Corporate Governance In The Lodging Industry: Special Case Of The Service Industry

This paper examines the corporate governance structure of publicly traded hospitality firms and determines whether the governance structure selected by these firms is consistent with minimizing monitoring and bonding costs dictated by the complexity of the business models. There is strong evidence that complex firms had larger board of directors, more outside board members, a greater fraction of CEO pay being variable, and more frequent occurrence of CEO/Chairman duality than simple firms. The results also present evidence of a positive relationship between firms that have the appropriate governance structures and the profitability and valuation of the firm

Using a Delphi process to determine optimal care for patients with pancreatic cancer

Aim Overall 5-year survival for pancreatic cancer is ~5%. Optimising the care that pancreatic cancer patients receive may be one way of improving outcomes. The objective of this study was to establish components of care which Australian health professionals believe important to optimally manage patients with pancreatic cancer. Methods Using a Delphi process, a multi-disciplinary panel of 250 health professionals were invited to provide a list of factors they considered important for optimal care of pancreatic cancer patients. They were then asked to score and then rescore (from one (no importance/disagree) to 10 (very important/agree) the factors. The mean and coefficient of variation scores were calculated and categorised into three levels of importance. Results Overall 63 (66% of those sent the final questionnaire; 25% of those initially invited) health professionals from 9 disciplines completed the final scoring of 55 statements/factors encompassing themes of presentation/staging, surgery and biliary obstruction, multi-disciplinary team details and oncology. Mean scores ranged from 3.7 to 9.7 with the highest related to communication and patient assessment. There was substantial intra- and inter- disciplinary variation in views about MDT membership and roles. Conclusion Overall the opinions of Australian health professionals reflect international guideline recommended care; however they identified a number of additional factors focusing on where patients should be treated, the importance of clear communication and the need for multi-disciplinary care which were not included in current clinical practice guidelines. Differences in priorities between specialty groups were also identified

"How do I wake up every day and live with this disease?": the challenge of pancreatic cancer

Pancreatic cancer has the lowest five-year relative survival rate of all cancers at less than 5%. By 2030, the mortality rate (now 4th) is expected to be 2nd highest. This short survival time and poor prognosis places people affected at risk of distress. Research is needed to investigate the impact of pancreatic cancer on the psychosocial/supportive care needs of patients and caregivers. The aims of this study were to identify the psychosocial and supportive care needs of all people affected by pancreatic cancer and areas of unmet need. A qualitative interpretive inquiry explored participants’ perspectives and experiences. Two groups (N=35) were recruited across Australia: those with pancreatic cancer (N=12) and caregivers (N=23, including a bereaved subgroup (N=14). The findings identified that people affected by pancreatic cancer experienced a pervasive nihilism. In effect, this destroyed trust, communication and the clinician/patient relationship, meaning people either became disengaged from or experienced disrupted continuity of care. In the absence of appropriate psychosocial/supportive care, people felt “isolated” and “alone. The interplay of nihilism, poor communication and unmet needs in medical and psychosocial care caused suffering and affected quality of life. People affected by pancreatic cancer have significant unmet psychosocial and supportive care needs (specifically relating to pancreatic exocrine insufficiency). Recommendations are made to improve quality of life, professional communication and address nihilism in this disease

Experiences of people with cancer of the unknown primary: what do we know and what do we need to do?

Abstract not available

As the bell tolls: a foundation study on pancreatic cancer consumer's research priorities

Abstract Background This is the first investigation of its kind to explore the views of people affected by pancreatic cancer with regard to research priorities. Pancreatic cancer has an extremely poor outlook in terms of early diagnosis, effective treatment and survival. Those affected by the disease generally lack opportunities to voice their needs or concerns in an organised manner, link with others affected by the condition and take part in research. Methods This qualitative study adopts a self-selected telephone focussed discussion group approach. Information was obtained from distinct carer and patient groups after adequate controls such as the 'safe space' technique (repeatedly enquiring on and respecting the emotional needs) were implemented to protect participants from undue physical and psychological distress. Results Five themes emerged overall, with three themes being common between the patients and carers groups. Early detection, clinician communication and public awareness were areas of recurring discussion and consensus for both groups. The fourth theme to emerge for the patient group centred on quality of care, while the fourth theme of the carer group focused on the need for more and improved treatment options. Conclusion Research priorities for pancreatic cancer consumers have been identified via an investigation that was tailored to meet exceptional needs. This research gives us a primary understanding of the role that pancreatic cancer patients can play in identifying areas of research that are responsive to their needs and priorities when suitably planned. Importantly it also provides a much greater understanding of the grim realities of the disease for those affected. This work is likely to be of value to anyone planning to work with those with a time limited, challenging condition.</p

The Unmet Needs of Pancreatic Cancer Carers Are Associated with Anxiety and Depression in Patients and Carers

Pancreatic cancer has one of the lowest survival rates, and patients experience debilitating symptoms. Family carers provide essential daily care. This study determined the prevalence of and risk factors for unmet supportive care needs among carers for pancreatic cancer patients and examined which carer needs were associated with anxiety and depression in carers and patients. Eighty-four pancreatic cancer patients and their carers were recruited. The carers completed a needs survey (SCNS-P&C). Both carers and patients completed the Hospital Anxiety and Depression Scale. Log binomial regression was used to identify associations between carer needs and anxiety and depression among carers and patients. The top 10 moderate-to-high unmet needs reported by ≥28% of carers were related to healthcare (e.g., discussing concerns with doctors) and information need domains (e.g., information about a patient’s physical needs), plus one other item related to hospital parking. Being male or caring for a patient within 4 months of their diagnosis were associated with greater unmet needs. Some unmet needs, including ‘accessing information about treatments’ and ‘being involved in patient care’, were associated with both carers and patients having anxiety and depression. Carers should be involved in health care consultations and provided with information and opportunities to discuss concerns

Defining research priorities for pancreatic cancer in Australia: results of a consensus development process

Introduction Pancreatic cancer (PC) is the sixth leading cause of cancer death in Australia and the fourth in the United States, yet research in PC is lagging behind that in other cancers associated with a high disease burden. In the absence of agreed processes to reliably identify research areas which can deliver significant advances in PC research, the Cancer Council NSW established a strategic define critical research issues and opportunities that could accelerate progress in this field in Australia. Materials and methods The process consisted of five distinct stages: a literature review on recent progress in PC research, semi-structured expert interviews, a Delphi process, consumer focus groups, and a nominal group process. Information collected at each step informed the development of subsequent stages. Results The results from these steps were refined by the nominal group into a set of seven specific pancreatic cancer research goals. The goals were disseminated and led to a new funding scheme for key PC research priorities. Discussion This prioritisation exercise provided a much needed ''road map'' for research prioritisation in PC and served as a checklist to researchers applying for PC research grants to confirm how their research can contribute towards accelerating progress in PC research in Australia