How to overcome barriers for innovations in organizations from the public sector – Local governments for the future

The barriers for innovations in organizations from the public sector, particularly local administration (cities, municipalities) are of highest relevance today with strong implications for the future. Capacity for innovation is recognized as a crucial factor for the development and survival of modern organizations. Already now the public sector must compete for funding, interest and good image according to the same rules as the private companies and this trend seems to strengthen. Cities deal with large, complex problems, which require innovative thinking. The problem is the lack of capacity to generate new solutions and, as a result, there are not enough non-standard strategies and groundbreaking ideas that could help produce prospect and success. Three research questions were set for the study: 1/ What are the main barriers for innovations in the local administration? 2/ What are the main drivers for innovations in the local administration? 3/ What kind of measures would help the local organizations to reduce these barriers? The research material and data collected during interviews with administrators, policy makers and researchers were analyzed with Causal Layered Analysis (CLA) and through the lenses of the three-dimensional system (mechanic, dynamic, organic). As a result, four visions of the future of the organizations from the public sector, five systemic barriers and four drivers for innovations were extracted. The visions are: 1) Locked Tower – the system with predominant mechanistic dimension; 2) Turtle in the City, with the organic dimension present to a bigger extent than in a previous one; 3) The Ice is Cracking – with the balance between mechanistic and organic dimension, the dynamic dimension appears; 4) Open and Fearless – the system with predominant dynamic dimension – emerging but aspirational at the moment. The study revealed that the hierarchical structure, fear of mistakes, old-school managers, who control and supervise but lack trust in their employees, as well as fragmented communication and too rigorous planning (i.e. lack of flexibility) are the key barriers that should be limited or removed if the cities want to be innovative, more prosperous and successful in the future. On the other hand, there several ways in which the public sector could improve its innovativeness and competitiveness. They are: investing in human resources, encouraging the experimenting culture, supporting brave leaders with vision and commitment and promoting the division of work that allows more time for brainstorming and implementing instead of planning and reporting. In the conclusion, the study provided the diagnosis of the barriers for innovations in the organizations from the public sector, more precisely in the city administration, and a set of recommendations on how to improve the situation.siirretty Doriast

Promoting the health and wellbeing of children: A feasibility study of a digital tool among professionals

The foundations of children's health and wellbeing are laid in early childhood. A gamified app (EmpowerKids tool) was designed to support professionals to have discussions with 6- to 12-year-olds from low-income families about their health and wellbeing. The aim of this feasibility study was to evaluate the usability and acceptability of the tool from the perspective of professionals in social, health and education settings. The study was conducted using a one-group post-test-only design. The usability data were collected using System Usability Scale and the acceptability data were collected using an open-ended questionnaire distributed to professionals (n = 24) in Estonia, Finland and Latvia. The data were collected during two phases. The tool was modified further on the basis of the results. The total usability scores were 82/100 (first testing) and 84/100 (second testing), indicating excellent usability. The answers related to acceptability were divided into four categories: suitability for the context; satisfaction and quality; attractiveness; modification needs. The professionals perceived that the tool helped them to build an overall picture of a child's health and wellbeing, and to gain information about the child's individual needs. The requirements for modification detected during the first testing were mostly related to difficulties with textual expressions and graphics. No major modification requirements were expressed during the second testing. The tool is considered feasible and may be used by professionals from different settings to support children's health and wellbeing. Further studies are needed to evaluate the effectiveness of the tool from the perspective of child outcomes.</p

Healthy Cities Phase V evaluation: further synthesizing realism

In this article we reflect on the quality of a realist synthesis paradigm applied to the evaluation of Phase V of the WHO European Healthy Cities Network. The programmatic application of this approach has led to very high response rates and a wealth of important data. All articles in this Supplement report that cities in the network move from small-scale, time-limited projects predominantly focused on health lifestyles to the significant inclusion of policies and programmes on systems and values for good health governance. The evaluation team felt that, due to time and resource limitations, it was unable to fully exploit the potential of realist synthesis. In particular, the synthetic integration of different strategic foci of Phase V designation areas did not come to full fruition. We recommend better and more sustained integration of realist synthesis in the practice of Healthy Cities in future Phase

Health Data Sharing Governance - the Voice of European Experts Interviewed

This article presents a summary of the main conclusions from 14 interviews with European experts, towards the creation of European guidelines on data sharing governance models and best practices, within the work carried out in the DigitalHealthEurope (DHE) H2020 project on Citizen-controlled data governance and data sharing. The overall work was broad and collected different stakeholders' opinions and visions on the theme by a large online survey, desk research and through public events, as well as a set of personal interviews, which are the specific outcome under analysis in the present article. The answers were gathered, clustered and analysed to understand the main trends, difficulties and best practices around Europe, the governance models currently in use and, in particular, how they guarantee the security and the privacy around citizens' data in order to build and maintain trust. Also, the incentive models used to engage with citizens, considering public and private initiatives' latest offers for consumers available on the market were studied. The key research questions underlying the process of information collection and the design of the inquiries concerned the policy and societal framework that leads to the need for citizen-centred governance models; the ways through which citizen-led data governance models, such as health cooperatives, can respond to current control challenges; lessons to be learned from data sharing initiatives that can be capitalised for health data campaigns; and finally the best practices and initiatives that may be used as reference for benchmarking, adaptation and adoption. The interviews and preliminary reports took place in 2020, accompanying the overall discussion and developments around the European Data Strategy and European Health Data Space

Enne­nai­kaisten kuolemien aiheuttamat elinvuosien menetykset pohjoisen ulottuvuuden kumppa­nuus­maissa 2003–13

Lähtö­kohdat: Täs­sä tutki­muk­sessa tarkas­tellaan ehkäis­tä­vissä olevien enne­nai­kaisten kuo­lemien ta­kia mene­tet­tyjä elin­vuosia Suo­messa ja seitse­mässä muus­sa poh­joisen ulot­tu­vuuden kumppa­nuus­maassa. Mene­telmät: Enne­nai­kai­seksi kuole­maksi määri­teltiin en­nen 70 ikä­vuotta tapah­tunut kuo­lema. Mene­tetyt elin­vuodet las­kettiin ikä­va­kioi­dusti 100 000 hen­kilöä koh­ti vuo­sina 2003, 2009 ja 2013. Tu­lokset: Eniten elin­vuosia mene­tettiin vuon­na 2013 Valko-Ve­nä­jällä, 9 851/100 000, ja vä­hiten Ruot­sissa, 2 511/100 000. Suo­messa me­netys oli 3 115/100 000 eli yh­teensä noin 170 000 elin­vuotta. Nais­ten mene­tetyt elin­vuodet olivat Suo­messa sa­malla ta­solla kuin Ruot­sissa, mut­ta mie­hillä mene­tykset olivat suu­remmat. Eniten mene­tet­tyjä elin­vuosia aiheut­tivat ul­koiset syyt, toi­seksi eniten syö­vät ja kolman­neksi eniten veren­kier­toe­linten sai­raudet. Alko­ho­li­kuo­lemien ta­kia mene­te­tyissä elin­vuo­sissa oli suurim­millaan yli 10-ker­tainen ero; Suo­mi si­joittui kes­kiarvon huonom­malle puo­lelle. Enne­nai­kai­sesti mene­tet­tyjen elin­vuosien mää­rä vä­heni kai­kissa tutki­mukseen osal­lis­tu­neissa mais­sa vuo­desta 2003 vuo­teen 2013. Pää­telmät: Vertai­lussa Suo­mi si­joittuu hy­vin syö­pien ja sy­dän- ja veri­suo­ni­tautien aiheut­taman enne­nai­kaisen kuollei­suuden ehkäi­syssä, mut­ta itse­murhien ehkäi­syssä ja eri­tyi­sesti alko­holin aiheut­tamien kuo­lemien ­vä­hen­tä­mi­sessä hei­kommin. Mies­ten ja nais­ten enne­nai­kaisen kuollei­suuden ta­kia mene­te­tyissä elin­vuo­sissa on Suo­messa huomat­tavan suu­ri ero

Helicobacter pylori infection. Diagnosis and treatment

Helicobacter pylori infection is common. The World Health Organization estimates that about 70% of people in developing countries and 30% in developed countries are infected with this bacterium. The infection spreads through personal contacts via an oral-oral, gastro-oral and faecal-oral route of transmission. Helicobacter pylori infection is asymptomatic in 80–90% of cases. Both invasive and non-invasive methods are used in the diagnosis of this infection. The choice of the method depends on the current clinical condition and the necessity to perform endoscopy of the upper gastrointestinal tract. Since the incidence and prevalence of Helicobacter pylori infection are high, H. pylori detection tests should be performed only when eradication therapy is  planned. According to the  guidelines of  the Working Group of  the Polish Society of Gastroenterology, eradication treatment involves a multidrug therapy with proton pump inhibitors, antibiotics and bismuth citrate. All of these drugs should be used for a period of 10–14 days. Clarithromycin should not be used as the first choice treatment because of increasing resistance in Poland. A breath test is an optimal way to evaluate the effectiveness of the antibacterial therapy but is rarely performed due to high price and low availability. Serology tests are available and cheap, but are not suitable to assess the efficacy of eradication. Helicobacter pylori antigen detection in stool is therefore important in the diagnosis. The test is not very expensive, available and characterised by very high sensitivity and specificity of up to 90%

SHAFE Mapping on Social Innovation Ecosystems

There have been several initiatives aiming to promote innovation and support stakeholders to increase investments in relevant societal areas connected to Smart Healthy Age-Friendly Environments&mdash;SHAFE. However, their impact usually runs shorter than desirable in the mid- and long-term due to the difficulty to identify, map, and connect stakeholders in the different European and world countries that are willing to work for the practical implementation of social innovation around SHAFE. This mapping and connection can contribute to increase awareness of innovation actors on social innovation concepts and, if well disseminated, may also leverage the creation of alliances and synergies between different stakeholders within ecosystems and between ecosystems. Understanding what relevant practices exist, how they are funded, and how they involve citizens and organisations is also key to ensure that business actors have access to social innovation and entrepreneurial knowledge, which is key for future sustainable societal change. The present study developed and implemented a survey replied by 61 organisations from 28 different countries. The results showed relevant inputs regarding different cultural and societal perceptions, including diverse end-user organisations, and will, thus, facilitate multistakeholder engagement, public awareness, and the overall upscaling of social innovation on SHAFE

Right ventricular myocardial oxygen tension is reduced in monocrotaline-induced pulmonary hypertension in the rat and restored by myo-inositol trispyrophosphate

International audienceAbstract Pulmonary hypertension (PH) initially results in compensatory right ventricular (RV) hypertrophy, but eventually in RV failure. This transition is poorly understood, but may be triggered by hypoxia. Measurements of RV oxygen tension (pO 2 ) in PH are lacking. We hypothesized that RV hypoxia occurs in monocrotaline-induced PH in rats and that myo-inositol trispyrophosphate (ITPP), facilitating oxygen dissociation from hemoglobin, can relieve it. Rats received monocrotaline (PH) or saline (control) and 24 days later echocardiograms, pressure–volume loops were obtained and myocardial pO 2 was measured using a fluorescent probe. In PH mean pulmonary artery pressure more than doubled (35 ± 5 vs. 15 ± 2 in control), RV was hypertrophied, though its contractility was augmented. RV and LV pO 2 was 32 ± 5 and 15 ± 8 mmHg, respectively, in control rats. In PH RV pO 2 was reduced to 18 ± 9 mmHg, while LV pO 2 was unchanged. RV pO 2 correlated with RV diastolic wall stress (negatively) and LV systolic pressure (positively). Acute ITPP administration did not affect RV or LV pO 2 in control animals, but increased RV pO 2 to 26 ± 5 mmHg without affecting LV pO 2 in PH. RV oxygen balance is impaired in PH and as such can be an important target for PH therapy. ITPP may be one of such potential therapies

Porównanie pośrednie wyników leczenia chorych na zaawansowane/przerzutowe czerniaki za pomocą niwolumabu lub pembrolizumabu — analiza wieloośrodkowa

Wstęp. Rozwój nowej klasy leków — inhibitorów punktów kontrolnych — zmienił rokowanie u chorych na nowotwory. Szczególną klasę leków stanowią przeciwciała przeciwko receptorowi programowanej śmierci komórki typu 1/ligandowi programowanej śmierci komórki typu 1 (niwolumab i pembrolizumab). Nie ma jednak badań z losowym doborem chorych, które porównywałyby bezpośrednio niwolumab i pembrolizumab. Ze względu na rozwój immunoterapii i wiele nowych rejestracji dla anty-PD-1 wskazane jest określenie, czy istnieją różnice w zakresie skuteczności i bezpieczeństwa w stosowaniu niwolumabu i pembrolizumabu. Materiał i metoda. Do badania włączono 499 chorych na nieoperacyjnego lub przerzutowego czerniaka, leczonych w latach 2016–2019 w pięciu referencyjnych ośrodkach onkologicznych w Polsce (Kraków, Gliwice, Lublin, Poznań, Wrocław). Kryterium włączenia do badania było leczenie w pierwszej linii za pomocą przeciwciał anty-PD-1 (niwolumab lub pembrolizumab). Wyniki. Mediany czasu przeżycia całkowitego (OS) i czasu przeżycia wolnego od progresji choroby (PFS) w całej badanej grupie wyniosły odpowiednio 19,9 i 7,9 miesiąca. Estymowane mediany OS i PFS wyniosły dla niwolumabu i pembrolizumabu odpowiednio 20,1 i 18,1 miesiąca oraz 8,5 i 6,0 miesięcy. Nie wykazano znamiennie statystycznej różnicy w zakresie median OS i PFS w grupach chorych otrzymujących niwolumab i pembrolizumab [odpowiednio p = 0,6291 (HR = 1,06; Cl 95% 0,8–1,4) i p = 0,0956 (HR = 1,20; Cl 95% 0,97–1,48)]. Odsetek działań niepożądanych związanych z układem immunologicznym (irAEs) w stopniu G3 i/lub G4 był podobny w grupach leczonych niwolumabem lub pembrolizumabem (odpowiednio 5,8 i 5,2%). Wnioski. Nie znaleziono różnic w zakresie OS, PFS oraz wskaźników obiektywnej odpowiedzi na leczenie (ORR) pomiędzy terapią niwolumabem a pembrolizumabem u wcześniej nieleczonych chorych na zaawansowanego/ rozsianego czerniaka. Nie wykazano różnic w zakresie częstości irAEs w stopniu G3 lub G4. Wybór leczenia określonym preparatem powinien się opierać na preferencjach chorego oraz klinicysty