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This paper seeks to highlight underlying issues of the tourism system that have led to tourism extremes of too much or too little tourism. Five phases are recognized that reflect different ways of dealing with too much tourism over time, after which the impact of a sudden lack of tourism is investigated in light of future renewal processes. This discussion highlights the remarkable capacity of the tourism industry to adjust to rapidly changing circumstances and crises, even when these cause anguish to individuals and within societies at large. The paper thus seeks to contextualize the current discussions regarding the transformation of tourism post COVID-19. It highlights the complexity of changing a tourism that multiple stakeholders depend on or have grown accustomed to. To come to a more balanced tourism, it is necessary to not only come up with alternative visions and strategies, but also to engage with the political economy nature of tourism development. A future research agenda should therefore also discuss facets of entangled power, social exclusion, inequalities and class differences to come to new reference points of what actually constitutes a more inclusive tourism success.
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In many regions, governments are motivating increased bicycle ridership by designing new and improving existing bicycle infrastructure. Cycle highways are an effective and cost-efficient type of bicycle-specific infrastructure that are designed to provide a functional connection between places where people work, go to school and live. One important element of developing high quality cycle highways is the development of an effective wayfinding system which allows current, potential, and new users to clearly identify and navigate a bicycle network. The wayfinding design standards used for conventional bicycle infrastructure may not be compatible for cycle highways, which encourage cyclists to travel at relatively higher speeds. This may warrant introducing specific wayfinding signage compatible for this new type of bicycle infrastructure. This study uses qualitative analysis including field observations, ride-along videos, and semi-structured interviews, to assess electrically assisted pedal bicycle (e-bike) users' opinions and experiences with wayfinding signage along a pilot cycle highway route located between Tilburg and Waalwijk in the Netherlands. In the summer of 2018, base-line observations and interviews were administered with twelve e-bike users who were unfamiliar with the route to assess their experiences with conventional signage for cyclists before changes were made to the wayfinding system. Follow-up observations were held in the fall, after the installation of two new pilot wayfinding systems that were specifically designed to accommodate cycle highway users. Initial findings suggest that the changes made to the location, size and clarity of the signage improve cyclists' overall experiences, and that cyclists' perceptions of the built environment are important. Specifically, it became easier for users to navigate the route, their overall travel related stress decreased, and several participants perceived shorter travel times. Policy makers and transportation planners are likely to be interested in the results of this study as they reveal how specific improvements to wayfinding along cycle highways not only help improve navigation, but also positively influence cyclists' overall comfort and stress.
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By use of a literature review and an environmental scan four plausible future scenarios will be created, based on the research question: How could the future of backpack tourism look like in 2030, and how could tourism businesses anticipate on the changing demand. The scenarios, which allow one to ‘think out of the box’, will eventually be translated into recommendations towards the tourism sector and therefore can create a future proof company strategy.
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All over the world entrepreneurs drive changes. They develop new products and services, inspire others and take decisions that result in growth of their businesses. But the world around entrepreneurs is changing and so are entrepreneurs. Life-long selfemployment or permanent wage employment are of the past. And the way people perceive self-employment is changing as well. And so must our thinking. Changes in our society call for policies and programmes in support of enterprising people. Diversity, mobility and connectivity offer new opportunities for enterprising people. Markets are changing, become more accessible and there is less need to be bound physically to one place for an entrepreneur. New avenues for business are open thanks to our improved access to information, our connectivity globally through social media and our ability to travel freely and frequently from one country to another. With less focus on life-long (self) employment people now combine paid work (or unpaid – house- work) with self-employment, or opt for just parttime entrepreneurship. New, hybrid forms of enterprising emerge. This combining of work with self-employment is rather common in developing countries, but in Europe it is a phenomenon not yet reported on in statistics and for which policy makers and service providers have no answers yet. Neither exist clear definitions or classifications. This book may serve as an eye-opener: hybrid entrepreneurs are indeed around us and deserve our attention. The research unit Financial Inclusion and New Entrepreneurship of The Hague University of Applied Science challenges policy makers, academics and service providers (such as educational institutes, business advisers and financial institutions) to pay more attention to hybrid entrepreneurs, those enterprising people who intend to create new values for a fair and sustainable society. They might not yet been seen, but they exist…..
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Travelling independently in an urban environment is challenging for people with a visual impairment (PVI). Current Wayfinding-apps lack detailed environmental information and are often not fully accessible. With the aim to design a wayfinding solution that facilitates independent travel and incorporates PVI needs and wishes, we deployed a cocreation design approach with PVI and professionals as co-creators. Our combination of different co-creation techniques and iterative prototyping expands the related research on wayfinding solutions and allowed us to zoom-in on specific features. Our approach started with a userrequirements analysis through selfexperience sessions, observations and focus groups. This was followed by iterative prototyping with user evaluations in controlled indoor and outdoor environments. Over a period of two years we created an accessible wayfinding solution in co-creation with 31 PVI and 19 professionals. This resulted in an optimized accessible interface, a personalized route, personalized wayfinding instructions and detailed orientation and environmental information. Lessons learned for co- design with PVI included setting up an accessible workshop environment, applying diverse evaluation methods and involving reoccurring participants.
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Rationale, aims and objective: Primary Care Plus (PC+) focuses on the substitution of hospital-based medical care to the primary care setting without moving hospital facilities. The aim of this study was to examine whether population health and experience of care in PC+ could be maintained. Therefore, health-related quality of life (HRQoL) and experienced quality of care from a patient perspective were compared between patients referred to PC+ and to hospital-based outpatient care (HBOC). Methods: This cohort study included patients from a Dutch region, visiting PC+ or HBOC between December 2014 and April 2018. With patient questionnaires (T0, T1 and T2), the HRQoL and experience of care were measured. One-to-two nearest neighbour calliper propensity score matching (PSM) was used to control for potential selection bias. Outcomes were compared using marginal linear models and Pearson chi-square tests. Results: One thousand one hundred thirteen PC+ patients were matched to 606 HBOC patients with well-balanced baseline characteristics (SMDs <0.1). Regarding HRQoL outcomes, no significant interaction terms between time and group were found (P > .05), indicating no difference in HRQoL development between the groups over time. Regarding experienced quality of care, no differences were found between PC+ and HBOC patients. Only travel time was significantly shorter in the HBOC group (P ≤ .001). Conclusion: Results show equal effects on HRQoL outcomes over time between the groups. Regarding experienced quality of care, only differences in travel time were found. Taken as a whole, population health and quality of care were maintained with PC+ and future research should focus more on cost-related outcomes.
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Lawmakers as representatives of the people should resist the anti-competitive proposals of the banking sector and embrace a vision of the digital euro that serves the collective interests of Europeans, Dr Martijn van der Linden and Vicky Van Eyck write. The influence of the banking lobby on policymakers risks undermining the digital euro's potential. Lawmakers as representatives of the people should resist the anticompetitive proposals of the banking sector and embrace a vision of the digital euro that serves the collective interests of Europeans. This means that the digital euro must be attractive, accessible and beneficial to all. The deliberation process must be free from the disproportionate influence of an industry that has much to lose from a level playing field for payment services and financial intermediation.
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In deze rapportage worden de bevindingen gepresenteerd van een studie naar de huidige en toekomstige focus van de toeristisch-recreatieve beleidskaders en samenwerkingsmogelijkheden van Emsland-Drenthe.
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Objective: Despite the increasing availability of eRehabilitation, its use remains limited. The aim of this study was to assess factors associated with willingness to use eRehabilitation. Design: Cross-sectional survey. Subjects: Stroke patients, informal caregivers, health-care professionals. Methods: The survey included personal characteristics, willingness to use eRehabilitation (yes/no) and barri-ers/facilitators influencing this willingness (4-point scale). Barriers/facilitators were merged into factors. The association between these factors and willingness to use eRehabilitation was assessed using logistic regression analyses. Results: Overall, 125 patients, 43 informal caregivers and 105 healthcare professionals participated in the study. Willingness to use eRehabilitation was positively influenced by perceived patient benefits (e.g. reduced travel time, increased motivation, better outcomes), among patients (odds ratio (OR) 2.68; 95% confidence interval (95% CI) 1.34–5.33), informal caregivers (OR 8.98; 95% CI 1.70–47.33) and healthcare professionals (OR 6.25; 95% CI 1.17–10.48). Insufficient knowledge decreased willingness to use eRehabilitation among pa-tients (OR 0.36, 95% CI 0.17–0.74). Limitations of the study include low response rates and possible response bias. Conclusion: Differences were found between patients/informal caregivers and healthcare professionals. Ho-wever, for both groups, perceived benefits of the use of eRehabilitation facilitated willingness to use eRehabili-tation. Further research is needed to determine the benefits of such programs, and inform all users about the potential benefits, and how to use eRehabilitation. Lay Abstract The use of digital eRehabilitation after stroke (e.g. in serious games, e-consultation and education) is increasing. However, the use of eRehabilitation in daily practice is limited. As a first step in increasing the use of eRehabilitation in stroke care, this study examined which factors influence the willingness of stroke patients, informal caregivers and healthcare professionals to use eRehabilitation. Beliefs about the benefits of eRehabilitation were found to have the largest positive impact on willingness to use eRehabilitation. These benefits included reduced travel time, increased adherence to therapy or motivation, and better health outcomes. The willingness to use eRehabilitation is limited by a lack of knowledge about how to use eRehabilitation.
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