Taking as its starting point the need to better understand the relationship between tourism and culture in a western European context, this research develops and applies a conceptual framework and methodology to evaluate the attitudes among residents of a tourist receiving community to the sociocultural impacts of tourism. To this end, a case study approach is used to evaluate the attitudes of the residents of Llangollen, a small market town in North-east Wales, to the sociocultural impacts of tourism on their town and way of life. As host to the annual Llangollen International Musical Eisteddfod, and as a popular destination for day visitors and longer stay tourists alike, the community of Llangollen is a mature tourist destination possessing a wide range of tourist and cultural facilities. The study examines a range of appropriate literature and develops a conceptual framework around three key theories: the notion of resident 'coping strategies' to deal with the impacts of tourism, the sociological principle of social exchange theory and the social-psychological theory of social representations, with the latter being central to the study's methodology. There were three elements to the field work. Firstly, preliminary sensitising interviews were carried out in order to highlight key areas of local concern, and to inform the design of the survey work. Secondly, a questionnaire survey was undertaken of the residents of Llangollen, which was then interpreted using two different methods of respondent segmentation and using an assessment of the difference between groups. Finally, focus group discussions were carried out in the town in order to assist in the interpretation of the questionnaire findings and also to provide a systematically-derived set of qualitative data in order to assess the relative merits of taking different methodological approaches to the research. The findings of the research show that the community of Llangollen is generally positive about the impacts of tourism, with the role of the International Eisteddfod being pivotal in cultural terms. The three different approaches to the analysis of the impacts of tourism in Llangollen provided different perspectives and insights. The multivariate technique of cluster analysis gave the clearest picture from the questionnaire of resident perceptions of the cultural impacts of tourism, whereas an equity-based approach gave more indication of exchange processes at work in the community. The use of focus group discussions proved to be by far the most valuable in terms of drawing out not only what were the attitudes of residents, but also how and why such attitudes had come about in the first place. Most importantly, this research has made much clearer the political, economic and cultural contexts within which the residents of Llangollen perceive the impacts of tourism, and how it is these contexts which are influential in the attitudes taken to the impacts of tourism on the community, on groups in the community, and on the individual members of the community. The research also suggests there is a need for tourism research to move away from its traditional reliance on the questionnaire survey, and the search for statistically significant but perhaps socially irrelevant groups. It is suggested that further use of focus group discussions may help to more fully understand the relationships between tourism and culture within local communities.

Surgical observation is an integral part of surgical training. Junior residents, who have limited understanding of the procedure being performed, frequently engage in observation in order to gain exposure to surgical techniques. This limited experience, and the relative lack of guidance currently provided to them, might limit their ability to learn by observing. This thesis examines learners’ perceptions of the value of surgical observation, the barriers to learning in the surgical environment, and the factors that facilitate learning within the context of the operating room. An intervention, employing predefined objectives in the form of sets of questions, was introduced and the impacts of this intervention in terms of junior residents’ attitudes toward observation were explored. Two rounds of focus groups examined learners’ perceptions: one before introducing the intervention and one after it. Transcripts from these focus groups were analyzed using a qualitative interpretative approach and focus group participants provided considerable insight into observational learning. Many barriers were identified, including logistical constraints and lack of guidance. The surgical culture, within which observation is perceived as less effective than performing the surgery itself, was also mentioned as a factor that impedes learning during observation. Following the intervention, participants felt more validated as learners in the operating room and appreciated having clear objectives when observing procedures. Participants did mention that their busy clinical obligations would likely limit their use of any educational intervention. It was also noted that interventions to promote learning through observation would have to be fully supported by their program to be used on a regular basis. In conclusion, many factors that impact learning during surgical observation were identified. While trainees felt that increased guidance for observation was helpful, the environment in which learning takes place would have to be optimized to facilitate junior trainees’ learning.

Excerpt: This Curriculum Guideline defines a recommended training strategy for family medicine residents. Attitudes, behaviors, knowledge, and skills that are critical to family medicine should be attained through longitudinal experience that promotes educational competencies defined by the Accreditation Council for Graduate Medical Education (ACGME), www.acgme.org.

Introduction: Childbirth is an important time in a client and patient’s life. The pregnant client seeks to obtain as much control over their circumstance as possible. The more perceived control in childbirth by the client, the better the outcomes are for the client-newborn dyad. One way that clients obtain control during childbirth is by participating in clinical decision making with their healthcare providers. This research intended to study the ways in which OB residents and midwifery students engaged in the understanding, learning and application of shared decision making with clients and patients. Methodology: This study utilised a constructivist grounded theory approach to obtain data and formulate a theory using semi-structured interviews with five senior obstetrical residents and five senior midwifery students from Ontario. Results: Qualitative data revealed four themes and eight sub-themes. Our theory describes the way residents and students absorb, mirror, and perform shared decision making through an informal process of observation and experience throughout their training. Our theory further describes how support for students and residents creates the foundation for learning shared decision making. Support includes how the mentor minimizes the impacts of the hierarchy of power in medical and midwifery education, as well as increasing psychological safety for the learner. Conclusion: The study results support the exploration of future methods for the teaching of shared decision making to obstetrical residents and midwifery students. Participants of this study agreed that more training is needed for shared decision making, as well as training for the mentor to ensure learners are optimizing their experience. More training needs to be available for mentors to help reduce the negative impacts of the hierarchy of power, and to increase psychological safety for the learner. / Thesis / Master of Health Sciences (MSc) / This thesis examines the ways in which obstetrical residents and senior midwifery students learn, understand and apply shared decision making in their training. Shared decision making is a way in which health care providers can work collaboratively with their patients or clients to make decisions that are best for their health. Both obstetrical residents and midwifery students were asked about how they understood shared decision making, and the process by which they learn and perform shared decision making. Childbirth is full of uncertainty and fear. Shared decision making may be one way that the pregnant patient or client navigates through the fear by having some control over their decision making. Our study intends to help understand how obstetrical residents and midwifery students gather the skills they need to do shared decision making and how best to support learners with this skill set in the future.

The existing research in the field of tourism has exhibited a clearer understanding of how residents perceive the dynamic and complex phenomena of tourism. Since the goals of tourism planning and development are to seek maximization of benefits and minimization of the costs of tourism, it is apparent that the effective evaluation of tourism impacts will be valuable information in successful strategies for tourism product development and operation. With these perspectives, this study attempted to investigate the underlying dimensions explaining residents' perceived tourism impacts and to identify relationships between determinants and residents' perceived tourism impacts. The social exchange theory provided a fundamental framework for this study. The dimensions of the tourism impacts were addressed by explicating economic, social/cultural, environmental/physical impacts of tourism development from literature review. Ten determinants which affect residents' perception were identified from past research on tourism impacts: birthplace, length of residency, community attachment, tourism related jobs, recreational activity, tourist contacts, tourism policy participation, travel experience, levels of tourism development, and growth of community. Norfolk/Virginia Beach/Newport News MSAs areas were selected as the study area because these areas provide fine multifaceted tourism attractions, generates many tourists, and influences the host community' life. A total of 316 useful respondents (13.2%) were analyzed by using the SPSS program. Two research questions were proposed. Factor analysis, multiple regression analysis, and multivariate analysis of variance (MANAOVA) were performed. From the findings of this study, residents perceived the impacts of tourism as five different dimensions embodying economic benefits, social costs, cultural enrichment, environmental deterioration, and physical enhancement. Their perceptions were affected by eight out of ten determinants. Generally, a higher level of tourism development and growth of community affects residents' perceptions of tourism impacts. Residents who were natives, who have higher community attachment, and who had been living in the research area for a shorter time period had more concerns about the perceived impacts of tourism. In addition, perceived tourism impacts were significantly differed across household incomes and ethnic groups. For future study, it is suggested that a further investigation of determinants affecting residents' perceptions is needed for better understanding and explanation of the impacts of tourism. It is believed that this study would help tourism planners and developers formulate and implement better strategies. / Master of Science

No / This article provides an overview of the person-centered care movement, which began in the U.K. in the mid 1990s and continues to grow today. After describing its key elements, the article outlines how it has influenced policy and care standards and raised expectations for the quality of care and quality of life for people living with dementia. While there are still many challenges to be overcome, this article argues that we now have a sound ethical, theoretical, empirical, policy, and political footing with which to proceed.

This study compares the perceptions of long-term residents in rapidly and moderately growing nonmetropolitan communities regarding the effect of newcomers on the community. Data for the study came from a 1975 survey of 1,065 adults in seven Utah communities. Results show that a significantly larger proportion of long-term residents in rapidly growing communities than in moderately growing communities feel that newcomers are having a bad effect on the community. The relationship between perceived effect of newcomers and various personal attributes are examined with rate of population growth as a control variable. The attributes are: 1) length of residence, 2) age, 3) sex, 4) religious preference, 5) income, 6) proportion family living nearby, and 7) proportion of friends living in the community. Brief attention was given to examining newcomers' perception of the effect newcomers are having on the community with the use of length of residence variable. The differences between the long-term and short-term residents were not statistically significantly different. But because of theoretical and practical consideration the remainder of the analysis focused on the attitude of long-term residents. None of the differences between the subgrouping for the respective attributes were statistically significant in both moderate and rapidly growing communities. In rapidly growing communities only one hypothesis was supported with respect to the differences in attitude towards newcomers. The supported hypothesis was that Mormons would be more likely to perceive the effect of newcomers as being bad than would non-Mormons. within the moderately growing communities, statistically significant differences were found between income groups, but they were not in the direction of the hypothesis. Perhaps the most important evidence that rate of population growth influences the long-term residents' perception of newcomers is that, except for non-Mormons, the percentage feeling that the effect of newcomers was bad was highest in rapidly growing communities. This indicates that the pressures associated with rapid growth are generally perceived across a wide variety of subgroups. The particular exception, the non-Mormons, suggests that in particular cases a subgroup might perceive the changes as beneficial and to view the overall process of growth , including the newcomers, more positively.

In recent years, sustainability has gained importance across the world. However, the social aspect of the concept has been explored the least. A trend leads towards cities targeting population growth. Densification is often seen as a tool to accommodate for a growing population in a rather sustainable way. This case study focusses on evaluations of Umeå Municipality’s population goal and densification, and on understanding the social sustainability of such strivings. Aiming to explore emotions, attitudes, and beliefs towards the population goal and densification, the study is based on three research questions, concerning: 1) the response towards the population goal and densification in Umeå; 2) the association of beliefs about social capital and equity in the neighborhood and the response towards the population goal and densification; and 3) the relationship between beliefs and emotions evoked by densification and the attitude towards densification. A web survey was carried out investigating people’s responses to the population goal and densification in Umeå, aiming to better understand the social sustainability of such strivings. In this study, social capital and equity were used as indicators for social sustainability. The literature suggests that the influence of density on social equity is predominantly positive, whereas the influence on social capital is ambiguous. More generally, the relationship between densification and social sustainability is seen as complex and context dependent. The survey indicates attitudes towards the population goal being neutral, and towards densification slightly negative. Moreover, it has been found that beliefs concerning the neighborhood influence the perception particularly of densification. Finally, this study shows that emotions play an important role when it comes to the acceptance of densification.

Thesis (M. Env. St.)--University of Adelaide, Mawson Graduate Centre for Environmental Studies, 1993. / Bibliography :leaves 84-86.

Rural areas face issues that leads to economic downturns. Nature based tourism is practiced to overcome these issues and improve economic development. The residents in the tourism destinations experience the outcomes of nature-based tourism and rural development. Their perception towards nature-based tourism depends on the outcomes they experience. Recognizing their perceptions aid the smooth operation of nature-based tourism. Moreover, residents’ contribution is impacted by their perception. Three research questions were developed to recognize the residents’ perceptions. The questions were perception of residents, expectations of residents and delivery of those expectations. Social exchange theory was the main theory used and economical, socio cultural and environmental aspects were the main focus. The research was conducted as a quantitative study. 66 responses were collected as the sample from Granö, a rural tourism destination in Northern Sweden. Descriptive statistics were used to analyze data. The results showed that residents perceive and expect nature-based tourism to develop economy, develop socio culture and protect environment. Further residents perceive and expect tourism aids to make people stay, rather than move out from the destination. In addition, the level of expectations was higher than their perception, but the delivery of those expectations was lower than both expectations and perceptions. The findings contribute tourism planners to cater the perceptions and expectations of the residents of a rural destination. Consideration of residents’ perceptions and expectations will make them feel their voices being heard and enhance smooth operation of tourism in the destination.