Strategies for Retaining Employees for Call Centers

Voluntary employee turnover has several adverse consequences for call center managers, including lowered productivity and decreased profitability. The purpose of this descriptive multiple case study was to explore strategies used to reduced voluntary employee turnover among 2 call center managers in the southern United States. These managers had been recommended by the human resource directors of the organizations because of their implementation of strategies to reduce voluntary employee turnover. The conceptual framework for this study was Herzberg\u27s motivation-hygiene theory. Data were collected from semistructured face-to-face interviews and employee handbooks. The data analysis consisted of compiling the data, disassembling the data into common codes, reassembling the data into themes, interpreting the meaning, and reporting the themes. The use of member checking and methodological triangulation increased the trustworthiness of the study. Themes that emerged were job satisfaction, employee compensation, opportunity and advancement, reward and recognition, and employee engagement. Recommendations for action include selecting strategies for reducing voluntary employee turnover and using the strategies to improve the commitment of the workers. The findings from this study may contribute to social change by providing strategies that call center managers can use to reduce voluntary employee turnover, thereby positively improving the standard of living for families, and strengthening community wealth and well-being

Strategies in Outsourcing R&D Processes to Maintain Market Competitiveness

In the 21st century, managing outsourced research and development (R&D) processes is critical to an organization\u27s success. Guided by the logistic outsourcing theory developed by de Boer, Gaytan, and Arroyo, the purpose of this single case study was to explore strategies and processes organizational leaders used to manage outsourced R&D to maintain market competitiveness. Semistructured interviews were conducted with 5 purposefully selected business leaders who were responsible for outsourcing R&D in a single Fortune 500 corporation in the Mid-Atlantic region of the United States. Company records were also gathered as data. Yin\u27s 5-step process for a case study and key words in context analysis were used to analyze the data. Findings included 3 main themes: (a) the outsourcing decision-making process with internal and external constraints, (b) the effectiveness of managing outsourcing services and processes, and (c) the influence of outsourcing on business effectiveness and new products. Findings also indicated no practical system to measure effectiveness of outsourced R&D services on market competitiveness. The lack of measurement effectiveness was due to a lack of processes in place to measure R&D performance and no practical approach to measure impact of R&D on market competitiveness. Findings offered insight into strategies used by business leaders to manage outsourced R&D processes. Findings may also have implications for positive social change such as impacting communities through employment, generating government revenues through taxes, and creating a positive impact on job creation in the industries that promote R&D outsourcing

Infection following bone tumor resection and reconstruction with tumoral prostheses: a literature review.

Bone resection is the choice treatment of malignant bone tumors. Tumor prosthesis is one of the most common solutions of reconstruction following resection of bone tumor located to the metaphysis of long bones. Periprosthetic infections are a frequent complication of limb-salvage surgery which is largely due to prolonged and repeated surgeries, as well as to the immunocompromised condition of these patients due to neoplastic treatment. Furthermore, the large exposure of tissues during this type of surgery and the dissection across vascular distributions also contributes to the high risk of infection. The authors reviewed the literature discussing the incidence of infections of tumor prosthesis implanted following resection of bone tumors, taking into account the different sites of implantation. In the English literature, the highest risk of infection which led to limb amputation was observed after proximal tibia resection and this difference was considered to be due to the poor condition of soft tissue and also after pelvic resection due to huge dead space after sarcoma resection not filled by implant. Independent of the location, the management of infected prosthesis is similar. That is, after one or more attempts at debridement and antibiotic therapy, it consists of implant removal and insertion of a new implant in a one- or two-stage procedure, with a decreased risk of failure with the two-stage procedure

Novel genetic mutation associated with hyperphosphatemic familial tumoral calcinosis/hyperostosis-hyperphosphatemia syndrome treated with denosumab: a case report

In this case report, a novel N-acetylgalactosaminyltransferase 3 homozygous mutation (c.782 G>A; p.R261Q) associated with hyperphosphatemic familial tumoral calcinosis/hyperostosis-hyperphosphatemia syndrome is described. The patient had elbow, pelvis, and lower limb pain and a hard mass in the hip and olecranon regions. Increased levels of inorganic phosphorus (Pi) and C-reactive protein were observed. After treating the patient with conventional drugs, we tested denosumab, which reduced but did not normalize the Pi

Neoadjuvant multidrug chemotherapy including High-Dose Methotrexate modifies VEGF expression in Osteosarcoma: an immunohistochemical analysis

<p>Abstract</p> <p>Background</p> <p>Angiogenesis plays a role in the progression of osteosarcoma, as well as in other mesenchymal tumors and carcinomas, and it is most commonly assessed by vascular endothelial growth factor (VEGF) expression or tumor CD31-positive microvessel density (MVD). Tumor VEGF expression is predictive of poor prognosis, and chemotherapy can affect the selection of angiogenic pattern. The aim of the study was to investigate the clinical and prognostic significance of VEGF and CD31 in osteosarcoma, both at diagnosis and after neoadjuvant chemotherapy, in order to identify a potential role of chemotherapy in angiogenic phenotype.</p> <p>Methods</p> <p>A retrospective analysis was performed on 16 patients with high grade osteosarcoma. In each case archival pre-treatment biopsy tissue and post-chemotherapy tumor specimens were immunohistochemically stained against CD31 and VEGF, as markers of angiogenic proliferation both in newly diagnosed primary osteosarcoma and after multidrug chemotherapy including high-dose methotrexate (HDMTX). The correlation between clinicopathological parameters and the degree of tumor VEGF and CD31 expression was statistically assessed using the χ²test verified with Yates' test for comparison of two groups. Significance was set at <it>p </it>< 0,05.</p> <p>Results</p> <p>Expression of VEGF was positive in 11 cases/16 of cases at diagnosis. Moreover, 8 cases/16 untreated osteosarcomas were CD31-negative, but the other 8 showed an high expression of CD31. VEGF expression in viable tumor cells after neoadjuvant chemotherapy was observed in all cases; in particular, there was an increased VEGF expression (post-chemotherapy VEGF - biopsy VEGF) in 11 cases/16. CD31 expression increased in 11 cases/16 and decreased in 3 cases after chemotherapy. The data relating to the change in staining following chemotherapy appear statistically significant for VEGF expression (<it>p </it>< 0,05), but not for CD31 (<it>p </it>> 0,05).</p> <p>Conclusions</p> <p>Even if the study included few patients, these results confirm that VEGF and CD31 expression is affected by multidrug chemotherapy including HDMTX. The expression of angiogenic factors that increase microvessel density (MVD) can contribute to the penetration of chemotherapeutic drugs into the tumor in the adjuvant stage of treatment. So VEGF could have a paradoxical effect: it is associated with a poor outcome but it could be a potential target for anti-angiogenic therapy.</p

Viscoelastic adaptation of tendon graft material to compression: biomechanical quantification of graft preconditioning

PURPOSE: The tensile viscoelastic behaviour of tendon tissue is of central biomechanical importance and well examined. However, the viscoelastic tendon adaptation to external compression, such as when a tendon graft is fixated with an interference screw, has not been investigated before. Here, we quantify this adaptive behaviour in order to develop a new method to mechanically precondition tendon grafts and to better understand volumetric changes of tendinous tissue. The hypothesis of this study was that under compressive loads, tendon grafts will undergo a temporary volumetric (and therefore diametric) reduction, due to the extrusion of water from the tendon. METHODS: Compressive testing was performed on a material testing machine and load applied through the use of a custom-made mould, with a semi-circular cross section to accommodate the tendon graft. The effects of different compressive forces on the length, diameter and weight of tendon grafts were measured by calipers and a weighing scale, respectively. Further, different strain rates (1 vs. 10 mm/min) (n = 6, per rate), compression method (steady compression vs. creep) (n = 15 for each method) and different compression durations (1, 5, 10 min) (n = 5 for each duration) were tested to identify the most effective combination to reduce graft size by preserving its macroscopic structure. RESULTS: The effect of compression on volume reduction (75 % of initial volume and weight) reached a plateau at 6,000 N on an 8-mm tendon bundle. Length thereby increased by approximately 10 %. Both steady compression and creeping were able to reduce dimensions of the graft; however, creeping was more effective. There was no difference in effect with different durations for compression (p > 0.05) in both methods. CONCLUSION: The viscoelastic behaviour of hamstring tendon grafts under pressure allows preconditioning of the grafts for reduction of volume and diameter and therefore to drill a smaller bone tunnel, retaining more of the original bone. At the same time, the collagen content of the transplant is preserved and a tight fit of the transplant in the bone tunnel achieved

Development and First Validation of a Disease Activity Score for Gout

Objective: To develop a new composite disease activity score for gout and provide its first validation. Methods: Disease activity has been defined as the ongoing presence of urate deposits that lead to acute arthritis and joint damage. Every measure for each Outcome Measures in Rheumatology core domain was considered. A 3-step approach (factor analysis, linear discriminant analysis, and linear regression) was applied to derive the Gout Activity Score (GAS). Decision to change treatment or 6-month flare count were used as the surrogate criteria of high disease activity. Baseline and 12-month followup data of 446 patients included in the Kick-Off of the Italian Network for Gout cohort were used. Construct- and criterion-related validity were tested. External validation on an independent sample is reported. Results: Factor analysis identified 5 factors: patient-reported outcomes, joint examination, flares, tophi, and serum uric acid (sUA). Discriminant function analysis resulted in a correct classification of 79%. Linear regression analysis identified a first candidate GAS including 12-month flare count, sUA, visual analog scale (VAS) of pain, VAS global activity assessment, swollen and tender joint counts, and a cumulative measure of tophi. Alternative scores were also developed. The developed GAS demonstrated a good correlation with functional disability (criterion validity) and discrimination between patient- and physician-reported measures of active disease (construct validity). The results were reproduced in the external sample. Conclusion: This study developed and validated a composite measure of disease activity in gout. Further testing is required to confirm its generalizability, responsiveness, and usefulness in assisting with clinical decisions