Innovation management in healthcare: A multi-level perspective in three essays

Innovation in healthcare is a central way of coping with the changes affecting the healthcare system through the megatrends of demographic change, digitalization as well as the opportunities in the life-sciences sector and the “-omics” subjects. Due to the multiple facets of the topic, research on innovation in healthcare is diverse and draws insights from systems theory, management theory, human resources, innovation and change management. While the literature on innovation in healthcare has grown steadily in the last 20 years and publications on pharmaceutical and medical device innovation, health technology assessment strategies, or digital innovations have increased significantly, other areas such as sectoral health innovation systems, the creation and implementation of innovation in hospitals still remain fairly uncharted. Applying established concepts such as systems of innovation theory, mass customization theory or management of employee involvement in innovation activities to the healthcare sector provides new insights into a field that is often considered a “blackbox”. This thesis adds to the topic in three essays, each focusing on a different aspect and depth level ranging from a macro perspective on healthcare innovation on a global scale to a meso level perspective on the implementation of personalized medicine in one country and putting a micro lens on innovation activities of hospital staff. The aim of this thesis is to provide an overview for researchers, policy makers and healthcare stakeholders about current developments, propose tools for measuring innovation and allow for benchmarking the current status quo in healthcare in order to foster new and innovative developments

Phytoplankton dynamics and bio-optical variables associated with Harmful Algal Blooms in aquaculture zones

The surveillance of Harmful Algal Blooms (HABs) in aquaculture zones is a crucial component in monitoring and mitigation of adverse effects caused by accumulation of high biomass of algal cells and/or associated toxins. Integrated findings of this thesis strongly stress the significance of synoptic bio-optical and conventional measures for efficient surveillance of HABs and their environmental triggers over required spatio-temporal scales, here shown for a case study in the Ebro Delta, NW Mediterranean. In particular, the installation of an environmental observatory in the Ebro Delta aquaculture area, and the capability of a radiometric sensor system as key component are highly motivated by study results. Yet it was clearly shown that for the interpretation of bio-optical data, detailed knowledge on bloom characteristics is crucial. By such effective coverage of bloom dynamics, combined with insights on environmental scenarios that promote the proliferation of certain taxa, public and private responses can be optimised. In a future scenario, this knowledge can be transferred to predictive models of HABs. In this sense, these future steps may advance towards preventive measures rather than mitigation actions to deal with this environmental hazard

Studying the role of Wnt signaling in induced pluripotent stem cell (iPSC) generation

Adulte humane somatische Zellen haben die Fähigkeit zur Reprogrammierung in pluripotente Stammzellen durch retrovirale Transduktion von diversen Faktoren (Oct4, Sox2, Klf4, c-Myc; Yamanaka et al. 2006 oder Oct4, Sox2, Lin28, Nanog; Yu et al. 2007). Obwohl die Reprogrammierung der Zelle in der Zukunft für die erneuerbarer Medizin viel Potenzial hat, sind die heutigen Methoden der Induzierung und Aufrechterhaltung des pluripotenten Zustandes äußerst ineffizient (berichtete Effizienz <0.01%) und es besteht ein onkogenes Risiko (Okita et al. 2007). Diverse Studien zeigen wie durch Änderung der Zellkulturbedingungen die Reprogrammierungseffizienz erheblich erhöht werden kann. Dies geschieht durch Zugabe von kleinen Molekülen oder Wachstumsfaktoren ins Zellkulturmedium (Marson et al. 2008). Wir führten eine Reihe an Experimenten durch, um festzustellen, ob Wnt Proteine, welche Signalmoleküle mit wirkungsvollen Stammzellaktivitäten sind, und deren Signalwege die Aneignung des pluripotenten Zustandes regulieren. Das Ziel dieses Projektes war die Auswirkung des Wnt Signalweges auf die Reprogrammierung der Zelle und dadurch die Regulation des induziert pluripotenten Zustandes zu studieren. Diese Arbeit gewährt Einblick in eine mögliche Methode, die zulässt, Wnt Proteine als Reagenzien zu verwenden, die induzierte pluripotente Stammzellen ohne virale Gentransduktion generieren. Außerdem wurde die Induktion der Pluripotenz auch durch drei Faktoren gewährleistet (ohne c-myc). Schlussendlich wurde festgestellt, dass Wnt3a die Effizienz der induzierten pluripotenten Stammzellen verbessert und speziell ohne c-myc, scheint Wnt3a das Fehlen des vierten Faktors zu kompensieren. Auf die Zellen, die mit drei Faktoren induziert wurden, wirkt der GSK3-inhibitor mit doppelt negativem Effekt als Wnt Signalwegaktivator und fördert die induziert pluripotente Stammzellenherstellung, während er in den mit vier Faktoren transduzierten Zellen nur toxisch wirkt. Wnt5a und Axinüberexpression inhibieren zum Teil den induziert pluripotenten Herstellungsvorgang nach Induzierung von drei und auch vier Faktoren. Die Ergebnisse dieses Projekts weisen auf eine definitive Unterstützung des Wnt Signalweges auf die Reprogrammierungseffizienz hin.Adult human somatic cells are capable of being reprogrammed to induced pluripotent stem cells (iPSC) by retroviral transduction of several transcription factors (Oct4, Sox2 and either Klf4, Yamanaka et al. 2006, and c-Myc or Lin28 and Nanog, Yu et al. 2007). While iPS cells hold therapeutic potential for the future of regenerative medicine, current methods of induction and maintenance of the pluripotent state are extremely inefficient (with reported efficiencies of <0.01%) and pose significant oncogenic risk (Okita et al. 2007). Several studies have demonstrated that the efficiency of reprogramming can be significantly enhanced by modifying culture conditions through the addition of small molecules or growth factors (Marson et al. 2008). Here we proposed a set of experiments to determine whether Wnt proteins, a class of signaling molecules with potent stem cell activities, and their signaling pathways regulate the acquisition of the pluripotent state. The goal of this project was to study the impact of Wnt signaling on the reprogramming and the regulation of the induced pluripotent state. This work provided insight into the possibility of utilizing Wnt proteins as reagents to generate iPS cells in the absence of viral gene transduction. Additionally, the induction of pluripotency was performed with only three factors (without the factor c-myc). In summary, Wnt3a increases efficiency of iPS cell number of four and three factor transduced iPS cells. Especially in the absence of c-myc, Wnt3a seems to compensate the lack of one factor. Another essential finding was the double negative effect of GSK3-inhibitor, especially in the three factor transduced iPS cells. In three factor transduced iPS cells the inhibitor acted as Wnt pathway activator and contributed to the iPSC formation, while in the four factor transduced cells, it was toxic to the cells. Wnt5a and Axin overexpression partly inhibited iPSC colony production consistently in three and four factor iPS cell production. The results suggest that Wnt signaling definitely supports iPSC generation, some of those molecules or overexpressed genes indicate an up- or down regulation of induced pluripotent stem cell formation

Sharp crossover from composite fermionization to phase separation in mesoscopic mixtures of ultracold bosons

We show that a two-component mixture of a few repulsively interacting ultracold atoms in a one-dimensional trap possesses very different quantum regimes and that the crossover between them can be induced by tuning the interactions in one of the species. In the composite fermionization regime, where the interactions between both components are large, none of the species show large occupation of any natural orbital. Our results show that by increasing the interaction in one of the species, one can reach the phase-separated regime. In this regime, the weakly interacting component stays at the center of the trap and becomes almost fully phase coherent, while the strongly interacting component is displaced to the edges of the trap. The crossover is sharp, as observed in the in the energy and the in the largest occupation of a natural orbital of the weakly interacting species. Such a transition is a purely mesoscopic effect which disappears for large atom numbers.Comment: 5 pages, 3 figure

TOWARDS AN OPEN HARDWARE PROTOTYPE PROCESS MODEL FOR LONG-TERM SUSTAINABILITY

The rise of open source models for software and hardware development has catalyzed the debate regarding sustainable business models. Open Source Software has already become a dominant part in the software industry, whereas Open Source Hardware is still a little-researched phenomenon but has the potential to do the same to manufacturing in a wide range of products. This article addresses this potential by introducing a research design to analyze the prototyping phase of six different Open Source Hardware projects tackling ecological, social, and economical challenges. Using a design science research methodology, a process model is developed to concretise the prototype development steps. The prototype phase is important because it is where fundamental decisions are made that affect the openness of the final product. This paper aims to advance the discourse on open production as a concept that enables companies to apply the aspect of openness towards collaboration-oriented and sustainable business models

Evaluation von Kommunikationstrainings. Eine Studie zu Ist-Stand, Bedarfen und Möglichkeiten der Evaluation von Kommunikationstrainings, die von Sprecherzieherinnen und Sprecherziehern (DGSS) durchgeführt werden.

Diese Arbeit beschäftigt sich mit der Evaluation von Kommunikationstrainings, die von ausgebildeten Sprecherzieherinnen und Sprecherziehern der Deutschen Gesellschaft für Sprechwissenschaft und Sprecherziehung e. V. (DGSS) durchgeführt werden. Dabei liegt der Fokus darauf, wie die Evaluationspraxis gestaltet wird und welche Bedeutung Evaluation für die durchfürenden Trainerinnen und Trainer hat. Neben der Auswertung der verschiedenen Studienelementen wie Online-Befragungen und Telefoninterviews bildet ein praxisorientierter Leitfaden den Abschluss der Dissertation