Advisory Board Company (United States)

Abstract This chapter explores the link among resilience, sustainable tourism development, and risk management in the hospitality sector. The goal is to understand how value theory can shape risk management strategies that boost resiliency and sustainability. Using qualitative methods, the study uses interviews and content analysis to examine hospitality professionals’ views. The results reveal that value-driven risk management is key to resilience and sustainable tourism. Practical implications include adopting risk management aligned with core values, building local partnerships, and implementing sustainable practices. This research links value theory with risk management in hospitality, highlighting ethical decision-making aspects. It emphasizes aligning risk strategies with core values for long-term sustainability, offering insights for policymakers and practitioners.

This paper explores the importance of fidelity in strengthening clinical translation and implementation of rehabilitation research interventions and in reducing unwarranted variation in practice patterns. Fidelity, or accurate and faithful delivery of an intervention, is critical for all aspects of the clinical translational research continuum. Fidelity intentionally defines and tracks the key or active ingredients of a research intervention, ensures adherence to and dose of these key ingredients across therapists and research sites, and clearly establishes what is new or different about an intervention as compared to usual or standard practice. Measurement and reporting standards for fidelity in rehabilitation research vary widely. Historically, rehabilitation researchers have not reported their fidelity process clearly, if at all. This reporting gap creates a multi-faceted conundrum for replication of research findings and eventual clinical implementation of rehabilitation interventions. Without clear fidelity metrics, researchers fail to establish what is novel or unique about an intervention and fail to differentiate a new intervention from other established approaches. Without seeking and applying fidelity metrics, clinicians have no way of replicating a new intervention or understanding which key ingredients replace or supersede old practice habits. Thus, failure of researchers to transparently communicate and of clinicians to understand and apply fidelity metrics widens unwarranted practice variations rather than improving our precision with rehabilitation interventions. Using 2 recent pediatric clinical trials as exemplars, we describe how the development and tracking of metrics defining fidelity for the Sitting Together and Reaching to Play (START-Play) intervention informed key ingredients and program differentiation as researchers moved from an efficacy to an effectiveness trial; and then propose how clinicians might use these same metrics to inform implementation of START-Play. This example will demonstrate how robust fidelity might serve as a common language for successful implementation of and improved precision with rehabilitation research interventions.

Housing outcomes in Aotearoa New Zealand are deeply intertwined with wellbeing, yet public discussion often focuses on isolated issues, rather than the housing system as a whole. This article offers a transdisciplinary, plain-language systems model to make visible the interconnections and trade-offs that complicate housing policy. Our Housing Outcomes and Multi-system Effects (HOME) model begins with a wellbeing lens by identifying how housing affordability, agency, place and house quality affect wellbeing, and progressively builds outwards to show how economic, social and regulatory systems shape these foundations. By emphasising system-wide relationships rather than single-lever fixes, the model provides a tool for those working across housing, social policy, urban development and infrastructure seeking deeper insight into how New Zealand’s housing system operates and where opportunities for more effective policy and practice may lie.

This commentary examines the systemic failures of the United States public warning system, using the January 2025 Palisades and Eaton wildfires in California as case studies. Despite advance warnings, local governments were unable to deliver timely evacuation alerts, exposing the limits of a fragmented, locallydriven alert infrastructure. The authors argue that the mantra "all disasters are local" has become a pretext for federal disengagement, leaving vulnerable populations at risk. They call for a federally led, interoperable, realtime national warning system capable of reaching all communities-before the next disaster strikes.

To determine the prevalence and factors associated with pain-related disabilities among First Nations people living off-reserve in Canada in 2017. Secondary analysis of the 2017 Aboriginal Peoples Survey, a cross-sectional survey of individuals living in private dwellings throughout Canada. First Nations people living off-reserve aged 15 years and older (n=9115; weighted n=482 066). Pain-related disabilities, defined as pain-related activity limitations lasting ≥6 months. Overall, 22.1% (95% CI 20.9% to 23.4%) of First Nations people living off-reserve reported pain-related disabilities. Prevalence was higher among females (26.1%; 95% CI (24.3% to 28.0%)), increased with age (34.3%; 95% CI (30.3% to 38.5%) among those 45 to 54 years) and was similar across geographic areas (ranging from 21.0%; 95% CI (18.3% to 23.9%) to 22.5%; 95% CI (20.8% to 24.2%)). Pain-related disabilities increased with the number of coexisting disabilities (96.2%; 95% CI (94.3% to 97.5%) among those with >3 disabilities) and was highest among those reporting physical disabilities (ranging from 88.2%; 95% CI (85.6% to 90.4%) for those with mobility disabilities to 91.0%; 95% CI (88.6% to 92.9%) for those with disability related to flexibility). Regression models suggested that individuals with unmet basic needs, housing dissatisfaction, unmet healthcare needs, a history of mental health consultations, part-time or no employment, chronic conditions, residential school attendance or a low sense of belonging were more likely to report pain-related disabilities. Pain-related disabilities are common among First Nations people living off-reserve, and their aetiology may be multifactorial. Continued collaboration with Indigenous partners is required to contextualise findings and to inform culturally responsive clinical and rehabilitation strategies.

Racial inequities in hospital-based care for Black adults are well-documented, yet the mechanisms by which interpersonal and institutional racism contribute to these inequities remain poorly understood. Non-clinician hospital staff, such as patient care assistants, spend significant time with patients and are often members of minoritized communities, yet their perspectives on racism in the hospital are rarely studied. To investigate non-clinician staff members' perspectives on how interpersonal and institutional racism affect hospital-based care for Black adult patients. Qualitative study using in-depth, semi-structured interviews and community-based participatory research principles. Fifteen hospital staff members (patient care assistants, custodians, transporters, and ward clerks) from a large, urban, academic medical center on the West Coast. Participants self-identified as Black (27%), Hispanic (20%), and/or Asian (53%). Semi-structured interviews explored respondents' perspectives on racism in the hospital. Interviews were analyzed using thematic analysis. A Community Advisory Board of eight Black individuals provided feedback and member checking. Five themes emerged from the data: (1) staff members experienced workplace racism; (2) racial stereotypes appeared to contribute to inequitable care for Black patients; (3) institutional factors, such as inadequate staffing, were felt to contribute to inequitable care; (4) individual factors, such as going "above-and-beyond" job responsibilities, helped mitigate inequitable care; and (5) institutional diversity, equity, and inclusion (DEI) interventions received mixed appraisals, with staff often excluded from initiatives. Inequities in hospital-based care for Black patients may have roots in complex interactions between individual biases, workplace discrimination, institutional factors, and systemic underinvestment in non-clinician staff. Respondents perceived that institutional factors, such as inadequate staffing and demanding workloads, amplified racist beliefs, resulting in inequitable care for Black patients. Hospitals should invest in non-clinician hospital staff and address structural factors impeding staff members' ability to provide equitable care to all patients.