Attempting to fly: Deployment of system-oriented design methodology conducted by the Norwegian Design Council

A metaphore Albatrosses are amongst the largest of flying birds. They are known to cover thousands of miles in a short space of time, they fly high and low, with such little effort that they can complete a full circle around the Earth in just over a month. An albatross's takeoff on the other hand, is an embarrassingly clumsy affair. On land they have to run, using a 'runway' area of flat open ground, usually placed on the windiest part of the breeding island, and sloping downhill to increase speed. They face downhill, into the wind, and start a headlong run with wings outstretched, this combined with a couple of flaps, usually gets them into the air. When landing on land they use their tails and webbed feet as ‘air brakes' and, if they are still too fast when they land, they may topple forward rather comically onto their beaks. What does this have to do with systems oriented design (SOD)? SOD is still maturing as a methodology and is not easy to communicate. To explain how we see SOD we use this metaphore. Our part in the developement of SOD so far has been as sensors and bridging partner to the Oslo School of Architecture and Design (AHO) and as an orchestrator of projects. This paper will focus on how the collaboration with AHO has put the Norwegian Design Council in a position to stage the necessary circumstances to get SOD projects in the air, and describe a specific case and its main

Integration of value adding services related to financing and ownership: A business model perspective

OA-merket på doi-sidenIt is an agreed fact among scholars that services are more sustainable compared to the products. By offering services, traditional companies can lock their customers into a long-term and sustainable revenue generation settlement. Available academic literature is abundant with methodologies related to service development. However, this study investigates various value adding service options related to financing and ownership of a product that can be offered on top of the existing products. It is important to understand these options from the consumer as well as supplier perspective. The most well established options available for financing/ownership are compiled, and sorted with respect to intangibility, ownership, financing and value addition scale. The study argues that the identified options incrementally add value to the existing offering by increasing the purchasing power and reducing the ownership obstacles for the customers. However, for the supplier, the decision depends on the trade-off between value addition for the customers and the business model changes required.publishedVersio

Genome wide single cell analysis of chemotherapy resistant metastatic cells in a case of gastroesophageal adenocarcinoma

<p>Abstract</p> <p>Background</p> <p>Metastatic progression due to development or enrichment of therapy-resistant tumor cells is eventually lethal. Molecular characterization of such chemotherapy resistant tumor cell clones may identify markers responsible for malignant progression and potential targets for new treatment. Here, in a case of stage IV adenocarcinoma of the gastroesophageal junction, we report the successful genome wide analysis using array comparative genomic hybridization (CGH) of DNA from only fourteen tumor cells using a bead-based single cell selection method from a bone metastasis progressing during chemotherapy.</p> <p>Case presentation</p> <p>In a case of metastatic adenocarcinoma of the gastroesophageal junction, the progression of bone metastasis was observed during a chemotherapy regimen of epirubicin, oxaliplatin and capecitabine, whereas lung-, liver and lymph node metastases as well as the primary tumor were regressing. A bone marrow aspirate sampled at the site of progressing metastasis in the right iliac bone was performed, and single cell molecular analysis using array-CGH of Epithelial Specific Antigen (ESA)-positive metastatic cells, and revealed two distinct regions of amplification, 12p12.1 and 17q12-q21.2 amplicons, containing the KRAS (12p) and ERBB2 (HER2/NEU) (17q) oncogenes. Further intrapatient tumor heterogeneity of these highlighted gene copy number changes was analyzed by fluorescence in situ hybridization (FISH) in all available primary and metastatic tumor biopsies, and ErbB2 protein expression was investigated by immunohistochemistry.</p> <p>ERBB2 was heterogeneously amplified by FISH analysis in the primary tumor, as well as liver and bone metastasis, but homogenously amplified in biopsy specimens from a progressing bone metastasis after three initial cycles of chemotherapy, indicating a possible enrichment of erbB2 positive tumor cells in the progressing bone marrow metastasis during chemotherapy. A similar amplification profile was detected for wild-type KRAS, although more heterogeneously expressed in the bone metastasis progressing on chemotherapy. Correspondingly, the erbB2 protein was found heterogeneously expressed by immunohistochemical staining of the primary tumor of the gastroesophageal junction, while negative in liver and bone metastases, but after three initial cycles of palliative chemotherapy with epirubicin, oxaliplatin and capecetabine, the representative bone metastasis stained strongly positive for erbB2.</p> <p>Conclusion</p> <p>Global analysis of genetic aberrations, as illustrated by performing array-CGH analysis on genomic DNA from only a few selected tumor cells of interest sampled from a progressing bone metastasis, can identify relevant therapeutic targets and genetic aberrations involved in malignant progression, thus emphasizing the importance and feasibility of this powerful tool on the road to more personalized cancer therapies in the future.</p

Enhanced Private Sector Engagement for Tuberculosis Diagnosis and Reporting through an Intermediary Agency in Ho Chi Minh City, Viet Nam

Under-detection and -reporting in the private sector constitute a major barrier in Viet Nam’s fight to end tuberculosis (TB). Effective private-sector engagement requires innovative approaches. We established an intermediary agency that incentivized private providers in two districts of Ho Chi Minh City to refer persons with presumptive TB and share data of unreported TB treatment from July 2017 to March 2019. We subsidized chest x-ray screening and Xpert MTB/RIF testing, and supported test logistics, recording, and reporting. Among 393 participating private providers, 32.1% (126/393) referred at least one symptomatic person, and 3.6% (14/393) reported TB patients treated in their practice. In total, the study identified 1203 people with TB through private provider engagement. Of these, 7.6% (91/1203) were referred for treatment in government facilities. The referrals led to a post-intervention increase of +8.5% in All Forms TB notifications in the intervention districts. The remaining 92.4% (1112/1203) of identified people with TB elected private-sector treatment and were not notified to the NTP. Had this private TB treatment been included in official notifications, the increase in All Forms TB notifications would have been +68.3%. Our evaluation showed that an intermediary agency model can potentially engage private providers in Viet Nam to notify many people with TB who are not being captured by the current system. This could have a substantial impact on transparency into disease burden and contribute significantly to the progress towards ending TB

Impact of Globalization on Model of Competition and Companies’ Competitive Situation

Part 1: Production ProcessInternational audienceGlobalization has changed the competitive environment of companies. This paper aims to contribute to understanding the changes a company can face through analyzing the impact of drivers and effects of globalization on the models of industry competition and the company value chain. The boundaries between the forces of competition are fading as economic globalization has led to a new dynamic in the competitive situation where companies and activities of the value chains change places between forces and impact and interact with each other in new ways. The boundaries of companies and their core can and are being redefined. As this potential evolves through offshoring, outsourcing and value chain fragmentation, the pressure of competition forces a continuing and increasing move in this direction

Identifying the Drivers of Economic Globalization and the Effects on Companies’ Competitive Situation

Part 1: Production ProcessInternational audienceGlobalization has changed the world. Thispaper aims to contribute to the understanding of how companies’ competitive situation is affected by globalization. The paper identifies the main drivers of economic globalization and categorizes the effects into size effects, location effects and pressure effects. Size relates to the magnitude of the potential competition. Location relates to the potential impact on a company’s activities in terms of what to do where and by whom. Pressure effects are the ones that are related to competitive pressure

Balancing cost and justice concerns in the energy transition: comparing coal phase-out policies in Germany and the UK

Europe’s two largest economies – Germany and the UK – are phasing out coal from electricity production as part of European efforts to fulfil increased climate policy ambitions that require comprehensive energy system transitions. German and UK governments varied in the ways they sought support from diverse societal interests to make the transition socially acceptable and politically feasible. Drawing on 22 expert interviews and process-tracing methods, this paper compares and explains how political and economic institutional differences influenced efforts to balance energy transition concerns, like speed and cost-effectiveness with justice for companies, workers and communities most adversely affected by the transition. We find that the increasing attention to just transition perspectives after the Paris Agreement affected the design of coal phase-out processes in different ways in the two countries. Just transition concerns were given priority by policymakers in Germany, but more so if they overlapped with the interests of incumbents. In the end, politically powerful stakeholders dominated the policy outcome. In the UK, policymakers and stakeholders gave only weak attention to just transition concerns, mainly because coal’s market position had collapsed. Coal interests did not have strong representation in the decision-making process. But we find that just transition concerns are likely to gain more attention in the UK because a more challenging transition away from gas will take place over the next two decades

Adolescents with Type 1 Diabetes--The Impact of Gender, Age, and Health-Related Functioning on Eating Disorder Psychopathology.

To investigate correlates of eating disorder psychopathology in adolescent males and females with type 1 diabetes.A total of 105 adolescents with type 1 diabetes (42% males), aged 12-20 years, were recruited from the Norwegian Childhood Diabetes Registry in this population-based study. All participants were interviewed with the Child Eating Disorder Examination. Additionally, the Brief Illness Perception Questionnaire, the Adolescent Coping Orientation for Problem Experiences and the Beliefs about Medicines Questionnaire were administered to assess health-related functioning. Clinical data were obtained from the Norwegian Childhood Diabetes Registry.Significant gender differences were demonstrated in the pattern of correlates of eating disorder pathology. Among females, eating disorder psychopathology was significantly associated with body mass index adjusted for age and gender, age, insulin restriction, coping, illness perceptions, and perceptions of insulin concern. In a regression model, age, illness perceptions, and insulin restriction remained significantly associated with eating disorder psychopathology, explaining 48% of the variance. None of the variables were associated with eating disorder psychopathology among males.Greater clinical awareness of illness perceptions, attitudes toward insulin, and insulin restriction may potentially decrease the risk of developing eating disorders among female adolescents with type 1 diabetes, and the subsequent increased morbidity and mortality associated with comorbid type 1 diabetes and eating disorders

Eating patterns in adolescents with type 1 diabetes: Associations with metabolic control, insulin omission, and eating disorder pathology

Objective: The purpose of this study was to investigate eating patterns among male and female adolescents with type 1 diabetes (T1D), and the associations with age, zBMI, eating disorder (ED) pathology, intentional insulin omission, and metabolic control. Method: The sample consisted of 104 adolescents (58.6% females) with child-onset T1D, mean age of 15.7 years (SD 1.8) and mean zBMI of 0.4 (SD 0.8). The Child Eating Disorder Examination (ChEDE) assessed meal/snack frequency and ED pathology. T1D clinical data was obtained from the Norwegian Childhood Diabetes Registry. Results: A significantly lower proportion of females than males (73.8% vs 97.7%) consumed breakfast on a daily basis. Approximately 50% of both genders ate lunch and 90% ate dinner daily. Among females, skipping breakfast was significantly associated with higher global ED psychopathology, shape concerns, self-induced vomiting, binge eating, insulin omission due to shape/weight concerns, and poorer metabolic control. Less frequent lunch consumption was significantly associated with poorer metabolic control. Skipping dinner was significantly associated with older age, higher dietary restraint, eating concerns, self-induced vomiting, and insulin omission. Among males, less frequent consumption of lunch and evening snacks was associated with attitudinal features of ED, including shape/weight concerns and dietary restraint. Discussion: Among adolescents with T1D, irregular or infrequent meal consumption appears to signal potential ED pathology, as well as being associated with poorer metabolic control. These findings suggest the importance of routinely assessing eating patterns in adolescents with T1D to improve detection of ED pathology and to facilitate improved metabolic control and the associated risk of somatic complications

Metabolic Control and Illness Perceptions in Adolescents with Type 1 Diabetes

Background. Disturbed eating behavior and psychosocial variables have been found to influence metabolic control, but little is known about how these variables interact or how they influence metabolic control, separately and combined. Objective. To explore associations between metabolic control (measured by HbA1c) and eating disorder psychopathology, coping strategies, illness perceptions, and insulin beliefs in adolescents with type 1 diabetes. Methods. A total of 105 patients (41.9% males) with type 1 diabetes (12–20 years) were interviewed with the Child Eating Disorder Examination. In addition, self-report psychosocial questionnaires were completed. Clinical data, including HbA1c, was obtained from the Norwegian Childhood Diabetes Registry. Results. Significant gender differences were demonstrated. Among females, HbA1c correlated significantly with eating restriction (.29, p < .05), the illness perception dimensions consequences, personal control, coherence, and concern (ranging from .33 to .48), and the coping strategy ventilating negative feelings (−.26, p < .05). Illness perception personal control contributed significantly to HbA1c in a regression model, explaining 23% of the variance among females (β .48, p < .001). None of the variables were significantly associated with HbA1c among males. Conclusions. Illness perceptions appear to be important contributors to metabolic control in females, but not males, with type 1 diabetes