Matkailijarakenteen ja kehitystarpeiden tutkiminen : case Hailuoto

Opinnäytetyöni tavoitteena oli selvittää Perämerellä sijaitsevan Hailuodon saaren kävijöiden rakennetta, ajanviettotapoja, mielikuvia, ostokäyttäytymistä ja kehittämisideoita. Tutkimuksen tarkoitus oli saada kattavaa tietoa Hailuodon kunnalle, mikä auttaa kehittämään paikkaa. Suoritin tutkimuksen kesällä 2017 ja toteutin sen kyselytutkimuksena. Paperinen kyselylomake oli strukturoitu, jossa oli myös muutama avoin kysymys. Lomakkeet olivat jaossa kahdeksassa Hailuodossa sijaitsevassa yrityksessä. Lisäksi keräsin vastauksia myös itse muutamia kertoja paikan päällä. Lopuksi syötin vastaukset tilasto-ohjelmaan ja analysoin ne. Opinnäytetyö koostuu teoriaosuudesta, joka käsittelee kuluttajakäyttäytymistä, ostopäätöksiin vaikuttavia tekijöitä, asiakaskokemusta ja siihen vaikuttavia tekijöitä sekä erilaisia matkailupalveluita. Tämän jälkeen kerroin tutkimuksen toteutuksesta ja mitä kaikkea siihen sisältyi. Opinnäytetyö oli määrällinen eli kvantitatiivinen tutkimus ja kohderyhmänä oli kaikenlaiset Hailuodossa kävijät. Vastaajat on valittu satunnaisotannalla. Tutkimuksen toteutuksen jälkeen kerroin tutkimustulokset. Opinnäytetyön lopussa on pohdintaosio, jossa kävin läpi tutkimusprosessia, omia ajatuksia, opinnäytetyön hyödynnettävyyttä ja jatkotutkimusaiheita. Tutkimustuloksista selvisi, että tyypillinen Hailuodossa kävijä on 51-65 vuotias eläkeläinen tai sosiaali-, terveys- ja liikunta-alan työntekijä. Kävijä on kotoisin Pohjois-Pohjanmaalta ja on viipymässä Hailuodossa yhden päivän. Tyypillisesti kävijä saapuu paikalle puolison tai ystävän kanssa. Kävijä on kuullut Hailuodosta ja sen palveluista ystävältä tai se on ollut jo ennestään tuttu. Hän on vieraillut Hailuodossa aikaisemmin yli 10 kertaa. Kävijä pitää Hailuodon ympäristöä ratkaisevana tekijänä, minkä takia on matkustanut paikkakunnalle. Tyypillinen kävijä käy katsomassa nähtävyyksistä Marjaniemeä ja majakkaa ja retkeilee luonnossa. Hän käyttää rahaa matkallaan 0-40 euroa ravintoloihin ja ostoksiin. Pääasiassa kävijöiden mielikuvat Hailuodosta ennen matkaa olivat olleet positiivisia ja he kuvailivat niitä sanoilla: merellinen, karu, pieni, luonnonläheinen ja syrjäinen. Valtaosa kävijöistä oli positiivisesti yllättyneitä ja kokemukset vastasivat mielikuvia tai olivat parempia. Monella myöskään ei ollut ennestään minkäänlaisia mielikuvia saaresta. Kävijät kaipasivat Hailuotoon leirintäaluetta ja toivoivat siistimpää ja parempaa jätehuoltoa Marjaniemeen. Kävijät haluaisivat pyörätien joka ulottuisi Huikun lauttarannasta saaren toiselle puolelle Marjaniemeen saakka. He myös toivoisivat selkeyttä tieopasteisiin ja selkeän infon saaren aktiviteeteista, reiteistä, majoitusvaihtoehtoista, tapahtumista ja nähtävyyksistä. Kävijät olivat kuitenkin pääasiassa tyytyväisiä Hailuotoon ja sen palveluihin. He pitivät saaren omaleimaisuudesta ja luonnon rauhasta.The goal of my thesis was to find out visitor structure, recreation habits, images, buying behaviors and development needs of an island called Hailuoto, which is situated in the Bothnian Bay. The purpose of the survey was to give inclusive information to the town of Hailuoto, which will help to develop the place. I did the research in summer 2017 and it was a questionnaire survey. The paper questionnaire was structured and included also a couple of open questions. The forms were given to eight companies in Hailuoto. In addition, I also collected answers by myself a couple of times in Hailuoto. In the end, I entered the answers into a statistical program and analyzed them. The thesis consists of a theoretical part, which tells about consumer behavior, buying habits and customer experience and factors affecting them and different tourism services. After this I told about doing the survey and what kind of things were included in that. The thesis was a quantitative survey and the target group was all kinds of visitors of Hailuoto. The survey takers were collected randomly. After this, I reported the results of the survey. In the end of the thesis there is a discussion part, where I wrote about the survey process, my own thoughts, recoverability and further research topics. The results of the survey revealed that a typical visitor of Hailuoto is 51-65 years old retired person or works in the social, health or sports industry. The visitor is from Northern Ostrobothnia and is staying for one day in Hailuoto. Typically, the visitor arrives with a partner or a friend. Visitor has heard about Hailuoto and its services from a friend or s/he already knows something about it. S/he has visited Hailuoto over 10 times. Visitor thinks that the environment is the main reason to go there. A typical visitor goes to see Marjaniemi and the lighthouse and hikes in the nature. S/he spends money between 0-40 euros, usually on restaurants and shopping. Visitors’ images of Hailuoto before the trip were mainly positive and they described the place with words such as: marine, bare, small, natural and distant. The majority of the visitors were positively surprised and the experiences were the same as their images before or even better. Many of them also had not had any kind of images of the island. Visitors hoped to get a camping area on Hailuoto and a cleaner and better waste disposal in Marjaniemi. Visitors wanted a bicycle way, which would reach from Huikku ferry wharf to the other side of the island, Marjaniemi. They also hoped for clearer signposts and good and clear info which would tell about the island’s activities, routes, options of accommodation, events and attractions. However, visitors were mainly happy with Hailuoto and its services. They liked the uniqueness and the peace of nature on the island

What are the characteristics of excellent physicians and residents in the clinical workplace? A systematic review.

OBJECTIVES: In order to recognise and facilitate the development of excellent medical doctors (physicians and residents), it is important to first identify the characteristics of excellence. Failure to recognising excellence causes loss of talent, loss of role models and it lowers work ethos. This causes less than excellent patient care and lack of commitment to improve the healthcare system. DESIGN: Systematic review performed according to the Association for Medical Education in Europe guideline. INFORMATION SOURCES: We searched Medline, Embase, Psycinfo, ERIC and CINAHL until 14 March 2022. ELIGIBILITY CRITERIA: We included original studies describing characteristics of excellent medical doctors, using a broad approach as to what is considered excellence. Assuming that excellence will be viewed differently depending on the interplay, and that different perspectives (peers, supervisors and patients) will add to a complete picture of the excellent medical doctor, we did not limit this review to a specific perspective. DATA EXTRACTION AND SYNTHESIS: Data extraction and quality assessment were performed independently by two researchers. We used the Quality Assessment Tool for Different Designs for quality assessment. RESULTS: Eleven articles were eligible and described the characteristics from different perspectives: (1) physicians on physicians, (2) physicians on residents, (3) patients on physicians and (4) mixed group (diverse sample of participants on physicians). The included studies showed a wide range of characteristics, which could be grouped into competencies (communication, professionalism and knowledge), motivation (directed to learning and to patient care) and personality (flexibility, empathy). CONCLUSIONS: In order to define excellence of medical doctors three clusters seem important: competence, motivation and personality. This is in line with Renzulli’s model of gifted behaviour. Our work adds to this model by specifying the content of these clusters, and as such provides a basis for definition and recognition of medical excellence

Unprofessional behaviour of GP residents and its remediation: a qualitative study among supervisors and faculty

Background Lapses in professionalism have profound negative effects on patients, health professionals, and society. The connection between unprofessional behaviour during training and later practice requires timely identification and remediation. However, appropriate language to describe unprofessional behaviour and its remediation during residency is lacking. Therefore, this exploratory study aims to investigate which behaviours of GP residents are considered unprofessional according to supervisors and faculty, and how remediation is applied. Methods We conducted eight semi-structured focus group interviews with 55 broadly selected supervisors from four Dutch GP training institutes. In addition, we conducted individual semi-structured interviews with eight designated professionalism faculty members. Interview recordings were transcribed verbatim. Data were coded in two consecutive steps: preliminary inductive coding was followed by secondary deductive coding using the descriptors from the recently developed 'Four I's' model for describing unprofessional behaviours as sensitising concepts. Results Despite the differences in participants' professional positions, we identified a shared conceptualisation in pinpointing and assessing unprofessional behaviour. Both groups described multiple unprofessional behaviours, which could be successfully mapped to the descriptors and categories of the Four I's model. Behaviours in the categories 'Involvement' and 'Interaction' were assessed as mild and received informal, pedagogical feedback. Behaviours in the categories 'Introspection' and 'Integrity', were seen as very alarming and received strict remediation. We identified two new groups of behaviours; 'Nervous exhaustion complaints' and 'Nine-to-five mentality', needing to be added to the Four I's model. The diagnostic phase of unprofessional behaviour usually started with the supervisor getting a 'sense of alarm', which was described as either a 'gut feeling', 'a loss of enthusiasm for teaching' or 'fuss surrounding the resident'. This sense of alarm triggered the remediation phase. However, the diagnostic and remediation phases did not appear consecutive or distinct, but rather intertwined. Conclusions The processes of identification and remediation of unprofessional behaviour in residents appeared to be intertwined. Identification of behaviours related to lack of introspection or integrity were perceived as the most important to remediate. The results of this research provide supervisors and faculty with an appropriate language to describe unprofessional behaviours among residents, which can facilitate timely identification and remediation.Public Health and primary carePrevention, Population and Disease management (PrePoD

Trans-splicing of the Ll.LtrB group II intron in Lactococcus lactis

The Ll.LtrB intron from the Gram-positive bacterium Lactococcus lactis is one of the most studied bacterial group II introns. Ll.LtrB interrupts the relaxase gene of three L. lactis conjugative elements. The relaxase enzyme recognizes the origin of transfer (oriT ) and initiates the intercellular transfer of its conjugative element. The splicing efficiency of Ll.LtrB from the relaxase transcript thus controls the conjugation level of its host element. Here, we used the level of sex factor conjugation as a read-out for Ll.LtrB splicing efficiency. Using this highly sensitive splicing/conjugation assay (107-fold detection range), we demonstrate that Ll.LtrB can trans-splice in L. lactis when fragmented at various positions such as: three different locations within domain IV, within domain I and within domain III. We also demonstrate that the intron-encoded protein, LtrA, is absolutely required for Ll.LtrB trans-splicing. Characteristic Y-branched trans-spliced introns and ligated exons are detected by RT-PCR from total RNA extracts of cells harbouring fragmented Ll.LtrB. The splicing/conjugation assay we developed constitutes the first model system to study group II intron trans-splicing in vivo. Although only previously observed in bacterial-derived organelles, we demonstrate that assembly and trans-splicing of a fragmented group II intron can take place efficiently in bacterial cells

Learning from lapses: How to identify, classify and respond to unprofessional behaviour in medical students

Croiset, G. [Promotor]Mook, W.N.K.A. van [Promotor]Kusurkar, R.A. [Copromotor]Teherani, A. [Copromotor