Southern European Region Research Articles

Open Innovation and Social Big Data for Sustainability: Evidence from the Tourism Industry

This paper aims to contribute to the debate on Open Innovation in the age of Big Data by shedding new light on the role that social networks can play as enabling platforms for tourists’ involvement and sources for the creation and management of valuable knowledge assets. The huge amount of data generated on social media by tourists related to their travel experiences can be a valid source of open innovation. To achieve this aim, this paper presents evidence of a digital tourism experience, through a longitudinal case study of a destination in Apulia, a Southern European region. The findings of the study demonstrate how social Big Data could open up innovation processes that could be of support in defining sustainable tourism experiences in a destination.

Short-term association between outdoor air pollution and osteoporotic hip fracture.

To examine the short-term effects of outdoor air pollution on the incidence of osteoporotic hip fracture in a southern European region. This is an ecological retrospective cohort study based on data obtained from three databases. In a time-series analysis, we examined the association between hip fracture incidence and different outdoor air pollutants (sulfur dioxide (SO2), monoxide (NO), nitrogen dioxide (NO2), ozone (O3), and particulate matter in suspension < 2.5 (PM2.5) and < 10-μm (PM10) conditions by using general additive models (Poisson distribution). The incidence rate ratio (IRR), crude and adjusted by season and different weather conditions, was estimated for all parameters. Hip incidence was later analyzed by sex and age (under or over age 75) subgroups. The main outcome measure was daily hospital admissions due to fracture. Hip fracture incidence showed association with SO2 (IRR 1.11 (95% CI 1.04-1.18)), NO (IRR 1.01 (95% CI 1.01-1.02)), and NO2 (IRR 1.02 (95% CI 1.01-1.04)). For O3 levels, this association was negative (IRR 0.97 (95% CI 0.95-0.99)). The association persisted for SO2 and NO2 when the models were adjusted by season. After adjusting by season and weather conditions, the association persisted for NO2. When participants were stratified by age and sex, associations persisted only in women older than 75years. A short-term association was observed with several indicators of air pollution on hip fracture incidence. This is the first study that shows these associations.

Weather conditions and their effect on seasonality of incident osteoporotic hip fracture.

The objective of this work is to evaluate seasonality and the effect of weather conditions on the incidence of osteoporotic hip fracture in a Southern European region. This retrospective cohort study included all patients admitted to Alcorcón Foundation University Hospital with a diagnosis of osteoporotic hip fracture between the years 1999 and 2015. In a time series analysis, we examined the association between hip fracture incidence and different weather conditions and seasonality using general additive models (with Poisson distribution). The incidence rate ratio (IRR) crude and adjusted by season was estimated for all parameters. Hip incidence was further analyzed by sex and age (below or over 75) subgroups. Four thousand two hundred seventy-one patients with an osteoporotic hip fracture were included (79% females, mean age 83.8). Season fracture rate was significantly higher in fall and winter (67.06 and 64.41 fractures/season) compared to summer and spring (59.71 and 60.06; p< 0,001). Hip fracture incidence was 15% greater in autumn and winter than in spring and summer. Fog [IRR 1.15 (95% CI: 1.003-1.33)], atmospheric pressure (per 100mb) [IRR 1.05 (95% CI: 1.004-1.114)], and frost [IRR 1.15 (95% CI: 1.03-1.30)] were significantly associated with increased hip fracture. Haze [IRR 1.10 (95% CI: 0.99-1.23)] showed a trend without statistical significance. Daily average temperature (per 5°C) [IRR 0.98 (95% CI: 0.957-0.996)], rain (per 10ml) [IRR 0.99 (95% CI: 0.981-1.0)], wind speed [IRR = 0.952, (95% CI: 0.907-0.998)], and daily ultraviolet radiation (per 100joules) [IRR 0.998 (95% CI: 0.996-1.0)] were negatively associated with fracture. After adjusting by season and trend, all these associations disappear. In this Southern region, hip fracture incidence exhibits a seasonal pattern different from those communicated in Northern regions. There is short-term association with different weather conditions that partly explain this seasonal pattern.

Perinatal and lifestyle factors mediate the association between maternal education and preschool children's weight status: the ToyBox study.

This study aimed to explore the associations among perinatal, sociodemographic, and behavioral factors and preschool overweight/obesity. Data were collected from 7541 European preschoolers in May/June 2012. Children's anthropometrics were measured, and parents self-reported all other data via questionnaires. Level of statistical significance was set at P ≤ 0.05. Certain perinatal factors (i.e., maternal prepregnancy overweight/obesity, maternal excess gestational weight gain, excess birth weight, and "rapid growth velocity"), children's energy balance-related behaviors (i.e., high sugar-sweetened beverage consumption, increased screen time, reduced active-play time), family sociodemographic characteristics (i.e., Eastern or Southern Europe, low maternal and paternal education), and parental overweight/obesity were identified as correlates of preschoolers' overweight/obesity. Furthermore, maternal prepregnancy overweight/obesity, children's "rapid growth velocity," and increased screen time mediated by 21.2%, 12.5%, and 5.7%, respectively, the association between maternal education and preschoolers' body mass index. This study highlighted positive associations of preschooler's overweight/obesity with excess maternal prepregnancy and gestational weight gain, excess birth weight and "rapid growth velocity," Southern or Eastern European region, and parental overweight/obesity. Moreover, maternal prepregnancy overweight/obesity, children's "rapid growth velocity," and increased screen time partially mediated the association between maternal education and preschoolers' body mass index. The findings of the present study may support childhood obesity prevention initiatives, because vulnerable population groups and most specifically low-educated families should be prioritized. Among other fields, these intervention initiatives should also focus on the importance of normal prepregnancy maternal weight status, normal growth velocity during infancy, and retaining preschool children's screen time within recommendations.

Road traffic injuries, mobility and gender. Patterns of risk in Southern Europe

Abstract Background The identification of risk groups for road traffic injuries (RTI) is essential for effective prevention strategies. This information is still limited in several geographical areas. The aim of this study was to evaluate the risk of RTI according to gender, age, mode of transport, type of journey and injury severity in a Southern European region. Methods A cross-sectional study was conducted during the period from January 2008 to December 2013 in Andalusia (South of Spain). We estimated the specific morbidity rates by gender, mode of transport and age. The relative risk assessment was performed by Poisson regression models adjusted by gender, age, type of journey, injury severity and mode of transport. The measure of exposure was person − hours travelled. Results Except for pedestrians, the highest RTI rates were found in women. This pattern was still fulfilled in minor injuries. In serious and fatal injuries, the trend was reversed with the risk of increased RTI in men. The most hazardous mode of transport was motorcycles, while public transport was the safest. Injury severity was positively associated with age for all modes of transport, except motorcycles where the opposite was the case. Finally, the risk of serious or fatal injury was greater in long-distance trips. Conclusions In our Southern European region, preventive strategies should be targeted in men, young and older people, motorcycles and long-distance drivers, as they present a higher risk of serious and fatal injuries.

Creating value from Social Big Data: Implications for Smart Tourism Destinations

This paper aims to demonstrate how the huge amount of Social Big Data available from tourists can nurture the value creation process for a Smart Tourism Destination. Applying a multiple-case study analysis, the paper explores a set of regional tourist experiences related to a Southern European region and destination, to derive patterns and opportunities of value creation generated by Big Data in tourism. Findings present and discuss evidence in terms of improving decision-making, creating marketing strategies with more personalized offerings, transparency and trust in dialogue with customers and stakeholders, and emergence of new business models. Finally, implications are presented for researchers and practitioners interested in the managerial exploitation of Big Data in the context of information-intensive industries and mainly in Tourism.

P.495 - Epidemiological population-based study of hereditary myopathies in a southern European region

P.495 - Epidemiological population-based study of hereditary myopathies in a southern European region

Modelling soil water and maize growth dynamics influenced by shallow groundwater conditions in the Sorraia Valley region, Portugal

The southern European region faces increasing pressure on fresh water resources due to economic development and climate change. Integrative modelling operational tools capable of simulating the full soil-water-atmosphere transfer system are needed to improve agricultural water management at the plot scale. In this study, the MOHID-Land model was used to simulate soil water dynamics and maize growth in a plot located in the Sorraia Valley region, southern Portugal, during the 2014 and 2015 growing seasons. The simulated crop parameters included the leaf area index, canopy height, aboveground biomass, and maize yields. A system-dependent boundary condition that triggered irrigation when a certain threshold pressure head (ht) was reached in the root zone domain was also implemented in MOHID-Land. This boundary condition was used to optimize the irrigation scheduling practices in scenarios with different groundwater depths and ht values. MOHID-Land successfully simulated soil water contents and crop growth during the monitored crop seasons, producing acceptable errors of the estimates after normalization (0.061≤NRMSE≤0.390), and relatively high modelling efficiencies (0.11≤EF≤0.94). Model simulations further showed the importance of capillary rise (CR) to the soil water balance, and confirmed the inefficient water use of current irrigation practices. The analyses of the irrigation scenarios showed an increase of CR from 17.7 to 66.9% of the actual evapotranspiration values after optimizing the irrigation scheduling practices, and the contribution of the shallow groundwater to the root zone. Water productivity also increased up to 12% when compared with the farmer’s standard irrigation practices. The MOHID-Land model proved to be an effective tool for irrigation water management in the Sorraia Valley region.

The Hidden Work of Women in Small Family Firms in Southern Spain

Women have historically played an important hidden role in family firms, and a great deal of research is now shedding light on this role. In spite of the more formal nature of female work at the present day, still a considerable volume of women’s contributions in family firms is unregistered and unpaid, even in developed regions. A questionnaire was administered to 396 women working in small and medium-sized family firms located in Andalucia, a southern European region, characterized by familialism and an important informal economy. Our results confirm the persistence of subordinate forms of unpaid family collaboration due to the neutrality assigned to female contributions under the traditional gendered division of work. But also this study shows how some of the women voluntarily embrace subordinate roles as a temporary way to gain professional experience, useful for their future work inside or outside the family firm.

Incidence and time trends of childhood lymphomas: findings from 14 Southern and Eastern European cancer registries and the Surveillance, Epidemiology and End Results, USA.

To describe epidemiologic patterns of childhood (0-14years) lymphomas in the Southern and Eastern European (SEE) region in comparison with the Surveillance, Epidemiology and End Results (SEER), USA, and explore tentative discrepancies. Childhood lymphomas were retrieved from 14 SEE registries (n=4,702) and SEER (n=4,416), diagnosed during 1990-2014; incidence rates were estimated and time trends were evaluated. Overall age-adjusted incidence rate was higher in SEE (16.9/106) compared to SEER (13.6/106), because of a higher incidence of Hodgkin (HL, 7.5/106 vs. 5.1/106) and Burkitt lymphoma (BL, 3.1 vs. 2.3/106), whereas the incidence of non-Hodgkin lymphoma (NHL) was overall identical (5.9/106 vs. 5.8/106), albeit variable among SEE. Incidence increased with age, except for BL which peaked at 4years; HL in SEE also showed an early male-specific peak at 4years. The male preponderance was more pronounced for BL and attenuated with increasing age for HL. Increasing trends were noted in SEER for total lymphomas and NHL, and was marginal for HL, as contrasted to the decreasing HL and NHL trends generally observed in SEE registries, with the exception of increasing HL incidence in Portugal; of note, BL incidence trend followed a male-specific increasing trend in SEE. Registry-based data reveal variable patterns and time trends of childhood lymphomas in SEE and SEER during the last decades, possibly reflecting diverse levels of socioeconomic development of the populations in the respective areas; optimization of registration process may allow further exploration of molecular characteristics of disease subtypes.

Energy performance certificates as tools for energy planning in the residential sector. The case of La Rioja (Spain).

The building construction sector is responsible for more than 30% of the world's total energy consumption and almost 30% of its CO2 emissions. European directives addressing energy performance have opened up a number of possibilities for action as they have evolved from obligatory measures to opportunities for advancement. Energy certifications for buildings and dwellings can illuminate many of the realities of construction, improve the efficiency of existing buildings and endow residential sector planning with a more realistic vision. This study examines the Autonomous Community of La Rioja – a Spanish region in which cold winter climate zones predominate – and analyzes how energy performance certificates can be used as a planning tool by calculating and verifying the average primary energy consumption and the corresponding CO2 emissions per square meter and per year for the residential sector. In addition, the differences between rural and urban areas are presented. The average primary energy consumption varied between 229.4 kWh/m2·year and 309.4 kWh/m2·year, depending on the climate zone, and the associated emissions varied from 51.7 kg CO2/m2·year to 72.0 kg CO2/m2·year. This study is an initial benchmark to develop all that concerns the residential sector in La Rioja's 2015–2025 Energy Plan. The data obtained will enable different energy rehabilitation scenarios to be sketched out. Based on this information, government agencies can determine appropriate policies to be implemented in the future. Therefore, this study is the first step in defining the actual energy consumption conditions for the residential sector in a southern European region.

Induced abortion in a Southern European region: examining inequalities between native and immigrant women.

To examine induced abortion (IA) inequalities between native and immigrant women in a Southern European region and whether these inequalities depend on a 2010 Law facilitating IA. We conducted two analyses: (1) prevalence of total IAs, repeat and second trimester IA, in native and immigrant women aged 12-49years for years 2009-2013 according to country of origin; and (2) log-binomial regression was used to quantify the association of place of origin with repeat and second trimester IAs among women with IAs. Immigrants were more likely to have an IA than Spanish women, with the highest probability in Sub-Saharan Africa (PR 8.32 95% CI 3.66-18.92). Immigrant women with an IA from countries other than Maghreb and Asia have higher probabilities of a repeat IA than women from Spain. Women from Europe non-EU/Romania were 50% (95% CI 0.30-0.79) less likely to have a second trimester IA, while women from Central America/Caribbean were 45% (95% CI 1.11-1.89) more likely than Spanish women. The 2010 Law did not affect these associations. There is a need for parenthood planning programs and more information and access to contraception methods especially in immigrant women to help decrease IAs.

The impact of the Great Recession on mental health and its inequalities: the case of a Southern European region, 1997-2013.

BackgroundNumerous studies have shown that macroeconomic changes have a great influence on health, prompting different concerns in recent literature about the effects of the current recession. The objetive of the study was to assess the changes in the mental health of the working-age population in the Basque Country (Spain) and its social inequalities following the onset of the 2008 recession, with special focus on the role of unemployment.MethodsRepeated cross-sectional study on the population aged 16–64, using four Basque Health Surveys (1997–2013). Age-adjusted prevalences of poor mental health and incremental prevalence ratios (working status and social class adjusted) between years were calculated. Absolute/relative measures of social inequalities were also calculated.ResultsFrom 2008, there was a clear deterioration in the mental health, especially among men. Neither changes in employment status nor social class accounted for these changes. In men, the deterioration affected all working status categories, except the retired but significant changes occurred only among the employed. In women, poor mental health significantly increased among the unemployed. Students were also especially affected. Relative inequalities increased only in men.ConclusionsThe Great Recession is being accompanied by adverse effects on mental health, which cannot be fully explained by the increase of unemployment. Public health professionals should closely monitor the medium and long-term effects of the crisis as these may emerge only many years after the onset of recessions.

Evidence of an indirect rebound effect with reversible heat pumps: having air conditioning but not using it?

Regional energy efficiency programmes are of particular interest as they tackle local constraints which are not always targeted by national energy policy. Within this framework, an energy efficiency programme for existing dwellings has been implemented in a southern European region, providing financial incentives for a combination of energy efficiency actions (heat pump combined with insulation and/or solar water heater). Ex-post evaluation results of this pilot programme are reported in this study. More than 200 households were surveyed regarding their individual energy consumption as well as house and household characteristics. Likewise, the survey highlights household behaviours concerning both space heating and air conditioning, before and after refurbishment. A 3-year billing analysis is used to calculate the energy savings attributed to the operation. Evaluations are carried out taking into account critical parameters like climate differences between years or direct (enhanced space heating comfort) and indirect (use of air conditioning) rebound effects via a statistical model. Moreover, an uncertainty assessment of energy savings was realized on the basis of three scenarios (low, median and high). This study is particularly focused on the use of air conditioning by households, data rarely found in the literature, whereas the consumption linked to air conditioning should increase in the residential sector especially in southern regions. These results help in answering questions about the installation of heat pumps in existing single-family houses with respect to energy savings as well as direct and indirect rebound effects.

Sprawl matters: the evolution of fringe land, natural amenities and disposable income in a Mediterranean urban area

We investigate the relationship between land-use changes (1987–2007) and the spatial distribution of the average declared income of resident population in a southern European metropolitan region (Athens, Greece) as a contribution to the analysis of suburbanization processes in the Mediterranean region. To demonstrate that urban expansion is accompanied with multiple modifications in the use of the surrounding non-urban land, we developed a computational approach based on spatial indexes of landscape configuration and proximity as a result of changes in the local socio-spatial structure. Diversity in the use of land surrounding built-up parcels in the Athens’ metropolitan region increased significantly between 1987 and 2007, reflecting a progressive fragmentation of the exurban landscape. The percentage of forests and (high-quality) natural land surrounding built-up parcels increased from 8.1 to 9.4 % between 1987 and 2007. The reverse pattern was observed for (low-quality) sparsely vegetated areas, declining from 65 to 47 %. Large built-up parcels were surrounded by a higher percentage of natural land than small parcels. The largest increase over time in forest and natural land surrounding built-up parcels was observed in municipalities with high per capita declared income, and the reverse pattern was observed for sparse vegetation. Our results demonstrate that scattered urban expansion determines a polarization in suburban areas with high-quality and low-quality natural amenities. Sprawl increases economic inequality and socio-spatial disparities contributing to a spatially unbalanced distribution of natural amenities with higher consumption of high-quality land.

Increase in socioeconomic inequalities in mortality in a Southern European region: a small-area ecological study.

This study sought to describe the total mortality trend by socioeconomic deprivation (SED) in the Madrid Autonomous Region, by sex and age group. Cross-sectional ecological study by census tract, in two periods: 1994-2000 (P1) with SED of 1996 census and 2001-07 (P2) with SED of 2001 census. We calculated the relative risks (RRs) and their 95% credibility intervals (95% CIs) by SED quintile (Q), taking the quintile of least deprivation as reference. Besag-York-Mollié ecological regression models and the Integrated Nested Laplace Approximation procedure were applied. The absolute differences in age-standardized rates were compared by SED quintile. Inequalities decreased in young adults: among men aged 20-39 years, the RR in Q5 versus Q1 ranged from 2.73 (95% CI, 2.51-3.02) in P1 to 1.93 (95% CI, 1.76-2.15) in P2, due to the greater improvement in the most underprivileged groups. In contrast, there was an increase in SED-related mortality in the 40-79 age group. Among men aged 40-59 years, the RR in Q5 versus Q1 rose from 1.88 (95% CI, 1.76-2.02) in P1 to 2.29 (95% CI, 2.17-2.43) in P2; the improvement was greater in the most privileged groups. In a context of an economic boom, inequalities were observed to increase among adults by a greater improvement in the most privileged groups.

The impact of several environmental factors on density of woodcocks (Scolopax rusticola) wintering in a southern European region

Knowledge of spatio-temporal animal distribution patterns is one of the main chapters of wildlife research, not only due to its biological and ecological importance but also its usefulness in the conservation and management of animal populations. Iberia is a target wintering region for the Eurasian woodcock (Scolopax rusticola). The aim of the present work is to determine which factors shape woodcock distribution patterns during the winter period. To ascertain this, we used data collected over three consecutive years (winter of 2010/2011–2012/2013) in a region from northern Iberia (Gipuzkoa). Woodcock numbers (W) were modeled using generalized linear mixed models. The models that best fitted our data included a significant effect of latitude, land uses, sampling year, and type of meadow on W (once weighted for the number of visits and the area of each meadow). Overall, W tended to be lower in sites from southern Gipuzkoa, in those areas where there was a higher proportion of tree plantations, in grazed mountain pastures, and during the winters of 2011 and 2012 in relation to 2010 (mean ± SD values in 2010, 0.4 ± 0.5 woodcocks/ha; 2011, 0.2 ± 0.3 woodcocks/ha; 2012, 0.2 ± 0.4 woodcocks/ha). Part of the observed variance was due to the “year” effect, which could include several potential explanatory variables. Future research should try to add variables such as year-associated meteorological conditions, at both breeding and non-breeding quarters. Locally, a mosaic of some forest/woodland with abundant meadows would allow numbers of woodcocks to reach an optimum within the region. Moreover, the species was more abundant in the north; hence, the zones close to the coast had more importance from a conservation standpoint.

Progressive decrease in the potential usefulness of meningococcal serogroup B vaccine (4CMenB, Bexsero®) in Gipuzkoa, Northern Spain.

The effectiveness of a vaccine is determined not only by the immunogenicity of its components, but especially by how widely it covers the disease-causing strains circulating in a given region. Because vaccine coverage varies over time, this study aimed to detect possible changes that could affect vaccine protection during a specific period in a southern European region. The 4CMenB vaccine is licensed for use in Europe, Canada, and Australia and is mainly directed against Neisseria meningitidis serogroup B. This vaccine contains four main immunogenic components: three recombinant proteins, FHbp, Nhba and NadA, and an outer membrane vesicle [PorA P1.4]. The allelic distribution of FHbp, Nhba, NadA, and PorA antigens in 82 invasive isolates (B and non-B serogroups) isolated from January 2008 to December 2013 were analyzed. 4CMenB was likely protective against 61.8% and 50% of serogroup B and non-B meningococci, respectively, in the entire period, but between 2012 and 2013, the predicted protection fell below 45% (42.1% for serogroup B isolates).The observed decreasing trend in the predicted protection during the 6 years of the study (Χ 2 for trend = 4.68, p = 0.03) coincided with a progressive decrease of several clonal complexes (e.g., cc11, cc32 and cc41/44), which had one or more antigens against which the vaccine would offer protection.

Development of a prediction model for fatal and non-fatal coronary heart disease and cardiovascular disease in patients with newly diagnosed type 2 diabetes mellitus: the Basque Country Prospective Complications and Mortality Study risk engine (BASCORE).

The aim of this study was to construct a model for predicting CHD and cardiovascular disease (CVD) risk in patients with newly diagnosed type 2 diabetes in a southern European region. External validation of two other cardiovascular risk models and internal validation of our model were assessed. We studied 65,651 people attending a primary care setting in the Basque Country Health Service. A 10-year prospective population-based cohort study was performed with 777 patients newly diagnosed with type 2 diabetes older than 24years in a Sentinel Practice Network. Cardiovascular risk factors, CVD events and mortality were registered. Coefficients for the significant predictors of CHD and CVD were estimated using Cox models. We assessed the discrimination and calibration of the UK Prospective Diabetes Study risk engine (UKPDS-RE), the Framingham Risk Score-Regicor Study (FRS-RS) and the cardiovascular risk model we developed. The incidence rate per 1,000 patients/year was calculated for microvascular and cardiovascular complications, and death. Age, the ratio of non-HDL- to HDL-cholesterol, HbA1c, systolic blood pressure and smoking were significant predictors of cardiovascular events. A risk model was developed using these predictors. The UKPDS-RE and FRS-RS showed inadequate discrimination (Uno's C statistics 0.62 and 0.58, respectively) and calibration (24% overestimation and 51% underestimation, respectively) for predicting CHD risk. The internal discrimination and calibration of the developed model were acceptable for predicting fatal/non-fatal 2- and 5-, but not 10-year CHD and CVD risk. This study is the first southern European validated population-derived model for predicting 5-year fatal/non-fatal CHD and CVD risk in patients with newly diagnosed type 2 diabetes.

Trends in the prevalences of congenital anomalies and age at motherhood in a southern European region: a population-based study

ObjectivesTo estimate the prevalences of the main groups of congenital anomalies and to assess their trend over time.DesignPopulation-based study of prevalences.SettingThe Basque Country, Spain.ParticipantsAll births and all congenital anomalies diagnosed...