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The aim of the study was to develop a low-cost method for tourism opportunity spectrum evaluation in rural landscapes. The method uses the geographic information system (GIS) for spatial analysis of the problem. Open source materials are used in the evaluation. Three principal indices derived from spatial data are evaluated: attraction index, view index, and access index. These form the basis for tourism suitability and opportunity spectrum evaluation. The analysis is realized for two types of tourists: those using cars, and hikers. The method permits the current state of tourism to be identified, and points out possible ways for further development as well as identifying valuable but overexploited zones which should be conserved. The obtained results can improve the sustainable management of landscapes and enhance the profits of rural areas.

Cynthia Kay,1,2 Erica Wozniak,2 Alice Ching,1 Joanne Bernstein1 1Clement J Zablocki - Department of Medicine, 2Center for Patient Care and Outcomes Research, Medical College of Wisconsin, Milwaukee, WI, USA Purpose: Ambulatory resources such as telephone calls, secure messages, nurse visits, and telephone triage are vital to the management of patients on chronic opioid therapy (COT). They are also often overlooked as health care services and yet to be broadly studied. The aim of the present study was to describe the Veterans Affairs (VA) health care utilization by patients based on COT, type, and amount of opioids prescribed. Patients and methods: A retrospective chart review was done on 617 patients on COT at a VA primary care clinic. Instances of health care utilization (emergency department visits [EDVs], hospitalizations, clinic visits, telephone triage calls, telephone calls/secure messages/nurse visits) were obtained. Results: Patients were likely to have more telephone calls, secure messages, or nurse visits if they were prescribed a schedule II opioid or if they were on more than one opioid. Model-based results found that patients on COT were more likely to have EDVs, telephone triage calls, and clinic contact compared to patients who were not on chronic opioids. Conclusion: The results are despite having a Patient Aligned Care Team, which is the VA’s patient-centered medical home. This suggests that reducing health care utilization for patients on COT may not be possible with just a primary care involvement. Keywords: opioids, Veterans Affairs, primary care, chronic pain

The aim of this paper is to describe the structure, production and function of secretory immunoglobulin A (sIgA) as well as changes of its concentration caused by exercise of various intensity and duration. Immunoglobulin A is the main class of antibodies present in the body secreted fluids such as saliva, tears or mucus from the intestines. It is generally recognized that IgA, due to its dominance in the immune system of mucous membranes, is the first line of defence against harmful environmental factors. The secretion and composition of saliva depends on the activity of the sympathetic and parasympathetic nervous systems. Physical activity, stimulating the autonomous nervous system, may reduce the amount of saliva and/or inhibit its secretion. The relationship between physical activity and the suppression of the immune system is not fully understood, but it is known that moderate intensity exercise can improve immune defences, while extreme effort can reduce them by creating an increased risk of upper respiratory tract inflammation (URTI). In athletes, the lowest risk of upper tract infection was connected with the case of moderate intensity exercise. It is now believed that the relationship between exercise volume and the risk of URTI has the shape of the letter “J”. This means that both too little and too much physical activity may increase the risk of upper respiratory tract infection. Training optimization and correct balance between exercise and rest periods may reduce the risk of adverse changes in the immune system and decrease the frequency of URTI. [ABSTRACT FROM AUTHOR]

Study design:A cross-sectional study with comparison group.Objectives:To examine the effect of rugby training on the blood antioxidant capacity in able-bodied and wheelchair rugby players with tetraplegia.Setting:Poland.Methods:Four groups of subjects participated in the study: sedentary able-bodied males (group SA, n=19), sedentary males with tetraplegia (group ST, n=10), able-bodied rugby players (group RA, n=22) and wheelchair rugby players with tetraplegia (group RT, n=14). The activities of superoxide dismutase (SOD), glutathione reductase (GR) and catalase (CAT) were determined in erythrocyte hemolysates, whereas glutathione peroxidase (GPX) activity was determined in whole-blood hemolysates. Concentrations of total antioxidant status (TAS) was determined in plasma.Results:SOD activity was significantly higher in the group SA compared with group ST and group RA. No significant differences occurred within the tetraplegic groups: RT and ST. Resting CAT and GPX activities were significantly higher in both the groups of rugby players than in the respective group of sedentary males. There were no differences in GR activity among all the studied groups. Plasma TAS concentration was higher in both the groups of able-bodied males compared with the respective groups of tetraplegics. The present study is the first to conduct an evaluation of wheelchair rugby training-induced adaptations to oxidative stress in individuals with tetraplegia.Conclusion:Adaptive response to training was similar in both able-bodied and wheelchair rugby players, and it was characterized by increased erythrocyte CAT and GPX activities in resting conditions improving resistance to oxidative stress. [ABSTRACT FROM AUTHOR]

The aim of paper is to present the diversity of water level fluctuations in degraded Baltic raised bogs. An attempt was made to answer the question how strong the diversity of fluctuations is both within each object and between two objects situated close to each other. Moreover, speed and value of the response of water level to atmospheric precipitation were analysed. The spatial scope of the paper covers two Baltic raised bogs in the lower part of the Łeba river valley: Czarne Bagno and Łebskie Bagno. The time scope covers years 2012-2014. The study found that both analysed bogs were a high dynamic in variation of groundwater level. Annual amplitudes of fluctuations in the water table was in the range of 28.4 to 77.9 cm (Łebskie Bagno) and of 45.6 to 105.0 cm (Czarne Bagno). It has been observed that lowering the water level on both peatlands always been recorded in the summer months, whilst the increase in the autumn, which lasted until spring. Retention and the water level on peatlands influenced primarily precipitation. Extreme meteorological conditions that make it less conspicuous is the variation resulting from factors such as location in different parts of the bog or type of degradation.