A political economy of TVET professionalisation: a case study of chefs at a Canadian polytechnic

This thesis focuses on a political economy analysis of the relationship between the professional identity and professional development practices of instructors in the postsecondary educational sector of technical and vocational education and training (TVET). My study brings together the concept of the dual-professional identity of postsecondary TVET instructors, the practice of professional development in TVET, and a political economy approach. The research methods adapted for this postgraduate research study were from a qualitative perspective using a case study approach. The case study involved eight culinary instructors, the supervisor of the professional cooking programme, and the director of the hospitality and culinary careers school at a postsecondary polytechnic in Canada, selected using a non-probability sampling technique. My research explored what a political economy analysis would reveal about the relationship between the professional identity and the professional development practices of the culinary instructors/chefs. Throughout this thesis, I use the term, TVET professionalisation, to denote this relationship This case study contributes to knowledge and the TVET community in three intersecting ways. Its first contribution is in context – the research took place in the Canadian postsecondary TVET sector, for purposes of analysing the professional identity/professional development relationship in consideration of the historical, structural, and socio-cultural contexts of the institution. The case study’s second contribution is in extending the literature of the political economy of skills. The findings demonstrate that analysing the professionalisation of the TVET culinary instructors, in consideration of the inter-relationship among the cultural, economic, political, and social contexts of the TVET system, is a suitable extension of the literature on the political economy of skills. From another perspective, the study also adds to the literature on the professionalisation of TVET instructors by considering professionalisation as an extension of the TVET workforce development imperative, which I note in this study as the discourse promoting employability and the axiomatic assumptions of TVET as 'training-for-growth' and 'skills-for work' (Anderson 2008). Thus, the study contributes to wider debates about the applicability of a political economy analysis beyond skill formation systems. Lastly, the case study contributes a conceptual framework for TVET professionalisation by interpreting the relationship between TVET professional identity and professional development through a political economy lens. The findings demonstrate that both the professional identity and the professional development practices of the culinary instructors in the case study were shaped by various contextual factors within the field of practice: namely, the instructor's personal history and sense of agency, the socio-cultural conventions of the culinary trade under investigation, the social and structural setting of the postsecondary TVET institution, and the workforce development imperative of TVET. The conceptual framework for TVET professionalisation also contributes another perspective toward the dual-professional identity of TVET instructors. Dual-professional identity formation within this study, and drawing upon the language of the research participants, refers to the process where the 'recipe' for the chefs' base identity was written in the professional trade of culinary arts. Once they joined the polytechnic, though, the chefs used the institution as 'stage' to 'go beyond the recipe' and elevate their identities by adding the ingredient of 'becoming an educator'. Based on an interpretation of the case study’s findings, through a political economy lens of analysis, I suggest that the 'skilled-educator' identity of the culinary instructors is bound by the structural and socio-economic contexts of the postsecondary polytechnic, whereas the 'skilled-tradesperson' identity of the culinary instructors reflects the historical and socio-cultural contexts of the instructors' lived experience as chefs. Further, I posit that each instructor's perception of meaningful professional development reflects the individual's personal sense of agency; what constitutes both a personal and shared sense of legitimacy concerning the value of professional development; and, an allegiance to one of the dual-professional identities over the other

Stereotactic body radiotherapy for primary prostate cancer

Prostate cancer is the most common non-cutaneous cancer in males. There are a number of options for patients with localized early stage disease, including active surveillance for low-risk disease, surgery, brachytherapy, and external beam radiotherapy. Increasingly, external beam radiotherapy, in the form of dose-escalated and moderately hypofractionated regimens, is being utilized in prostate cancer, with randomized evidence to support their use. Stereotactic body radiotherapy, which is a form of extreme hypofractionation, delivered with high precision and conformality typically over 1 to 5 fractions, offers a more contemporary approach with several advantages including being non-invasive, cost-effective, convenient for patients, and potentially improving patient access. In fact, one study has estimated that if half of the patients currently eligible for conventional fractionated radiotherapy in the United States were treated instead with stereotactic body radiotherapy, this would result in a total cost savings of US$250 million per year. There is also a strong radiobiological rationale to support its use, with prostate cancer believed to have a low alpha/beta ratio and therefore being preferentially sensitive to larger fraction sizes. To date, there are no published randomized trials reporting on the comparative efficacy of stereotactic body radiotherapy compared to alternative treatment modalities, although multiple randomized trials are currently accruing. Yet, early results from the randomized phase III study of HYPOfractionated RadioTherapy of intermediate risk localized Prostate Cancer (HYPO-RT-PC) trial, as well as multiple single-arm phase I/II trials, indicate low rates of late adverse effects with this approach. In patients with low-to intermediate-risk disease, excellent biochemical relapse-free survival outcomes have been reported, albeit with relatively short median follow-up times. These promising early results, coupled with the enormous potential cost savings and implications for resource availability, suggest that stereotactic body radiotherapy will take center stage in the treatment of prostate cancer in the years to come

Implications of sperm banking for health-related quality of life up to 1 year after cancer diagnosis.

Sperm banking is recommended for all men diagnosed with cancer where treatment is associated with risk of long-term gonadatoxicity, to offer the opportunity of fatherhood and improved quality of life. However, uptake of sperm banking is lower than expected and little is known about why men refuse. Our aims were to determine: (i) demographic and medical variables associated with decisions about banking and (ii) differences in quality of life between bankers and non-bankers at diagnosis (Time 1 (T1)) and 1 year later (Time 2 (T2))

Imaging Biomarkers in Prostate Stereotactic Body Radiotherapy: A Review and Clinical Trial Protocol

Advances in imaging have changed prostate radiotherapy through improved biochemical control from focal boost and improved detection of recurrence. These advances are reviewed in the context of prostate stereotactic body radiation therapy (SBRT) and the ARGOS/CLIMBER trial protocol. ARGOS/CLIMBER will evaluate 1) the safety and feasibility of SBRT with focal boost guided by multiparametric MRI (mpMRI) and 18F-PSMA-1007 PET and 2) imaging and laboratory biomarkers for response to SBRT. To date, response to prostate SBRT is most commonly evaluated using the Phoenix Criteria for biochemical failure. The drawbacks of this approach include lack of lesion identification, a high false-positive rate, and delay in identifying treatment failure. Patients in ARGOS/CLIMBER will receive dynamic 18F-PSMA-1007 PET and mpMRI prior to SBRT for treatment planning and at 6 and 24 months after SBRT to assess response. Imaging findings will be correlated with prostate-specific antigen (PSA) and biopsy results, with the goal of early, non-invasive, and accurate identification of treatment failure

European canine lymphoma network consensus recommendations for reporting flow cytometry in canine hematopoietic neoplasms

BACKGROUND: Flow cytometry (FC) is assuming increasing importance in diagnosis in veterinary oncology. The European Canine Lymphoma Network (ECLN) is an international cooperation of different institutions working on canine lymphoma diagnosis and therapy. The ECLN panel of experts on FC has defined the issue of reporting FC on canine lymphoma and leukemia as their first hot topic, since a standardized report that includes all the important information is still lacking in veterinary medicine. METHODS: The flow cytometry panel of the ECLN started a consensus initiative using the Delphi approach. Clinicians were considered the main target of FC reports. A panel of experts in FC was interrogated about the important information needed from a report. RESULTS: Using the feedback from clinicians and subsequent discussion, a list of information to be included in the report was made, with four different levels of recommendation. The final report should include both a quantitative part and a qualitative or descriptive part with interpretation of the salient results. Other items discussed included the necessity of reporting data regarding the quality of samples, use of absolute numbers of positive cells, cutoff values, the intensity of fluorescence, and possible aberrant patterns of antigen expression useful from a clinical point of view. CONCLUSION: The consensus initiative is a first step towards standardization of diagnostic approach to canine hematopoietic neoplasms among different institutions and countries. This harmonization will improve communication and patient care and also facilitate the multicenter studies necessary to further our knowledge of canine hematopoietic neoplasms

The effect of care setting in the delivery of high‐value colon cancer care

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/108690/1/cncr28874.pd

What do measures of patient satisfaction with the doctor tell us?

Objective: To gain an understanding of how patient satisfaction (PS) with the doctor (PSD) is conceptualized through an empirical review of how it is currently being measured. The content of PS questionnaire items was examined to (a) determine the primary domains underlying PSD, and (b) summarize the specific doctor-related characteristics and behaviors, and patient-related perceptions, composing each domain. Methods: A scoping review of empirical articles that assessed PSD published from 2000 to November 2013. MEDLINE and PsycINFO databases were searched. Results: The literature search yielded 1726 articles, 316 of which fulfilled study inclusion criteria. PSD was realized in one of four health contexts, with questions being embedded in a larger questionnaire that assessed PS with either: (1) overall healthcare, (2) a specific medical encounter, or (3) the healthcare team. In the fourth context, PSD was the questionnaire's sole focus. Five broad domains underlying PSD were revealed: (1) Communication Attributes; (2) Relational Conduct; (3) Technical Skill/Knowledge; (4) Personal Qualities; and (5) Availability/Accessibility. Conclusions: Careful consideration of measurement goals and purposes is necessary when selecting a PSD measure. Practice implications: The five emergent domains underlying PSD point to potential key areas of physician training and foci for quality assessment