Breast cancer teams:the impact of constitution, new cancer workload and methods of operation on their effectiveness

National guidance and clinical guidelines recommended multidisciplinary teams (MDTs) for cancer services in order to bring specialists in relevant disciplines together, ensure clinical decisions are fully informed, and to coordinate care effectively. However, the effectiveness of cancer teams was not previously evaluated systematically. A random sample of 72 breast cancer teams in England was studied (548 members in six core disciplines), stratified by region and caseload. Information about team constitution, processes, effectiveness, clinical performance, and members' mental well-being was gathered using appropriate instruments. Two input variables, team workload (P=0.009) and the proportion of breast care nurses (P=0.003), positively predicted overall clinical performance in multivariate analysis using a two-stage regression model. There were significant correlations between individual team inputs, team composition variables, and clinical performance. Some disciplines consistently perceived their team's effectiveness differently from the mean. Teams with shared leadership of their clinical decision-making were most effective. The mental well-being of team members appeared significantly better than in previous studies of cancer clinicians, the NHS, and the general population. This study established that team composition, working methods, and workloads are related to measures of effectiveness, including the quality of clinical care. © 2003 Cancer Research UK.

New networked technologies and carers of people with dementia: an interview study

Dementia is one of the greatest contemporary health and social care challenges, and novel approaches to the care of its sufferers are needed. New information and communication technologies (ICT) have the potential to assist those caring for people with dementia, through access to networked information and support, tracking and surveillance. This article reports the views about such new technologies of 34 carers of people with dementia. We also held a group discussion with nine carers for respondent validation. The carers' actual use of new ICT was limited, although they thought a gradual increase in the use of networked technology in dementia care was inevitable but would bypass some carers who saw themselves as too old. Carers expressed a general enthusiasm for the benefits of ICT, but usually not for themselves, and they identified several key challenges including: establishing an appropriate balance between, on the one hand, privacy and autonomy and, on the other: maximising safety; establishing responsibility for and ownership of the equipment and who bears the costs; the possibility that technological help would mean a loss of valued personal contact; and the possibility that technology would substitute for existing services rather than be complementary. For carers and dementia sufferers to be supported, the expanding use of these technologies should be accompanied by intensive debate of the associated issues.

Top teams and strategy in a UK university

This paper reports on the results of an in-depth study of how a top management team (TMT) puts strategy into practice in a UK university. A study of the top team in Warwick University was conducted to analyse how strategy was formulated and implemented. The results suggest that a combination of two broad theoretical lenses provide useful analytical insight. These are strategy as practice and strategy as process. The main elements of this university’s strategy result from an interplay of localized routines and patterns of action within an organizational context, which both produces and is a product of such actions. The TMT itself was found to be clearly identifiable and stable in composition. The team exhibited identifiable patterns of strategic thinking and acting. However, the role of organizational structure was also found to be a key influence on the actions and processes of the TMT with strong central control tendencies in the team being counterbalanced by devolved operational control to individual departments. The data also reveal inter-relationships between organizational structures and the TMT in four key areas: direction-setting, monitoring and control, the allocation of resources, and processes of interaction. The overall conclusion is that to understand how strategy is practised, analysis needs to focus on how patterns of action are associated with the characteristics of both the team and the wider organization. The nature and characteristics of these patterns can be related to how strategy is put into practice.

Everyday use of Spanish among bilingual teachers in New York City and their attitudes toward the language

The attitudes that bilingual teachers have toward the use of foreign languages seem to have an effect on the success of bilingual education programs. In this study, our purpose is to shed light on how often bilingual teachers in New York City use Spanish in their everyday lives, and to examine their attitudes toward the use of Spanish in the U.S. Overall, results indicate only moderate frequencies of use of Spanish in everyday life among bilingual teachers. In addition, the study shows that bilingual teachers have a favorable attitude toward the use of Spanish in the U.S. However, bilingual teachers whose first language is English seem to have a more favorable attitude than those whose first language is Spanish. Among the native Spanish speakers, those born abroad show a more favorable attitude than those born in the U.S. Although no group seems to favor the use of lexical borrowings and code-switching, bilingual native Spanish-speaking teachers born in the U.S. seem to have a less favorable attitude than native Spanish-speaking teachers born abroad. In addition, native Spanish-speaking teachers born abroad seem to have a less favorable attitude toward lexical borrowings and code-switching than U.S.-born teachers whose first language is English. Recommendations for the training of bilingual teachers are discussed in the conclusions of the study.

Exits, entrances and entrepreneurship : an exploration of economic theories of entrepreneurship through new independent entry and infant exit

The thesis began as a study of new firm formation. Preliminary research suggested that infant death rate was considered to be a closely related problem and the search was for a theory of new firm formation which would explain both. The thesis finds theories of exit and entry inadequate in this respect and focusses instead on theories of entrepreneurship, particularly those which concentrate on entrepreneurship as an agent of change. The role of information is found to be fundamental to economic change and an understanding of information generation and dissemination and the nature and direction of information flows is postulated to lead coterminously to an understanding of entrepreneurhsip and economic change. The economics of information is applied to theories of entrepreneurhsip and some testable hypotheses are derived. The testing relies on etablishing and measuring the information bases of the founders of new firms and then testing for certain hypothesised differences between the information bases of survivors and non-survivors. No theory of entrepreneurship is likely to be straightforwardly testable and many postulates have to be established to bring the theory to a testable stage. A questionnaire is used to gather information from a sample of firms taken from a new micro-data set established as part of the work of the thesis. Discriminant Analysis establishes the variables which best distinguish between survivors and non-survivors. The variables which emerge as important discriminators are consistent with the theory which the analysis is testing. While there are alternative interpretations of the important variables, collective consistency with the theory under test is established. The thesis concludes with an examination of the implications of the theory for policy towards stimulating new firm formation.

Antecedents and consequences of new product development and international new product rollout timeliness:an examination of mediating and moderating influences

The study examined the relationships between antecedents, timeliness in NPD and INPR, and consequences. A conceptual framework was tested using 232 new products from South Korean firms. The hypothesized relationships among the constructs in the model were evaluated by multiple regression and hierarchal regression analyses using SPSS 12 as well as by structural equation modelling (SEM) using SIMPLIS LISREL. In addition, confirmatory factor analysis (CFA) was carried out using SIMPLIS LISREL. In the direct relationships, cross-functional linkages and marketing synergy exhibited a statistically significant effect on NPD timeliness. The results also supported the influences of the HQ-subsidiary/agent relationship and NPD timeliness on INPR timeliness as well as INPR timeliness on performance. In the mediating effect tests, marketing proficiency significantly accounts for the relationships between cross-functional linkages and NPD timeliness, between marketing synergy and NPD timeliness, and between the HQ-subsidiary/agent relationship and INPR timeliness. Technical proficiency also mediates the effect of the HQ-subsidiary/agent relationship on INPR timeliness. The influence of NPD timeliness on new product performance in target markets is attributed to INPR timeliness. As for the results of the external environmentals and standardization influences, competitive intensity moderates the relationship between NPD timeliness and new product performance. Technology change also moderates the relationship between cross-functional linkages and NPD timeliness and between timeliness in NPD and INPR and performance. Standardization has a moderating role on the relationship between NPD timeliness and INPR timeliness. This study presents the answers to research questions which concern what factors are predictors of criterion variables, how antecedents influence timeliness in NPD and INPR and when the direct relationships in the INPR process are strengthened.