Innovation process and uncertainties in resource-constrained environments : A case from the water service sector in East Africa

Innovation processes face significant and not well-understood uncertainties in resource-constrained environments in developing countries. Through a case study of a water innovation process focused on Kenya, this article studies the prevailing uncertainties and management principles. With the help of a framework that combines information on technological, organizational, commercial and social aspects, our study identifies uncertainties in four distinctive stages of resource-constrained innovation: (1) Ideation and conceptualization, (2) Learning-based product and business development, (3) Scrutinized product and business development and (4) Commercialization. We recognize three principles required to manage uncertainties and develop successful resource-constrained innovations: (1) the utilization of versatile research and development approaches, (2) building internal acceptability, trust and legitimacy and (3) leveraging range of partnerships and networks to access complementary resources and capabilities in different process stages. Our findings suggest that management of uncertainties requires proactive utilization of partner networks and context-specific strategies in different stages. With this research, we contribute to the understanding of innovation processes by advancing process-based knowledge of water innovation, uncertainties and related management strategies in resource-constrained environments.Peer reviewe

Efficient numerical methods for strongly anisotropic elliptic equations

International audienc

GAD65 antigen therapy in recently diagnosed type 1 diabetes mellitus

BACKGROUND: The 65-kD isoform of glutamic acid decarboxylase (GAD65) is a major autoantigen in type 1 diabetes. We hypothesized that alum-formulated GAD65 (GAD-alum) can preserve beta-cell function in patients with recent-onset type 1 diabetes. METHODS: We studied 334 patients, 10 to 20 years of age, with type 1 diabetes, fasting C-peptide levels of more than 0.3 ng per milliliter (0.1 nmol per liter), and detectable serum GAD65 autoantibodies. Within 3 months after diagnosis, patients were randomly assigned to receive one of three study treatments: four doses of GAD-alum, two doses of GAD-alum followed by two doses of placebo, or four doses of placebo. The primary outcome was the change in the stimulated serum C-peptide level (after a mixed-meal tolerance test) between the baseline visit and the 15-month visit. Secondary outcomes included the glycated hemoglobin level, mean daily insulin dose, rate of hypoglycemia, and fasting and maximum stimulated C-peptide levels. RESULTS: The stimulated C-peptide level declined to a similar degree in all study groups, and the primary outcome at 15 months did not differ significantly between the combined active-drug groups and the placebo group (P=0.10). The use of GAD-alum as compared with placebo did not affect the insulin dose, glycated hemoglobin level, or hypoglycemia rate. Adverse events were infrequent and mild in the three groups, with no significant differences. CONCLUSIONS: Treatment with GAD-alum did not significantly reduce the loss of stimulated C peptide or improve clinical outcomes over a 15-month period. (Funded by Diamyd Medical and the Swedish Child Diabetes Foundation; ClinicalTrials.gov number, NCT00723411.)