Editorial

This second issue of Knowledge Management Research & Practice (KMRP) continues the international nature of the first issue, with papers from authors based on four different continents. There are five regular papers, plus the first of what is intended to be an occasional series of 'position papers' from respected figures in the knowledge management field, who have specific issues they wish to raise from a personal standpoint. The first two regular papers are both based on case studies. The first is 'Aggressively pursuing knowledge management over two years: a case study a US government organization' by Jay Liebowitz. Liebowitz is well known to both academics and practictioners as an author on knowledge management and knowledge based systems. Government departments in many Western countries must soon face up to the problems that will occur as the 'baby boomer' generation reaches retirement age over the next decade. This paper describes how one particular US government organization has attempted to address this situation (and others) through the introduction of a knowledge management initiative. The second case study paper is 'Knowledge creation through the synthesizing capability of networked strategic communities: case study on new product development in Japan' by Mitsuru Kodama. This paper looks at the importance of strategic communities - communities that have strategic relevance and support - in knowledge management. Here, the case study organization is Nippon Telegraph and Telephone Corporation (NTT), a Japanese telecommunication firm. The third paper is 'Knowledge management and intellectual capital: an empirical examination of current practice in Australia' by Albert Zhou and Dieter Fink. This paper reports the results of a survey carried out in 2001, exploring the practices relating to knowledge management and intellectual capital in Australia and the relationship between them. The remaining two regular papers are conceptual in nature. The fourth is 'The enterprise knowledge dictionary' by Stuart Galup, Ronald Dattero and Richard Hicks. Galup, Dattero and Hicks propose the concept of an enterprise knowledge dictionary and its associated knowledge management system architecture as offering the appropriate form of information technology to support various different types of knowledge sources, while behaving as a single source from the user's viewpoint. The fifth and final regular paper is 'Community of practice and metacapabilities' by Geri Furlong and Leslie Johnson. This paper looks at the role of communities of practice in learning in organizations. Its emphasis is on metacapabilities - the properties required to learn, develop and apply skills. This discussion takes work on learning and core competences to a higher level. Finally, this issue includes a position paper 'Innovation as an objective of knowledge management. Part I: the landscape of management' by Dave Snowden. Snowden has been highly visible in the knowledge management community thanks to his role as the Director of IBM Global Services' Canolfan Cynefin Centre. He has helped many government and private sector organizations to consider their knowledge management problems and strategies. This, the first of two-part paper, is inspired by the notion of complexity. In it, Snowden calls for what he sees as a 20th century emphasis on designed systems for knowledge management to be consigned to history, and replaced by a 21st century emphasis on emergence. Letters to the editor on this, or any other topic related to knowledge management research and practice, are welcome. We trust that you will find the contributions stimulating, and again invite you to contribute your own paper(s) to future issues of KMRP.

Patient experiences of serious adverse drug reactions and their attitudes to medicines:a qualitative study of survivors of Stevens-Johnson syndrome and toxic epidermal necrolysis in the UK

Background: Adverse drug reactions (ADRs) cause significant morbidity and mortality and account for around 6.5% of hospital admissions. Patient experiences of serious ADRs and their long-term impact on patients' lives, including their influence on current attitudes towards medicines, have not been previously explored. Objective: The aim of the study was to explore the experiences, beliefs, and attitudes of survivors of serious ADRs, using drug-induced Stevens-Johnson syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) as a paradigm. Methods: A retrospective, qualitative study was undertaken using detailed semi-structured interviews. Fourteen adult survivors of SJS and TEN, admitted to two teaching hospitals in the UK, one the location of a tertiary burns centre, were interviewed. Interview transcripts were independently analysed by three different researchers and themes emerging from the text identified. Results: All 14 patients were aware that their condition was drug induced, and all but one knew the specific drug(s) implicated. Several expressed surprise at the perceived lack of awareness of the ADR amongst healthcare professionals, and described how the ADR was mistaken for another condition. Survivors believed that causes of the ADR included (i) being given too high a dose of the drug; (ii) medical staff ignoring existing allergies; and (iii) failure to monitor blood tests. Only two believed that the reaction was unavoidable. Those who believed that the condition could have been avoided had less trust in healthcare professionals. The ADR had a persisting impact on their current lives physically and psychologically. Many now avoided medicines altogether and were fearful of becoming ill enough to need them. © 2011 Adis Data Information BV. All rights reserved. Conclusions: Life-threatening ADRs continued to affect patients’ lives long after the event. Patients’ beliefs regarding the cause of the ADR differed, and may have influenced their trust in healthcare professionals and medicines. We propose that clear communication during the acute phase of a serious ADR may therefore be important.