Costa Blanca: Public Space And Perceived Image as Key to Tourism Competitiveness

Los destinos turísticos tradicionales del litoral español se enfrentan a profundas transformaciones debidas a varios factores, entre los que se encuentran cambios notables en el comportamiento de la demanda y un intenso crecimiento de la competencia a todos los niveles, que puede poner en duda la pervivencia del modelo de desarrollo de estas áreas maduras. Lejos de ser una excepción, la situación que se describe para la Costa Blanca es extrapolable a otros destinos turísticos en otras regiones y en ámbitos urbanos, que se enfrentan al reto de incorporar nuevas estrategias de renovación, diversificación y reestructuración de su tejido urbano y turístico, como clave de reorientación de su ciclo de vida. A partir del estudio del caso de la Costa Blanca, pero con una vocación globalizadora, se tratan a continuación argumentos referidos a los cambios en la demanda turística y de ocio cotidiano, y cómo ello afecta a la necesidad de intervenir de un modo distinto en el diseño y gestión del tejido urbano que perciben los visitantes y residentes. Se percibe de forma clara que se ha de trabajar de un modo distinto tanto la escena urbana como el territorio turístico a partir de la potenciación de valores diferenciadores: por una adecuada intervención urbanística en los espacios públicos con acciones capaces de distinguir al destino de sus competidores, por la incorporación de nuevos elementos de atracción e innovación urbana, o por una gestión más eficiente de los servicios y las funciones urbanas de los destinos turísticos. A partir de varios indicadores se demuestra que la competitividad de los destinos tradicionales, sean áreas costeras o ciudades, ya no sólo reside en sus recursos patrimoniales, litorales o climáticos, sino que su valor diferenciador se vincula también a la calidad urbana percibida y a la capacidad de incorporar en las acciones de futuro las nuevas necesidades de residentes y visitantes, cada vez más exigentes e impredecibles.

Key to League of Nations documents placed on public sale, 1920-1929 /

Kept up to date by supplements, 1930-1934/36.

Key-catalogue of the Crustacea and arachnoids of importance in public health,

At head of title: Treasury Department. United States Public Health Service.

Farm and forest produced alcohol [microform] : the key to liquid fuel independence : a compendium of papers /

Reuse of record except for individual research requires license from Congressional Information Service, Inc.

Preparing for high school entrance and scholarship examinations; with separate answer key, for use in parochial, private, and public schools.

Mode of access: Internet.

Tourism in Albarracín and Region. Local Public Action and dynamics in recent key sustainable tourism development

Spanish tourist destinations in rural areas have been established over more than two decades of implementation of various public policy instruments (mainly tourism and rural development policies). These convey complementary objectives in theory but provoke distant results in practice. The intervention of these instruments produces in the region of Sierra de Albarracín (Teruel) two types of destination whose sustainability is committed: the historical urban site of Albarracín as a consolidated cultural tourism destination based on heritage and the Sierra as a generic and incipient destination of rural tourism. It is discussed how the deployment of the local public action causes a fragmented territory in two models of management and tourism development. Cooperation is presented as a key element for the necessary rethinking of tourism development in the region.

Improving Patients’ Experience and Outcome of Total Joint Replacement: the RESTORE Programme

BACKGROUND: Total hip replacements (THRs) and total knee replacements (TKRs) are common elective procedures. In the REsearch STudies into the ORthopaedic Experience (RESTORE) programme, we explored the care and experiences of patients with osteoarthritis after being listed for THR and TKR up to the time when an optimal outcome should be expected. OBJECTIVE: To undertake a programme of research studies to work towards improving patient outcomes after THR and TKR. METHODS: We used methodologies appropriate to research questions: systematic reviews, qualitative studies, randomised controlled trials (RCTs), feasibility studies, cohort studies and a survey. Research was supported by patient and public involvement. RESULTS: Systematic review of longitudinal studies showed that moderate to severe long-term pain affects about 7–23% of patients after THR and 10–34% after TKR. In our cohort study, 10% of patients with hip replacement and 30% with knee replacement showed no clinically or statistically significant functional improvement. In our review of pain assessment few research studies used measures to capture the incidence, character and impact of long-term pain. Qualitative studies highlighted the importance of support by health and social professionals for patients at different stages of the joint replacement pathway. Our review of longitudinal studies suggested that patients with poorer psychological health, physical function or pain before surgery had poorer long-term outcomes and may benefit from pre-surgical interventions. However, uptake of a pre-operative pain management intervention was low. Although evidence relating to patient outcomes was limited, comorbidities are common and may lead to an increased risk of adverse events, suggesting the possible value of optimising pre-operative management. The evidence base on clinical effectiveness of pre-surgical interventions, occupational therapy and physiotherapy-based rehabilitation relied on small RCTs but suggested short-term benefit. Our feasibility studies showed that definitive trials of occupational therapy before surgery and post-discharge group-based physiotherapy exercise are feasible and acceptable to patients. Randomised trial results and systematic review suggest that patients with THR should receive local anaesthetic infiltration for the management of long-term pain, but in patients receiving TKR it may not provide additional benefit to femoral nerve block. From a NHS and Personal Social Services perspective, local anaesthetic infiltration was a cost-effective treatment in primary THR. In qualitative interviews, patients and health-care professionals recognised the importance of participating in the RCTs. To support future interventions and their evaluation, we conducted a study comparing outcome measures and analysed the RCTs as cohort studies. Analyses highlighted the importance of different methods in treating and assessing hip and knee osteoarthritis. There was an inverse association between radiographic severity of osteoarthritis and pain and function in patients waiting for TKR but no association in THR. Different pain characteristics predicted long-term pain in THR and TKR. Outcomes after joint replacement should be assessed with a patient-reported outcome and a functional test. CONCLUSIONS: The RESTORE programme provides important information to guide the development of interventions to improve long-term outcomes for patients with osteoarthritis receiving THR and TKR. Issues relating to their evaluation and the assessment of patient outcomes are highlighted. Potential interventions at key times in the patient pathway were identified and deserve further study, ultimately in the context of a complex intervention.

Turbocharging Networks in the Public Sector

Networks have come to occupy a key position in the strategic armoury of the government, business and community sectors and now have impact on a broad array of policy and management arenas. An emphasis on relationships, trust and mutuality mean that networks function on a different operating logic to the conventional processes of government and business. It is therefore important that organizational members of networks are able to adopt the skills and culture necessary to operate successfully under these distinctive kinds of arrangements. Because networks function from a different operational logic to traditional bureaucracies, public sector organizations may experience difficulties in adapting to networked arrangements. Networks are formed to address a variety of social problems or meet capability gaps within organizations. As such they are often under pressure to quickly produce measurable outcomes and need to form rapidly and come to full operation quickly. This paper presents a theoretical exploration of how diverse types of networks are required for different management and policy situations and draws on a set of public sector case studies to understand/demonstrate how these various types of networked arrangements may be ‘turbo-charged’ so that they more quickly adopt the characteristics necessary to deliver required outcomes.

Survey design: Insights from a public sector ERP success story

Research on the impact of Information Systems (IS) reported in both academic literature and popular press has reported confounding results. Some studies have reported encouraging results of IS, while others have reported nil or detrimental results. The contradictory results of these research studies can be partially attributed to the weaknesses in survey instruments. In an attempt to increase the validity of conclusions of IS assessment studies, survey instrument design should follow a rigorous and scientific procedure. This paper illustrates key validity and reliability issues in measuring Information Systems performance, using examples from a study designed to assess Enterprise Resource Planning systems success. The article emphasizes on the importance of the survey method and the theoretical considerations of item derivation, scale development and item evaluation. Examples are provided from the ERP assessment study to supplement the readers understanding of the theoretical concepts of survey design.

Learning, language and leadership : conduits to dynamic public service networks

Networks are having a profound impact on the way society is organised at the local, national and international level. Networks are not ‘business as usual’. The defining feature of networks and a key indicator for their success is the strength and quality of the interactions between members. This relational power of networks provides the mechanism to bring together previously dispersed and even competitive entities into a collective venture. Such an operating context demands the ability to work in a more horizontal, relational manner. In addition a social infrastructure must be formed that will support and encourage efforts to become more collaborative. This paper seeks to understand how network members come to know about working in networks, how they work on their relationships and create new meanings about the nature of their linked work. In doing so, it proposes that learning, language and leadership, herein defined as the ‘3Ls’ represent critical mediating aspects for networks.

Dismantling the public sector bastion : evaluation capital works

Purpose: The determination of the most appropriate procurement system for a capital works project is a challenging task for public sector clients considering the array of assessment criteria that are considered and the procurement methods that are available. This is particularly pertinent to the Western Australian public sector where they have had a propensity to use traditional lump sum as the default procurement solution despite knowing that the selection of an inappropriate procurement method may lead to cost and time overruns, claims, and disputes’ on projects. This paper presents a six step procurement method evaluation approach that requires public sector agencies to consider in detail an array of options so as to obtain value for money. Design/methodology/approach: A procurement evaluation approach is developed and is examined using a focus group of 12 participants comprising of a public sector client, project team and key stakeholders. The focus group was used to examine the developed approach in the context of a real-life capital works project. Findings: The procurement method evaluation approach was deemed to be pragmatic and enabled decision-makers to re-evaluate outcomes from previous steps in the process. All focus group participants stated the six step process enabled a recommendation that was grounded in reflection and detailed evaluation. Practical implications: The developed procurement approach has enabled the public sector client evaluate the way in which they view procurement method selection and examine how they obtain ‘value for money’. Originality/value: The six step procurement approach makes use of quantitative and qualitative techniques and is reliant on discourse and reflection in making a procurement method recommendation. Consequently, the approach enables public sector clients to account for the complexities often associated with procurement selection.