TRial of an Educational intervention on patients' knowledge of Atrial fibrillation and anticoagulant therapy, INR control, and outcome of Treatment with warfarin (TREAT)

Background Atrial fibrillation (AF) patients with a high risk of stroke are recommended anticoagulation with warfarin. However, the benefit of warfarin is dependent upon time spent within the target therapeutic range (TTR) of their international normalised ratio (INR) (2.0 to 3.0). AF patients possess limited knowledge of their disease and warfarin treatment and this can impact on INR control. Education can improve patients' understanding of warfarin therapy and factors which affect INR control. Methods/Design Randomised controlled trial of an intensive educational intervention will consist of group sessions (between 2-8 patients) containing standardised information about the risks and benefits associated with OAC therapy, lifestyle interactions and the importance of monitoring and control of their International Normalised Ratio (INR). Information will be presented within an 'expert-patient' focussed DVD, revised educational booklet and patient worksheets. 200 warfarin-naïve patients who are eligible for warfarin will be randomised to either the intervention or usual care groups. All patients must have ECG-documented AF and be eligible for warfarin (according to the NICE AF guidelines). Exclusion criteria include: aged < 18 years old, contraindication(s) to warfarin, history of warfarin USE, valvular heart disease, cognitive impairment, are unable to speak/read English and disease likely to cause death within 12 months. Primary endpoint is time spent in TTR. Secondary endpoints include measures of quality of life (AF-QoL-18), anxiety and depression (HADS), knowledge of AF and anticoagulation, beliefs about medication (BMQ) and illness representations (IPQ-R). Clinical outcomes, including bleeding, stroke and interruption to anticoagulation will be recorded. All outcome measures will be assessed at baseline and 1, 2, 6 and 12 months post-intervention. Discussion More data is needed on the clinical benefit of educational intervention with AF patients receiving warfarin. Trial registration ISRCTN93952605

The European Union and global governance:a handbook

The role of the European Union in global politics has been of growing interest over the past decade. The EU is a key player in global institutions such as the World Trade Organization (WTO) and NATO. It continues to construct an emerging identity and project its values and interests throughout contemporary international relations. The capacity of the EU to both formulate and realise its goals, however, remains contested. Some scholars claim the EU’s `soft power’ attitude rivals that of the USA’s `hard power’ approach to international relations. Others view the EU as insufficiently able to produce a co-ordinated position to project upon global politics. Regardless of the position taken within this debate, the EU’s relationship with its external partners has an increasingly important impact upon economic, political and security concerns on an international level. Trade negotiations, military interventions, democracy promotion, international development and responses to the global economic crisis have all witnessed the EU playing a central role. This has seen the EU become both a major force in contemporary institutions of global governance and a template for supranational governance that might influence other attempts to construct regional and global institutions. This volume brings together a collection of leading EU scholars to provide a state-of-the-art overview covering these and other debates relating to the EU’s role in contemporary global governance. The Handbook is divided into four main sections: Part I: European studies and global governance – provides an overview and critical assessment of the leading theoretical approaches through which the EU’s role in global governance has been addressed within the literature. Part II: Institutions – examines the role played by the key EU institutions in pursuing a role for the EU in contemporary international relations. Part III: Policy and issue areas – explores developments within particular policy sectors, assessing the different impact that the EU has had in different issue areas, including foreign and security policy, environmental policy, common commercial policy, the Common Agricultural Policy, development policy, accession policy, the Neighbourhood Policy and conflict transformation. Part IV: The global multilevel governance complex and the EU – focuses on the relationship between the EU and the institutions, regions and countries with which it forms a global multilevel governance complex, including chapters on the EU’s relationship with the WTO, United Nations, East Asia, Africa and the USA.

User interface design support for the development of knowledge-based systems

The present scarcity of operational knowledge-based systems (KBS) has been attributed, in part, to an inadequate consideration shown to user interface design during development. From a human factors perspective the problem has stemmed from an overall lack of user-centred design principles. Consequently the integration of human factors principles and techniques is seen as a necessary and important precursor to ensuring the implementation of KBS which are useful to, and usable by, the end-users for whom they are intended. Focussing upon KBS work taking place within commercial and industrial environments, this research set out to assess both the extent to which human factors support was presently being utilised within development, and the future path for human factors integration. The assessment consisted of interviews conducted with a number of commercial and industrial organisations involved in KBS development; and a set of three detailed case studies of individual KBS projects. Two of the studies were carried out within a collaborative Alvey project, involving the Interdisciplinary Higher Degrees Scheme (IHD) at the University of Aston in Birmingham, BIS Applied Systems Ltd (BIS), and the British Steel Corporation. This project, which had provided the initial basis and funding for the research, was concerned with the application of KBS to the design of commercial data processing (DP) systems. The third study stemmed from involvement on a KBS project being carried out by the Technology Division of the Trustees Saving Bank Group plc. The preliminary research highlighted poor human factors integration. In particular, there was a lack of early consideration of end-user requirements definition and user-centred evaluation. Instead concentration was given to the construction of the knowledge base and prototype evaluation with the expert(s). In response to this identified problem, a set of methods was developed that was aimed at encouraging developers to consider user interface requirements early on in a project. These methods were then applied in the two further projects, and their uptake within the overall development process was monitored. Experience from the two studies demonstrated that early consideration of user interface requirements was both feasible, and instructive for guiding future development work. In particular, it was shown a user interface prototype could be used as a basis for capturing requirements at the functional (task) level, and at the interface dialogue level. Extrapolating from this experience, a KBS life-cycle model is proposed which incorporates user interface design (and within that, user evaluation) as a largely parallel, rather than subsequent, activity to knowledge base construction. Further to this, there is a discussion of several key elements which can be seen as inhibiting the integration of human factors within KBS development. These elements stem from characteristics of present KBS development practice; from constraints within the commercial and industrial development environments; and from the state of existing human factors support.

Knowledge-based development in leading regions across the globe:an exploratory analysis of the co-evolution of resources, capabilities, and outputs

It is widely observed that the global geography of innovation is rapidly evolving. This paper presents evidence concerning the contemporary evolution of the globe's most productive regions. The paper uncovers the underlying structure and co-evolution of knowledge-based resources, capabilities and outputs across these regions. The analysis identifies two key trends by which the economic evolution and growth patterns of these regions are differentiated-namely, knowledge-based growth and labour market growth. The knowledge-based growth factor represents the underlying commonality found between the growth of economic output, earnings and a range of knowledge-based resources. The labour market growth factor represents the capability of regions to draw on their human capital. Overall, spectacular knowledge-based growth of leading Chinese regions is evident, highlighting a continued shift of knowledge-based resources to Asia. It is concluded that regional growth in knowledge production investment and the capacity to draw on regional human capital reserves are neither necessarily traded-off nor complementary to each other. © 2012 Urban Studies Journal Limited.

Executive remuneration, financial performance and corporate governance in UK and Spanish listed firms

This study examines the relationship between executive directors’ remuneration and the financial performance and corporate governance arrangements of the UK and Spanish listed firms. These countries’ corporate governance framework has been shaped by differences in legal origin, culture and backgrounds. For example, the UK legal arrangements can be defined as to be constituted in common-law, whereas for Spanish firms, the legal arrangement is based on civil law. We estimate both static and dynamic regression models to test our hypotheses and we estimate our regression using Ordinary Least Squares (OLS) and the Generalised Method of Moments (GMM). Estimated results for both countries show that directors’ remuneration levels are positively related with measures of firm value and financial performance. This means that remuneration levels do not lead to a point whereby firm value is reduced due to excessive remuneration. These results hold for our long-run estimates. That is, estimates based on panel cointegration and panel error correction. Measures of corporate governance also impacts on the level of executive pay. Our results have important implications for existing corporate governance arrangements and how the interests of stakeholders are protected. For example, long-run results suggest that directors’ remuneration adjusts in a way to capture variation in financial performance

Using XML and XSLT for flexible elicitation of mental-health risk knowledge

Current tools for assessing risks associated with mental-health problems require assessors to make high-level judgements based on clinical experience. This paper describes how new technologies can enhance qualitative research methods to identify lower-level cues underlying these judgements, which can be collected by people without a specialist mental-health background. Content analysis of interviews with 46 multidisciplinary mental-health experts exposed the cues and their interrelationships, which were represented by a mind map using software that stores maps as XML. All 46 mind maps were integrated into a single XML knowledge structure and analysed by a Lisp program to generate quantitative information about the numbers of experts associated with each part of it. The knowledge was refined by the experts, using software developed in Flash to record their collective views within the XML itself. These views specified how the XML should be transformed by XSLT, a technology for rendering XML, which resulted in a validated hierarchical knowledge structure associating patient cues with risks. Changing knowledge elicitation requirements were accommodated by flexible transformations of XML data using XSLT, which also facilitated generation of multiple data-gathering tools suiting different assessment circumstances and levels of mental-health knowledge. © 2007 Informa UK Ltd All rights reserved.

Knowledge transfer in website design:exploring the processes and benefits of design collaboration for non-creative Micros

This thesis explores the interaction between Micros (<10 employees) from non-creative sectors and website designers ("Creatives") that occurred when creating a website of a higher order than a basic template site. The research used Straussian Grounded Theory Method with a longitudinal design, in order to identify what knowledge transferred to the Micros during the collaboration, how it transferred, what factors affected the transfer and outcomes of the transfer including behavioural additionality. To identify whether the research could be extended beyond this, five other design areas were also examined, as well as five Small to Medium Enterprises (SMEs) engaged in website and branding projects. The findings were that, at the start of the design process, many Micros could not articulate their customer knowledge, and had poor marketing and visual language skills, knowledge core to web design, enabling targeted communication to customers through images. Despite these gaps, most Micros still tried to lead the process. To overcome this disjoint, the majority of the designers used a knowledge transfer strategy termed in this thesis as ‘Bi-Modal Knowledge Transfer’, where the Creative was aware of the transfer but the Micro was unaware, both for drawing out customer knowledge from the Micro and for transferring visual language skills to the Micro. Two models were developed to represent this process. Two models were also created to map changes in the knowledge landscapes of customer knowledge and visual language – the Knowledge Placement Model and the Visual Language Scale. The Knowledge Placement model was used to map the placement of customer knowledge within the consciousness, extending the known Automatic-Unconscious -Conscious model, adding two more locations – Peripheral Consciousness and Occasional Consciousness. Peripheral Consciousness is where potential knowledge is held, but not used. Occasional Consciousness is where potential knowledge is held but used only for specific tasks. The Visual Language Scale was created to measure visual language ability from visually responsive, where the participant only responds personally to visual symbols, to visually multi-lingual, where the participant can use visual symbols to communicate with multiple thought-worlds. With successful Bi-Modal Knowledge Transfer, the outcome included not only an effective website but also changes in the knowledge landscape for the Micros and ongoing behavioural changes, especially in marketing. These effects were not seen in the other design projects, and only in two of the SME projects. The key factors for this difference between SMEs and Micros appeared to be an expectation of knowledge by the Creatives and failure by the SMEs to transfer knowledge within the company.

Regional evolution and waves of growth:a knowledge-based perspective

The evolution of a regional economy and its competitiveness capacity may involve multiple independent trajectories through which different sets of resources and capabilities evolve together. However, there is a dearth of evidence concerning how these trends are occurring across the globe. Based on the underlying tenets of the streams of research relating to regional competitiveness, knowledge cities/regions, and knowledge-based urban development, this paper seeks to present an empirical approach to establishing such evidence in relation to the recent development of the globe’s most productive regions from the viewpoint of their growth trajectories and the particular form of growth they are experiencing. The aim is to uncover the underlying structure of the changes in knowledge-based resources, capabilities and outputs across regions, and offer an analysis of these regions according to an uncovered set of key trends. The analysis identifies three key trends by which the economic evolution and growth patterns of these regions are differentiated – namely the Fifth Wave Growth, the Third & Fourth Wave Growth, and Government-led Third Wave Growth. Overall, spectacular knowledge-based growth of leading Chinese regions is evident, highlighting a continued shift of knowledge-based resources to Asia. In addition, a superstructure is observed at the global scale, consisting of two separate continuums that explicitly distinguish Chinese regions from the rest in terms of regional growth trajectories. © 2014 Elsevier Ltd. All rights reserved. © 2014 Elsevier Ltd. All rights reserved.

Knowledge workers and their relationships with organisations

The programme of research examines knowledge workers, their relationships with organisations, and perceptions of management practices through the development of a theoretical model and knowledge worker archetypes. Knowledge worker and non-knowledge worker archetypes were established through an analysis of the extant literature. After an exploratory study of knowledge workers in a small software development company the archetypes were refined to include occupational classification data and the findings from Study 1. The Knowledge Worker Characteristics Model (KWCM) was developed as a theoretical framework in order to analyse differences between the two archetypes within the IT sector. The KWCM comprises of the variables within the job characteristics model, creativity, goal orientation, identification and commitment. In Study 2, a global web based survey was conducted. There were insufficient non-knowledge worker responses and therefore a cluster analysis was conducted to interrogate the archetypes further. This demonstrated, unexpectedly, that that there were marked differences within the knowledge worker archetypes suggesting the need to granulate the archetype further. The theoretical framework and the archetypes were revised (as programmers and web developers) and the research study was refocused to examine occupational differences within knowledge work. Findings from Study 2 identified that there were significant differences between the archetypes in relation to the KWCM. 19 semi-structured interviews were conducted in Study 3 in order to deepen the analysis using qualitative data and to examine perceptions of people management practices. The findings from both studies demonstrate that there were significant differences between the two groups but also that job challenge, problem solving, intrinsic reward and team identification were of importance to both groups of knowledge workers. This thesis presents an examination of knowledge workers’ perceptions of work, organisations and people management practices in the granulation and differentiation of occupational archetypes.

How does knowledge relate to political action?

In this paper we investigate the relation between knowledge and political action, focusing on knowledge claims stemming from science that at the same time have relevance in a policy context. In so doing, we will revisit some well-known and some lesser known approaches, such as C.P. Snow's thesis of the two cultures and Mannheim's conceptualization of theory and practice. We arrive at a distinction between knowledge for practice and practical knowledge, which we briefly apply to the case of climate change science and policy. We state as our thesis that policy is ever more reliant on knowledge, but science can deliver ever less certainty. Political decisions and programs have to recognize this fact, either implicitly or explicitly. This creates a paradox that is normally resolved through the political decision and not the dissemination of "truth" in the sense of uncontested knowledge. We use the case of the Intergovernmental Panel on Climate Change as an example. © 2012 Copyright ICCR Foundation.

Understanding knowledge coordination dynamics in traditional and fast-response IT organizations

This research takes a dynamic view on the knowledge coordination process, aiming to explain how the process is affected by changes in the operating environment, from normal situations to emergencies in traditional and fast-response organizations, and why these changes occur. We first conceptualize the knowledge coordination process by distinguishing between four dimensions - what, when, how and who - that together capture the full scope of the knowledge coordination process. We use these dimensions to analyze knowledge coordination practices and the activities constituting these practices, in the IT functions of traditional and fast-response (military) organizations where we distinguish between "normal" and "emergency" operating conditions. Our findings indicate that (i) inter-relationships between knowledge coordination practices change under different operating conditions, and (ii) the patterns of change are different in traditional and fast-response organizations.

Network evolution and the spatiotemporal dynamics of knowledge sourcing

Knowledge accessing from external organisations is important to firms, especially entrepreneurial ones which often cannot generate internally all the knowledge necessary for innovation. There is, however, a lack of evidence concerning the association between the evolution of firms and the evolution of their networks. The aim of this paper is to begin to fill this gap by undertaking an exploratory analysis of the relationship between the vintage of firms and their knowledge sourcing networks. Drawing on an analysis of firms in the UK, the paper finds some evidence of a U-shaped relationship existing between firm age and the frequency of accessing knowledge from certain sources. Emerging entrepreneurial firms tend to be highly active with regard to accessing knowledge for a range of sources and geographic locations, with the rate of networking dropping somewhat during the period of peak firm growth. For instance, it is found that firms tend to less frequently access knowledge sources such as universities and research institutes in their own region during a stage of peak turnover growth. Overall, the results suggest a complex relationship between the lifecycle of the firm and its networking patterns. It is concluded that policymakers need to become more aware that network formation and utilisation by firms is likely to vary dependent upon their lifecycle position.

Salespersons as internal knowledge brokers and new products selling:discovering the link to genetic makeup

Managers increasingly realize the importance of involving the sales force in new product development. However, despite recent progress, research on the specific role of the sales force in product innovation-related activities remains scarce. In particular, the importance of a salespersons’ internal knowledge brokering has been neglected. This study develops and empirically validates the concept of internal knowledge brokering behavior and its effect on selling new products and developing new business, and explores whether a salesperson’s internal brokering qualities are determined by biological traits. The findings reveal that salespeople with the DRD2 A1 gene variant engage at significant lower levels of internal knowledge-brokering behavior than salespeople without this gene variant, and as a result are less likely to engage effectively in new product selling. The DRD4 gene variant had no effect on internal knowledge brokering. Management and future research implications are discussed.

Country strategic risk and knowledge management:a proposed framework for improvement

The world is in a period of reflection about social and economic models. In particular there is a review of the capacities that countries have for improving their competitiveness. The experiences in a society are part of the process of learning and knowledge development in that society: especially in the development of communities. Risks appear continually in the process of the search for, analysis and implementation of solutions to problems. This paper discusses the issues related to the improvement of productivity and knowledge in a society, the risk that poor or even declining productivity brings to the communities and the need to develop people that support the decision making process in communities.The approach to improve the communities' development is through the design of a research programme in knowledge management based on distance learning. The research programme implementation is designed to provide value added to the decisions in communities in order to use collective intelligence, solve collective problems and to achieve goals that support local solutions. This program is organized and focused on four intelligence areas, artificial, collective, sentient and strategic. These areas are productivity related and seek to reduce the risk of lack of competitiveness through formal and integrated problem analysis. In a country such as Colombia, where different regions face varying problems to solve and there is a low level of infrastructure, the factors of production such as knowledge, skilled labour and "soft" infrastructure can be a way to develop the society.This entails using the local physical resources adequately for creating value with the support of people in the region to lead the analysis and search for solutions in the communities. The paper will describe the framework and programme and suggest how it could be applied in Colombia.

Vállalati vezetők innovációs érzékenysége, szemlélete és szándékaik – egy felmérés tapasztalatai (Managers' innovation sensivity, approach, and purposes – experience of a survey)

A magyar vállalatok innovatív képességét felmérő kérdőíves kutatások eltérő eredményeket adtak, ami a piaci szereplők eltérő innováció-értelmezésével magyarázható. A szerzők feltevése szerint a vállalati vezetők jellemzően innovatívnak tartják magukat, és ez alapján jelentős részük fejlesztéseket tervez a jövőben, amelyhez pályázati forrásokat kívánnak igénybe venni. A gyakorlati életben az innováció fogalmát a tudományos definíciónál tágabban értelmezik, a vállalatnál bevezetett újdonságokat (például a piaci versenytársaktól átvett új terméket) is innovációnak értékelik. A vállalati növekedést a finanszírozási nehézségek korlátozzák. A támogatások, a hitelek és a kockázati tőke jellegű források eltérő mértékben játszanak szerepet a vállalatok életében. A szerzők tanulmányukban a vállalatok innovatív tevékenysége és a különböző források megléte közötti kapcsolatot, valamint a pályázati rendszerhez fűződő vállalati tapasztalatokat vizsgálják. /===/ Questionnaire surveys of innovation abilities of the Hungarian enterprises have given different results, which could be explained by different innovation interpretation of the market players. According to the authors' hypothesis the managers consider themselves innovative, and many of them plan developments in the future to realize them with tender sources. In the practice idea of innovation is broader interpreted than the scientific definition, and novelties introduced at the companies (eg. a new product taken over from competitors) is also considered innovation. Corporate growth is limited by financing difficulties. Supports, credits and sources of venture capital character play a role int he corporate life to different extent. Authors investigate the connection between the innovative activity of companies and the existence of several sources, and corporate experience linked to tendering system.