Firms and markets that profit from investment in design and product development

This paper concerns a study which aimed to identify: (a) how returns from investments in design and product development vary with the types of market in which a firm operates; (b) the long-term benefits of investment in product design and innovation. The study built upon an earlier research project, which involved a survey of design and product development projects in 221 SMEs which had received some government support for design. This paper focuses on the results of a longitudinal, follow-up survey of a sample of 42 firms and projects, 8–9 years after the original study. • The firms which had grown in turnover operated in growing markets and had typically developed innovative or niche products, while the declining firms generally operated in static or declining markets in which they had many competitors. • The fast growing firms employed a statistically significantly higher proportion of RD&D staff; used external expertise for product development more often; and introduced new products more frequently, than the slow-growing or declining firms. • All the growing firms had managers with a positive attitude towards design and innovation and increased their investment in RD&D during the recession, while most managers in the declining firms had a narrow and limited understanding of the contribution of design and reduced their investment. • Since the earlier survey, performance, quality and price remain the key factors in product competition, although there is evidence of price and delivery becoming relatively more important – consistent with trends since the late 1980s in which firms increasingly have to compete on price and service as well as on product quality and design. • SME managers and designers are now aware that multiple factors should be considered when designing a product but, given the differences in the commercial performance of the products, probably not all firms were equally effective in ensuring that these factors were actually taken into account. These findings support previous research that business success and investment in design and product development are likely to be mutually reinforcing, while poor financial performance and a failure to invest can lead to a cycle of decline

Postsurgical pain outcome of vertical and transverse abdominal incision: Design of a randomized controlled equivalence trial [ISRCTN60734227]

BACKGROUND: There are two ways to open the abdominal cavity in elective general surgery: vertically or transversely. Various clinical studies and a meta-analysis have postulated that the transverse approach is superior to other approaches as regards complications. However, in a recent survey it was shown that 90 % of all abdominal incisions in visceral surgery are still vertical incisions. This discrepancy between existing recommendations of clinical trials and clinical practice could be explained by the lack of acceptance of these results due to a number of deficits in the study design and analysis, subsequent low internal validity, and therefore limited external generalisability. The objective of this study is to address the issue from the patient's perspective. METHODS: This is an intraoperatively randomized controlled observer and patient-blinded two-group parallel equivalence trial. The study setting is the Department of General-, Visceral-, Trauma Surgery and Outpatient Clinic of the University of Heidelberg, Medical School. A total of 172 patients of both genders, aged over 18 years who are scheduled for an elective abdominal operation and are eligible for either a transverse or vertical incision. To show equivalence of the two approaches or the superiority of one of them from the perspective of the patient, a primary endpoint is defined: the pain experienced by the patient (VAS 0–100) on day two after surgery and the amount of analgesic required (piritramide [mg/h]). A confidence interval approach will be used for analysis. A global α-Level of 0.05 and a power of 0.8 is guaranteed, resulting in a size of 86 patients for each group. Secondary endpoints are: time interval to open and close the abdomen, early-onset complications (frequency of burst abdomen, postoperative pulmonary complications, and wound infection) and late complications (frequency of incisional hernias). Different outcome variables will be ranked by patients and surgeons to assess the relevance of possible endpoints from the patients' and surgeons' perspective. CONCLUSION: This is a randomized controlled observer and patient-blinded two-group parallel trial to answer the question if the transverse abdominal incision is equivalent to the vertical one due to the described endpoints

Gantz Neues Reiß Büchlein Vor die Kunstliebende Jugend = Libellus linearis picturæ in gratiam Inventutis novissimè in lucem ... / gezeichnet von Johann Zacharias Reidel Mahler in Augspurg. Casper Rad excudit

GANTZ NEUES REISS BÜCHLEIN VOR DIE KUNSTLIEBENDE JUGEND = LIBELLUS LINEARIS PICTURÆ IN GRATIAM INVENTUTIS NOVISSIMÈ IN LUCEM ... / GEZEICHNET VON JOHANN ZACHARIAS REIDEL MAHLER IN AUGSPURG. CASPER RAD EXCUDIT Gantz Neues Reiß Büchlein Vor die Kunstliebende Jugend = Libellus linearis picturæ in gratiam Inventutis novissimè in lucem ... / gezeichnet von Johann Zacharias Reidel Mahler in Augspurg. Casper Rad excudit (1) Einband (1) Kupfertitel (4) Gants Neues Reiß Büchlein Vor die Kunstliebende Jugend (6