Evolving progress in oncologic and operative outcomes for esophageal and junctional cancer : lessons from the experience of a high-volume center

Objective: Modern series from high-volume esophageal centers report an approximate 40% 5-year survival in patients treated with curative intent and postoperative mortality rates of less than 4%. An objective analysis of factors that underpin current benchmarks within high-volume centers has not been performed. Methods: Three time periods were studied, 1990 to 1998 (period 1), 1999 to 2003 (period 2), and 2004 to 2008 (period 3), in which 471, 254, and 342 patients, respectively, with esophageal cancer were treated with curative intent. All data were prospectively recorded, and staging, pathology, treatment, operative, and oncologic outcomes were compared. Results: Five-year disease-specific survival was 28%, 35%, and 44%, and in-hospital postoperative mortality was 6.7%, 4.4%, and 1.7% for periods 1 to 3, respectively (P < .001). Period 3, compared with periods 1 and 2, respectively, was associated with significantly (P < .001) more early tumors (17% vs 4% and 6%), higher nodal yields (median 22 vs 11 and 18), and a higher R0 rate in surgically treated patients (81% vs 73% and 75%). The use of multimodal therapy increased (P < .05) across time periods. By multivariate analysis, age, T stage, N stage, vascular invasion, R status, and time period were significantly (P < .0001) associated with outcome. Conclusions: Improved survival with localized esophageal cancer in the modern era may reflect an increase of early tumors and optimized staging. Important surgical and pathologic standards, including a higher R0 resection rate and nodal yields, and lower postoperative mortality, were also observed. Copyright © 2012 by The American Association for Thoracic Surgery.

Lessons from the 4-hour standard in England for Australia

Australia is in the process of making the most important change to its health care system since the implementation of Medicare.1 We agree with Cameron and Cooke that there are important lessons for Australia from the implementation of the 4-hour rule in the United Kingdom. As in Robert Zemeckis’s 1985 movie classic, Back to the future, the old question of “If I had the opportunity to do something again, what would I have done differently?” applies. We challenge the assumption that Australia is embarking on something that the UK has recently abandoned. The UK has not actually abandoned the 4-hour rule but expanded it into a suite of eight indicators that include three time-based measures, including total time in the emergency department (ED).

Inward internationalization of consumer services : lessons from Australian firms

Purpose - The aim of this paper is to explore the inward internationalization process of consumer services. A review of the service internationalization literature is conducted and the resource-based view of the firm is used as a theoretical approach. Design/methodology - Case study methodology is used to explore the internationalization process of five different consumer service sectors: tourism, education, accommodation, transport and entertainment. The main data collection method was interviews conducted with top managers of 12 Australian consumer service firms from these sectors. Findings - Findings of this study show that inward internationalizing services confront most of their barriers, such as immigration policies, exchange rate fluctuations, and cultural differences, in the domestic market where the service is provided. The findings also suggest that superior intentional performance for consumer service firms combines firm-specific resources and capabilities, such as market orientation, service quality, cultural sensitivity, international communicational activities, partnerships and networks, with country-specific resources and capabilities, such as country-of-origin image and government support. Research limitations/implications - This is one of the few studies in the academic literature that directly addresses the issue of inward internationalization of consumer services. Limitations derive from the qualitative nature of this study. Practical implications - The process of inward internationalization applies to a broad range of service industries and can assist firms to develop more effective international marketing strategies. Originality/value - This study contributes to the international services literature by identifying the main barriers and drivers of international performance for inward internationalizing consumer service firms, which is a topic that has been neglected in the literature.

Reconciling dilemmas of social justice in literacy lessons : a case study of preservice primary teachers

Literacy is promoted as one factor in overcoming disadvantage. In this paper, we employ Fraser’s (1997 & 2008) framing of social justice in order to analyse the disparate agendas of literacy education for improved outcomes in national policy. We do this to better understand the dilemmas confronting preservice teachers as they prepare to become teachers in complex education contexts. We then examine what 20 preservice primary teachers say about social justice in interview responses to a scripted scenario. Our findings demonstrate that most preservice teachers are trying to demonstrate that they have a well-placed commitment to teaching for social justice, however, most of our respondents are yet to frame productive practices that might work in providing socially just education for the students they will teach. These outcomes raise possibilities for future iterations of preservice teacher courses at the case study site and beyond.

Developmental lessons from the Capricornia Arts Mob (CAM)

The Capricornia Arts Mob (CAM) is a collective of Aboriginal and Torres Strait Islander visual artists, sculptors, photographers, carvers and writers based in the Rockhampton region of Central Queensland. This paper explores the early development of CAM, identifies some of the lessons its members have learned about working together, and considers its role as a regional artists’ collective. The authors identify that traditional Indigenous practices, such as yarning and the sharing of food, have helped to facilitate the emergence of CAM as a vibrant, challenging, eclectic artistic family. They recognise the cultural challenges faced by the collective – including finding a culturally appropriate place to meet and work, and the cross-cultural issues that can emerge within Aboriginal and Torres Strait Islander groups. In just 18 months, CAM has held successful exhibitions and developed public artworks. It is a strong part of regional Queensland’s arts scene, which supports emerging artists and provides a space to celebrate and support Indigenous art.

The case of LLACE : challenges, triumphs, and lessons of a community archives

This article uses the Lavender Library, Archives, and Cultural Exchange of Sacramento, Incorporated, a small queer community archives in Northern California, as a case study for expanding our knowledge of community archives and issues of archival practice. It explores why creating a separate community archives was necessary, the role of community members in founding and maintaining the archives, the development of its collections, and the ongoing challenges community archives face. The article also considers the implications community archives have for professional practice, particularly in the areas of collecting, description, and collaboration.

Scientific visualisations for developing students’ understanding of concepts in chemistry : some findings and some lessons learned

Scientific visualisations such as computer-based animations and simulations are increasingly a feature of high school science instruction. Visualisations are adopted enthusiastically by teachers and embraced by students, and there is good evidence that they are popular and well received. There is limited evidence, however, of how effective they are in enabling students to learn key scientific concepts. This paper reports the results of a quantitative study conducted in Australian chemistry classrooms. The visualisations chosen were from free online sources, intended to model the ways in which classroom teachers use visualisations, but were found to have serious flaws for conceptual learning. There were also challenges in the degree of interactivity available to students using the visualisations. Within these limitations, no significant difference was found for teaching with and without these visualisations. Further study using better designed visualisations and with explicit attention to the pedagogy surrounding the visualisations will be required to gather high quality evidence of the effectiveness of visualisations for conceptual development.

Improving megasite management performance through incentives : lessons learned from the Shanghai Expo construction

As the biggest expo site in history, construction of the Shanghai Expo site faced a lot of challenges, including involvement of lots of investors, megaconstruction scale, concurrent construction mode, involvement of more than 40,000 migrant workers, and extremely tight completion deadlines, among others. Consequently, these challenges imposed great obstacles on accomplishing the safety, quality, and environmental goals. Through a case study of the Shanghai Expo construction, this paper paper presents the design and implementation of multicriteria incentives in megaprojects to accomplish the safety, quality, and environmental goals. Both quantitative and qualitative findings were triangulated to demonstrate the outcome of the incentives. Six critical success factors (CSFs) for the incentives, rule design, process orientation, top management support, training and promotion, communication in process, and process learning and improvement are identified and validated through case study data and content analysis. It is believed that the findings of this paper can enhance understanding of multicriteria incentive schemes in general and provide insights in implementing these incentive schemes in future megaprojects, particularly in the People’s Republic of China (PRC).

Lessons from a face-to-face meeting on embedding Aboriginal and Torres Strait Islander perspectives : ‘A contract of intimacy’

This paper presents the findings from a conversation between an Aboriginal educator and a non-Indigenous pre-service educator about the importance and complexities of building productive partnerships. Although the participants focused on the challenges and benefits of building relationships between Aboriginal and Torres Strait Islander educators and non-Indigenous educators in Australian early years settings, the more significant outcome of the meeting was the personal connection two young women were able to make when a friendship began to develop. The project was intended to enable an opportunity for the participants ‘to engage in reflexivity on their pedagogic work’, something Mills (2012) understands as crucial to the support of social justice and transformation in the classroom.

Embedding nature into cities – a case study of economic lessons from Singapore

Built environment design around the world faces a number of 21st Century challenges such as rising urban heat island effect and rising pollution, which are further worsened by consequences of climate change and increasing urban populations. Such challenges have caused cities around the globe to investigate options that can help to significantly reduce the environmental pressures from current and future development, requiring new areas of innovation. One such area is ‘Biophilic Urbanism’, which refers to the use of natural elements as design features in urban centres to assist efforts to address climate change issues in rapidly growing economies. Singapore is an illustration of a thriving economy that exemplifies the value of embedding nature into its built environment. The significance of urban green space has been recognised in Singapore as early as the 1960s when Lee Kuan Yew embarked on the ‘Garden City’ concept. 50 years later, Singapore has achieved its Garden City goal and is now entering a new era of sustainability, to create a ‘City in a Garden’. Although the economics of such efforts is not entirely understood, the city of Singapore has continued to pursue visions of becoming a biophilic city. Indeed, there appears to be important lessons to be learned from a city that has challenged the preconceived notion that protecting vegetation in a city is not economically viable. Hence, this paper will discuss the case study of Singapore to highlight the drivers, along with the economic considerations identified along the way. The conclusions have implications for expanding the notion of biophilic urbanism, particularly in the Australian context by discussing the lessons learned from this city. The research is part of Sustainable Built Environment National Research Centre, and has been developed in collaboration with the Curtin University Sustainability Policy Institute.

Online teacher education : lessons from the cyber-trenches

This paper provides an overview of ‘lessons learned’ from the author’s decade long involvement in online teaching and learning, including eight years in the development, implementation, teaching and administration of a wholly online Master of Arts in Applied Linguistics coursework degree program, which attracted several hundred students annually from around the world, and has won awards for innovation, including being identified as a ‘flagship’ program during an external review of the university.

Evaluation of a community-based intervention to promote physical activity in youth : lessons from active winners

Purpose To test the effects of a community-based physical activity intervention designed to increase physical activity and to conduct an extensive process evaluation of the intervention. Design Quasi-experimental. Setting Two rural communities in South Carolina. One community received the intervention, and the other served as the comparison. Subjects Public school students who were in fifth grade at the start of the study (558 at baseline) were eligible to participate. A total of 436 students participated over the course of the study. Intervention The intervention included after-school and summer physical activity programs and home, school, and community components designed to increase physical activity in youth. The intervention took place over an 18-month period. Measures. Students reported after-school physical activity at three data collection points (prior to, during, and following the intervention) using the Previous Day Physical Activity Recall (PDPAR). They also completed a questionnaire designed to measure hypothesized psychosocial and environmental determinants of physical activity behavior The process evaluation used meeting records, documentation of program activities, interviews, focus groups, and heart rate monitoring to evaluate the planning and implementation of the intervention. Results There were no significant differences in the physical activity variables and few significant differences in the psychosocial variables between the intervention and comparison groups. The process evaluation indicated that the after-school and summer physical activity component of the intervention was implemented as planned, but because of resource and time limitations, the home, school, and community components were not implemented as planned. Conclusions The intervention did not have a significant effect on physical activity in the target population of children in the intervention community. This outcome is similar to that reported in other studies of community-based physical activity intervention.

ACE research vignette 036 : SMEs, Growth, and Job Creation: Lessons from Systematic Research

This series of research vignettes is aimed at sharing current and interesting research findings from our team of international Entrepreneurship researchers. This vignette, written by Professor Per Davidsson, summarises some important, stylized facts about small and medium enterprises (SMEs), growth, and job creation. It was specially prepared for “The G20 Agenda for Growth: Opportunities for SMEs Conference” in Melbourne, June 20, 2014. For this reason its format deviates slightly from other vignettes in the series.