The Learning Tourism Destination: The potential of a learning organisation approach for improving the sustainability of tourism destinations

Globalisation, increasing complexity, and the need to address triple-bottom line sustainability has seen the proliferation of Learning Organisations (LO) who, by definition, have the capacity to anticipate environmental changes and economic opportunities and adapt accordingly. Such organisations use system dynamics modelling (SDM) for both strategic planning and the promotion of organisational learning. Although SDM has been applied in the context of tourism destination management for predictive reasons, the current literature does not analyse or recognise how this could be used as a foundation for an LO. This study introduces the concept of the Learning Tourism Destinations (LTD) and discusses, on the basis of a review of 6 case studies, the potential of SDM as a tool for the implementation and enhancement of collective learning processes. The results reveal that SDM is capable of promoting communication between stakeholders and stimulating organisational learning. It is suggested that the LTD approach be further utilised and explored.

A Step-by-Step Approach to Transit Oriented Development Project Delivery

A major challenge in successfully implementing transit-oriented development (TOD) is having a robust process that ensures effective appraisal, initiation and delivery of multi-stakeholder TOD projects. A step-by step project development process can assist in the methodic design, evaluation, and initiation of TOD projects. Successful TOD requires attention to transit, mixed-use development and public space. Brisbane, Australia provides a case-study where recent planning policies and infrastructure documents have laid a foundation for TOD, but where barriers lie in precinct level planning and project implementation. In this context and perhaps in others, the research effort needs to shift toward identification of appropriate project processes and strategies. This paper presents the outcomes of research conducted to date. Drawing on the mainstream approach to project development and financial evaluation for property projects, key steps for potential use in successful delivery of TOD projects have been identified, including: establish the framework; location selection; precinct context review; preliminary precinct design; the initial financial viability study; the decision stage; establishment of project structure; land acquisition; development application; and project delivery. The appropriateness of this mainstream development and appraisal process will be tested through stakeholder research, and the proposed process will then be refined for adoption in TOD projects. It is suggested that the criteria for successful TOD should be broadened beyond financial concerns in order to deliver public sector support for project initiation.

Adjustment to a low-control situation: Reexamining the role of coping responses

The aim of the study was to test a revised conceptualization of the role of coping in adjustment to a low-control stressor-women's adjustment to a failed in vitro fertilization (NF) attempt. Data were collected prior to the IVF treatment (Time I) and twice after the failed NF attempt (1 to 2 weeks after finding out the results, n = 171, and fi weeks later, n = 139). Initial adjustment was assessed at Time I, whereas measures of coping and both self-report and partner ratings of adjustment were obtained at Times ? and 3. As predicted, escapist strategies and problem-management strategies (mainly at Time ?) were associated with poor adjustment, whereas problem-appraisal coping was associated with better adjustment., There was also support for the proposed positive relationship between adjustment and emotional approach coping (on self-report adjustment).

Incorporating cognitive-behavioral therapy with occupational therapy: A comparative study with patients with low back pain

This paper reports on the implementation of a psychoeducational program utilizing cognitive-behavioral principles. The efficacy of this psychoeducational treatment program in modifying dysfunctional attitudes in patients with chronic low back pain was examined using a two-group pretest posttest design with a follow-lip at 3 months Thirty patients (average age = 44.37 SD = 13.71) participated in the study, with 15 in the psychoeducational treatment group and 15 in the placebo control group. These two conditions were added on to an existing eclectic inpatient pain management program. After assessment on the IPAM (The Integrated Psychosocial Assessment Model), scores were reduced to multivariate composite scores on the factors of illness behavior depressed and negative cognitions, and acute pain strategies. Results of a group x time repeated measures analysis of variance for the three pain factors revealed a significant main effect for group (F(23,1) = 5.00 p < .04), tempered by a significant interaction between group and rime on the 'depressed and negative' pain factor (F(23,1) = 4.77 p < .04). Patients in the treatment group improved significantly over time and significantly more than the placebo control group patients at posttreatment. Results provide support for the program in increasing patients' feelings of control over their pain and the use of positive coping strategies, while reducing perceived helplessness, depression, disability, and pain intensity.

Effect of metabolic inhibitors on cyclosporine pharmacokinetics using a population approach

Drugs known to inhibit the metabolism of cyclosporine are administered concomitantly to those who undergo cardiothoracic transplantation. The aim of this study was to examine in quantitative terms the relationship between cyclosporine oral dose rate and the trough concentration (Css(trough)) at steady state in patients who undergo cardiothoracic transplantation and are administered cyclosporine alone or in combination with drugs known to inhibit its metabolism. Dose and whole blood cyclosporine Css(tough) observations measured using the enzyme-multiplied immunoassay technique (EMIT) (396 observations) or the TDx assay (435 observations) were collected as part of routine blood concentration monitoring from 182 patients who underwent cardiothoracic transplantation. Data were analyzed using a linear mixed-effects modeling approach to examine the effect of metabolic inhibitors on dose-rate-Css(trough) ratio. The mean (and 95% confidence interval) dose-rate-Css(trough) ratio for cyclosporine generated from concentrations measured using EMIT was 94 (82.5-105.5) Lh(-1) for patients administered cyclosporine alone, 66.7 (58.1-75.3) Lh(-1) for patients administered concomitant diltiazem, 47.9 (15.4 -80.4) Lh(-1) for patients administered concomitant itraconazole, 21.7 (14.8-28.5) Lh(-1) for patients administered concomitant ketoconazole, and 14.9 (11.8-18.1) Lh(-1) for patients concomitantly administered diltiazem and ketoconazole. For patients administered concomitant cyclosporine, ketoconazole, and diltiazem, the dosage of cyclosporine, if it is administered alone, should be 20% to achieve the same blood concentrations. This will allow safer drug concentration targeting of cyclosporine after cardiothoracic transplantation.

Nurturing communication by health professionals toward patients: A communication accommodation theory approach

This study explores the role of nurturing communication in distinguishing interpersonal and intergroup interactions between health professionals and patients, from the perspective of communication accommodation theory (CAT). Participants (47 men and 87 women) rated videotapes of actual hospital consultations on 12 goal and 16 strategy items derived from CAT. Health professionals in interpersonal interactions were perceived to pay more attention to relationship and emotional needs and to use more nurturant discourse management and emotional expression. These results point the way toward elucidating the perceived optimal balance in accommodative behavior, both group based and interpersonal, in these contexts, and they highlight the importance of nurturant communication to this process.

A state-contingent production approach to principal-agent problems with an application to point-source pollution control

Two basic representations of principal-agent relationships, the 'state-space' and 'parameterized distribution' formulations, have emerged. Although the state-space formulation appears more natural, analytical studies using this formulation have had limited success. This paper develops a state-space formulation of the moral-hazard problem using a general representation of production under uncertainty. A closed-form solution for the agency-cost problem is derived. Comparative-static results are deduced. Next we solve the principal's problem of selecting the optimal output given the agency-cost function. The analysis is applied to the problem of point-source pollution control. (C) 1998 Published by Elsevier Science S.A. All rights reserved.