Academic activism in tourism studies:Critical Narratives from Four Researchers

A climate of neoliberalism challenges the work of scholars whose research focuses on societal well-being through embedded community research and critical analysis of public policy, planning, and industry practices, what we call academic activism. This article draws on the autoethnographic insights and critical narratives of four tourism scholars to describe and analyze in a systematic manner the experiences of these researchers each engaged in what they consider to be academic activism. Our aim is to bring into focus and raise as matters of concern the future of tourism research in the neoliberal university and the need for greater critical and reflexive engagement by researchers in their positionality and agency. Although the contexts in which we work and our experiences differ greatly, the article identifies common themes, challenges, and opportunities within our approaches to research and action. Four emergent themes arose through the narrative analysis that helped to structure insights and findings: experiential journeys that shaped our current academic positionality and philosophical approaches to research and practice; a preference for embedded situated methodologies; a reflexive understanding of our political positioning; and a critical situated approach to understanding the external influences upon our research and strivings to contribute to the public good. The article raises challenging questions on the meaning of tourism research and the "public good" in the neoliberal university, and what being an academic activist entails in this context.</jats:p

Visualising the invisible: collaborative approaches to local-level resilient development in the Pacific Islands region

The Pacific Islands region has made strong progress on the integration of climate change, disaster management and development frameworks, particularly via the Pacific Urban Agenda and the Framework for Resilient Development in the Pacific. These frameworks highlight the need for local- level collaboration in achieving ambitious pathways for climate- and disaster-resilient development. However, to date little research has investigated the role that local-level collaboration plays in implementation. Additionally, there is a lack of guidance on how to design and implement local-level collaboration that is informed by in-country practitioner experiences. This study addresses those gaps. Its findings indicate that in the Pacific collaborative attributes span individuals, institutions, collaborative arrangements, and broader governance systems. They also suggest that the skills needed to undertake collaboration well at the local level are, in part, already manifest in Pacific cultures as invisible skill sets. More can be done to make the invisible visible by documenting and developing the ‘soft skills’ that are necessary to achieve climate- and disaster-resilient development. This action could contribute to bridging the gap between ambition and reality

Partnering for real world learning, sustainability and tourism education

Purpose – The purpose of this article is to study how real world learning was used to engender and enhance sustainability principles and practices with 11 micro-, small- and medium-tourism business enterprises and 101 university tourism students enrolled across three university courses. Design/methodology/approach – Action research processes were used to focus curricula on “education about and for sustainability”. A participatory paradigm informed the action research processes. The key methodology was qualitative. Empirical materials were generated through lived experiences, reflexive team conversations, team journals, reflexive journals and student learning materials. Reflexive conversations and reflective dialogue framed interpretations. Findings – The action research process found that pedagogies, andragogies and ethnogogies that emphasize social processes of meaning making and sensemaking enhance and engender “education about sustainability” and “education for sustainability”, especially when coupled with real world learning as a platform for social and profession-building processes between university students, course teaching staff and industry, in this case, micro-, small- and medium-tourism entrepreneurs. Research limitations/implications – The qualitative findings of this action research study are specific to the participants involved. Generalizability to other university and business settings and goodness of fit require further study. Practical implications – Insights are provided with regard to implementing real world learning in university undergraduate and postgraduate courses by partnering with industry and focusing on education for sustainability (EfS). A demonstration of the effectiveness of action research as a tool for changing curricula is provided. Social implications – Learning is a social process of meaning making. Time for real world social interaction is critical for learning. Partnering with industry complements student learning and facilitates the translation of theory into practice. Originality/value – EfS is engendered and enhanced when learning-teaching engagements are predicated on real world settings, circumstances and experiences.Griffith Business School, Department of Tourism, Sport and Hotel ManagementNo Full Tex

Delivering a multi-functional and resilient urban forest

Tree planting is widely advocated and applied in urban areas, with large-scaleprojects underway in cities globally. Numerous potential benefits are used to justify these planting campaigns. However, reports of poor tree survival raise questions about the ability of such projects to deliver on their promises over the long-term. Each potential benefit requires different supporting conditions—relating not only to the type and placement of the tree, but also to the broader urban system within which it is embedded. This set of supportingconditions may not always be mutually compatible and may not persist for the lifetime of the tree. Here, we demonstrate a systems-based approach that makes these dependencies, synergies, and tensions more explicit, allowing them to be used to test the decadal-scale resilience of urban street trees. Our analysis highlights social, environmental, and economic assumptions that are implicit within planting projects; notably that high levels of maintenance and public support for urban street trees will persist throughout their natural lifespan, andthat the surrounding built form will remain largely unchanged. Whilst the vulnerability of each benefit may be highly context specific, we identify approaches that address some typical weaknesses, making a functional, resilient, urban forest more attainable.

Computerized clinical decision support systems for acute care management: A decision-maker-researcher partnership systematic review of effects on process of care and patient outcomes

<p>Abstract</p> <p>Background</p> <p>Acute medical care often demands timely, accurate decisions in complex situations. Computerized clinical decision support systems (CCDSSs) have many features that could help. However, as for any medical intervention, claims that CCDSSs improve care processes and patient outcomes need to be rigorously assessed. The objective of this review was to systematically review the effects of CCDSSs on process of care and patient outcomes for acute medical care.</p> <p>Methods</p> <p>We conducted a decision-maker-researcher partnership systematic review. MEDLINE, EMBASE, Evidence-Based Medicine Reviews databases (Cochrane Database of Systematic Reviews, DARE, ACP Journal Club, and others), and the Inspec bibliographic database were searched to January 2010, in all languages, for randomized controlled trials (RCTs) of CCDSSs in all clinical areas. We included RCTs that evaluated the effect on process of care or patient outcomes of a CCDSS used for acute medical care compared with care provided without a CCDSS. A study was considered to have a positive effect (<it>i.e.</it>, CCDSS showed improvement) if at least 50% of the relevant study outcomes were statistically significantly positive.</p> <p>Results</p> <p>Thirty-six studies met our inclusion criteria for acute medical care. The CCDSS improved process of care in 63% (22/35) of studies, including 64% (9/14) of medication dosing assistants, 82% (9/11) of management assistants using alerts/reminders, 38% (3/8) of management assistants using guidelines/algorithms, and 67% (2/3) of diagnostic assistants. Twenty studies evaluated patient outcomes, of which three (15%) reported improvements, all of which were medication dosing assistants.</p> <p>Conclusion</p> <p>The majority of CCDSSs demonstrated improvements in process of care, but patient outcomes were less likely to be evaluated and far less likely to show positive results.</p

Effectiveness of a national quality improvement programme to improve survival after emergency abdominal surgery (EPOCH): a stepped-wedge cluster-randomised trial

Background: Emergency abdominal surgery is associated with poor patient outcomes. We studied the effectiveness of a national quality improvement (QI) programme to implement a care pathway to improve survival for these patients. Methods: We did a stepped-wedge cluster-randomised trial of patients aged 40 years or older undergoing emergency open major abdominal surgery. Eligible UK National Health Service (NHS) hospitals (those that had an emergency general surgical service, a substantial volume of emergency abdominal surgery cases, and contributed data to the National Emergency Laparotomy Audit) were organised into 15 geographical clusters and commenced the QI programme in a random order, based on a computer-generated random sequence, over an 85-week period with one geographical cluster commencing the intervention every 5 weeks from the second to the 16th time period. Patients were masked to the study group, but it was not possible to mask hospital staff or investigators. The primary outcome measure was mortality within 90 days of surgery. Analyses were done on an intention-to-treat basis. This study is registered with the ISRCTN registry, number ISRCTN80682973. Findings: Treatment took place between March 3, 2014, and Oct 19, 2015. 22 754 patients were assessed for elegibility. Of 15 873 eligible patients from 93 NHS hospitals, primary outcome data were analysed for 8482 patients in the usual care group and 7374 in the QI group. Eight patients in the usual care group and nine patients in the QI group were not included in the analysis because of missing primary outcome data. The primary outcome of 90-day mortality occurred in 1210 (16%) patients in the QI group compared with 1393 (16%) patients in the usual care group (HR 1·11, 0·96–1·28). Interpretation: No survival benefit was observed from this QI programme to implement a care pathway for patients undergoing emergency abdominal surgery. Future QI programmes should ensure that teams have both the time and resources needed to improve patient care. Funding: National Institute for Health Research Health Services and Delivery Research Programme

Effectiveness of a national quality improvement programme to improve survival after emergency abdominal surgery (EPOCH): a stepped-wedge cluster-randomised trial

BACKGROUND: Emergency abdominal surgery is associated with poor patient outcomes. We studied the effectiveness of a national quality improvement (QI) programme to implement a care pathway to improve survival for these patients. METHODS: We did a stepped-wedge cluster-randomised trial of patients aged 40 years or older undergoing emergency open major abdominal surgery. Eligible UK National Health Service (NHS) hospitals (those that had an emergency general surgical service, a substantial volume of emergency abdominal surgery cases, and contributed data to the National Emergency Laparotomy Audit) were organised into 15 geographical clusters and commenced the QI programme in a random order, based on a computer-generated random sequence, over an 85-week period with one geographical cluster commencing the intervention every 5 weeks from the second to the 16th time period. Patients were masked to the study group, but it was not possible to mask hospital staff or investigators. The primary outcome measure was mortality within 90 days of surgery. Analyses were done on an intention-to-treat basis. This study is registered with the ISRCTN registry, number ISRCTN80682973. FINDINGS: Treatment took place between March 3, 2014, and Oct 19, 2015. 22 754 patients were assessed for elegibility. Of 15 873 eligible patients from 93 NHS hospitals, primary outcome data were analysed for 8482 patients in the usual care group and 7374 in the QI group. Eight patients in the usual care group and nine patients in the QI group were not included in the analysis because of missing primary outcome data. The primary outcome of 90-day mortality occurred in 1210 (16%) patients in the QI group compared with 1393 (16%) patients in the usual care group (HR 1·11, 0·96-1·28). INTERPRETATION: No survival benefit was observed from this QI programme to implement a care pathway for patients undergoing emergency abdominal surgery. Future QI programmes should ensure that teams have both the time and resources needed to improve patient care. FUNDING: National Institute for Health Research Health Services and Delivery Research Programme