COMPARISON OF DIFFERENT AGILE METHODOLOGIES AND FIT ASSESSMENT IN AN INDUSTRIAL CONTEXT

The paper collects together and describes the main and most known Agile methodologies. Those methodologies are then compared in order to assess their fit in the context of highly innovative non-software companies. In particular, the focus is on a full system supplier for food processing and packaging equipment, packaging material and services. The fit between the Agile methodologies and the company is performed considering the innovation and development processes in place into the Research and Development department of the company itself. By doing so the paper aims at contributing to the theme of Agile application in non-software industries. Moreover, it will support in the choice of which method or framework suits better having clear the needs and characteristics of that specific context. Finally, the paper provides also a suggestion about how to approach this kind of choices

Specialistsjuksköterskors erfarenheter av evidensbaserad vård och mobilisering av patienter på intensivvårdsavdelning : En intervjustudie

Bakgrund: Specialistsjuksköterskan inom intensivvård ansvarar för att tillgodose god och säker evidensbaserad omvårdnad för olika patientkategorier. Men kontextuella faktorer, organisatoriska- sociala-, eller professionella, kan medföra utmaningar att implementera evidensbaserade arbetssätt såsom tidig mobilisering inom intensivvård.Syfte: Med utgångspunkt i tidig mobilisering av intensivvårdspatienter beskriva specialistsjuksköterskans erfarenheter av evidensbaserad vård. Metod: En intervjustudie med kvalitativ induktiv ansats genomfördes på en intensivvårdsavdelning i Mellansverige. Sju semistrukturerade intervjuer genomfördes med specialistsjuksköterskor inom intensivvård och analyserades med kvalitativ innehållsanalys. Huvudresultat: Resultatet utgjordes av två kategorier; “erfarenheter av evidensbaserad kunskap och arbetssätt utifrån mobilisering på IVA” och “faktorer som kan hindra eller underlätta evidensbaserade arbetssätt och mobilisering på IVA”.Olika uppfattningar avseende innebörden av evidens framkom, men majoriteten var samstämmiga i definitionen av evidens som forskningsbaserat och att evidensbaserade arbetssätt är viktiga för att tillgodose omvårdnad av god kvalitet. Arbetet på intensivvårdsavdelning sker i möjligaste mån evidensbaserat och vårdrutiner, vårdhandboken och vetenskapliga artiklar ansågs vara källor till evidens. Specialistsjuksköterskor hade olika åsikter angående ansvarig för mobilisering samt när det skulle utföras. Trots att mobilisering ansågs viktigt, utfördes det inte alltid. Slutsats: De hinder och underlättande faktorer till tidig mobilisering och evidensbaserad vård som framkom var relaterade till organisation, vårdpersonal och patient. Resultatet i denna studie kan öka kunskapen om hinder och underlättande faktorer för tidig mobilisering samt bidra till utveckling av systematiska arbetssätt för evidensbaserad vård inom intensivvård

Specialistsjuksköterskors erfarenheter av evidensbaserad vård och mobilisering av patienter på intensivvårdsavdelning : En intervjustudie

Bakgrund: Specialistsjuksköterskan inom intensivvård ansvarar för att tillgodose god och säker evidensbaserad omvårdnad för olika patientkategorier. Men kontextuella faktorer, organisatoriska- sociala-, eller professionella, kan medföra utmaningar att implementera evidensbaserade arbetssätt såsom tidig mobilisering inom intensivvård.Syfte: Med utgångspunkt i tidig mobilisering av intensivvårdspatienter beskriva specialistsjuksköterskans erfarenheter av evidensbaserad vård. Metod: En intervjustudie med kvalitativ induktiv ansats genomfördes på en intensivvårdsavdelning i Mellansverige. Sju semistrukturerade intervjuer genomfördes med specialistsjuksköterskor inom intensivvård och analyserades med kvalitativ innehållsanalys. Huvudresultat: Resultatet utgjordes av två kategorier; “erfarenheter av evidensbaserad kunskap och arbetssätt utifrån mobilisering på IVA” och “faktorer som kan hindra eller underlätta evidensbaserade arbetssätt och mobilisering på IVA”.Olika uppfattningar avseende innebörden av evidens framkom, men majoriteten var samstämmiga i definitionen av evidens som forskningsbaserat och att evidensbaserade arbetssätt är viktiga för att tillgodose omvårdnad av god kvalitet. Arbetet på intensivvårdsavdelning sker i möjligaste mån evidensbaserat och vårdrutiner, vårdhandboken och vetenskapliga artiklar ansågs vara källor till evidens. Specialistsjuksköterskor hade olika åsikter angående ansvarig för mobilisering samt när det skulle utföras. Trots att mobilisering ansågs viktigt, utfördes det inte alltid. Slutsats: De hinder och underlättande faktorer till tidig mobilisering och evidensbaserad vård som framkom var relaterade till organisation, vårdpersonal och patient. Resultatet i denna studie kan öka kunskapen om hinder och underlättande faktorer för tidig mobilisering samt bidra till utveckling av systematiska arbetssätt för evidensbaserad vård inom intensivvård

Value Chain vs Life Cycle Approach for Product Extensions

Abstract-The methodology presented in this paper aims at supporting the whole needs and the Stakeholder Requirements definition in product development or product extension projects. To achieve that goal, the methodology forces to take into account the relevant Stakeholders and the Product Life-Cycle phases they impact on for that product. The paper shows a practical example taken from a real product extension project where the methodology was used. Since the main inputs for product extensions usually come from the marketing department, it resulted to be very effective in broadening the perspective. Thus it ended up in a holistic list of requirements, covering the needs of all the Stakeholders. Requirements frame the development problem, hence, as more they are complete as less failure risks there are. The methodology requires further experiments in other industries to prove its generality. Nonetheless it is expected to provide great support in product extension activities by lowering failure risk and by helping in satisfying all the Stakeholder needs

Product Service System Design: How to Design Humans Application of a methodology in a PSS development with high human involvement

A three-step methodology is proposed to support development teams in product-service system (PSS) development projects. The methodology specifically addresses the problem of designing humans as part of the system. The human presence is a matter of fact when it comes to PSSs. They are the soft system delivering the service part of the PSS, which is also the most value adding for stakeholders. Furthermore many manufacturing companies are moving towards the integration of products and services. There are many structured approaches to support the design of software and tangible objects, i.e. the hard system. However there is a lack of guidance when it comes to the human presence design and integration with the hard system. The methodology aims at filling this gap. It was validated in a PSS development project within a company with a strong focus in product development. Hence it had to fit to an already in place product development framework. The findings were used to further refine the methodology. The methodology was fully applicable within that specific framework. However further validation runs are necessary to ensure its generality. The methodology will support the shift from pure manufacturer to product-service deliverer for those companies willing to change the rules of competition and to deliver more value to their customers

Prognostic Significance of Controlled Attenuation Parameter in Patients With Compensated Advanced Chronic Liver Disease.

Obesity and steatosis have been associated with liver disease progression in patients with compensated advanced chronic liver disease (cACLD) (liver stiffness measurement [LSM] ≥ 10 kPa). The controlled attenuation parameter (CAP) estimates steatosis during LSM by transient elastography. We aimed to evaluate whether CAP is associated with the development of clinically relevant events in cACLD. Consecutive patients with cACLD and CAP measurements observed between September 2013 and September 2015 were retrospectively studied. Classical decompensation and severe bacterial infections on follow-up were recorded. A predefined CAP cut-off for steatosis was used (220 dB/m; 90% sensitivity). The association among LSM, CAP, and events was assessed by univariate and multivariate Cox regression. Among the 193 patients (viral etiology = 58%; median Child score = 5; LSM = 15.1 kPa; CAP = 255 ± 62 dB/m) who were followed up in median for 18 months, 18 developed clinically relevant events (11 liver decompensation, 7 severe bacterial infections). Patients developing events had higher LSM (median: 30.8 versus 14.3 kPa, < 0.001) and showed trends for higher CAP (275 ± 46 versus 252 ± 63 dB/m, = 0.07), lower platelet count (134 ± 74 versus 167 ± 74 G/L, = 0.07), and worse liver function versus patients remaining compensated. Body mass index was similar in the two groups. All events were more frequent in patients with CAP being greater than or equal to 220 dB/m (12.9% versus 1.6% in CAP < 220; = 0.013), and 10 of 11 episodes of liver decompensation occurred in patients with CAP being greater than or equal to 220 dB/m. Following multivariate analysis, LSM and CAP greater than or equal to 220 dB/m remained independently associated with clinical events in the whole population and in patients with clinically significant portal hypertension. The CAP being greater than or equal to 220 dB/m is associated with increased risk of clinical decompensation and bacterial infections independent of LSM in patients with cACLD and allows refining the noninvasive risk stratification in this population. ( 2018; 00:000-000)

Reinfusion of highly purified CD133+ bone marrow-derived stem/progenitor cells in patients with end-stage liver disease: A phase I clinical trial

Background: Bone marrow stem/progenitor cells seem to be effective in liver regeneration after tissueinjury. Aim: To evaluate the feasibility and safety of the mobilization and reinfusion of CD133+stem/progenitorcells in patients with end-stage liver disease.Methods: Autologous CD133+stem/progenitor cells, mobilized with granulocyte-colony stimulating fac-tor, were collected by leukapheresis and reinfused at increasing doses through the hepatic artery startingfrom 5 × 104/kg up to 1 × 106/kg.Results: 16 subjects with Model for End-stage Liver Disease (MELD) score between 17 and 25 wereenrolled, 14 mobilized an adequate number of CD133+stem/progenitor cells and 12 were reinfused.No severe adverse events related to the procedure were reported. MELD score significantly worsenedduring mobilization in Child Turcotte Pugh-C patients. A significant improvement of liver function wasobserved 2 months after reinfusion (MELD 19.5 vs 16; P = 0.045). Overall, 5 patients underwent livertransplantation within 12 months from reinfusion and 2 died because of progressive liver failure.Conclusions: CD133+stem/progenitor cells reinfusion in patients with end-stage liver disease is feasi-ble and safe. A worsening of liver function was observed during mobilization in Child Turcotte Pugh-Cpatients. The temporary improvement of MELD score after reinfusion suggests that stem cells therapymay be a “bridge to transplant” approach for these patients