Groups Of Visitors Research Articles

Managing the perception of service quality; the importance of understanding differences between demographic and behavioural customer segments amongst theme park visitors

PurposeThe aim of this study was to investigate the differences in the perception of service quality among various demographic and behavioural visitor segments within the theme park tourism market.Design/methodology/approachA quantitative survey was conducted using a structured questionnaire which was distributed to 655 theme park visitors. Different groups of visitors were identified through the use of cluster analysis based on the evaluation of both demographic variables and a number of behavioural factors associated with their characteristics in terms of “time and cost” allocations for visits to a theme park.FindingsThe findings confirm that differences in demographic characteristics significantly affect perceptions of visitors as demonstrated in the way they are likely to evaluate importance and performance factors in a theme park’s delivery of services. In contrast, behavioural segmentation in terms of time allocation and associated expenditure is unlikely to produce significant differences in the visitors’ perceptions of the level of service provided.Originality/valueAlthough there are many studies related to visitors’ perceived service quality, none of them use the same methodology as applied in this study of theme park industry. The research results reveal important implications for the theme park industry because of this new understanding of the segmentation differences for visitor-perceived service quality. By directing attention of management to these differences, improvements in service quality perceptions can more readily be achieved.

The Concept of “Book Town” as an Innovative Way of Using Local Resources for Tourism Purposes

Abstract Subject and purpose of work: The aim of this paper is to present the origin and assumptions of the concept of “book towns”, along with the conditions of its development and different ways of using this concept in shaping tourist attractiveness. Materials and methods: This paper was prepared on the basis of domestic and foreign literature overview, as well as with the case study method. The examples presented in this article encompass four “book towns” from different continents (Hay-On-Wye in Wales, Torup in Denmark, Clunes in Australia and Paju in South Korea). Results: Each of the analysed towns has a unique identity and its own idea of development. A book served as a tool for building social capital, entrepreneurship development (particularly in Torup) and forming new tourist destinations. Conclusions: The concept of “book town”, which was created in the 60s of the twentieth century, still arouses the interest of local communities and various groups of visitors, including, among others, tourists, booksellers and bibliophiles. Its uniqueness lies in the fact that a “book town” offers not only economic benefits but is primarily a tool for comprehensive interpretation and protection of local culture.

Integrating the little talks intervention into Early Head Start: An experimental examination of implementation supports involving fidelity monitoring and performance feedback

Enriching home visiting services by incorporating scientifically-supported interventions is a means for improving their effectiveness in promoting child development. However, deliberate efforts to ensure that home visitors are fully knowledgeable and supported to implement interventions with parents of young children are necessary. In this experimental study, a randomly-assigned group of Early Head Start home visitors monitored the fidelity of their provision of a scientifically-based intervention, Little Talks, and the program's general child development services. On a bi-weekly basis, home visitors received performance feedback specific to their implementation of Little Talks and based upon the fidelity data. Findings demonstrated that home visitors showed immediate and consistent mastery of the Little Talks content, while the quality of their implementation, including their clinical decision-making and collaborative processes, improved to adequate levels over time. The Little Talks home visitors showed generalized improvements in their ability to obtain Parent Input while providing the program's typical child development services were detected. In fact, Little Talks home visitors' were superior in obtaining Parent Input relative to comparison home visitors. Further, parents for whom low-quality intervention implementation was observed discontinued their enrollment in home visiting prematurely, while high-quality implementation was associated with sustained enrollment. Limitations for this study are identified, leading to future directions for advancing home visitors' incorporation of evidence-based practices.

Recommendation in museums: paths, sequences, and group satisfaction maximization

This work addresses the problem of generating and then recommending an artworks sequence for a group of visitors within a museum. Differently from a recommender system for an e-commerce application, the problem, here, is trying to maximize the satisfaction of the proposed recommendations, while taking into account an items' ordering that satisfies each group member during the sequence and the artworks locations in the museum. Moreover, since many visitors may not be able to visit every artwork, the recommender system should provide suggestions while satisfying temporal visit constraints. The problem formulation is discussed together with the characteristics of a feasible solution. An exact search algorithm from the literature is used to efficiently solve the problem and to define the prerequisites for the recommender system. Finally, we evaluate a prototype implementation with both an offline analysis and a pilot study in a simulated museum environment.

Back to nature! Or not? Urban dwellers and their forest in berlin

What type of urban nature do urban dwellers prefer? Contributing to this ongoing discussion, this study presents the results of an internet and on-site field survey on general use and visitation pattern conducted in Grunewald Forest via a questionnaire; this is a 3000 ha area southwest of Berlin, Germany. The questions were developed in close cooperation with the local forestry administration and targeted the uncovering of user-specific needs and climate change-related conflicts. More than 1300 valid answers were analyzed, which made it possible to (1) identify and characterize different visitor groups, (2) identify reasons for an urban forest visit, (3) uncover the needs for infrastructure and information, (4) reflect on the survey methods used. The interesting findings include (I) the reasons for a visit highly coincide with forest-related properties in particular; however, the infrastructure preferences reveal the desire for managed greenspace; and (II) the answers obtained from the field differ significantly from those obtained online in various respects. The differences found suggest that the survey, with both online and on-site answers, is a major advantage for future studies regarding urban green infrastructure use. These results can be fruitfully used to inform urban forest management regarding user needs and create a better forestry information policy in the future.

A cyclical learning model to promote children’s online and on-site museum learning

PurposeThis paper aims to propose an online and on-site cyclical learning model (OOCLM). It considers how combining digital applications can promote a museum’s virtuous learning cycle between online and on-site spaces for children.Design/methodology/approachA practical cyclical learning service has been successfully implemented in a science museum in Taiwan. This provides a thematic game-based learning environment, allowing all the children to create their unique museum experiences before, during and after their visit. A questionnaire was developed to examine the children’s perceptions of the OOCLM to ascertain whether they were satisfied with the pre-visit, on-site visit and post-visit services offered.FindingsThe learning model considered the contextual factors that influence digital applications in museums. The digital and physical resources are well integrated, and the museum’s online and on-site services are linked to effectively promote children’s cyclical learning.Practical implicationsThe results show that most of the children highly appreciated the learning model. The model presents an interactive learning environment for children’s cyclical learning and repeat visits.Originality/valueThe OOCLM considers the related contextual influences of digital applications in museum learning; it effectively bridges the museum’s online and on-site services to promote the museum’s virtuous learning cycle and long-term museum learning resource management. This study provides a benchmark example to develop sustainable cyclical learning services for target visitor groups and to motivate their long-term interaction with the museum.

Postnatal depression: Can visual media and dramatisation of a young woman's experiences, enable student health care professionals develop knowledge to enhance clinical practice skills?

IntroductionSince the presentation of the symptoms of postnatal depression (PND) can vary; healthcare professionals must receive the appropriate level of training to develop the knowledge required for the effective assessment and referral of women. Yet, healthcare professionals may have limited knowledge in perinatal mental health and students may lack practice opportunities to develop the knowledge and clinical skills. For these reasons, the use of alternative learning resources within perinatal mental health education is vital.ObjectivesTo explore the use of visual media in perinatal mental health education.AimsAgainst the background of increasing concerns about the ability of professionals to assess women with PND, this paper will consider how using dramatisation as a teaching approach can enable students to develop their knowledge and guide clinical skill development.MethodsThree separate groups of senior student midwives and health visitors were asked to evaluate a dramatisation developed from women's lived experience of PND. Pre and post verbal evaluation of the drama were undertaken with the use of focus groups guided by semi-structured questions. Ethical approval was granted by the university.ResultsFollowing thematic analysis three issues were identified:–the role of the healthcare professional;–improvements needed in care;–issues of education and training.ConclusionsAgainst the background of limited placement experience and opportunity for assessment of PND, the use of visual media can improve student healthcare professionals’ learning; with the use of structured facilitation, there is a great potential for multidisciplinary learning.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Combining GPS & survey data improves understanding of visitor behaviour

Visitor tracking is frequently used in tourism planning for large sites, but is far less common at individual attractions, despite a body of literature examining the detrimental impact of crowding on visitor experience. This study used handheld geographic positioning system (GPS) units to track 931 groups of visitors around a single tourist attraction to determine where they went and how long they dwelt at particular locations. The tracking data were combined with survey data to discover whether different types of visitors behaved differently when exploring the attraction. The majority of visitors followed similar routes revealing a strong ‘main path inertia’ with over half missing exhibits away from the perceived main route. Different group types varied in how long they dwelt at different locations and in how long they spent at the attraction altogether.

ARE HEALTH VISITORS' OBSERVATIONS OF EARLY PARENT-INFANT INTERACTIONS RELIABLE? A CROSS-SECTIONAL DESIGN.

Health visitors need competences to promote healthy early parent-infant relationships. The aims of this study were to explore whether there are differences between groups of health visitors with and without additional parenting program education in terms of their knowledge of infant-parent interaction and their observation and assessment skills of such interactions. The cross-sectional study included 36 health visitors' certified Marte Meo therapists and 85 health visitors without additional parenting program education. Health visitors' observation skills were measured assessing five video-recorded mother-infant interactions. A questionnaire was used to measure their intention, self-efficacy, and knowledge. More certified Marte Meo therapists than health visitors without additional parenting program education reported a significantly higher mean level of knowledge of the early relationship, 6.42 (95% CI; 6.18-6.66) versus 5.05 (95% CI; 4.86-6.10), p = .04; and more certified Marte Meo therapists than health visitors without additional parenting program education reported a higher mean level of knowledge of infant self-regulation, 2.44 (95% CI; 2.18-2.71) versus 1.83 (95% CI; 1.62-2.03), p < .001. In the latter group, 54% (95% CI; 0.43-0.64) reported a significantly higher need for further education versus 22% (95% CI; 0.11-0.39), p = .001. Compared to health visitors without any parenting program education, health visitors certified as Marte Meo therapists reported a significantly higher frequency of correct assessment of mothers' sensitivity in two of five video-recordings, with 77.78% (95% CI; 0.61-0.87) compared to 45.88% (95% CI; 0.35-0.57) in Video 3, p = .001, and 69.44% (95% CI; 0.52-0.82) compared to 49.41% (95% CI; 0.39-0.60) in Video 4, p = .04, respectively. The results of the present study support the use of video-based education of health visitors to increase their knowledge of and skills in assessing parent-infant interactions. Randomized controlled trials are needed to determine whether the improved level of health visitors' knowledge and observation skills may be assigned to participation in the Marte Meo education program.

Effects of visitor numbers on captive European red squirrels (Sciurus vulgaris) and impacts on visitor experience.

Visitors to zoological collections can have substantial effects on captive animals that vary according to species, enclosure design, visitor proximity, and husbandry methods. One particularly intense form of visitor interaction occurs in immersive exhibits such as walk-through enclosures. Such enclosures are increasingly common but effects on animal behavior are currently understudied. Here, the behavior of captive European red squirrels (Sciurus vulgaris) is studied in relation to visitor numbers in a walk-through enclosure. We also quantify the correlation between squirrel encounters and visitor experience. Interaction with humans increased significantly as the number of visitors inside the enclosure increased. The number of children present significantly increased locomotion and decreased eating, possibly due to disturbance and squirrels moving away from busy areas. By contrast, the number of adults significantly increased eating and decreased inactivity due to squirrels approaching visitors. The positive reinforcement training used by the keepers (offering food rewards to the squirrels for coming to them to allow routine medical checks) meant that squirrels associated adults with food opportunities. Squirrel encounter rate (number of squirrels seen by each group of visitors) was significantly affected by the number of adults and visitor duration (positive relationships) and noise as perceived by visitors (negative relationship). Encounter rate was positively correlated with overall visitor experience. Our results indicate that visitors affect behavior but this effect is influenced by husbandry methods. It is vital that visitors, especially children, minimize noise, and move slowly in the enclosure, both for the sake of the animals and their own experience.

Differences in pollination success between local and foreign flower color phenotypes: a translocation experiment with Gentiana lutea (Gentianaceae).

BackgroundThe adaptive maintenance of flower color variation is frequently attributed to pollinators partly because they preferentially visit certain flower phenotypes. We tested whether Gentiana lutea—which shows a flower color variation (from orange to yellow) in the Cantabrian Mountains range (north of Spain)—is locally adapted to the pollinator community.MethodsWe transplanted orange-flowering individuals to a population with yellow-flowering individuals and vice versa, in order to assess whether there is a pollination advantage in the local morph by comparing its visitation rate with the foreign morph.ResultsOur reciprocal transplant experiment did not show clear local morph advantage in overall visitation rate: local orange flowers received more visits than foreign yellow flowers in the orange population, while both local and foreign flowers received the same visits in the yellow population; thus, there is no evidence of local adaptation in Gentiana lutea to the pollinator assemblage. However, some floral visitor groups (such as Bombus pratorum, B. soroensis ancaricus and B. lapidarius decipiens) consistently preferred the local morph to the foreign morph whereas others (such as Bombus terrestris) consistently preferred the foreign morph.DiscussionWe concluded that there is no evidence of local adaptation to the pollinator community in each of the two G. lutea populations studied. The consequences for local adaptation to pollinator on G. lutea flower color would depend on the variation along the Cantabrian Mountains range in morph frequency and pollinator community composition.

A Quality Assessment of Tourist Information: the Case of Nautical Tourism at Shiretoko Peninsula

The success of tourism promotion in a destination partially depends on the extent to which it successfully links varied products catering to a heterogeneous group of visitors in a multi-client system. In contemporary destination marketing, communication between the service providers at the destination and the (prospective) tourists has become increasingly important as a result of the rise in informal communication channels and social media. This paper focuses on the effect of using different information sources when booking a cruise tour in Shiretoko Peninsula (a natural World Heritage Site) by employing a multi-group structural model. Our findings revealed that a mismatch between the expectation created by the visitors based on the information about the site and the satisfaction they experience when visiting the place can be a strong factor of dissatisfaction, with negative implications on the possible recommendations and loyalty. Additionally, it was possible to conclude that information available on the internet and via guidebooks seems to negatively affect satisfaction on certain elements and routes, while local information from tourist offices, hotels and local shops was found less problematic.

Home Visiting in Two Cultures

ABSTRACTThe home visiting component of early childhood education programs provides an important portal through which to observe family interactions as well as gain insights about the ethnotheories of the home visitor. Home visits were videotaped in the United States and in Turkey to analyze training and program effectiveness. One striking feature of this comparison was the role played by the home visitor in interpreting the cultural values associated with the intervention program. The videos portrayed home visits as cultural windows into intervention priorities. To capture the perspectives represented in the home visit videos, a video-cued multivocal ethnographic method was used to investigate cultural meanings attributed to home visiting practices. Focus groups of Turkish home visitors watched a video from an American home visiting program and focus groups of American home visitors watched a video from Turkish home visiting program. A semistructured set of discussion questions followed the videos, and the group responses were recorded. The resultant thematic analysis revealed culturally informed collections of professional beliefs and expectations. As the focus groups interpreted the practices of professionals from another culture, their comments revealed their own cultural perspectives on the roles to be played by home visitors in the lives of families.

Haben Zoos einen Bildungseffekt? Quantitative Bildungserfolgserhebung am Beispiel des Zoo Zürich

Is the Zoo of Zurich an institution that imparts knowledge or educational benefit? The primary objective of the referenced master thesis was to analyse and seek to quantify certain parameters of this premise. In order to attain this objective, and in collaboration with Zoo Zurich, a broadly based evaluation via survey and analysis of the knowledge acquired and retained by visitors to the zoo was conducted. Applying 16 scientifically designed questionnaires, each developed for a specific sub-area (or animal enclosure) of Zoo Zurich, the majority of the zoo's available educational offerings could be included in the survey. The questions developed for the survey were based on six knowledge domains, all considered relevant and categorised in terms of change in attitude and behaviour by visitors to the zoo. The interviews carried out, encompassed 1’273 pre or ‘entrance’ and 1’234 post or ‘exit’ interviews, for a total sample size of 2’507 interviews.In a first step, the data analysis focused on the knowledge imparted during a single visit to the zoo. Via hypothesis testing, it was possible to prove with a 99% level of significance, that a single visit to Zoo Zurich can provide a significantly positive educational effect.Statements regarding the level of retention of such knowledge transfer were not yet possible with these insights gained. For this reason in a second step, a multiple regression (31 significant variables, R2=0.22) was calculated, for which the results obtained from the interviewees constituted the dependent variable. The conclusion attained was again positive: A single visit to the zoo has a significantly positive educational effect, and which accounted for approx. 5 percentage points within the questionnaires. In addition it was now possible to establish, that an increasing number of visits to Zoo Zurich translate into materially higher results (99% significance). Thus for example, the average knowledge or educational advantage attributable to frequent visitors (three or more visits per year) is 3.5 percentage points higher than other visitor groups. Consequently, the knowledge or educational effect gained at Zoo Zurich rather than merely temporary, instead indicates a certain level of sustainability or permanence of retention. This was also shown by the fact that the reduction or loss of knowledge due to lack of knowledge brush-up through a renewed visit to the zoo, did not occur rapidly but rather over several years.Next to these findings, particularly in focus also was the notable impact of children on the level of knowledge transfer by the Zoo Zurich. Thus, as became visible from the multiple regression, visitor groups with toddlers achieved significantly lower results in knowledge transfer or educational benefit versus those groups without children or visitors with adolescent children. As a result, the current potential for knowledge transfer at Zoo Zurich is, to a considerable extent, impaired. This given amongst the visitor groups questioned, that 63% were accompanied by children on average being five years of age.In a further step, the data were analysed as to whether the demonstrated transfer of knowledge or educational effect occurred across the entire Zoo Zurich, or if differences were verifiable amongst the selected 16 sub-areas or animal enclosures. The results revealed that four of the examined 16 sub-areas had a significantly positive educational effect. Allowing for expansion of the level of significance applied to 90%, an educational effect became visible in a further five sub-areas of Zoo Zurich. However, further study is needed to attain certainty for these five sub-areas. In seven sub-areas, on average, an educational effect could not be ascertained.In a closing step toward completeness of the insights gained, a final question was considered: What type of knowledge does the educational effect of Zoo Zurich encompass? To this end, the transfer of knowledge was individually tested for the six pivotal knowledge domains. The analysis showed a significantly positive educational effect in three of the six knowledge domains. Thus, zoo visitors exhibited an enhanced knowledge regarding appearance, names, and geographical distribution of the animal species observed. For the remaining knowledge domains of biotopes, behaviour & characteristics, and threats & protection, a visit to Zoo Zurich did not result in a change of knowledge.The question formulated at the beginning can, given the evaluations completed, be answered with a Yes: The Zoo of Zurich does impart knowledge. However, this knowledge transfer does not include all sub-areas of Zoo Zurich, nor all as pivotal defined knowledge domains.(The complete article in English relating to this abstract is available from the author via email: marc.duer@datazug.ch)

Tourism networking for regional place innovation in Swedish Lapland

The article presents a case study of tourism networking in the regional destination Swedish Lapland, exploring how 'place innovation' can be used as a new scientific and practical concept to study co-innovative development of attractive and sustainable places. Drawing upon previous studies of inclusive innovation, place innovation and tourism destination development, it is distinguished how the networking among the involved entrepreneurs, designers, architects, destination management organisations, business promoters, municipalities, researchers etc., is characterised by negotiations in relation to the main components, target groups and innovation forms of place innovation. These encompass the components of configuration, content and communication, the target groups of visitors, residents and businesses, as well as the innovation forms of service innovation, user-driven innovation and social innovation. The specific set of interacting actors in the studied network made the negotiations result in a prioritisation of the commercial content over the public and civil content, of visitors over residents and businesses, and of service innovation and social innovation over user-driven innovation, affecting the prospects of attaining attractive and sustainable regional destinations.

The Building Bridges Research Project at the London Science Museum: Using an Ethnographic Approach with Under-Represented Visitor Groups

The Building Bridges Research Project at the London Science Museum: Using an Ethnographic Approach with Under-Represented Visitor Groups

Atrakcyjność turystyczna gminy Uniejów w opinii turystów i kuracjuszy

W niniejszym artykule podjęto próbę oceny atrakcyjności turystycznej gminy Uniejów w opinii turystów oraz kuracjuszy. W tym celu przeprowadzono ankietę z przedstawicielami obu grup. Respondentów wybrano losowo. Kwestionariusz składał się z 22 pytań, które dotyczyły zarówno oceny atrakcyjności turystycznej, rekreacyjnej, jak i bazy noclegowej oraz gastronomicznej Uniejowa. Ponadto w kwestionariuszu zamieszczono pytania diagnozujące znajomość wśród respondentów innych atrakcyjnych turystycznie miejsc w okolicy, przyczyny ich przyjazdu do Uniejowa oraz częstotliwość i długość tych wizyt. Turyści i kuracjusze mogli również przedstawić swoje pomysły dotyczące uatrakcyjnienia miasta i gminy Uniejów. Analizowany obszar został bardzo dobrze oceniony pod względem atrakcyjności terenów rekreacyjnych przez osoby ankietowane. Władze gminy powinny jednak podejmować dalsze działania i inwestycje mające na celu wzrost atrakcyjności tego obszaru dla turystów i kuracjuszy.

Willingness-To-Pay for Improving Marine Biodiversity: A Case Study of Lastovo Archipelago Marine Park (Croatia)

The sustainable financing of marine protected areas is still an important issue on the conservation agenda even in European countries with strong governance and regulatory frameworks. With the example of the Lastovo Archipelago Marine Park in Croatia, this paper discusses options for funding based on visitors’ willingness-to-pay to conserve marine biodiversity. The site is attractive to general tourists coming by ferries and sailors with private boats alike, which is at the same time a challenge and an opportunity for designing an efficient and effective funding scheme. The authors investigate the willingness-to-pay (WTP) of these two groups of visitors for the conservation of characteristic habitats and species based on the visualization of three different scenarios. In the statistical analysis, the authors find a significant WTP that could contribute to the long-term management and financing of the site, taking into account the perceptions and attitudes of the different groups of tourists. All in all, this study provides several conclusions for levying entry fees depending on a segmentation of tourists with respect to their preferences, behavior, socio-economic characteristics, and alternative destinations.

World’s largest case management RCT

We have developed and implemented a large scale, centralized case management program to prevent healthcare consumption for frequent visitors to Emergency Departments. In a randomized trial of more than 12 000 patients we demonstrate sustained reductions of up to 20-40% in health care utilization. This session will focus on results and learnings gathered during a 5-year multicenter trial, growing from a small pilot to an international concept.The results have been published in several articles, e.g. A case management intervention targeted to reduce health care consumption for frequent emergency department visitors: results from an adaptive randomized trial in European Journal of Emergency Medicine (2015/05/06).The reason for initiating this program was the insight that a small group of frequent visitors to Emergency Departments accounts for a disproportionally large fraction of the overall healthcare costs. In response, several programs for integrated care aimed at reducing healthcare consumption in this group have been tested, with varying results. However, we can now present evidence with our program.The aim of the program is to improve patients’ quality of life while reducing unplanned care admissions. In addition, the program further improves providers’ and payers’ understanding of the factors driving unplanned care admissions and what can be done to address them. The model is based on existing health care structures to enable long term sustainability.The program consists of patient identification through a predictive model finding patients with high, and avoidable, risk for care. After inclusion, the patient meets a specially trained nurse, called a health coach, in an assessment interview, followed by telephone contact. The intervention is focused on strengthening the patients’ ability to self-manage and navigate in the health care system. The frequency of the contact between the health coach and the patient depends on the risk of the patient needing care. After 6-9 months, the contact is ended, and the health coach continues with new patients.The target group is patients in five counties in Sweden, one in Denmark and one in United Kingdom. The program has been commissioned by health care regions, managed by Health Navigator and evaluated and published in collaboration with the Karolinska Institute in Stockholm, Sweden.The results show statistically significant reductions in care consumption of up to 20-40% vs randomized controls. Meanwhile, the self-assessed quality of life for the participating patients has increased. In addition, there has been no significant change in mortality.The results have been published in several articles, e.g. A case management intervention targeted to reduce health care consumption for frequent emergency department visitors: results from an adaptive randomized trial in European Journal of Emergency Medicine (2015/05/06).In developing this from a small pilot at one hospital in one county council to implementation in several countries, we have learnt that case management programs like this are sensitive. If not implemented correctly, it could even result in an increase of health consumption. The collaboration between identification, intervention and evaluation is key to succeed, also on a large scale.Key success elements of the program concern patient identification, intervention and continuous evaluation. To begin with, identification should be early and proactive, since coaching has the biggest impact at the early stage of disease progression. Also, a combination of tools and clinical judgement is necessary for a successful identification, with predictive models helping to identify patients at risk of high healthcare utilization but clinical judgement is needed to identify patients likely to respond favorably to health coaching.When it comes to the intervention, rapid enrollment within days of identification minimizes deterioration of risk. A holistic and personalized assessment for each patient further increases the probability to succeed. The nurses providing the intervention need clear methods and standardized support tools in their daily work. The focus should not be medical, but rather on the activation of the patient itself through motivational/ educational coaching.Finally, continuous evaluation is needed on several levels, starting with the patient. The results for each patient provide valuable input for future coaching needs. Also, each nurse needs feedback on frequency of patient contacts and focus on intervention. Finally, aggregated results analysis provides continuous learning to constantly develop the predictive model and intervention content.To conclude, our study provides evidence that a carefully designed telephone-based intervention with accurate and systematic patient selection and appropriate staff training in a centralized setup can lead to sustainable, significant decreases in healthcare consumption and costs. Transferring the learnings to other target groups, geographies or health care systems are possible, but require careful assessment along the way.

Interpretation in wildlife tourism: Assessing the effectiveness of signage on visitor behaviour at a seal watching site in Iceland

The effectiveness of interpretive signage as a means of modifying visitor behaviour to reduce negative impacts on wildlife was tested empirically at a seal watching site on Vatnsnes peninsula in North West Iceland. From July to September 2014, the actions of 2440 visitors were observed and their behaviour recorded. To test the importance of how interpretive information is presented, signs with either ontological (instructions without explanation) or teleological (instructions with explanation) information were positioned along the path towards the site. A control group, to which no signs were provided, was also observed. Our results show that the majority of the tested behaviour was influenced when signs were present and that under some conditions teleological signs were more effective than ontological. The type of visitor group was found to significantly influence behaviour, with families having the most intrusive behaviour compared to singles, couples or other groups. The findings of this study contribute to a better understanding of how interpretative signage can modify tourist behaviour to facilitate sustainable wildlife tourism. The use of teleological signs for managing wildlife tourism activities is recommended because they are more effective than ontological signs in terms of modifying the general visitor behaviour. In addition, signage and other management strategies should address the different needs and responses relevant to the nature of the tourist group visiting the site. Special focus should be placed on families when signs are designed because this group type showed the highest probability of causing disturbance at the site. Management implicationsIn this paper we show that interpretation through signage can be a useful tool for sustainable development and management of wildlife watching. We recommend the following when designing interpretive signs:•Visitors should be provided with teleological, rather than ontological, information.•Signs should include illustrations with informative text.•The information provided should take care to address families because they show the most intrusive behaviour.•Information should be offered in multiple languages, as appropriate, to make information accessible to the greatest number of visitors.•The content of the information should include practical information about wildlife protection, take home messages and comparisons between wildlife and humans to enable visitors to more readily establish a psychological connection with the wildlife. Although signage has many advantages, other methods for conveying information, such as guided tours with educated guides, are suggested as a way of supplementing signs.