A VSA-SS Approach to Healthcare Service Systems. The Triple Target of Efficiency, Effectiveness and Sustainability

The main purpose of this paper is to highlight the new opportunities that the Viable Systems Approach (VSA) can provide for observing complex service systems and explaining social phenomena through general schemes of interpretation. At the same time, it explores methodological links with the Service Science (SS) approach in order to propose (VSA)’s contribution to moulding a unified vision of complex objects of analysis, and to evidence the many converging elements that emerge from the two perspectives as well as the benefits that derive from different interpretation schemes. In particular, in our paper we analyze healthcare service complexity in a relational perspective, using a VSA-SS conceptual framework to interpret the emergent systems instability in the Italian Health Service. The application of principles and concepts proper to the (VSA) and the SS approaches to articulated service structures, such as healthcare, identifies critical features and interesting new “therapeutic” prospects for healthcare service systems in order to guarantee their viability. The paper proposes an innovative methodological basis for evaluating the level of appropriateness of the healthcare service and, at the same time, evidences the need for achieving a balanced triple target of efficiency, effectiveness and sustainability (EES) in healthcare service systems governance. As a result, a new area of cross fertilization for collaborative research emerges

Addressing the social and economic challenges of Orphan Drugs: a managerial perspective

The work aims to propose preliminary reflections upon a managerial view concerning the open issue of Orphan Drugs. After an overview of the scenario of Orphan Drugs at an international level and a short literature review, the work highlights a dominant economic rationality, which essentially follows a ‘linear’ logic, in the approach to frame the problem of Orphan Drugs both from a policy making and a scientific perspective. By widening the view in the framing of the problem, a more radical change appears to be required in order to overcome the dilemma of reconciling the economic and the social perspectives and be able to address the issue of Orphan Drugs accordingly. A deep rethinking of business models within the context of the worldwide engagement for a more sustainable and inclusive world is at the basis of a new Inclusive Development strategy, which is outlined as a possible pathway to reconcile the economic and social perspectives in the management of businesses

An Introduction to the Viable Systems Approach and its Contribution to Marketing

Organizations are increasingly challenged by dynamism and turbulence that determine conditions of complexity in decision making. The aim of this paper is to highlight the need for a general frame of reference for management and marketing and to justify why adopting a systems approach is adequate at both theoretical and practical level. Specifically, the purpose of this paper is to explain why a systems approach is needed to understand business and market dynamics, and why the VSA may represent a good integrator of management and marketing theories and practices. The paper begins with a brief review of systems theories that have been proposed in the general context of management and marketing. It proceeds by illustrating the fundamental principles and concepts of the VSA and its contribution to marketing. The paper closes by discussing future research avenues and suggesting implications for researchers and practitioners

Reflections on Service Systems Boundaries: A Viable Systems Perspective. The case of the London Borough of Sutton

The aim of this paper is to propose a systems interpretation of the concept of complexity and its implications for a theoretical discussion of the concept of boundary in complex service systems. The proposal highlights the interpretative contribution of a dual perspective of observation that distinguishes between a structure-based view and a systems-based view. When dealing with complexity, the phenomenon under investigation cannot be addressed through management approaches that aim to measure and control it in a vain attempt to find the best solution. Due to the inner nature of complexity, a more rewarding approach to a full understanding of problematic situations should place consolidated management models within a more general interpretation framework that suggests preliminary insights about the real nature of the investigated phenomenon. First, this paper outlines the theoretical background of the literature on service, service systems and complex service systems, providing evidence of the contribution of recent service research advances such as service science and service-dominant logic. Next, the paper focuses on the basic principles of systems thinking to introduce the Viable Systems Approach (vSa) as a general framework of reference for both the investigation and the governance of social organisations. The vSa conceptual framework is adopted for proposing some reflections from a systems perspective in the investigation of the case of the London Borough of Sutton (LBS). The focus is on interpreting the paradoxical situation of an increased fear of crime among LBS residents despite the evidence of reduction in the crime rate. Although the incidence has fallen for most types of crimes, a recent poll confirmed that crime is still rated as the most important issue for residents. Therefore, improving safety and reducing crime remain the top priorities for the Safer Sutton Partnership Service. In short, this study proposes to consider ‘‘reducing the fear of crime in a community’’ as a complex service system

AI technologies & value co-creation in luxury context

The aim of the paper is to contribute to the literature on the conceptualization of technology as an operant resource and the role of Artificial Intelligence (AI) in value co-creation processes. Resource integration and interaction determine such co-creation, however the issue pivots on whether AI is effectively able to co-create value as an operant resource. With an integrated framework based on the Service Science (SS), the Viable Systems Approach (VSA) & the Variety Information Model (VIM), the Authors show how to the various kinds of AI technology corresponds a diverse level of co-creation. Our (conceptual) study, highlights how AI (e.g. chatbot) with its client profiling capacity achieves consonance in a luxury goods context, thus interpreting customer expectations. At the same time, the man-machine virtuous circuit qualifies the shift from AI (a combination of various technologies with cognitive abilities – listening, comprehending, acting, learning and at times speaking – capable of matching human intelligence) to the more potent IA Intelligence Augmentation

Supplementation with ribonucleotide-based ingredient (Ribodiet®) lessens oxidative stress, brain inflammation, and amyloid pathology in a murine model of Alzheimer

Abstract Alzheimer's disease (AD) is the most common type of dementia worldwide, characterized by the deposition of neurofibrillary tangles and amyloid-β (Aβ) peptides in the brain. Additionally, increasing evidence demonstrates that a neuroinflammatory state and oxidative stress, iron-dependent, play a crucial role in the onset and disease progression. Besides conventional therapies, the use of natural-based products represents a future medical option for AD treatment and/or prevention. We, therefore, evaluated the effects of a ribonucleotides-based ingredient (Ribodiet®) in a non-genetic mouse model of AD. To this aim, mice were injected intracerebroventricularly (i.c.v.) with Aβ1–42 peptide (3 µg/3 μl) and after with Ribodiet® (0.1–10 mg/mouse) orally (p.o.) 3 times weekly for 21 days following the induction of experimental AD. The mnemonic and cognitive decline was then evaluated, and, successively, we have assessed ex vivo the modulation of different cyto-chemokines on mice brain homogenates. Finally, the level of GFAP, S100β, and iron-related metabolic proteins were monitored as markers of reactive gliosis, neuro-inflammation, and oxidative stress. Results indicate that Ribodiet® lessens oxidative stress, brain inflammation, and amyloid pathology via modulation of iron-related metabolic proteins paving the way for its rationale use for the treatment of AD and other age-related diseases

IL-17A neutralizing antibody regulates monosodium urate crystal-induced gouty inflammation

Gout is a paradigm of acute, self-limiting inflammation caused by the deposition of monosodium urate (MSU) crystals within intra-and/or peri-articular areas, leading to excruciating pain, joint swelling and stiffness. The infiltration of leukocytes drives the inflammatory response and remains an attractive target for therapeutic intervention. In this context, emerging evidence supports the view that systemic differentiation of Th17 cells and their in situ infiltration as one of the potential mechanisms by which these cells, and their main product IL-17, causes damage to target tissues. To test if IL-17 was having a detrimental role in gouty onset and progression we targeted this cytokine, using a neutralizing antibody strategy, in an experimental model of gout. Joint inflammation was induced in CD-1 mice by the intra-articular (i.a.) administration of MSU crystals (200 μg/20 μl). Animals from IL-17Ab-treated groups received 1, 3 and 10 μg (i.a.) in 20 μl of neutralizing antibody after MSU crystals administration. Thereafter, joints were scored macroscopically, and knee joint oedema determined with a caliper. Histological analysis, myeloperoxidase assay and western blots analysis for COX-2/mPGEs-1/IL-17R pathway were conducted at 18 h (peak of inflammation) to evaluate leukocytes infiltration and activation, followed by the analysis, in situ, of pro/anti-inflammatory cytokines and chemokines. Flow cytometry was also used to evaluate the modulation of infiltrated inflammatory monocytes and systemic Th17 and Treg profile. Treatment with IL-17Ab revealed a dose-dependent reduction of joint inflammation scores with maximal inhibition at 10 μg. The neutralizing antibody was also able to significantly reduce leukocytes infiltration and MPO activity as well the expression of JE, IL-1α, IL-1β, IL-16, IL-17, C5a, BLC and, with a less extent IP-10, Rantes, KC, TIMP-1, SDF-1 and metalloproteinases in inflamed tissues. Biochemical analysis also revealed that IL-17Ab treatment modulated COX-2/mPGEs-1 pathway (and related PGE2 production) without interfering with IL-17R expression. Furthermore, flow cytometry analysis highlighted a selective modulation of infiltrating inflammatory monocytes (B220-/GR1hi-F480hi/CD115+) and circulating Th17, but not Treg, cells after IL-17Ab treatment. Collectively the results of this study report for the first time, that i.a. injection of MSU crystals stimulates in vivo production of Th17 cells and Th17-related inflammatory cyto-chemokines. In addition, we have demonstrated that the administration of a neutralizing antibody against IL-17 attenuates joint symptoms, swelling and leukocytes infiltration to the inflamed tissue, possibly providing a new strategy for the treatment of gouty inflammation and/or arthritis