Residents' perceptions of walkability attributes in objectively different neighbourhoods: a pilot study

Physical attributes of local environments may influence walking. We used a modified version of the Neighbourhood Environment Walkability Scale to compare residents' perceptions of the attributes of two neighbourhoods that differed on measures derived from Geographic Information System databases. Residents of the high-walkable neighbourhood rated relevant attributes of residential density, land-use mix (access and diversity) and street connectivity, consistently higher than did residents of the low-walkable neighbourhood. Traffic safety and safety from crime attributes did not differ. Perceived neighbourhood environment characteristics had moderate to high test retest reliabilities. Neighbourhood environment attribute ratings may be used in population surveys and other studies. (c) 2004 Elsevier Ltd. All rights reserved.

Resident’s Perceptions on Impacts of Hosting the Guimaraes 2012 European Capital of Culture: Comparisons of the Pre- and Post Periods

Residents tend to have high expectations regarding the benefits of hosting a mega- event, in particular the creation of new infrastructure, growth in GDP and employ- ment, image enhancement and the spin-offs of attracting tourists and fostering sustainable growth of the cultural supply (Jeong and Faulkner 1996; Deccio and Baloglu 2002; Gursoy and Kendall 2006; Getz 2008; Langen and Garcia 2009; Ritchie et al. 2009; Gursoy et al. 2011; Palonen 2011). Nevertheless, they normally recognise that some costs will be incurred (Kim and Petrick 2005; Kim et al. 2006; Ritchie et al. 2009; Gursoy et al. 2011; Lee et al. 2013). So, it was not surprising that the nomination of Guimaraes, a small city in the northwest of Portugal, as one of the two European Capitals of Culture in 2012 (2012 ECOC), had raised great expectations in the local community vis- a-vis its socio-economic and cultural benefits. Our research was designed to examine the Guimar~aes residents’ perceptions of the impacts of hosting the 2012 ECOC, approached at two different times: before and after the event, to try and capture the evolution of the residents’ assessment of its impacts. From the empirical literature, we know that residents’ perceived impacts tend to change as time goes by (Kim et al. 2006; Ritchie et al. 2009; Gursoy et al. 2011; Lee et al. 2013). The data were gathered via two surveys applied to Guimaraes residents, one in 2011, before the event, and the other afterwards, in 2013. The Guimaraes residents’ assessment was thought to be essential to get an accurate appraisal of the impact of the mega-event as they were a main part of the hosting process. 2012 ECOC impacts were mainly felt by local people who, in most cases, will go on feeling them in the short and long term. The research was thought to be socially pertinent as the opinions collected through the surveys can help to prevent repeating mistakes when similar mega- events are organised in the future, and to increase the positive impacts derived from hosting them. When we talk about the social pertinence of the empirical results, we want to stress that the expertise acquired can be useful to any host city or country.

The two opposing impacts of heritage making on local communities : residents’ perceptions: a Portuguese case

This article examines the impact associated with the making of heritage and tourism at a destination. Special attention is paid to the residents’ perceptions of the impact. The examination is focused on the rural village of Sortelha, in Portugal, where, in recent decades, a state-led programme was implemented in order to renovate the historic buildings and built fabric and to generate benefits for the local community. Based on ethnographic materials collected in 2003, 2009 and 2013, the study demonstrates that the making of heritage may give rise to two opposing impacts simultaneously – increased social cohesion and place pride, on the one hand, and envy and competition (and, hence, social atomisation), on the other hand – and that residents are entirely cognisant of the tension between the two. The study has the potential to contribute to both the theoretical and the applied literature on heritage making.

Perceptions and evaluations of biosphere reserves by local residents in Switzerland and Ukraine

In a cross-cultural study perceptions of local people living in the surroundings of biosphere reserves in Switzerland and Ukraine were examined using the method of qualitative interviews. In the UNESCO Biosphere Entlebuch in Switzerland people stated that they hoped for a better regional economic development due to the existence of the biosphere reserve. However, at the same time people feared further restrictions regarding land-use. In the Carpathian Biosphere Reserve located in Transcarpathia/Ukraine people tended to connect certain conditions – such as the high price for wood – directly to the existence of the biosphere reserve, when in fact these conditions and the biosphere reserve were separate, parallel developments. In both case studies three key-categories influencing local residents’ perceptions and evaluations of biosphere reserves could be identified. These categories are (1) the economic situation, (2) the history of nature protection, and (3) the power balance between the involved stakeholders. Paying close attention to those three categories will help planners and managers of protected areas to better understand the reasoning of local residents for or against a biosphere reserve in their area.

‘I always look under the bed for a man’. Needs and barriers to the expression of sexuality in residential aged care: the views of residents with and without dementia

Objectives: This qualitative study canvassed residents' perceptions of the needs and barriers to the expression of sexuality in long-term care. Methods: Sixteen residents, including five with dementia, from six aged care facilities in two Australian states were interviewed. Data were analysed using a constant comparative method. Results: Four categories describe residents' views about sexuality, their needs and barriers to its expression: ‘It still matters’; ‘Reminiscence and resignation’, ‘It's personal’, and ‘It's an unconducive environment’. Discussion: Residents, including those with dementia, saw themselves as sexual beings and with a continuing need and desire to express their sexuality. The manner in which it was expressed varied. Many barriers to sexual expression were noted, including negative attitudes of staff, lack of privacy and limited opportunities for the establishment of new relationships or the continuation of old ones. Interviewees agreed that how a resident expressed their sexuality was their business and no one else's.

Supporting staff to identify residents in pain: A controlled pretest-posttest study in residential aged care

Practical strategies are needed to improve pain awareness among aged care staff and promote a systematic approach to pain identification using evidence-based tools. The purpose of this study was to evaluate a pain identification tool for use by nursing and non-professional staff in residential aged care facilities (RACFs). A controlled pretest-posttest intervention design was conducted in two RACFs in Brisbane, Australia. Completed surveys were returned by 216 staff and 74 residents at baseline and 218 staff and 94 residents at 3-month follow-up. Chart audits were conducted on 308 residents at baseline and 328 at follow-up. Groups were compared on: (1) staff knowledge and attitudes regarding pain, perceived confidence and skills for pain assessment, and perceived quality of pain management, (2) frequency of pain assessments and use of pain interventions, and (3) residents’ perceptions of the quality of pain management. Both groups had high knowledge scores and reported high levels of confidence, skills and perceived quality of pain management at baseline and follow-up. The intervention group showed significant improvement in routine pain assessment and use of non-drug pain interventions. However, due to unexpected changes in control group conditions, both groups increased episodic pain assessment. Overall, staff believed the intervention was clinically useful and fostered a team approach to pain assessment. We found the introduction of pain identification resources with implementation strategies to support frontline staff was partially effective in improving staff and resident outcomes. Nonetheless, our findings confirm the need for change and importance of translational pain research in RACFs.

Addressing Obesity: Fear of Crime, Perceptions of Disorder and Disaparities in Child and Adolescent Use of Public Parks

Abstract The objectives of this study were: 1) To determine factors which inhibit and facilitate child and adolescent use of outdoor spaces for healthy physical activity by race and ethnicity in four Houston communities and 2) To propose guidelines for encouraging and maintaining child and adolescent outdoor physical activity. Using local health data and Houston Police Department crime statistics, four communities were identified for the study that had the highest concentration of crime and the racial/ ethnic groups of interest. The researchers then identified public parks in the communities. At least two parks were observed in each of the four communities from 2010 to 2011 during spring, summer, fall and winter. The parks were observed for use by children and adolescents and to describe the condition of the park spaces. The communities were Alief (Asian), Sunnyside (Black), Eldridge- West Oaks (White) and Northside- Northline (Hispanic). Observations were made at varying hours of both day and night, weekdays and weekends. Photographs were taken and the condition of the spaces noted in detail. One hundred and twenty persons, 18 years and over, using the spaces or otherwise in these communities were conveniently sampled and interviewed about their health and the extent to which they, or any children or adolescents under their care, used the outdoor spaces of interest. Data were analyzed qualitatively and with basic descriptive statistics. The photographs, journal notes and observation notes of all investigators and key personnel were analyzed. Interview data were also coded to identify patterns and themes in the responses. The findings indicate disparities in the quality and quantity of park equipment and the maintenance of the areas. Where perceptions of disorder were described, there was often visible evidence to support the perceptions. In many cases, residents' perceptions of crime were corroborated by police data. While interview reports did not seem to support the expectation that the condition of the parks was a significant deterrent to their use by children and adolescents, the condition of the parks might be said to limit the extent of that use. Specific reports of disorder that inhibited use included hearing gunfire, seeing drug dependent homeless persons and/or suspected prostitutes in an area.

Tourism Impacts of a Portuguese World Heritage Historic Center: Residents’ Perspectives

The World Heritage List (WHL) is widely considered a powerful tool for national tourism campaigns. Sites inscribed on the WHL by the United Nations Educational, Scientific, and Cultural Organization (UNESCO) are commonly treated as catholicons in promoting the tourism industry, which in turn helps to promote economic growth and development. This study analyzes local community perceptions of the importance of the World Heritage Site (WHS) classification of the historic center of the Portuguese city of E ́vora. The research also includes an analysis of the local residents’ perceived tourism impacts on the municipality of E ́ vora. The methodology consists of quan- titative research based on a self-administered survey applied to convenience sam- ples of local residents of the municipality of E ́ vora in the beginning of 2014. The local residents’ perceptions of the level of importance of the WHS classification to the municipality and its impact in the increase of tourists is analyzed. Positive and negative tourism impacts are then ranked and a principal components factor analysis is employed separately to the two groups of impacts in order to identify underlying dimensions associated with residents’ perceptions on tourism develop- ment. Based on the results of the factor analysis, independent sample t-tests are used to investigate differences regarding positive and negative tourism impacts between residents that live near and far from the historic center, and between residents who work/have worked in the tourism sector and residents that work/ have worked in other sectors.

The lived world of older urban Australians: relating everyday living to GPS tracking data

Neighbourhood like the concept of liveability is usually measured by either subjective indicators using surveys of residents’ perceptions or by objective means using secondary data or relative weights for objective indicators of the urban environment. Rarely, have objective and subjective indicators been related to one another in order to understand what constitutes a liveable urban neighbourhood both spatially and behaviourally. This paper explores the use of qualitative (diaries, in-depth interviews) and quantitative (Global Positioning Systems, Geographical Information Systems mapping) liveability research data to examine the perceptions and behaviour of 12 older residents living in six high density urban areas of Brisbane. Older urban Australians are one of the two principal groups highly attracted to high density urban living. The strength of the relationship between the qualitative and quantitative measures was examined. Results of the research indicate a weak relationship between subjective and objective indicators. Linking the two methods (quantitative and qualitative) is important in obtaining a greater understanding of human behaviour and the lived world of older urban Australians and in providing a wider picture of the urban neighbourhood.

Understanding causal relationships between the built and social environment, health and associated behaviours and risk factors

Introduction: Built environment interventions designed to reduce non-communicable diseases and health inequity, complement urban planning agendas focused on creating more ‘liveable’, compact, pedestrian-friendly, less automobile dependent and more socially inclusive cities.However, what constitutes a ‘liveable’ community is not well defined. Moreover, there appears to be a gap between the concept and delivery of ‘liveable’ communities. The recently funded NHMRC Centre of Research Excellence (CRE) in Healthy Liveable Communities established in early 2014, has defined ‘liveability’ from a social determinants of health perspective. Using purpose-designed multilevel longitudinal data sets, it addresses five themes that address key evidence-base gaps for building healthy and liveable communities. The CRE in Healthy Liveable Communities seeks to generate and exchange new knowledge about: 1) measurement of policy-relevant built environment features associated with leading non-communicable disease risk factors (physical activity, obesity) and health outcomes (cardiovascular disease, diabetes) and mental health; 2) causal relationships and thresholds for built environment interventions using data from longitudinal studies and natural experiments; 3) thresholds for built environment interventions; 4) economic benefits of built environment interventions designed to influence health and wellbeing outcomes; and 5) factors, tools, and interventions that facilitate the translation of research into policy and practice. This evidence is critical to inform future policy and practice in health, land use, and transport planning. Moreover, to ensure policy-relevance and facilitate research translation, the CRE in Healthy Liveable Communities builds upon ongoing, and has established new, multi-sector collaborations with national and state policy-makers and practitioners. The symposium will commence with a brief introduction to embed the research within an Australian health and urban planning context, as well as providing an overall outline of the CRE in Healthy Liveable Communities, its structure and team. Next, an overview of the five research themes will be presented. Following these presentations, the Discussant will consider the implications of the research and opportunities for translation and knowledge exchange. Theme 2 will establish whether and to what extent the neighbourhood environment (built and social) is causally related to physical and mental health and associated behaviours and risk factors. In particular, research conducted as part of this theme will use data from large-scale, longitudinal-multilevel studies (HABITAT, RESIDE, AusDiab) to examine relationships that meet causality criteria via statistical methods such as longitudinal mixed-effect and fixed-effect models, multilevel and structural equation models; analyse data on residential preferences to investigate confounding due to neighbourhood self-selection and to use measurement and analysis tools such as propensity score matching and ‘within-person’ change modelling to address confounding; analyse data about individual-level factors that might confound, mediate or modify relationships between the neighbourhood environment and health and well-being (e.g., psychosocial factors, knowledge, perceptions, attitudes, functional status), and; analyse data on both objective neighbourhood characteristics and residents’ perceptions of these objective features to more accurately assess the relative contribution of objective and perceptual factors to outcomes such as health and well-being, physical activity, active transport, obesity, and sedentary behaviour. At the completion of the Theme 2, we will have demonstrated and applied statistical methods appropriate for determining causality and generated evidence about causal relationships between the neighbourhood environment, health, and related outcomes. This will provide planners and policy makers with a more robust (valid and reliable) basis on which to design healthy communities.

Ecoturismo en comunidades rurales: análisis de los impactos negativos para la población local. Un estudio de caso

En los últimos años han aparecido nuevas formas de turismo más sostenibles, donde existen elementos relacionados con el descanso, el disfrute y la protección del medio ambiente o el conocimiento de la cultura local, a través de políticas que favorecen la sostenibilidad del destino. En este sentido, el ecoturismo se configura como una tipología turística que se desarrolla en contacto con la naturaleza. Este turismo ayuda a mejorar el desarrollo socioeconómico de las comunidades locales, a la vez, que fomenta la conservación de los recursos naturales y el respeto hacia el medio ambiente. Aunque, esta tipología de turismo también genera importantes impactos negativos. El objetivo principal de esta investigación es analizar los impactos socioeconómicos, culturales y medioambientales percibidos por el ecoturismo por parte de los residentes de comunidades rurales de República Dominicana. La técnica de recolección de datos utilizada ha consistido en un cuestionario. Entre las principales conclusiones, cabe destacar que actualmente no se perciben impactos negativos, pero si hay una serie de elementos que hay que ir considerando, con la finalidad de que no se conviertan en un impacto a corto plazo para la comunidad rural.

Principles of fatigue in residency education: a qualitative study

Background: Proposals to implement fatigue-management strategies in residency education assume that medicine shares the view
of other risk-adverse industries that fatigue is hazardous. This view is an essential underpinning of fatigue-management strategies
that other industries have embedded as part of their workplace occupational health and safety programs. We sought to explore how
residents understand fatigue in the context of their training environment.

Methods: We interviewed 21 residents in 7 surgical and nonsurgical programs at Western University in 2014. All participants met the
inclusion criteria of routinely working 24-hour call shifts while enrolled in their training program. Data collection and analysis occurred iteratively in keeping with constructivist grounded theory methodology and informed theoretical sampling to sufficiency.

Results: Four predominant principles of fatigue captured how the social learning environment shaped residents’ perceptions of
fatigue. These included the conceptualization of fatigue as (a) inescapable and therefore accepted, (b) manageable through experience, (c) necessary for future practice and (d) surmountable when required.

Interpretation: This study elaborates our understanding of how principles of fatigue are constructed and reinforced by the training
environment. Whereas fatigue is seen as a collective hazard in other industries, our data showed that, in residency training, fatigue
may be seen as a personal challenge. Consequently, fatigue-management strategies that conceptualize fatigue as an occupational
threat may have a limited impact on resident behaviour and patient safety.

Étude exploratoire du soutien social dans le processus menant à l'hébergement des aînés en perte d'autonomie

Contexte : Au Québec, la très grande majorité des personnes âgées vivent dans un logement conventionnel. Pour celles qui sont en plus grande perte d’autonomie et qui ont besoin d’un environnement adapté à leurs besoins, soit environ 12 % de la population âgée de 65 ans ou plus en 2006, les options sont relativement limitées. Au 1er rang, on retrouve les résidences privées, pour ceux et celles qui en ont les moyens. Pour les autres, il y a les centres de soins de longue durée publics ou privés. Viennent ensuite les organismes sans but lucratif qui opèrent des projets résidentiels pour aînés, les communautés religieuses qui accueillent des personnes âgées dans leurs résidences, les ressources intermédiaires, les ressources de type familial, les habitations à loyer modique pour personnes âgées et les coopératives d’habitation. Les ressources alternatives du type projets novateurs arrivent en dernière position, ce qui explique que l’on en sait encore très peu sur la transition vers ce type d’hébergement. Problème et objet de recherche : La transition vers un milieu de vie substitut est un processus qui peut être potentiellement stressant dans la vie d’une personne âgée. Son réseau de soutien peut être appelé à jouer un rôle important pour l’aider à vivre cette transition avec plus de facilité. Si la littérature sur le soutien social est abondante, elle est plus limitée en ce qui concerne la relation entre le soutien social et la transition en milieu d’hébergement. La plupart des travaux recensés étudient les conséquences de l’hébergement durant les mois qui suivent le relogement. Quelques études analysent le processus décisionnel mais rares sont celles qui s’intéressent à toutes les étapes du processus qui précèdent le relogement. La plupart des recherches analysent surtout le point de vue des aidants et parfois celui des professionnels. Celui des personnes âgées est moins connu. But et objectifs : Le but de cette étude consiste à mieux comprendre comment opèrent les différentes formes de soutien social auprès des personnes âgées durant les diverses étapes du processus de transition en milieu d’hébergement. Plus précisément, elle vise à mieux comprendre comment ces personnes perçoivent les différents types de soutien apporté par leur réseau de soutien durant la transition, la signification que prend pour elles l’aide reçue, les besoins auxquels répond le soutien reçu et pourquoi elles apprécient ou non le soutien reçu. Cadre conceptuel : Cette recherche de type exploratoire et rétrospective se situe dans une approche des parcours de vie. La transition en milieu d’hébergement est étudiée comme un processus faisant partie de la trajectoire résidentielle de la personne. On privilégie une approche interactionnelle et constructiviste du soutien social qui accorde une attention plus grande aux interprétations subjectives des personnes faisant partie des réseaux de soutien. Méthodologie : On a interviewé huit (8) résidents (6 femmes et 2 hommes) de 64 ans ou plus, vivant dans un milieu d’hébergement alternatif de type projet novateur : les Habitations St-Christophe, une ressource alternative située dans la ville de Laval au Québec. Les perceptions des sujets du soutien social reçu durant la transition sont analysées à l’aide de la théorisation ancrée, la plus appropriée pour comprendre de l’intérieur le point de vue des participants. Résultats : L’analyse des perceptions des résidents interviewés du processus qui les a conduits aux Habitations St-Christophe a permis de mieux comprendre l’influence de leurs trajectoires résidentielles, les transitions ayant mené à leur hébergement, leurs perceptions du processus décisionnel et du rôle joué par des tiers dans les décisions prises, ainsi que les motifs de ces décisions, de même que le rôle joué par le soutien social durant la transition. Trois modèles de réseaux ont été identifiés, en tenant compte de la fréquence des contacts, de l’intensité des liens et de la disponibilité du soutien. Les formes les plus importantes de soutien reçu ont été identifiées à partir des perceptions des sujets de l’aide émotionnelle, instrumentale et cognitive fournie pendant la transition et de leur appréciation du soutien reçu. L’analyse a permis d’identifier deux modèles de transition (transition réfléchie, préparée et anticipée versus transition précipitée) et deux modèles de soutien (soutien valorisé versus soutien peu valorisé). Conclusions : Outre les éléments de convergence et les points de divergence observés entre nos résultats et la littérature, un certain nombre d’enseignements ont été retenus au niveau de l’intervention. Ceux-ci concernent les conditions gagnantes à mettre en place par les gestionnaires des services publics, certains principes à respecter dans les interventions, les mesures à prendre pour améliorer les interventions des professionnels et les interventions à mettre en place à l’intention des personnes âgées et de leurs proches aidants.

Une urbanisation de corps et d'esprit : sécurité, civilisation et rendement dans une favela de Rio de Janeiro

Ce mémoire interroge l’histoire, l’articulation pratique et les effets de ce que l’on appelle actuellement au Brésil «l’urbanisation intégratrice», un type d’intervention étatique dans les favelas (bidonvilles) de Rio de Janeiro. Il s’agit d’une énième tentative de régler le «problème de la favela», consistant en l’urbanisation de son territoire (insertion d’infrastructure publique, consolidation du cadre bâti) et la légalisation de son statut et de ses pratiques (octroi de droits de propriété foncière et insertion de règlementation publique). Officiellement, c’est une manière de mettre fin à l’exclusion dont les populations faveladas sont victimes depuis l’apparition des favelas à Rio. L’analyse est faite à partir de l’étude du PAC-Favelas, un programme du gouvernement fédéral lancé en 2008, et son application dans la favela Rocinha. Il est proposé de considérer l’urbanisation intégratrice en tant que dispositif sécuritaire ou biopolitique, c’est-à-dire en tant qu’appareil de gouvernement de la population locale. À travers le projet, on planifie de formaliser les conduites, d’accroître la circulation des ressources, de transformer les perceptions des résidents, de contenir les excès et les risques associés à la favela et de tendre vers la prise en charge entièrement planifiée – en un mot, d’assurer le passage vers l’intervention permanente. Concrètement, cela revient pour l’État à procéder à une sélection, par des moyens légitimés ou indirects (le plan, la loi, le marché), des individus et des pratiques désormais admissibles sur le territoire. L’espace se raréfie, le contrôle augmente et les prix montent : ne peut demeurer que celui qui a déjà atteint un certain niveau de stabilité, reléguant les plus précaires à devoir progressivement quitter le territoire. Urbaniser la Rocinha, c’est un peu forcer son embourgeoisement en la rendant enfin sécurisée, civilisée et rentable.

Percepción de residentes de medicina de urgencias en Colombia del ambiente educativo en los servicios de urgencias

Introducción: La atención de calidad en urgencias sólo es posible si los médicos han recibido una enseñanza de alta calidad. La escala PHEEM (Postgraduate Hospital Educational Environment Measure) es un instrumento válido y fiable, utilizado internacionalmente para medir el entorno educativo, en la formación médica de posgrado. Materiales y métodos: Estudio de corte trasversal que utilizó la escala PHEEM versión en español para conocer el entorno educativo de los programas de urgencias. El coeficiente alfa de Cronbach se calculó para determinar la consistencia interna. Se aplicó estadística descriptiva a nivel global, por categorías e ítems de la escala PHEEM y se compararon resultados por sexo, año de residencia y programa. Resultados: 94 (94%) residentes llenaron el cuestionario. La puntuación media de la escala PHEEM fue 93,91 ± 23,71 (58,1% de la puntuación máxima) que se considera un ambiente educativo más positivo que negativo, pero con margen de mejora. Hubo una diferencia estadísticamente significativa en la percepción del ambiente educativo entre los programas de residencia (p =0,01). El instrumento es altamente confiable (alfa de Cronbach = 0,952). La barrera más frecuente en la enseñanza fue el hacinamiento y la evaluación fue percibida con el propósito de cumplir normas. Discusión: Los resultados de este estudio aportaron evidencia sobre la validez interna de la escala PHEEM en el contexto colombiano. Este estudio demostró cómo la medición del ambiente educativo en una especialidad médico-quirúrgica, con el uso de una herramienta cuantitativa, puede proporcionar información en relación a las fortalezas y debilidades de los programas.