Grading and disease management in national screening for diabetic retinopathy in England and Wales

Aims - A National Screening Programme for diabetic eye disease in the UK is in development. We propose a grading and early disease management protocol to detect sight-threatening diabetic retinopathy and any retinopathy, which will allow precise quality assurance at all steps while minimizing false-positive referral to the hospital eye service. Methods - Expert panel structured discussions between 2000 and 2002 with review of existing evidence and grading classifications. Proposals - Principles of the protocol include: separate grading of retinopathy and maculopathy, minimum number of steps, compatible with central monitoring, expandable for established more complex systems and for research, no lesion counting, no ‘questionable’ lesions, attempt to detect focal exudative, diffuse and ischaemic maculopathy and fast track referral from primary or secondary graders. Sight-threatening diabetic retinopathy is defined as: preproliferative retinopathy or worse, sight-threatening maculopathy and/or the presence of photocoagulation. In the centrally reported minimum data set retinopathy is graded into four levels: none (R0), background (R1), preproliferative (R2), proliferative (R3). Maculopathy and photocoagulation are graded as absent (M0, P0) or present (M1, P1). Discussion - The protocol developed by the Diabetic Retinopathy Grading and Disease Management Working Party represents a new consensus upon which national guidelines can be based leading to the introduction of quality-assured screening for people with diabetes.

Spectrum of morphological and visual changes due to vitreomacular interface disorders encountered in a large consecutive cohort of patients

Aim: Identify the incidence of vitreomacular traction (VMT) and frequency of reduced vision in the absence of other coexisting macular pathology using a pragmatic classification system for VMT in a population of patients referred to the hospital eye service. Methods: A detailed survey of consecutive optical coherence tomography (OCT) scans was done in a high-throughput ocular imaging service to ascertain cases of vitreomacular adhesion (VMA) and VMT using a departmental classification system. Analysis was done on the stages of traction, visual acuity, and association with other macular conditions. Results: In total, 4384 OCT scan episodes of 2223 patients were performed. Two hundred and fourteen eyes had VMA/VMT, with 112 eyes having coexisting macular pathology. Of 102 patients without coexisting pathology, 57 patients had VMT grade between 2 and 8, with a negative correlation between VMT grade and number of Snellen lines (r= -0.61717). There was a distinct cutoff in visual function when VMT grade was higher than 4 with the presence of cysts and sub retinal separation and breaks in the retinal layers. Conclusions: VMT is a common encounter often associated with other coexisting macular pathology. We estimated an incidence rate of 0.01% of VMT cases with reduced vision and without coexisting macular pathology that may potentially benefit from intervention. Grading of VMT to select eyes with cyst formation as well as hole formation may be useful for targeting patients who are at higher risk of visual loss from VMT.

In My Opinion: Michael E. Hurst: July 8, 1931 - March 22, 2001

My reflections of Michael E. Hurst are a much more modest enterprise than a memoir or biography. My portrait of him will only portray the images I observed and remember: As he was an adult when I met him, it is far from a complete picture of him. I was his academic dean, fellow professor, and friend. While fame has eluded most people I know. Hurst was the exception: everyone in the food service industry knew him.

A Case Study in Crisis Management: Le Petit Gourmet Catering

The skills of crisis management are more and more valuable in the food service industry. How a manager handles a crisis can spell the difference between success and failure. Finding a good model for crisis management is difficult. The author offers a case study to introduce one such model.

Industry Education: The Merger Continues

In the discussion - Industry Education: The Merger Continues - by Rob Heiman Assistant Professor Hospitality Food Service Management at Kent State University, the author originally declares, “Integrating the process of an on-going catering and banquet function with that of selected behavioral academic objectives leads to an effective, practical course of instruction in catering and banquet management. Through an illustrated model, this article highlights such a merger while addressing a variety of related problems and concerns to the discipline of hospitality food service management education.” The article stresses the importance of blending the theoretical; curriculum based learning process with that of a hands-on approach, in essence combining an in-reality working program, with academics, to develop a well rounded hospitality student. “How many programs are enjoying the luxury of excessive demand for students from industry [?],” the author asks in proxy for, and to highlight the immense need for qualified personnel in the hospitality industry. As the author describes it, “An ideal education program concerns itself with the integration of theory and simulation with hands-on experience to teach the cognitive as well as the technical skills required to achieve the pre-determined hospitality education objectives.” In food service one way to achieve this integrated learning curve is to have the students prepare foods and then consume them. Heiman suggests this will quickly illustrate to students the rights and wrongs of food preparation. Another way is to have students integrating the academic program with feeding the university population. Your author offers more illustrations on similar principles. Heiman takes special care in characterizing the banquet and catering portions of the food service industry, and he offers empirical data to support the descriptions. It is in these areas, banquet and catering, that Heiman says special attention is needed to produce qualified students to those fields. This is the real focus of the discussion, and it is in this venue that the remainder of the article is devoted. “Based on the perception that quality education is aided by implementing project assignments through the course of study in food service education, a model description can be implemented for a course in Catering and Banquet Management and Operations. This project model first considers the prioritized objectives of education and industry and then illustrates the successful merging of resources for mutual benefits,” Heiman sketches. The model referred to above is also the one aforementioned in the thesis statement at the beginning of the article. This model is divided into six major components; Heiman lists and details them. “The model has been tested through two semesters involving 29 students,” says Heiman. “Reaction by all participants has been extremely positive. Recent graduates of this type of program have received a sound theoretical framework and demonstrated their creative interpretation of this theory in practical application,” Heiman says in summation.

In My Opinion.. Legend in his Time: Lendal H. Kotschevar

Lednal H. Kotschevar is a pioneer in the food service industry. His life spans that of the 20th century and his influence in the hospitality discipline molded its growth and its directions.

Strategies for Tomorrow's Hospitality Workforce

The hospitality industry has been facing serious labor shortages, especially in the food service area. As the proportion of younger workers shrinks, alternative sources of employees have to be sought to alleviate the labor shortage. The authors review alternative sources for facing the labor shortage and discuss strategies to attract the largest and potentially viable segment for the hospitality industry - the older worker.

Visitor At-Destination Search for Travel-Related Services

The phenomenon of at-destination search activity and decision processes utilized by visitors to a location is predominantly an academic unknown. As destinations and organizations increasingly compete for their share of the travel dollar, it is evident that more research need to be done regarding how consumers obtain information once they arrive at a destination. This study examined visitor referral recommendations provided by hotel and non-hotel ''locals" in a moderately-sized community for lodging, food service, and recreational and entertainment venues.

Appraising Work Group Performance: New Productivity Opportunities in Hospitality Management

In - Appraising Work Group Performance: New Productivity Opportunities in Hospitality Management – a discussion by Mark R. Edwards, Associate Professor, College of Engineering, Arizona State University and Leslie Edwards Cummings, Assistant Professor, College of Hotel Administration University of Nevada, Las Vegas; the authors initially provide: “Employee group performance variation accounts for a significant portion of the degree of productivity in the hotel, motel, and food service sectors of the hospitality industry. The authors discuss TEAMSG, a microcomputer based approach to appraising and interpreting group performance. TEAMSG appraisal allows an organization to profile and to evaluate groups, facilitating the targeting of training and development decisions and interventions, as well as the more equitable distribution of organizational rewards.” “The caliber of employee group performance is a major determinant in an organization's productivity and success within the hotel and food service industries,” Edwards and Cummings say. “Gaining accurate information about the quality of performance of such groups as organizational divisions, individual functional departments, or work groups can be as enlightening...” the authors further reveal. This perspective is especially important not only for strategic human resources planning purposes, but also for diagnosing development needs and for differentially distributing organizational rewards.” The authors will have you know, employee requirements in an unpredictable environment, which is what the hospitality industry largely is, are difficult to quantify. In an effort to measure elements of performance Edwards and Cummings look to TEAMSG, which is an acronym for Team Evaluation and Management System for Groups. They develop the concept. In discussing background for employees, Edwards and Cummings point-out that employees - at the individual level - must often possess and exercise varied skills. In group circumstances employees often work at locations outside of, or move from corporate unit-to-unit, as in the case of a project team. Being able to transcend individual-to-group mentality is imperative. “A solution which addresses the frustration and lack of motivation on the part of the employee is to coach, develop, appraise, and reward employees on the basis of group achievement,” say the authors. “An appraisal, effectively developed and interpreted, has at least three functions,” Edwards and Cummings suggest, and go on to define them. The authors do place a great emphasis on rewards and interventions to bolster the assertion set forth in their thesis statement. Edwards and Cummings warn that individual agendas can threaten, erode, and undermine group performance; there is no - I - in TEAM.

The Tax Reform Act of 1986: Impact On Hospitality Industries

In her discussion - The Tax Reform Act Of 1986: Impact On Hospitality Industries - by Elisa S. Moncarz, Associate Professor, the School of Hospitality Management at Florida International University, Professor Moncarz initially states: “After nearly two years of considering the overhaul of the federal tax system, Congress enacted the Tax Reform Act of 1986. The impact of this legislation is expected to affect virtually all individuals and businesses associated with the hospitality industry. This article discusses some of the major provisions of the tax bill, emphasizing those relating to the hospitality service industries and contrasting relevant provisions with prior law on their positive and negative effects to the industry. “On October 22, 1986, President Reagan signed the Tax Reform Act of 1986 (TRA 86) with changes so pervasive that a recodification of the income tax laws became necessary…,” Professor Moncarz says in providing a basic history of the bill. Two, very important paragraphs underpin TRA 86, and this article. They should not be under-estimated. The author wants you to know: “With the passage of TRA 86, the Reagan administration achieved the most important single domestic initiative of Reagan's second term, a complete restructuring of the federal tax system in an attempt to re-establish fairness in the tax code…,” an informed view, indeed. “These changes will result in an estimated shift of over $100 billion of the tax burden from individuals to corporations over the next five years [as of this article],” Professor Moncarz enlightens. “…TRA 86 embraces a conversion to the view that lowering tax rates and eliminating or restricting tax preferences (i.e., loopholes) “would be more economically and socially productive.” Hence, economic decisions would be based on economic efficiency as opposed to tax effect,” the author asserts. “…both Congress and the administration recognized from its inception that the reform of the tax code must satisfy three basic goals,” and these goals are identified for you. Professor Moncarz outlines the positive impact TRA 86 will have on the U.S. economy in general, but also makes distinctions the ‘Act will have on specific segments of the business community, with a particular eye toward the hospitality industry and food-service in particular. Professor Moncarz also provides graphs to illustrate the comparative tax indexes of select companies, encompassing the years 1883-through-1985. Deductibility and its importance are discussed as well. The author foresees Limited Partnerships, employment, and even new hotel construction and/or rehabilitation being affected by TRA 86. The article, as one would assume from this type of discussion, is liberally peppered with facts and figures.

Larceny by Menu

Consumers are being ripped off by the food service industry when menus in establishments serving food misrepresent, substitute, and manipulate portions and the status of foods being served. A billion dollars a year in fraud is involved when menus offer the consumer one thing and deliver another.

Nutrition: Whose Responsibility?

The population is spending increasing amounts of money for food away from the home. At the same time people are eating in a more healthful manner. The author discusses what the food service industry can and should do to better meet the needs and demands of consumers.

Leveraged Buyouts: Opportunities and Risks

This article presents a general overview of leveraged buyouts, relating their feasibility as an option for hospitality management. Specifically, the author explores the background and main features of leveraged buyouts, focusing attention on their risks and rewards, management's opportunities, tax ramifications, planning, and future outlook. Denny's leveraged buyout is examined in order to provide an insight into the structuring of a buyout for a major food service firm.

Cross-Cultural Cuisine: Long-Term Trend or Short-Lived Fad

Defining a consumer interest as a long-term trend or short-lived fad has significant implicatiosn for restauranteurs' management decisions. The terms "trend" and "fad" can be operationally defined for the food service industry. The authors examine today's popular cross-cultural cuisine to determine its trend or fad status and discuss the catalysts that promoted or hindered its trend/fad status, as well as implications for the food service industry.

Making Life More Satisfying for Hospitality Managers

Because of the considerable amount of time that hospitality managers spend at work, the relationship between life satisfaction and job satisfaction is of particular interest. Dissonance may result when the role at work conflicts with the role at home of with the family. Food service managers indicate that the top inter-role conflicts area is that work time takes up time that they would like to spend with family and others; that they are too tired to do some of the things they would like to do after work; and that the job makes it difficult to be the kind of friend, spouse, or parent that they would like to be.