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Cardiovascular prevention in elderly patients

Journal of Geriatric Cardiology 2022年第5期19卷 377-392页

作者： Clara Bonanad Rosa Fernández-Olmo Sergio garcía-Blas Jose Antonio Alarcon Pablo Díez-Villanueva Carmen Rus Mansilla héctor garcía-pardo Pablo Toledo Ana Ayesta Eva Pereira Antoni Carol Almudena Castro-Conde Carmen de Pablo-Zarzoso Manuel Martínez-Sellés Vicente Arrarte Raquel Campuzano Albert Ariza-Solé Servicio de Cardiología Hospital Clínico Universitario de ValenciaValenciaSpain Instituto de Investigación Sanitaria INCLIVA ValenciaSpain Servicio Cardiología hospital Universitario de Jaén Spain Servicio Cardiología hospital de Donosti Spain Servicio de Cardiología Hospital Universitario La Princesa de MadridSpain Servicio de Cardiología Hospital Alto Gudalquivir de AndújarJaénSpain Servicio de Cardiología Hospital Rio Hortega de ValladolidSpain Servicio Cardiología hospital Clínico San Cecilio de Granada Spain Servicio de Cardiología Hospital Universitario Central de AsturiasSpain Servicio de Cardiologia Hospital de LugoSpain Servicio de Cardiología Hospital Moisés Broggi de BarcelonaSpain Servicio de Cardiología hospital Universitario de la Paz de Madrid Spain Servicio de Cardiología Hospital Ramón y Cajal de MadridSpain Department of Cardiology.hospital Universitario Gregorio Marañón CIBERCV.Universidad EuropeaUniversidad Compluten Servicio de Cardiología del hospital General de Alicante Spain Servicio de Cardiología hospital Universitario Fundación de Alcorcón de MadridSpain Servicio de Cardiología Hospital Bellvitge de BarcelonaBioheartGrup de Malalties CardiovascularsInstitut d’InvestigacióBiomèdica de BellvitgeIDIBELLL’Hospitalet de LlobregatBarcelonaSpain

In recent decades,life expectancy has been increasing significantly.In this scenario,health interventions are ne-cessary to improve prognosis and quality of life of elderly with cardiovascular risk factors and cardiovascular disease.however,the number of elderly patients included in clinical trials is low,thus current clinical practice guidelines do not include specific re-commendations.This document aims to review prevention recommendations focused in patients≥75 years with high or very high cardiovascular risk,regarding objectives,medical treatment options and also including physical exercise and their inclusion in cardiac rehabilitation programs.Also,we will show why geriatric syndromes such as frailty,dependence,cognitive impair-ment,and nutritional status,as well as comorbidities,ought to be considered in this population regarding their important pro-gnostic impact.

关键词： prevention patients cardiovascular

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A regionalized IO-model to value seasonal recreational ecosystem services in a mountain National Park in Spain

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Journal of Mountain Science 2022年第1期19卷 211-227页

作者： Víctor MARTIN BARROSO Mónica de CASTRO-pardo Pascual FERNÁNDEZ MARTÍNEZ João C.AZEVEDO Department of Applied Economics I and history and economic institutions Faculty of Law and Social SciencesUniversidad Rey Juan CarlosCampus of VicálvaroTulipanMóstoles 28933Spain Department of Financial and Actuarial Economics and Statistics-Statistics and Operational Research Complutense University of MadridCampus of SomosaguasPozuelo de Alarcon 28223Spain Centro de Investigação de Montanha Instituto Politécnico de BragançaCampus de Santa ApolóniaBragança 5300-253Portugal

Recreational Ecosystem Services(RES)are among the most frequently evaluated ecosystem services.RES are seen as a major opportunity for sustainable development in areas of high ecological value resulting from the presence of emblematic species,habitats or scenery,often integrated in conservation areas,in particular in mountain areas affected by depopulation,rising environmental risks and poverty.Economically,the assessment of RES has been based on Contingent Valuation and Choice Experiments,methods with limitations related to their subjectivity.Alternatively,Input-Output(IO)models provide a very accurate and effective way of valuation of RES with regional information regarding interindustry transactions.Whilst data on nature tourist expenditure may be only available annually,tourism inflows have a strong seasonal behavior,which impacts the profitability of several local economic activities.In this paper,we firstly constructed a novel regionalized IO-model based on Cross-Industry Location Quotients using employment data and,secondly,based on Monte Carlo simulation,we estimated nature tourist expenditure monthly using data on nature tourism inflows.This method allowed for a more precise RES evaluation,estimating direct,indirect and induced monthly economic impacts of nature-based tourism.The method was applied to the Ordesa and Monte Perdido(OMP)National Park in the Spanish Pyrenees.To estimate the average tourist expenditure,we collected and analyzed spending on commerce,hospitality and restaurants,leisure,and transport of 385 visitors.Results suggest that using a regionalized IO model leads to a considerable reduction of over-estimation of the economic impact of tourist expenditure estimated by conventional methods.Taking into consideration the direct,indirect and induced effects of tourist expenditure in 2016-2018,the total annual output effect in the OMP National Park amounted to€208.8 million,while the total income effect amounted to€86.29 million.Also,a total of 2,429 jobs were created which indicates that for

关键词： Input-Output Monte Carlo Simulation Location quotients Recreational Ecosystem Services Nature tourism Sustainable mountain development

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