The good measurement qualities of the CPOT scale obtained during a painful procedure recommend its use in intensive care units (ICUs) for adult patients with artificial ventilation.

No abstract

This article examines the underinvestigated topic of how destination marketing organizations (DMOs) engage stakeholders in destination management and marketing through leverage on off-line tools, official destination websites, and social media platforms. Building on a significant body of literature and advances in quantitative and qualitative research, we provide three methodological tools: two scales assessing DMO stakeholder engagement off-line and online and a social media index measuring tourist engagement. Our results confirm that in Italy regional DMOs are capitalizing on the digital platforms and off-line participatory tools to enhance stakeholder engagement in destinations’ decision making. Theoretical and managerial implications for destination management in the digital era are suggested.

No abstract

No abstract

Purpose The purpose of this paper is to investigate the role of intersectoriality within the cultural, creative and tourism industries in Italian local development. Design/methodology/approach The research design builds on the literature on culture-led development and adapts the established body of empirical research on industrial districts to tourism and cultural development. The quantitative analysis of intersectoral specialization and the clustering of cultural, creative and tourism industries in Italian local labour systems (LLSs) combines specialization indexes with principal component analysis and cluster analysis. Findings About 50 per cent of Italian LLSs specialize in the economy of culture and tourism, mostly in material culture, although tourism has the highest level of specialization. There are three main patterns of agglomeration and clustering. The largest cluster is that of the cultural heritage and content and information industries, which coincides with the systems of medium-sized and large cities, followed by systems of tourism monoculture. The smallest is made up of material culture, typically made-in-Italy sectors. The tourism and material culture industries are monocultures – where tourism agglomerates, but material culture does not. Research limitations/implications The analytical approach is quantitative and based on Istat’s Industry and Trade (2012) data set. Further studies are needed on the interaction between agglomerated specialized industries. Originality/value This paper contributes to the theoretical and political debate on the value generation and innovation potential of culture and creativity, and bridges the knowledge domains of local development and managerial studies. Novel statistical evidence on intersectoral specialization and the clustering of the cultural, creative and tourism sectors in Italy at the inter-municipal level is provided. This study helps to identify an Italian model of the economy of culture and tourism.

No abstract

WHS management is inspired by the integrated and participatory approach adopted in well-managed protected areas and implemented in all sectors participating in sustainable development. As the effectiveness of this approach is affected by local context, the Dolomites natural WHS has been chosen to investigate with WHS status and stakeholder engagement in their design, under different institutional and socioeconomic conditions. Combining quantitative analysisclassifying WHS and neighbouring mountain municipalities according to their sustainable tourism developmentand an online questionnaire sent to the area's mayors, the research revealed differing perceptions in the WHS municipalities and where tourism-driven socio-economic wellbeing is already evident. In these areas, tourism is expected to grow more in future than in non-WHS and marginal destinations, but as part of a diversified economy. The autonomy and power of stakeholders in decision making is also perceived to be higher here, although participation is still largely induced, as the participatory capacity of some groups is weak. Concerns that sustainable development may limit autonomy and exclude other alternatives suggest that extensive and less regulated tourism development in the Dolomites' mass destinations is likely to continue.