Driving frugal innovation in SMEs: how sustainable leadership, knowledge sources and information credibility make a difference

This study investigates the driving factors behind frugal innovation in Small and Medium-sized Enterprises (SMEs). It specifically examines sustainable leadership as an independent variable, considering its impact on frugal innovation, with sources of knowledge mediating this relationship and information credibility moderating the effects. Employing a Partial Least Squares Structural Equation Modeling (PLS-SEM) approach, data were gathered from 325 employees of SMEs in Pakistan. This methodology was chosen for its ability to handle complex relationships between multiple variables simultaneously, offering robust insights into the interplay among sustainable leadership, sources of knowledge, information credibility, and frugal innovation. The results reveal significant associations between sustainable leadership, sources of knowledge, information credibility, and frugal innovation. Sustainable leadership demonstrates a substantial influence on both sources of knowledge and frugal innovation. Furthermore, sources of knowledge play a vital role in mediating the relationship between sustainable leadership and frugal innovation. Information credibility emerges as a significant moderator, affecting the pathways between sustainable leadership, sources of knowledge, and frugal innovation. The findings underscore the importance of sustainable leadership and credible information sources in driving frugal innovation within SMEs. They highlight the intricate interdependencies among these variables and emphasize the pivotal role of information credibility in shaping these dynamics. These results carry significant implications for SMEs in Pakistan, shedding light on the mechanisms through which sustainable leadership and reliable knowledge sources can stimulate frugal innovation in emerging economies.

Task-shifting for point-of-care cervical cancer prevention in low- and middle-income countries: a case study from Uganda

Cervical cancer remains the leading cause of female cancer deaths in sub-Saharan Africa. This is despite cervical cancer being both preventable and curable if detected early and treated adequately. This paper reports on a series of action-research 'cycles' designed to progressively integrate a comprehensive, task-shifted, point-of-care, prevention program in a community-based public health facility in Uganda. The work has been undertaken through a UK-Ugandan Health Partnership coordinated by Knowledge for Change, a UK-registered Charity. The intervention demonstrates the effectiveness of task-shifting responsibility to Community Health Workers combined with the use of Geographic Information Systems to strategically guide health awareness-raising and the deployment of medical devices supporting respectful and sustainable point-of-care screen-and-treat services. The integration of this with public human immunodeficiency virus services demonstrates the ability to engage hard-to-reach 'key populations' at greatest risk of cervical cancer. The findings also demonstrate the impact of external influences including the Results Based Financing approach, adopted by many foreign Non-Governmental Organizations. The model presents opportunities for policy transfer to other areas of health promotion and prevention with important lessons for international Health partnership engagement. The paper concludes by outlining plans for a subsequent action-research cycle embracing and evaluating the potential of Artificial Intelligence to enhance service efficacy.

Frugal indigenous vessel loop made from a surgical glove

We report a simple cost effective alternative to commercially available vessel loops made from sterilized surgical gloves for retraction of vital structures during vascular trauma, micro-vascular, micro-neural surgery.

A Narrative Review of Innovative Responses During the COVID-19 Pandemic in 2020

Objectives: The coronavirus disease 2019 (COVID-19) pandemic presented unprecedented challenges to healthcare systems worldwide. While existing studies on innovation have typically focused on technology, health providers still only have a vague understanding of the features of emergency responses during resource exhaustion in the early stage of a pandemic. Thus, a better understanding of innovative responses by healthcare systems during a crisis is urgently needed. Methods: Using content analysis, this narrative review examined articles on innovative responses during the COVID-19 pandemic that were published in 2020. Results: A total of 613 statements about innovative responses were identified from 296 articles and were grouped under the following thematic categories: medical care (n = 273), workforce education (n = 144), COVID-19 surveillance (n = 84), medical equipment (n = 59), prediction and management (n = 34), and governance (n = 19). From the four types of innovative responses extracted, technological innovation was identified as the major type of innovation during the COVID-19 pandemic, followed by process innovations, frugal innovation, and repurposing. Conclusion: Our review provides insights into the features, types, and evolution of innovative responses during the COVID-19 pandemic. This review can help health providers and society show better and quicker responses in resource-constrained conditions in future pandemics.

A Wearable Soft Robotic Exoskeleton for Hip Flexion Rehabilitation

Leg motion is essential to everyday tasks, yet many face a daily struggle due to leg motion impairment. Traditional robotic solutions for lower limb rehabilitation have arisen, but they may bare some limitations due to their cost. Soft robotics utilizes soft, pliable materials which may afford a less costly robotic solution. This work presents a soft-pneumatic-actuator-driven exoskeleton for hip flexion rehabilitation. An array of soft pneumatic rotary actuators is used for torque generation. An analytical model of the actuators is validated and used to determine actuator parameters for the target application of hip flexion. The performance of the assembly is assessed, and it is found capable of the target torque for hip flexion, 19.8 Nm at 30°, requiring 86 kPa to reach that torque output. The assembly exhibits a maximum torque of 31 Nm under the conditions tested. The full exoskeleton assembly is then assessed with healthy human subjects as they perform a set of lower limb motions. For one motion, the Leg Raise, a muscle signal reduction of 43.5% is observed during device assistance, as compared to not wearing the device. This reduction in muscle effort indicates that the device is effective in providing hip flexion assistance and suggests that pneumatic-rotary-actuator-driven exoskeletons are a viable solution to realize more accessible options for those who suffer from lower limb immobility.

Linkages Between Knowledge Management Process and Corporate Sustainable Performance of Chinese Small and Medium Enterprises: Mediating Role of Frugal Innovation

In the contemporary world, frugal innovation (FI) is the most discussed area to enhance corporate sustainable performance (CSP) in manufacturing firms. The knowledge management process (KMP) is also a key determinant of FI. Existing literature is limited to knowledge management (KM) and its impact on CSP. This study aims to determine the effect of the KMP (acquisition, dissemination, and application) on sustainable corporate performance with the association of FI. The survey method was used to collect data from 356 small and medium enterprises (SMEs) in China. Structure equation modeling was applied to obtain the results of collected data. Results show that all three dimensions of KM have a significant impact on CSP. Furthermore, FI also has a significant and positive impact on CSP. Results further show that FI partially mediates the relationship of the knowledge dissemination, knowledge application and sustainable corporate performance but no mediation role FI was found between knowledge acquisition and CSP. The findings of this study will provide useful insights for experts and manufacturers. It will help to understand the role of KM in their organizational behavior by being an economical manufacturing process. This study underscored the importance of the KMP to policymakers. In countries such as China that have global orders, KM is an essential determinant of FI. KM is a tool used to achieve CSP goals inside and outside of an enterprise, thus the development firms need to focus on KM.

A comparison of the warming capabilities of two Baragwanath rewarming appliances with the Hotline fluid warming device

Background

Accidental intraoperative hypothermia is a common and avoidable adverse event of the perioperative period and is associated with detrimental effects on multiple organ systems and postoperative patient outcomes. In a resource-limited environment, prevention of intraoperative hypothermia is often challenging. Resourceful clinicians overcome these challenges through creative devices and frugal innovations.

Objectives

To investigate the thermal performance of two Baragwanath Rewarming Appliances (BaRA) against that of the Hotline device to describe an optimal setup for these devices.

Methods

This was a quasi-experimental laboratory study that measured the thermal performance of two BaRA devices and the Hotline device under a number of scenarios. Independent variables including fluid type, flow rate, warming temperature and warming transit distance were sequentially altered and temperatures measured along the fluid stream. Change in temperature (ΔT) was calculated as the difference between entry and exit temperature for each combination of variables for each warming device.

Results

A total of 219 experiments were performed. At a temperature of 43.0°C and a transit distance of 200 cm, the BaRA A configuration either matched or exceeded the ΔT of the Hotline over all fluid type and flowrate combinations. The BaRA B configuration does not provide comparable thermal performance to the Hotline. Measured flowrates were noticeably slower than manufacturer-quoted values for all intravenous (IV) cannulae used.

Conclusion

A warm-water bath at 43.0°C with 200 cm of submerged IV tubing provides thermal performance comparable to the Hotline device, with all fluid type and flowrate combinations.

Contributions of the study

The present study provides an evidence-based method for warming intravenous fluid in resource-limited scenarios.

The LeVe CPAP System for Oxygen-Efficient CPAP Respiratory Support: Development and Pilot Evaluation

Background: The COVID-19 pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has placed a significant demand on healthcare providers (HCPs) to provide respiratory support for patients with moderate to severe symptoms. Continuous Positive Airway Pressure (CPAP) non-invasive ventilation can help patients with moderate symptoms to avoid the need for invasive ventilation in intensive care. However, existing CPAP systems can be complex (and thus expensive) or require high levels of oxygen, limiting their use in resource-stretched environments. Technical Development + Testing: The LeVe ("Light") CPAP system was developed using principles of frugal innovation to produce a solution of low complexity and high resource efficiency. The LeVe system exploits the air flow dynamics of electric fan blowers which are inherently suited to delivery of positive pressure at appropriate flow rates for CPAP. Laboratory evaluation demonstrated that performance of the LeVe system was equivalent to other commercially available systems used to deliver CPAP, achieving a 10 cm H2O target pressure within 2.4% RMS error and 50-70% FiO2 dependent with 10 L/min oxygen from a commercial concentrator. Pilot Evaluation: The LeVe CPAP system was tested to evaluate safety and acceptability in a group of ten healthy volunteers at Mengo Hospital in Kampala, Uganda. The study demonstrated that the system can be used safely without inducing hypoxia or hypercapnia and that its use was well-tolerated by users, with no adverse events reported. Conclusions: To provide respiratory support for the high patient numbers associated with the COVID-19 pandemic, healthcare providers require resource efficient solutions. We have shown that this can be achieved through frugal engineering of a CPAP ventilation system, in a system which is safe for use and well-tolerated in healthy volunteers. This approach may also benefit other respiratory conditions which often go unaddressed in Low and Middle Income Countries (LMICs) for want of context-appropriate technology designed for the limited oxygen resources available.

Low-cost procedure for deformity correction in rheumatoid hands

BACKGROUND

Surgical correction of ulnar drift of metacarpo-phalangeal joint (MPJ) due to Rheumatoid arthritis (RA) is conventionally done by silicon joint arthroplasty which is expensive and may be associated with many complications. We report the outcome of low-cost autologous interpositional arthroplasty.

MATERIAL AND METHODS

Five patients (8 hands, 32 arthroplasties) underwent correction of ulnar drift of MPJ by dorsal capsule interpositional arthroplasty. Results were assessed according to the degree of recovery of movement at the MPJ and correction of ulnar drift. Functional improvement was graded as excellent, good and fair. Pain alleviation was assessed by visual analogue score (VAS) score.

RESULTS

Excellent results were seen in 3 patients (5 hands, 20 arthroplasties), good in 1 patient (2 hands, 8 arthroplasties) and fair in 1 patient (1 hand, 4 arthroplasties). VAS score for pain decreased from mean preoperative 8.2/10 to 1/10. On average follow up of 1.4 years there was good hand function, no recurrence of deformities and patients were pain free.

CONCLUSION

Interpositional arthroplasty for MPJ using dorsal capsule for correction of post RA ulnar drift is a low-cost option which improves the hand function and cosmesis. Additionally, it avoids all the complications related with the use of silicon joints.

Use of an Interdisciplinary Student Medical Innovation and Entrepreneurship Program to Create Affordable Global Health Care Solutions

BACKGROUND

Bench to Bedside is a 7-month-long medical innovation and entrepreneurship program at the University of Utah in which teams comprising students from various disciplines work together to identify health care problems and develop novel technology solutions. Student teams are provided a small prototyping budget, access to device development workshops, prototyping facilities, and expert faculty and industry mentors. Teams then compete for seed funding at the Bench to Bedside competition at the end of the program. In 2014, we created global health-specific resources, mentorship, guidance, and award incentives as a means to drive global health technology development in the program and then studied our impact after 6 years.

METHODS

We reviewed program data collected continuously between 2011 and 2018 to evaluate the impact of global health incentive initiatives on the development of global health-related technologies. We quantified the number of global health teams based on both team-declared data and objective evaluation of each competing technology.

RESULTS

The initiation of global health technology incentives was associated with an annual overall doubling of teams pursuing the development of global health-related technologies from an average of 11.4% to 24.8% ( P = .003).

CONCLUSIONS

A student medical technology innovation program designed to address global health needs is an effective means of generating new solutions to improve global health care. The use of global health-specific awards and mentors raised awareness of the need for affordable global solutions and incentivized teams to pursue development.

Frugal innovation: doing more with less for more

The global economy will face significant challenges over the next few decades. On the one hand, it must meet the needs of 7 billion consumers (growing to 9 billion by 2050), including the currently unmet basic needs of large numbers in developing countries in areas such as food, energy, housing and health. On the other hand, it must achieve this growth without exceeding the resources available on the planet or causing environmental devastation. This paper argues that such change is possible through a systemic shift to a frugal economy that involves radical, frugal innovation across sectors. Such a transformation will involve the participation of large and small firms, consumers and governments alike. The paper introduces the notion of frugal innovation-the creation of faster, better and cheaper solutions for more people that employ minimal resources-and discusses strategies and examples of such change already taking place in core sectors like manufacturing, food, automotive and energy in developing and developed economies. It also outlines the role of the interaction between large and small firms as well as between firms and consumers in making change possible, as well as the role of governments in driving change where market mechanisms alone will not suffice.This article is part of the themed issue 'Material demand reduction'.

The Emergence of Personalized Health Technology

Personalized health technology is a noisy new entrant to the health space, yet to make a significant impact on population health but seemingly teeming with potential. Devices including wearable fitness trackers and healthy-living apps are designed to help users quantify and improve their health behaviors. Although the ethical issues surrounding data privacy have received much attention, little is being said about the impact on socioeconomic health inequalities. Populations who stand to benefit the most from these technologies are unable to afford, access, or use them. This paper outlines the negative impact that these technologies will have on inequalities unless their user base can be radically extended to include vulnerable populations. Frugal innovation and public–private partnership are discussed as the major means for reaching this end.

Building a global business continuity programme

Business continuity programmes provide an important function within organisations, especially when aligned with and supportive of the organisation's goals, objectives and organisational culture. Continuity programmes for large, complex international organisations, unlike those for compact national companies, are more difficult to design, build, implement and maintain. Programmes for international organisations require attention to structural design, support across organisational leadership and hierarchy, seamless integration with the organisation's culture, measured success and demonstrated value. This paper details practical, but sometimes overlooked considerations for building successful global business continuity programmes.