Qualitative research methods in neurosurgery: an unexplored avenue.

OBJECTIVE: Explore the value and potential of qualitative research to neurosurgery and provide insight and understanding to this underused methodology. BACKGROUND: The definition of qualitative research is critically discussed and the heterogeneity within this field of inquiry explored. The value of qualitative research to the field of neurosurgery is articulated through its contribution to understanding complex clinical problems. DISCUSSION: To resolve some of the misunderstanding of qualitative research, this paper discusses research design choices. We explore approaches that use qualitative techniques but are not, necessarily, situated within a qualitative paradigm in addition to how qualitative research philosophy aids researchers to conduct interpretive inquiry that can reveal more than simply what was said by participants. Common research designs associated with qualitative inquiry are introduced, and how complex analysis may contribute more in-depth insights is explained. Approaches to quality are discussed briefly to support improvements in qualitative methods and qualitative manuscripts. Finally, we consider the future of qualitative research in neurosurgery, and suggest how to move forward in the qualitative neurosurgical evidence base. CONCLUSION: There is enormous potential for qualitative research to contribute to the advancement of person-centred care within neurosurgery. There are signs that more qualitative research is being conducted and that neurosurgical journals are increasingly open to this methodology. While studies that do not engage fully within the qualitative paradigm can make important contributions to the evidence base, due regard should be given to immersive inquiry within qualitative paradigms to allow complex, in-depth, investigations of the human experience

Coordinating knowledge creation: A systematic literature review on the interplay between operational excellence and industry 4.0 technologies

In the process of creating new knowledge, literature has scarcely studied how bodies of knowledge arising from different sources should be coordinated to enhance performance. In particular, the present research focuses on two sources of newly created knowledge, i.e., operational excellence and Industry 4.0, to understand whether they should be implemented sequentially or simultaneously. Operational excellence refers to the implementation of practices such as just in time, total quality management, and Six Sigma that help a firm to create knowledge that facilitates waste reduction and customer value improvement. Industry 4.0 refers to the implementation of new technologies such as artificial intelligence, big data, robotics, Internet of Things, and laser cutting that help a firm to create knowledge to improve overall business performance. We identified and analyzed 30 papers published in 13 peer-reviewed journals and conference proceedings in the field of operations management. Our findings based on the systematic literature review suggest that the interplay between operational excellence and Industry 4.0 can be categorized into four groups: (1) Industry 4.0 supports operational excellence; (2) operational excellence supports Industry 4.0; (3) complementary; and (4) no interdependence. Majority of the papers under study are in the first category, suggesting Industry 4.0 technologies as enabler of operational excellence

A Multicentric Prospective Incidence Study of Guillain-Barre Syndrome in Italy. the ITANG Study

To assess Guillain-Barre syndrome (GBS) incidence we relied on the Italian Network for the study of GBS (ITANG) established in 2010 in 7 Italian regions to analyse the association between influenza vaccination and GBS. Methods: All individuals aged 6518 years, presenting with clinical manifestations that suggested GBS according to the universally accepted Asbury's diagnostic criteria (1990) were prospectively notified to a centralised database by ITANG neurologists over the period October 1, 2010-September 30, 2011. Through a telephone survey, 9 trained interviewers followed up the cases to diagnosis and then for 1 year since hospital discharge. Validation of case reporting was performed with the support of administrative data in 5 regions. Results: We found 365 cases fulfilling the definition for GBS or one of its variants over 19,846,068 population 6518 years of age, yielding an annual incidence rate of 1.84 per 100,000 (95% CI 1.65-2.03), 2.30 (95% CI 1.99-2.60) in men and 1.41 (95% CI 1.18-1.64) in women. A highly significant peak of incidence was observed in February 2011 as compared to reference month (September 2011, rate ratio 3.3:1, p < 0.01). Conclusions: In Italy, GBS incidence was among the highest reported in Europe and higher than previously observed in Italian studies