Validating A knowledge transfer framework in health services

The study of knowledge transfer (KT) has been proceeding in parallel but independently in health services and in business, presenting an opportunity for synergy and sharing. This paper uses a survey of 32 empirical KT studies with their 96 uniquely named determinants of KT success to identify ten unique determinants for horizontal knowledge transfer success. These determinants, the outcome measure of Knowledge Use, and separate explicit and tacit transfer flows constitute the KT Framework, extending the work of previous KT framework authors. Our Framework was validated through a case study of the transfer of clinical practice guideline knowledge between the cardiac teams of selected Ontario hospitals, using a survey of senders and receivers developed from the KT literature. The study findings were: 8 of 10 determinants were supported by the Successful Transfer Hospitals; and 4 of 10 determinants were found to a higher degree in the Successful than non-Successful transfer hospitals. Taken together, the results show substantive support for the KT Framework determinants, indicating aggregate support of 9 of these determinants, but not the 10th - Knowledge Complexity. The transfer of tacit knowledge was found to be related to the transfer of the explicit knowledge and expressed as the transfer or recreation of resource profile and internal process tacit knowledge, where this tacit transfer did not require interactions between Sender and Receiver. This study provides managers with the building blocks to assess and improve the success rates of their knowledge transfers.

Increasing inter-generational social mobility: is educational expansion the answer?

Reforms which increase the stock of education in a society have long been held by policy-makers as key to improving rates of intergenerational social mobility. Yet, despite the intuitive plausibility of this idea, the empirical evidence in support of an effect of educational expansion on social fluidity is both indirect and weak. In this paper we use the raising of the minimum school leaving age from 15 to 16 years in England and Wales in 1972 to estimate the effect of educational participation and qualification attainment on rates of intergenerational social class mobility. Because, in expectation, children born immediately before and after the policy was implemented are statistically exchangeable, the difference in the amount of education they received may be treated as exogenously determined. The exogenous nature of the additional education gain means that differences in rates of social mobility between cohorts affected by the reform can be treated as having been caused by the additional education. The data for the analysis come from the ONS Longitudinal Study, which links individual records from successive decennial censuses between 1971 and 2001. Our findings show that, although the reform resulted in an increase in educational attainment in the population as a whole and a weakening of the association between attainment and class origin, there was no reliably discernible increase in the rate of intergenerational social mobility.

Serum estradiol: oocyte ratio as a predictor of reproductive outcome: an analysis of data from >9000 IVF cycles in the Republic of Ireland

Purpose The purpose of this study was to evaluate the serum estradiol (E2) per oocyte ratio (EOR) as a function of selected embryology events and reproductive outcomes with IVF. Methods This retrospective analysis included all IVF cycles where oocyte collection and fresh transfer occurred between January 2001 and November 2012 at a single institution. Patients were divided by three age groups (<35, 35–39, and ≥40 years) and further stratified into nine groups based on EOR (measured in pmol/L/oocyte). Terminal serum E2 (pmol/mL) was recorded on day of hCG trigger administration, and fertilization rate, cleavage rate, number of good quality embryos, and reproductive outcomes were recorded for each IVF cycle. Results During the study interval, 9109 oocyte retrievals were performed for 5499 IVF patients (mean = 1.7 cycles/patient). A total of 63.4 % of transfers were performed on day 3 (n = 4926), while 36.6 % were carried out on day 5 (n = 2843). Clinical pregnancy rates were highest in patients with EOR of 250–750 and declined as this ratio increased, independent of patient age. While the odds ratio (OR) for clinical pregnancy where EOR = 250–750 vs. EOR > 1500 was 3.4 (p < 0.001; 95 % CI 2.67–4.34), no statistically significant correlation was seen in fertilization, cleavage rates or number of good quality embryos as a function of EOR. Conclusions Predicting reproductive outcomes with IVF has great utility both for patients and providers. The former have the opportunity to build realistic expectations, and the latter are better able to counsel according to measured clinical parameters. A better understanding of follicular dynamics and ovarian response to gonadotropin stimulation could optimize IVF treatments going forward.

A framework for evaluating the European airline costs of disabled persons and persons with reduced mobility

In recent years, airlines have been servicing a greater variety, and increasing numbers, of disabled persons and persons with reduced mobility (PRMs), particularly associated with ageing, obesity and medical needs. With the quantity of PRMs likely to increase in the future, there will be a growing impact on the airlines' associated actual and opportunity costs, about which there is minimal literature and data. Therefore the aim of this paper is to identify standard functional key factors (FKFs) with which airlines could audit their PRMs costs, and which could be used by other interested bodies, such as governments, when considering relevant aviation policy. These FKFs are related to nine areas, namely PRMs’ transfers; mobility aids; aircraft delays/diversions costs; staff training costs; staff health, safety and welfare; aircraft fixtures and equipment costs; airport costs; transaction costs; and opportunity costs. Further research is needed to obtain the data for these FKFs.

Should cash transfer be conditional? Condition, preventive care, and health outcomes

We study a Conditional Cash Transfer program in which the cash transfers to the mother only depends on the fulfillment of the national preventive visit schedule by her children born before she registered in the program. We estimate that preventive visits of children born after the mother registered in the program are 50% lower because they are excluded from the conditionality requirement. Using the same variation, we also show that attendance to preventive care improves children's health.

Contribution of direct electron transfer mechanisms to overall electron transfer in microbial fuel cells utilising Shewanella oneidensis as biocatalyst

Objectives To investigate the contribution of direct electron transfer mechanisms to electricity production in microbial fuel cells by physically retaining Shewanella oneidensis cells close to or away from the anode electrode. Results A maximum power output of 114 ± 6 mWm−2 was obtained when cells were retained close to the anode using a dialysis membrane. This was 3.5 times more than when the cells were separated away from the anode. Without the membrane the maximum power output was 129 ± 6 mWm−2. The direct mechanisms of electron transfer contributed significantly to overall electron transfer from S. oneidensis to electrodes, a result that was corroborated by another experiment where S. oneidensis cells were entrapped in alginate gels. Conclusion S. oneidensis transfers electrons primarily by direct electron transfer as opposed to mediated electron transfer.