Exploring feedback from research nurses in relation to the design and conduct of a randomised controlled trial of wound care treatments: a sequential, dependent, mixed-methods study

Background Research nurse involvement in trials is crucial to successful conduct, however their feedback on trial design and conduct is not necessarily always collected and shared. This study was designed to explore research nurse feedback in relation to study and protocol design and implementation in the National Institute for Health Research Programme Grants for Applied Research funded Surgical Wounds Healing by Secondary Intention pilot and feasibility trial (SWHSI). The primary aim of this study was to inform the design and conduct of a proposed future, larger study in this area. Given the evidence gap, it was deemed prudent to share these findings for the benefit of others. Methods A sequential, dependent mixed methods study, comprising a Likert scale questionnaire and semi-structured interviews, explored the experiences, in relation to study design and conduct, of research nurses involved in the trial. Of the 10 research nurses involved in the trial, eight nurses completed a questionnaire and were interviewed. Questionnaire data was analysed using descriptive statistics and interview data using thematic analysis. Results A range of questionnaire responses were provided, however at least 50% (n=4) of respondents indicated that they were happy with both the study design and conduct. Interview data identified key themes to consider when involving research nurses in the design, delivery and conduct of RCTs; removing barriers to recruitment, time management, engagement strategies and resource provision. ConclusionEngagement of research nurses is important to enable effective trial conduct. Research teams should therefore consider how best to obtain and include input from all members of the research team from the outset. Furthermore, the sharing of feedback on research design and conduct, from the perspective of research nurses delivering trial recruitment and retention, remains crucial to effective and efficient trial conduct

Confinement effects on glass forming liquids probed by DMA

Many molecular glass forming liquids show a shift of the glass transition T-g to lower temperatures when the liquid is confined into mesoporous host matrices. Two contrary explanations for this effect are given in literature: First, confinement induced acceleration of the dynamics of the molecules leads to an effective downshift of T-g increasing with decreasing pore size. Second, due to thermal mismatch between the liquid and the surrounding host matrix, negative pressure develops inside the pores with decreasing temperature, which also shifts T-g to lower temperatures. Here we present dynamic mechanical analysis measurements of the glass forming liquid salol in Vycor and Gelsil with pore sizes of d=2.6, 5.0 and 7.5 nm. The dynamic complex elastic susceptibility data can be consistently described with the assumption of two relaxation processes inside the pores: A surface induced slowed down relaxation due to interaction with rough pore interfaces and a second relaxation within the core of the pores. This core relaxation time is reduced with decreasing pore size d, leading to a downshift of T-g proportional to 1/d in perfect agreement with recent differential scanning calorimetry (DSC) measurements. Thermal expansion measurements of empty and salol filled mesoporous samples revealed that the contribution of negative pressure to the downshift of T-g is small (<30%) and the main effect is due to the suppression of dynamically correlated regions of size xi when the pore size xi approaches

Impacts of the global economic crisis on cyprus tourism and policy responses

This study examines the impacts of the global economic crisis on Cyprus tourism and the pertinent policy responses. A qualitative approach was adopted by conducting eight semi-structured interviews with tourism authorities and suppliers/professionals. Findings indicated the main impacts of the crisis on Cypriot tourism: lack of competitiveness, decreased visitation/revenues, inadequate quality and escalated pricing. Furthermore, findings identify three types of policy measures: (i) immediate response measures; (ii) foreign investment in tourism; and (iii) diversification of the tourism product and quality improvement. The study highlights the need for Cyprus to develop a comprehensive tourism planning framework. It is suggested that crisis plans of small island states should be developed upon a holistic framework that leverages their destination capitals

Towards reviving post-Olympic Athens as a cultural destination

This paper examines the effects of global change on the status and qualities of the Greek national capital, Athens, focusing on how they affect the development of cultural tourism in the city. Although Athens constituted one of the most significant destinations for Greek tourism in the past, in recent years it started to weaken. Athens is characterised by a series of problems, among them are the degradation of its environment and quality of life and traffic congestion. However, in terms of tourism development, the Olympic Games helped in re-imaging the city and upgrading its infrastructure. This study based on semi-structured interviews with top officials reveals how global change has affected Athens’ socio-cultural/economic status, identity and image. Despite the tourism policy/planning responses to global changes, Athens’ tourism continues to decline leaving unexplored potential such as its rich cultural heritage, new multicultural identity and the New Acropolis Museum. The paper suggests that cultural elements of capital cities must be multidimensional including a variety of attractions and amenities. The use of cultural heritage assets needs to be in line with global developments in order for cities to effectively leverage heritage for cultural tourism

How can we manage the tourist-historic city? Tourism strategy in Cambridge, UK, 1978-2003

This paper draws on research into twenty-five years of tourism planning and management in Cambridge, UK, to explore the long-term effect that tourism strategies can have in managing the development of tourism in historic cities. It focuses particularly on strategic aims and the policies designed to implement them through regulating the city. It finds that five successive Tourism Strategies from 1978 onward have had consistent aims, strongly influenced by the locality characteristics of Cambridge. It explores how strategic aims are derived, focusing on the balance between local and external influences, and how policies to implement the aims are developed. It argues that locality factors, and the role of local regimes and policy communities are more important than national government policy in accounting for aims and policies. It suggests that tourism management issues are rarely finally resolved, and the most important element of policy is creating capacity for continuing management

Commercial hospitality in destination experiences: McDonald's and tourists' consumption of space

This paper examines the multiple roles that globalised, branded spaces of hospitality can play in tourists' experiences in destinations. It is argued that previous studies have not considered adequately how such commercial hospitality services and spaces interact with and influence tourists' experiences of places. Drawing on a netnographic analysis of online discussions of McDonald's, this study explores how tourists perceive these hospitality venues, and how they use them to engage with foreign destinations and negotiate the ‘work of tourism’. The data show how tourists (re)construct their identities through reflections on consuming McDonald's. The data also demonstrate that tourists critically evaluate discourses of authenticity and the (in)authenticity of consuming McDonald's. The paper concludes by discussing the implications for the marketing and management of McDonald's and similar branded commercial hospitality venues, the marketing and management of destinations, and it outlines avenues for further research

The impacts of foot and mouth disease on a peripheral tourism area: the role and effect of crisis management.

This study reports on the consequences of endemic cattle and sheep disease (2001) on two separate areas on the tourist industry; (a) the Grampian Region of Scotland (indirectly affected) and (b) Cumbria in England (directly affected), and secondly on the effects of various crisis management strategies to alleviate the ensuing problems in both areas. Data were collected by a survey of a sample of 200 tourism orientated SME operators in Grampian and 170 businesses in Cumbria. The results show two forms of impact caused by the disease, direct and those less obvious or tangible. Direct impact was the dramatic loss of trade, most dramatically experienced by the lack of tourists visiting the areas. Indirect effects included loss of supply, change to the product offered and cuts in future investment. In the combination of these impacts, it was clear that the effects would have longevity far beyond the period of the actual crisis. Although the actual presence of the disease was geographically limited in Grampian, the consequences rippled out to affect areas that had no direct connection. In Cumbria, the effects were only slightly more severe but the response more direct and initially effective. Significantly the data also demonstrated a perception of minimal effort by the government to limit the consequences to the farming industry especially in Grampian. We conclude that the tourist industry in peripheral regions is fragile and highly vulnerable to any external shocks. However, we also note the ability of small rural firms to respond to such catastrophes and to avert the worst impacts of crisis

‘You can never cross the same river twice’: climbers’ embodied quests for ‘original adventure’ in southern Thailand

This article presents ethnographic research into individual narratives of adventure in a small, undeveloped bay called Ton Sai in southern Thailand’s Krabi Province. Ton Sai is extremely popular with Western rock climbers and increasingly with other adventure seekers and backpackers questing for ‘authentic’ Thailand, yet is subject to almost no representation in the commercial sense. It is an example of a destination that is not on the corporate ‘radar’, yet, as will be seen, is famed, desired and produced by ‘niche’ tourists seeking very specifically valued tropical adventures. This research aims to interrogate how such a destination becomes, and remains, valued as adventurous by climbers and therefore shed some light on individual, subjective production of adventure in specific Developing World contexts. Drawing on original interview and other ethnographic data collected during winter 2012/2013, this article argues that even when third-party commercial mediators are absent, the powers of quest for authenticity and adventure are powerful enough to turn the wheels of mediation themselves. In the ‘elite circles’ in which this group manoeuvres, notions of ideal adventure space run deep and are reproduced discursively and through embodied performances in an exoticised environment that is valued for its ‘primitive timelessness’. The implications of this for locals are explored

Cultural political economy and urban heritage tourism

The paper explains a cultural political economy “framing” for interpreting heritage tourism in urban contexts. Key ideas behind this research perspective are explained and illustrated through discussion of past research studies of urban heritage tourism. It is underpinned by a relational view of the inter-connectedness of societal relations, and an emphasis on taking seriously both the cultural/semiotic and the economic/political in the co-constitution of urban heritage tourism’s social practices and features. A case study of heritage tourism in Nanjing, China considers cultural political economy’s relevance and value, including the distinctive research questions it raises. It reveals, for example, how economic relations in the built environment were related to tourist meaning-making and identities in the cultural/semiotic sphere