Objective: This study aims to assess the comparative effectiveness of a conventional splitting needle or a peelable cannula vs. the modified Seldinger technique (MST) by utilizing a dedicated micro-insertion kit across various clinically significant metrics, including insertion success, complications, and catheter-related infections. Methods: We conducted a retrospective observational cohort study using an anonymized data set spanning 3 years (2017-2019) in a large tertiary-level neonatal intensive care unit in Qatar. Results: A total of 1,445 peripherally inserted central catheter (PICC) insertion procedures were included in the analysis, of which 1,285 (89%) were successful. The primary indication for insertion was mainly determined by the planned therapy duration, with the saphenous vein being the most frequently selected blood vessel. The patients exposed to MST were generally younger (7 ± 15 days vs. 11 ± 26 days), but exhibited similar mean weights and gestational ages. Although not statistically significant, the MST demonstrated slightly higher overall and first-attempt insertion success rates compared to conventional methods (91 vs. 88%). However, patients undergoing conventional insertion techniques experienced a greater incidence of catheter-related complications (p < 0.001). There were 39 cases of catheter-related bloodstream infections (CLABSI) in the conventional group (3.45/1,000 catheter days) and eight cases in the MST group (1.06/1,000 catheter days), indicating a statistically significant difference (p < 0.001). Throughout the study period, there was a noticeable shift toward the utilization of the MST kit for PICC insertions. Conclusion: The study underscores the viability of MST facilitated by an all-in-one micro kit for neonatal PICC insertion. Utilized by adept and trained inserters, this approach is associated with improved first-attempt success rates, decreased catheter-related complications, and fewer incidences of CLABSI. However, while these findings are promising, it is imperative to recognize potential confounding factors. Therefore, additional prospective multicenter studies are recommended to substantiate these results and ascertain the comprehensive benefits of employing the all-in-one kit.
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Sustainable consumption is interlinked with sustainable production. This chapter will introduce the closed-loop production, the circular economy, the steady state economy, and Cradle to Cradle (C2C) models of production. It will reflect on the key blockages to a meaningful sustainable production and how these could be overcome, particularly in the context of business education. The case study of the course for bachelor’s students within International Business Management Studies (IBMS) program at three Universities of Applied Science (vocational schools), and at Leiden University College in The Netherlands will be discussed. Student teams from these schools were given the assignment to make a business plan for a selected sponsor company in order to advise them how to make a transition from a linear to circular economy model. These case studies will illustrate the opportunities as well as potential pitfalls of the closed loop production models. The results of case studies’ analysis show that there was a mismatch between expectations of the sponsor companies and those of students on the one hand and a mismatch between theory and practice on the other hand. The former mismatch is explained by the fact that the sponsor companies have experienced a number of practical constraints when confronted with the need for the radical overhaul of established practices within the entire supply chain and students have rarely considered the financial viability of the "ideal scenarios" of linear-circular transitions. The latter mismatch applies to what students had learned about macro-economic theory and the application through micro-economic scenarios in small companies. https://www.springer.com/gp/book/9783319656076 LinkedIn: https://www.linkedin.com/in/helenkopnina/
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Creative SMEs are heavily focusing on the creating process designing new products and services. Consequently, their managers tend to loose contact with crucial management issues. Especially their knowledge of the financial aspects of their business can be so limited that they fail to connect with the financial viability of their business, which can lead to serious business problems. This paper draws on a number of studies that examine the role of outsiders -contracted professional service providers- in relation to business success of SMEs. In the light of the potential growth of Flemish creative SMEs on international markets the question can be raised as to what extent outsiders, and more specifically financial service providers like accountants and banks, contribute to the export success of these firms. In this paper therefore the role played by accountants and banks was explored to solve export-related questions by small furniture designers in Flanders, Belgium. Export can be considered as the most successful growth and therefore raises interesting management issues for creative SMEs. Little is known about the content and intensity of services of accountants and bank employees in relation to export-related questions of owner-managers of small creative firms. In order to examine the fit between supply and demand the focus is on outsider contribution during six phases of export.
