Influential factors of aligning Spotify squads in mission-critical and offshore projects – a longitudinal embedded case study

Changing the development process of an organization is one of the toughest and riskiest decisions. This is particularly true if the known experiences and practices of the new considered ways of working are relative and subject to contextual assumptions. Spotify engineering culture is deemed as a new agile software development method which increasingly attracts large-scale organizations. The method relies on several small cross-functional self-organized teams (i.e., squads). The squad autonomy is a key driver in Spotify method, where a squad decides what to do and how to do it. To enable effective squad autonomy, each squad shall be aligned with a mission, strategy, short-term goals and other squads. Since a little known about Spotify method, there is a need to answer the question of: How can organizations work out and maintain the alignment to enable loosely coupled and tightly aligned squads? In this paper, we identify factors to support the alignment that is actually performed in practice but have never been discussed before in terms of Spotify method. We also present Spotify Tailoring by highlighting the modified and newly introduced processes to the method. Our work is based on a longitudinal embedded case study which was conducted in a real-world large-scale offshore software intensive organization that maintains mission-critical systems. According to the confidentiality agreement by the organization in question, we are not allowed to reveal a detailed description of the features of the explored project

Investigation of Complexity and regulatory role of physiological activities during a pacing exercise

Existing physiological control fatigue models propose that there may be a regulator in the central nervous system which modulates our daily physical activity. Within limits, this regulator ensures physical activity is completed without physiological system failure through interactive communications between the peripheral systems and the central systems. The ability of the central nervous system to regulate exercise is vital to optimise sport performance when severe intensity exercise might be required for prolonged or frequent periods. Based on mathematical models, this investigation explores the complex relationship between some of the mechanisms controlling physical activity and behaviour. In order to analyse the system control mechanisms, heart rate, volume of oxygen consumption and power output were measured for ten well-trained male cyclists. Using power spectrum analysis, fractal analysis, recurrence quantification techniques and continuous wavelet transforms, we show that the system control mechanisms regulating physiological systems, have distinct complexity. Moreover, the potential central controller uses specific frequency bands simultaneously to control and communicate with the various physiological systems. We show that pacing trials are regulated by different physiological systems

Barriers to Quality Perioperative Care Delivery in Low- and Middle-Income Countries: A Qualitative Rapid Appraisal Study

BACKGROUND: Provision of timely, safe, and affordable surgical care is an essential component of any high-quality health system. Increasingly, it is recognized that poor quality of care in the perioperative period (before, during, and after surgery) may contribute to significant excess mortality and morbidity. Therefore, improving access to surgical procedures alone will not address the disparities in surgical outcomes globally until the quality of perioperative care is addressed. We aimed to identify key barriers to quality perioperative care delivery for 3 “Bellwether” procedures (cesarean delivery, emergency laparotomy, and long-bone fracture fixation) in 5 low- and middle-income countries (LMICs). METHODS: Ten hospitals representing secondary and tertiary facilities from 5 LMICs were purposefully selected: 2 upper-middle income (Colombia and South Africa); 2 lower-middle income (Sri Lanka and Tanzania); and 1 lower income (Uganda). We used a rapid appraisal design (pathway mapping, ethnography, and interviews) to map out and explore the complexities of the perioperative pathway and care delivery for the Bellwether procedures. The framework approach was used for data analysis, with triangulation across different data sources to identify barriers in the country and pattern matching to identify common barriers across the 5 LMICs. RESULTS: We developed 25 pathway maps, undertook >30 periods of observation, and held >40 interviews with patients and clinical staff. Although the extent and impact of the barriers varied across the LMIC settings, 4 key common barriers to safe and effective perioperative care were identified: (1) the fragmented nature of the care pathways, (2) the limited human and structural resources available for the provision of care, (3) the direct and indirect costs of care for patients (even in health systems for which care is ostensibly free of charge), and (4) patients’ low expectations of care. CONCLUSIONS: We identified key barriers to effective perioperative care in LMICs. Addressing these barriers is important if LMIC health systems are to provide safe, timely, and affordable provision of the Bellwether procedures