL) in healthy newborn infants. All mothers who gave birth to a single healthy infant, between February and March 2004 at the Obstetric Clinic of University of Messina (Italy), were invited to participate if they were willing to attempt to breastfeed exclusively. BM Na+ concentration, DBMI, Na+ intake and %WL were determined on the third day after delivery. Statistical analysis was performed by Spearman's correlation test, classification and regression trees and the generalised linear model. Of the 270 eligible mothers, 208 participated in the study. The results showed that on the third day postpartum BM Na+ concentration was 23·05 (sd 1·10) mmol/l, mean DBMI was 202 (sd 68·9) g/d, and mean Na+ intake was 4·36 (sd 0·22) mmol/d and 1·36 (sd 0·07) mmol/kg per d. BM Na+ concentration was inversely related to infant DBMI, and Na+ intake was directly related to infant DBMI and not to BM Na+ concentration. %WL was significantly correlated only to DBMI. In conclusion, the present data demonstrate, for the first time, that when lactogenesis is suboptimal, BM Na+ concentration is higher, but infants' Na+ intake is lower. Finally, the present data probably suggest that for the clinical assessment of breast-feeding, evaluation of milk intake remains the best method.