Visitors' satisfaction of visit and the economic impacts of perceptions of ecotourism development support in Alamout area, Iran

Economic impacts are the main factor in developing sustainable ecotourism. They provide alternatives for the local community to support their lives in addition to traditional farming. Several research studies have focused on local perceptions upon tourism development impacts, but visitors' opinions have received less consideration. This study, therefore, is focused on visitors' perceptions and their intention to support ecotourism development in the Alamout area in Iran. A survey was conducted to assess the visitors' perception, intention to revisit and their support for ecotourism development. The structural equation modelling was developed by using AMOS to analyse the data. The result of the study indicates that "Create jobs", "Economic benefits to residents" and "Employment opportunity" were the high agreed positive economic impacts while "Increase the real estate prices", "Attract non-local investors" and "Increase in the price of goods" were the high negative perceived impacts from visitors' view. Results of the confirmatory factor analysis confirmed that visitors who perceived negative economic impacts were less likely to revisit or recommend the area

A Survey on Intensive Care Unit Information Systems in Hospitals Affiliated with Shahid Beheshti University of Medical Sciences

Introduction: The information system of the intensive care unit has been designed and established in order to manage patients’ data and quickly retrieve patients’ information in this unit. This research was carried out to study the information system of the ICU and reporting capabilities in the hospitals affiliated with Shahid Beheshti University of Medical Sciences (SBMU). Methods: In this descriptive cross-sectional study, the study population included ICU information systems in seven hospitals that had the system in place. Data gathering tools were a questionnaire and a checklist. The content validity was performed to ensure the validity of the checklist and questionnaire. The test-retest method was used to determine the questionnaire reliability (r = 0.89). Data were analyzed using descriptive statistics. Results: Data collection in the ICU information system in all hospitals understudy is done both in the form of paper forms and electronically. Regarding reporting capability,  patients’ demographic information reports, admission reports, discharge reports, transfers, diagnoses, mortality, and management reports, none of the studied hospitals, the automatic reporting capability scores (GCS), reporting patient safety indicators through alerts and reminders, reporting the cost of medications, reporting disease severity, including Sequential Organ Failure Assessment (SOFA), and Acute Physiology and Chronic Health Evaluation (APACHE), were not observed. Conclusion: Implementing comprehensive and integrated ICU information systems can be an effective step towards organizing patient information and improving the quality of service provided to them. Therefore, the deployment of an ICU information system is necessary to improve care delivery in ICUs

Protocol Adherence in Prehospital Medical Care Provided for Patients with Chest Pain and Loss of Consciousness; a Brief Report

Introduction: Although many protocols are available in the field of the prehospital medical care (PMC), there is still a notable gap between protocol based directions and applied clinical practice. This study measures the rate of protocol adherence in PMC provided for patients with chest pain and loss of consciousness (LOC).Method: In this cross-sectional study, 10 educated research assistants audited the situation of provided PMC for non-traumatic chest pain and LOC patients, presenting to the emergency department of a tertiary level teaching hospital, compare to national recommendations in these regards.Results: 101 cases with the mean age of 56.7 ± 12.3 years (30-78) were audited (55.4% male). 61 (60.3%) patients had chest pain and 40 (39.7%) cases had LOC. Protocol adherence rates for cardiac monitoring (62.3%), O2 therapy (32.8%), nitroglycerin administration (60.7%), and aspirin administration (52.5%) in prehospital care of patients with chest pain were fair to poor. Protocol adherence rates for correct patient positioning (25%), O2 therapy (75%), cardiac monitoring (25%), pupils examination (25%), bedside glucometery (50%), and assessing for naloxone administration (55%) in prehospital care of patients with LOC were fair to poor.Conclusion: There were more than 20% protocol violation regarding prehospital care of chest pain patients regarding cardiac monitoring, O2 therapy, and nitroglycerin and aspirin administration. There were same situation regarding O2 therapy, positioning, cardiac monitoring, pupils examination, bedside glucometery, and assessing for naloxone administration of LOC patients in prehospital setting

Stakeholders’ perceptions and attitudes towards ecotourism development in Alamout, Iran

The traditional lifestyles, conservative mindsets, a reluctance to see change in their natural environment and low education of rural communities are barriers to the development of ecotourism. As such, the consequential dearth of facilities that result in potential ecotourism destinations is a deterrent to tourists. The Alamout area of Iran possesses natural and historical attractions but remains undeveloped for these reasons. The ecotourism industry is very closely related to the visitors, local communities and resource managers and it is imperative that they, as stakeholders, must show support for as well as interest and involvement in ecotourism and its development for the industry to be successful. In many literatures, it has been shown that most researchers have focused on the locals while some have considered visitors but too little attention has been paid to the area of ecotourism development support and involvement through investigations of the points of view of different stakeholders. Three core theories were combined to achieve synergy between stakeholders’ perception of impacts, their intention to be involved in and give support to Ecotourism development in the area. Both the Theory of Reasoned Action and Theory of Planned Behaviour were used to derive the concept of intention and behaviour through respondents’ attitude and perceptions. Social Exchange Theory explicates each person’s involvement in different activities concerning the advantages and tangible or intangible profits. Stakeholders Theory posits that an industry’s success depends on its ability to manage relationships with its stakeholders and explains that people try to care for and conserve everything which has value for them. First, positive and negative impacts derived from literature were discussed and finalised with administrators relevant to this study area. Then data were collected from visitors to four major tourism sites in the Alamout area and from members of the local communities living in the six villages around these sites during the period from June to September 2011. Structural equation modelling was used to find the relation between items and their high level latent variables using AMOS. Of the study population, 451 persons completed the questionnaire including 236 visitors and 215 locals. In both groups, males were dominant due to cultural attitudes. Local communities mostly consisted of white beard leaders and high council members of the villages and their jobs were highly dependent on natural resources, such as agriculture and gardening. Visitors were mostly young students or small families working in government organizations. Outcomes of the study indicate that a positive relation exists between total positive impact perceptions and intentions to be involved in Ecotourism development among the visitors and locals. Results of both models indicate a negative statistically significant relation between total negative impact perceptions of visitors and locals and their intentions to be involved in Ecotourism development. Visitors and locals expressed high support for Ecotourism development. They expressed support for establishing infrastructure and indicated their agreement with establishing a domestic museum and organising traditional festivals. They believed that Ecotourism has a vital role to play in the future and agreed that the Tourism organization should plan for Ecotourism development in the Alamout area