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Future probing

Digital technologies permeate and transform organisational practices. As a society, we need means to explore the uncharted terrain that lies ahead and the desirability and consequences of possible courses of action to move forward. We investigate a design approach, called ‘future probing’, to envision and critically analyse possible futures around digital technologies. We first reconstruct our journey and describe related insights on the process, content and context level. Reflecting on the journey, we then extract a key insight revolving around the challenge for participants to link back from exploring the future to their present practice. In a first attempt at theorizing these difficulties, we see future probing as a practice that opens up adaptive space (Uhl-Bien & Arena, 2017) in which people from different backgrounds engage in dialogue about possible futures of digital technologies. We found that adaptive processes, like semi structuring, temporary decentralisation, and collaboration (Uhl-Bien & Arena, 2018) were supported by the future probing practices and seemed to create space for employees to engage in exploration. There was still a lack of compelling acts of brokering and network cohesion (Uhl-Bien & Arena, 2018). This may indicate why linking back to daily practice is challenging. We assume that organising for adaptability requires a deliberate act of connecting far future explorations with present action, and propose that besides explorative skills, ‘adaptive anticipating’ action is needed to make the connection and that linking back through near future experiments might be a way to achieve this.

Pragmatic research tactics for starting IT engineers

Peer reviewed research paper SEFI Engineering Education congress 2018 Within higher engineering education, students have to learn to close knowledge gaps that arise in professional assignments, such as capstone projects. These knowledge gaps can be closed through simple inquiry, but can also require more rigorous research. Since professionals work under tight constraints, they face constant trade-offs between quality, risk and efficiency to find answers that are acceptable. This means engineers use pragmatic research tactics that aim for the highest chance to find answers that fit sufficiently to close knowledge gaps in order to solve the problem with optimal use of time and resources. The problem is that research and problem-solving literature richly supplies solid strategies suitable to plan the research in projects as a whole, but hardly supplies flexible tactics to search for information within a project. This paper reports pragmatic tactics that starting bachelor engineering professionals use to acquire sufficiently good answers to questions that arise in the context of their assignments. For this, we conducted semi-structured interviews among computer science engineers with three to five years of work experience. The study reveals three pragmatic tactics: concentric, iterative and probe-response. The ambition level of the project determines when questions are sufficiently answered, and we distinguish tree sufficiency levels: check for viable answer, boost critical demand and change the game. The aim of this research is to add a view that makes pragmatic research choices for novice engineers more open to discussion and realistic.

Effectiveness of a combined lifestyle intervention using dietary counselling and resistance exercise in obese older adults with type 2 diabetes (the PROBE study)

Should the ultrasound probe replace your stethoscope?

BACKGROUND: In critically ill patients, auscultation might be challenging as dorsal lung fields are difficult to reach in supine-positioned patients, and the environment is often noisy. In recent years, clinicians have started to consider lung ultrasound as a useful diagnostic tool for a variety of pulmonary pathologies, including pulmonary edema. The aim of this study was to compare lung ultrasound and pulmonary auscultation for detecting pulmonary edema in critically ill patients.METHODS: This study was a planned sub-study of the Simple Intensive Care Studies-I, a single-center, prospective observational study. All acutely admitted patients who were 18 years and older with an expected ICU stay of at least 24 h were eligible for inclusion. All patients underwent clinical examination combined with lung ultrasound, conducted by researchers not involved in patient care. Clinical examination included auscultation of the bilateral regions for crepitations and rhonchi. Lung ultrasound was conducted according to the Bedside Lung Ultrasound in Emergency protocol. Pulmonary edema was defined as three or more B lines in at least two (bilateral) scan sites. An agreement was described by using the Cohen κ coefficient, sensitivity, specificity, negative predictive value, positive predictive value, and overall accuracy. Subgroup analysis were performed in patients who were not mechanically ventilated.RESULTS: The Simple Intensive Care Studies-I cohort included 1075 patients, of whom 926 (86%) were eligible for inclusion in this analysis. Three hundred seven of the 926 patients (33%) fulfilled the criteria for pulmonary edema on lung ultrasound. In 156 (51%) of these patients, auscultation was normal. A total of 302 patients (32%) had audible crepitations or rhonchi upon auscultation. From 130 patients with crepitations, 86 patients (66%) had pulmonary edema on lung ultrasound, and from 209 patients with rhonchi, 96 patients (46%) had pulmonary edema on lung ultrasound. The agreement between auscultation findings and lung ultrasound diagnosis was poor (κ statistic 0.25). Subgroup analysis showed that the diagnostic accuracy of auscultation was better in non-ventilated than in ventilated patients.CONCLUSION: The agreement between lung ultrasound and auscultation is poor.TRIAL REGISTRATION: NCT02912624. Registered on September 23, 2016.

Exploring posters as a probing tool to engage nurses in a development process

from the article: "In this paper, we explore the characteristics of posters as an efficient and effective probing tool for hospital nurse participation in the development of processes, services or products. The main challenge in this respect is the limited time and attention available to nurses during their work shifts. For this, we analysed the design and effectiveness of posters from earlier projects and used existing knowledge on probing for preliminary guidelines focused on design elements, context of placement, and fit with work process. We then designed a poster for gathering insights during nurses’ work shifts into their administrative tasks and perceived relevance. To evaluate, this table poster design was consecutively placed on three nursing units in a Dutch hospital. Activities of nurses with the poster and necessary interventions were analysed and used for further insights into the characteristics of effective posters for this specific target group. The research raised new questions about how best to elicit nurses’ participation during work shifts."

Obese older Type 2 Diabetes Mellitus patients with muscle insulin resistance benefit from an enriched protein drink during combined lifestyle intervention

(1) Background: Recent research showed that subtypes of patients with type 2 diabetes may differ in response to lifestyle interventions based on their organ-specific insulin resistance (IR). (2) Methods: 123 Subjects with type 2 diabetes were randomized into 13-week lifestyle intervention, receiving either an enriched protein drink (protein+) or an isocaloric control drink (control). Before and after the intervention, anthropometrical and physiological data was collected. An oral glucose tolerance test was used to calculate indices representing organ insulin resistance (muscle, liver, and adipose tissue) and β-cell functioning. In 82 study-compliant subjects (per-protocol), we retrospectively examined the intervention effect in patients with muscle IR (MIR, n = 42) and without MIR (no-MIR, n = 40). (3) Results: Only in patients from the MIR subgroup that received protein+ drink, fasting plasma glucose and insulin, whole body, liver and adipose IR, and appendicular skeletal muscle mass improved versus control. Lifestyle intervention improved body weight and fat mass in both subgroups. Furthermore, for the MIR subgroup decreased systolic blood pressure and increased VO2peak and for the no-MIR subgroup, a decreased 2-h glucose concentration was found. (4) Conclusions: Enriched protein drink during combined lifestyle intervention seems to be especially effective on increasing muscle mass and improving insulin resistance in obese older, type 2 diabetes patients with muscle IR.