A hybrid space to support the regeneration of competences for re-industrialization

Since the 1970s, in many European industrialized areas, cities have undergone radical trans-formations to cope with de-industrialization but also with the new needs of the post Fordistic or-ganization of the factories and their ecosystems: logistics and transport requirements were de-manding new functional areas, business services - from individual units up to big service compa-nies - needed different configurations of working spaces, urban sprawling increased to satisfy resi-dential needs. A huge amount of manufacturing buildings has become no longer appropriate for many production processes and the future of the old industrial premises has punctuated the public debate of the past forty years: from their restoring (to keep traces of local socio-technical identity), to their demolition (to provide new appropriate production or living spaces), to their re-use (for hosting new activities). In the somewhat drastic passage from the past industrial era to the future digital economy, medium size cities in industrialized areas present some specific challenges when they have to support the new manufacturing age: not only with new spaces, but also with new skills. In recent years, many public (and also private) initiatives have proposed and implemented the transformation of old manufacturing building in new settings to foster creativity-and-innovation, a condition considered essential, among others, to create new opportunities for growth. Are the re-uses of buildings effective for that goal? Is contamination in hybrid spaces the crucial ingredient for their success in supporting creativity? These questions appear even more critical when we are confronted with the creation of new skills for re-industrialization in areas that are still pillars of manufacturing activities but that are progressively lost the social fabric that reproduced skills. Although their general character is to enable information and communication flows, cities in industrialized areas have lost some important pieces of knowledge on material processes. In this contribution we address some of those issues by investigating the action-research called "Officina Emilia" that was initiated in Italy exactly with the goal of regenerating compe-tence networks in a manufacturing area. Officina Emilia developed some distinctive features: the creation of an original space, Museolaboratorio, designed as a hybrid space; the action-research program to introduce changes through the context-based technology education; the intent to build on a large and qualified network, supporting the innovation in the education system at regional level. These features will be discussed below. The rationale for this analysis is to single out which are the agents, the processes and some conditions that may hamper similar initiatives. In this chap-ter we first introduce, in section 2, the interdependencies between economic system and education system. We discuss a new approach to technology education in context, and the specific characters of what is needed to improve such context-based education. In section 3 we present the education activities produced by Officina Emilia. In section 4 we comment on the lessons learned from the action-research that created a hybrid space. Our focus is on the relevant agents, artefacts and inter-action processes that can support social innovation in education to enhance significant learning, to meet the changes of the world of production and to address the complexity of concrete situations. Section 5 concludes with some remarks

A hybrid space to support the regeneration of competences for re-industrialization. Lessons from a research-action

Since the 1970s, in many European industrialized areas, cities have undergone radical transformations to cope with de-industrialization but also with the new needs of the post Fordistic organization of the factories and their ecosystems: logistics and transport requirements were demanding new functional areas, business services - from individual units up to big service companies - needed different configurations of working spaces, urban sprawling increased to satisfy residential needs. A huge amount of manufacturing buildings has become no longer appropriate for many production processes and the future of the old industrial premises has punctuated the public debate of the past forty years: from their restoring (to keep traces of local socio-technical identity), to their demolition (to provide new appropriate production or living spaces), to their re-use (for hosting new activities). In the somewhat drastic passage from the past industrial era to the future digital economy, medium size cities in industrialized areas present some specific challenges when they have to support the new manufacturing age: not only with new spaces, but also with new skills. In recent years, many public (and also private) initiatives have proposed and implemented the transformation of old manufacturing building in new settings to foster creativity-andinnovation, a condition considered essential, among others, to create new opportunities for growth. Are the re-uses of buildings effective for that goal? Is contamination in hybrid spaces the crucial ingredient for their success in supporting creativity? These questions appear even more critical when we are confronted with the creation of new skills for re-industrialization in areas that are still pillars of manufacturing activities but that are progressively lost the social fabric that reproduced skills. Although their general character is to enable information and communication flows, cities in industrialized areas have lost some important pieces of knowledge on material processes. In this contribution we address some of those issues by investigating the action-research called "Officina Emilia" that was initiated in Italy exactly with the goal of regenerating competence networks in a manufacturing area. Officina Emilia developed some distinctive features: the creation of an original space, Museolaboratorio, designed as a hybrid space; the action-research program to introduce changes through the context-based technology education; the intent to build on a large and qualified network, supporting the innovation in the education system at regional level. These features will be discussed below. The rationale for this analysis is to single out which are the agents, the processes and some conditions that may hamper similar initiatives. In this chapter we first introduce, in section 2, the interdependencies between economic system and education system. We discuss a new approach to technology education in context, and the specific characters of what is needed to improve such context-based education. In section 3 we present the education activities produced by Officina Emilia. In section 4 we comment on the lessons learned from the action-research that created a hybrid space. Our focus is on the relevant agents, artefacts and interaction processes that can support social innovation in education to enhance significant learning, to meet the changes of the world of production and to address the complexity of concrete situations. Section 5 concludes with some remarks on the lost and missing links hampering the actionresearch to become a driver of change

Innovation in education and re-industrialisation in Europe

In this paper we discuss innovations in education, with a focus on those oriented towards knowledge-driven re-industrialisation in Europe. We first introduce the specific education needs for re-industrialisation with regard (a) to young people’s knowledge and skills in science, technology, engineering and mathematics (STEM), and (b) to specific training needs of mid-level technicians. Then we propose the adoption of a context-based approach to place science and technology within young people’s daily lives and to promote links between science, technology and society. In particular, we propose the use of robotics labs to improve context-based approach to technology education. We suggest action-research as a feasible practice to boost bottom-up changes in teaching and learning activities, and we focus on the university initiative Officina Emilia as an exemplar of such actions, as the initiative involves university researchers, manufacturing and services companies, education agencies, civil society. The paper offers some concluding remarks on two main ingredients that can support a more appropriate set of education and training activities to enhance knowledge-driven re-industrialisation: first, the need to allow the emergence of hybrid places fostering innovation, with the involvement of different agents; second, the robotics labs, among others, as a means to foster a multidisciplinary perspective, crucial for the new challenges that education faces in supporting re-industrialization

Transfusion thresholds and beyond

Comment on Liberal transfusion strategy improves survival in perioperative but not in critically ill patients. A meta-analysis of randomised trials. [Br J Anaesth. 2015

Fibrinogen concentrate in surgery

Fibrinogen is a plasma glycoprotein synthesised by the liver which plays a critical role in haemostasis by acting as an endogenous substrate for fibrin formation and by inducing clot formation and platelet aggregation

The use of fibrinogen concentrate for the management of trauma-related bleeding. A systematic review and meta-analysis

Haemorrhage following injury is associated with significant morbidity and mortality. The role of fibrinogen concentrate in trauma-induced coagulopathy has been the object of intense research in the last 10 years and has been systematically analysed in this review. A systematic search of the literature identified six retrospective studies and one prospective one, involving 1,650 trauma patients. There were no randomised trials. Meta-analysis showed that fibrinogen concentrate has no effect on overall mortality (risk ratio: 1.07, 95% confidence interval: 0.83-1.38). Although the metaanalytic pooling of the current literature evidence suggests no beneficial effect of fibrinogen concentrate in the setting of severe trauma, the quality of data retrieved was poor and the final results of ongoing randomised trials will help to further elucidate the role of fibrinogen concentrate in traumatic bleeding

Safety of intravenous tranexamic acid in patients undergoing major orthopaedic surgery. A meta-analysis of randomised controlled trials

Among the various pharmacological options to decrease peri-operative bleeding, tranexamic acid appears to be one of the most interesting. Several trials have consistently documented the efficacy of this synthetic drug in reducing the risk of blood loss and the need for allogeneic blood transfusion in patients undergoing total hip and knee arthroplasty. The safety of intravenous tranexamic acid in major orthopaedic surgery, particularly regarding the risk of venous thromboembolism, was systematically analysed in this review. A systematic search of the literature identified 73 randomised controlled trials involving 4,174 patients and 2,779 controls. The raw overall incidence of venous thromboembolism was 2.1% in patients who received intravenous tranexamic acid and 2.0% in controls. A meta-analytic pooling showed that the risk of venous thromboembolism in tranexamic acid-treated patients was not significantly different from that of controls (risk difference: 0.01%, 95% confidence interval [CI]: -0.05%, 0.07%; risk ratio: 1.067, 95% CI: 0.760-1.496). Other severe drug-related adverse events occurred very rarely (0.1%). In conclusion, the results of this systematic review and meta-analysis show that intravenous tranexamic acid is a safe pharmacological treatment to reduce blood loss and transfusion requirements in patients undergoing major orthopaedic surgery

The use of viscoelastic haemostatic assays in non-cardiac surgical settings. a systematic review and meta-analysis

Background: Thrombelastography (TEG) and rotational thromboelastometry (ROTEM) are viscoelastic haemostatic assays (VHA) which exploit the elastic properties of clotting blood. The aim of this systematic review and meta-analysis was to evaluate the usefulness of these tests in bleeding patients outside the cardiac surgical setting. Materials and methods: We searched the Cochrane Library, MEDLINE, EMBASE and SCOPUS. We also searched clinical trial registries for ongoing and unpublished studies, and checked reference lists to identify additional studies. Results: We found 4 randomised controlled trials (RCTs) that met our inclusion criteria with a total of 229 participants. The sample size was small (from 28 to 111 patients) and the follow-up periods very heterogenous (from 4 weeks to 3 years). Pooled data from the 3 trials reporting on mortality (199 participants) do not show any effect of the use of TEG on mortality as compared to standard monitoring (based on the average treatment effect from a fixed-effects model): Risk Ratio (RR) 0.71; 95% Confidence Interval (CI): 0.43 to 1.16. Likewise, the use of VHA does not reduce the need for red blood cells (mean difference -0.64; 95% CI: -1.51 to 0.23), platelet concentrates (mean difference -1.12; 95% CI: -3.25 to 1.02), and fresh frozen plasma (mean difference -0.91; 95% CI: -2.02 to 0.19) transfusion. The evidence on mortality and other outcomes was uncertain (very low-certainty evidence, down-graded due to risk of biases, imprecision, and inconsistency). Conclusions: Overall, the certainty of the evidence provided by the trials was too low for us to be certain of the benefits and harms of viscoelastic haemostatic assay in non-cardiac surgical settings. More, larger, and better-designed RCTs should be carried out in this area