Radical Prostatectomy: Hospital volumes and surgical volumes – does practice make perfect?

<p>Abstract</p> <p>Background</p> <p>Between the years 1993 and 2003, more than 140,000 men underwent radical prostatectomy (RP), thus making RP one of the most common treatment options for localized prostate cancer in the United States.</p> <p>Discussion</p> <p>Localized prostate cancer treated by RP is one of the more challenging procedures performed by urologic surgeons. Studies suggest a definite learning curve in performing this procedure with optimal results noted after performing >500 RPs. But is surgical volume everything? How do hospital volumes of RP weigh in? Could fellowship training in RP reduce the critical volume needed to reach an 'experienced' level?</p> <p>Summary</p> <p>As we continue to glean data as to how to optimize outcomes after RP, we must not only consider surgeon and hospital volumes of RP, but also consider training of the individual surgeon.</p

Cell Phones, Student Rights, and School Safety: Finding the Right Balance

Despite the potential instructional benefits of integrating devices such as cell phones into schools and classrooms, research reveals that their improper use can negatively impact student behaviour, learning, and well-being. This paper reviews the literature and litigation on cell phone use in schools due to controversies over cheating, cyberbullying, sexting, and searches of student cell phones. Recent studies suggested that the presence of cell phones and related technologies in classrooms could detract from students’ academic performances while contributing to higher rates of academic dishonesty and cyberbullying. The growing prevalence of cyberbullying is especially concerning because it can have severely negative, even tragic, effects on student mental health and safety. However, given the relatively discreet nature of cell phone use, regulations about their use can be difficult to enforce. After reviewing literature and litigation on the potential risks associated with inappropriate cell phone use in schools, this paper offers suggestions for educators to consider when devising or revising policies balancing students’ individual rights with their safety and well-being before ending with a brief conclusion

Strategic Alliances In The Financial Services And Chemical Industries

The penetration and practice of strategic alliances and Total Quality Management in a goods industry (Chemical Industry) was compared to that for a service industry (Financial Services).&nbsp;&nbsp; The ingoing hypothesis that the Financial Services Industry and the Chemical Industry were similar as it relates to strategic alliances and TQM, based on the longevity of these concepts, was not fully supported. Clear industry similarities and differences were noted. For example, the penetration of TQM and strategic alliances was deeper in the Chemical Industry. This is thought to be the result of the earlier application of TQM and strategic alliances in goods industries. Company size, as measured by revenue, did not affect whether small or medium sized companies in either industry practiced TQM, engaged in strategic alliances or the number of strategic alliances that each had.&nbsp; The proportion of strategic alliance practitioners who also practiced TQM was statistically similar for both industries. Importantly, a high, and similar, proportion of strategic alliance participants in both industries achieved business growth.&nbsp; While those practitioners did achieve a reduction of the numbers of suppliers there is significant room for improvement in both industries. Strategic alliance performance met or exceeded expectations and alliance costs were on or below forecasts in both industries but the result was significantly better for the Financial Services industry in both instances. The lower outcomes for the Chemical Industry are most likely rooted in negative aspects of relationships with strategic alliance partners as suggested by the top 5 advantages and top 5 disadvantages responses. Significantly, a high proportion of strategic alliances will continue with most of these being with the current partner and a few with new partners.&nbsp; The Financial Services Industry outperforms the Chemical Industry on this measure.It is recommended that firms in the Financial Services Industry closely examine the benefits that strategic alliances can yield, and then conduct pilot tests. On the other hand, firms in the Chemical Industry need to improve their relationships with potential partners in order to maximize the outcome of strategic alliances

Strategic Alliances In The Food And Beverage Industry

Strategic Alliances are an important component of an effective Total Quality Management program (TQM) and of business growth.&nbsp; The Food and Beverage industry was studied as part of a long-term longitudinal research program, covering diverse industries, to determine the extent of penetration and effectiveness of strategic alliances and TQM. The results indicated that 62% of respondents participate in strategic alliances and 82% practice TQM. Over 74% of firms that did participate reported achieving or exceeded alliance goals and, significantly, 73% experienced increased business revenue. Approximately 11.84% of participants reported that costs exceeded expectations while 15.13% enjoyed lower costs. Some methods to enhance strategic alliance effectiveness are discussed.&nbsp;Total Quality Management (TQM) is a philosophy that includes the idea that to achieve the highest level of quality one must extend the quality system and program as far back in the Supply Chain as possible, i.e., to the supplier(s), the supplier&rsquo;s supplier and beyond if applicable (first, second, third, etc., tier suppliers), and as far forward as possible, i.e., to customers1.&nbsp; TQM also embraces the following five concepts namely; continuous improvement&nbsp; (a never ending search for perfection), bench-marking (learning from the &ldquo;best-of-the best or &ldquo;best-in-class&rdquo;), use of empowered employee teams6, just-in-time practices (JIT) (use of strategic alliances and few suppliers2), and knowledge of tools (at least 51 tools including Statistical Quality Control3).&nbsp;JIT practices include the use of strategic alliances; which may be with first, second and third tier suppliers and/or with customers; to achieve competitive advantages as well as to improve quality throughout the business system of an enterprise.2&nbsp;&nbsp; A Strategic Alliance is a formal agreement to supply a good(s) or services(s) and to jointly expand knowledge, develop applications and commercialize new products, with the rights of co-ownership, and commercial exploitation of the inventions within the boundaries of the Alliance particulars. Alliance partners work together to serve the ultimate consumer by doing together what each partner could not do alone. The Strategic Alliance agreement includes Supply, Technology, Intellectual Property, Legal and Termination/Disengagement sub-agreements and, generally, has a term of at least 3 years but not usually more than 5 years. The objective of a Strategic Alliance is to achieve competitive advantage for each partner through productivity and quality improvements and significant innovation.2&nbsp;This research was undertaken to determine the penetration of TQM and strategic alliances in the Food and Beverage industry.&nbsp; The intent is to re-study this industry in about 4 to 5 years to understand the evolution of TQM and strategic alliances from the baseline reported herein. The authors comprise the Strategic Alliance Research Group that expects to study a broad array of US industries on these subjects.5 The reader is referred to the authors&rsquo; Web site at www.tsarg.com for the organization&rsquo;s vision, mission, objectives and recent research

Teaching, Learning, and Leading: Preparing Teachers as Educational Policy Actors

Within the current federal, state, and local contexts of educational reform, teachers must be recognized as central actors in policy work, but rarely do we explicitly consider preparing teachers to become policy actors. Understanding these implications for teacher education, we investigate teacher candidates’ learning of the complexity and dynamism of educational policy through a field-based teacher preparation program. Situated across four unique school contexts in the diverse neighborhoods of Chicago, Illinois, we qualitatively study the cases of eight teacher candidates as they explore policy in practice. We found that candidates developed enduring understandings about policy as complex, situated, and multilayered, as well as the central role of the teacher. This learning was mediated by multiple facets of the field-based module, including readings, panels, and observations. Implications center on the use of field-based teacher education to support policy-related learning and development