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This study analyses Italian knitwear manufacturers that operate both in international consumer and in business markets and assesses the different forms of competition that exist between them. The purpose of the research is to analyse the different positioning of these firms within the chain of production that they belong to. The firms that deal with fashion operate in different competitive contexts and have to launch new products frequently (seasonal collections of various lines and brands), erecting barriers (to mobility and imitation) related to competitors and lowering obstacles related to their stakeholders. Sweater manufacturers adopt strategic technologies based on the continuous development of product innovation and marketing strategies. The research was carried out through analytical case studies of the most representative firms of the sector and provides many implications for management practice and avenues for future academic research.

The authors structure the field of over-design, over-specification, and over-requirement (OOO) drawing from extant knowledge related to innovative managerial procedures in manufacturing systems, project portfolio management, and performance management. More specifically, we propose allowing the dominant perspectives of OOO and paving the way towards a coherent recognition foundation of innovative strategies in manufacturing systems. This lends itself to an analysis of innovative phenomena in design and production systems that generate OOO and helps to understand what the effects of the OOO on business performance are. The clothing industry in Italy was chosen as a target context because many innovative pioneering medium sized enterprises (MSEs) were operating in the industry. Because of the exploratory nature of the research, a multiple case study approach is adopted in this study. Drawing from extant managerial literature, the proposed structure shows which business model objects and interactions within R&D-manufacturing-marketing activities should be considered when engaging in managing innovative and temporary project portfolio. [ABSTRACT FROM AUTHOR]

Background: Simulation has been recognized as a shift in healthcare education that can improve skills and patient safety and outcomes. High-fidelity simulation of critical medical situations can be a source of stress among participants that can interfere with students' abilities leading to unexpected emotional responses. The aim of this study is to determine if two simulation methods, high-fidelity (HF) and procedural simulation (PS), may be associated with stress responses at a self-perceived and biological level (salivary cortisol variations), and to compare stress levels of the two different simulation method. We also wanted to find independent variables associated with cortisol total hormonal output. Methods: A quasi-experimental before-after study was used including the administration of questionnaires, and biomarkers evaluation by salivary cortisol samples before and after simulation. A total of 148 students were eligible and agreed to participate in the study. We used paired T-test for mean comparison regarding State-trait anxiety for both HF and PT simulations. For NASA-TLX we performed a T-test mean comparison between groups. We used paired T-test mean comparison for cortisol analysis. Multivariable linear regression has been used to assess variables associated with AUCg values and perceived stress. Results: values of STAI-Y scores were relatively higher at the end of the HF and PS sessions. NASA-TLX was significantly higher at baseline for the HF simulations, with respect to the PS simulation. Cortisol fold increase was significantly different in the two groups. Linear regression showed that cortisol AUCg was related to the STAI-Y score in both groups. Conclusion: Participating students developed a stress response both after in the HF and PS training, testified by psychological and biological outputs. According to our results, stress levels were increased for simply being in a simulation scenario than to the intrinsic complexity of the task required. More studies are needed to confirm this trend and to clarify the role of simulated stress response in a long-term learning scenario. [ABSTRACT FROM AUTHOR]

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