Integrated and seamless?:Single Parents’ Experiences of Cross-Organizational Interaction

The lack of integration of public organizations and services is a recurring challenge for scholars, policymakers, and citizens. Within the e-government field, scholars have presented web-stage models, which predict that digitization will lead to a fully integrated public sector and seamless user journeys for citizens. Although these models have not delivered on their promises, scholars and policymakers still regard digitization as a means to integrate the public sector, achieve efficiency gains, and improve service quality. We argue that the web-stage models overlook barriers to integration, as they are mostly conceptual, and primarily focus on the potential of technology, rather than its actual implementation and use. Moreover, the models occur on the organizational level of analysis and ignore citizens and their actual experiences. Therefore, we present an empirical study of how citizens experience crossorganizational interaction during benefit application following a family break-up or divorce. Through observations, contextual interviews, focus group discussions and workshops we identify seven challenges citizens experience. These challenges make citizens aware that they are interacting with different organizations and break their experience of an integrated public sector. Further, the challenges cause citizens to turn from the digital channels towards traditional channels to complete their interaction. Thus, the lack of integration challenge both citizens’ satisfaction and efficiency gains from public sector digitalization

Creating, Reinterpreting, Combining, Cuing: Paper Practices on the Shopfloor

Despite the advent of a flurry of digital technologies, paper prevails on manufacturing shopfloors. To understand the roles and value of paper on the shopfloor, we have studied the manufacturing practices at two state-of-the-art automotive supplier facilities, applying ethnographic fieldwork, in-depth interviews, as well as photo and document analysis. We find that paper has unique affordances that today’s digital technologies cannot easily supplant on current shopfloors. More specifically, we find four paper practices: (1) creating and adapting individual information spaces, (2) reinterpreting information, (3) combining information handover with social interaction, and (4) visual cuing. We discuss these practices and the unique affordance of paper that currently support shopfloor workers and also consider the limitations of paper, which are becoming increasingly apparent, since more tasks increasingly depend on real-time information

Feasibility of transcutaneous auricular vagus nerve stimulation in treatment of drug resistant epilepsy:A multicenter prospective study

Background: Transcutaneous auricular vagus nerve stimulation (ta-VNS) is a new non-invasive technique developed as treatment option for drug resistant epilepsy. A few studies have been carried out showing that the efficacy and tolerability of ta-VNS is comparable with traditional implanted VNS but the feasibility of the therapy has been poorly described. This study aimed to explore potential clinical benefits of ta-VNS and to evaluate adaptation, compliance, as well as the usability of the device from a service design perspective. Methods: A prospective, multicenter, clinical, investigator-initiated trial was conducted using the NEMOS (R) taVNS device. After eight weeks baseline, all subjects started ta-VNS with individually adjusted currents for four hours per day for six-months (first endpoint) followed by optional 12 months follow-up (second endpoint). The primary outcome was six months retention rate of ta-VNS therapy. Secondary outcomes included the user retention rate at 12 months follow-up, compliance, changes in scores of psychometric measures. For the study of feasibility, a service design questionnaire on medical devices used in the home was developed. Results: In total 37 subjects had been included in the study after 45 months where the study was prematurely terminated due to recruitment problems and due to a high drop-out rate. Twenty-two subjects (59 %) completed the first six months of the study and in total six subjects (16 %) completed the following 12 months follow-up. The reasons for discontinuation were a mixture of medical and practical issues of which the majority were related to a combination of both. Those, who managed to continue to use ta-VNS throughout the study, gave generally higher scores for the device usability and compatibility with lifestyle. The study turned out to be inadequately powered to reach any conclusion in terms of the clinical benefits of ta-VNS but present an example of difficulties that are encountered in conducting high-quality studies with digital devices. Conclusion: The feasibility of ta-VNS therapy showed to be relatively modest which is most likely due to practical usability issues and lifestyle fits. The results of this study stress the importance of generating data based on patients experiences at an early stage during the development phase and when designing clinical trials on medical devices that depend on patient's active participation and motivation