Educational Group Practices in Primary Care: Interaction Between Professionals, Users and Knowledge

OBJECTIVE To investigate the concept understood by Family Healthcare Strategy (ESF) professionals of knowledge, education and subjects participating in learning activities. METHOD Qualitative study carried out with the ESF professionals with university degree, members of the healthcare staff who undertook educational health group activities at Basic Healthcare Units (UBS) in Belo Horizonte. The following triangulation techniques were used: participant observation, photos and field notes; interviews with professionals; and document analysis. RESULTS We identified three interaction patterns that are different from each other. Firstly, the professional questions, listens and provides information to users, trusting in the transmission of knowledge; secondly, the professional questions and listens, trusting that users can learn from each other; thirdly, the professional questions, listens, discusses and produces knowledge with users, both teaching and learning from each other. CONCLUSION There are educational practices that include unique methods capable of creating a militant space for citizenship engagement.

On heuristic and linear models of judgment: Mapping the demand for knowledge

Research on judgment and decision making presents a confusing picture of human abilities. For example, much research has emphasized the dysfunctional aspects of judgmental heuristics, and yet, other findings suggest that these can be highly effective. A further line of research has modeled judgment as resulting from as if linear models. This paper illuminates the distinctions in these approaches by providing a common analytical framework based on the central theoretical premise that understanding human performance requires specifying how characteristics of the decision rules people use interact with the demands of the tasks they face. Our work synthesizes the analytical tools of lens model research with novel methodology developed to specify the effectiveness of heuristics in different environments and allows direct comparisons between the different approaches. We illustrate with both theoretical analyses and simulations. We further link our results to the empirical literature by a meta-analysis of lens model studies and estimate both human andheuristic performance in the same tasks. Our results highlight the trade-off betweenlinear models and heuristics. Whereas the former are cognitively demanding, the latterare simple to use. However, they require knowledge and thus maps of when andwhich heuristic to employ.

Complementarity between technology make and buy in innovation strategies: Evidence from Belgiam manufacturing firms

This paper characterizes the innovation strategy of manufacturing firms andexamines the relation between the innovation strategy and importantindustry-, firm- and innovation-specific characteristics using Belgiandata from the Eurostat Community Innovation Survey. In addition to importantsize effects explaining innovation, we find that high perceived risks andcosts and low appropriability of innovations do not discourage innovation,but rather determine how the innovation sourcing strategy is chosen. Withrespect to the determinants of the decision of the innovative firm toproduce technology itself (Make) or to source technology externally (Buy),we find that small firms are more likely restrict their innovation strategyto an exclusive make or buy strategy, while large firms are more likely tocombine both internal and external knowledge acquisition in their innovationstrategy. An interesting result that highlights the complementary nature ofthe Make and Buy decisions, is that, controlled for firm size, companies forwhich internal information is an important source for innovation are morelikely to combine internal and external sources of technology. We find thisto be evidence of the fact that in-house R&D generates the necessaryabsorptive capacity to profit from external knowledge acquisition. Also theeffectiveness of different mechanisms to appropriate the benefits ofinnovations and the internal organizational resistance against change areimportant determinants of the firm's technology sourcing strategy.

AWSum-Combining Classification with Knowledge Aquisition

Many classifiers achieve high levels of accuracy but have limited applicability in real world situations because they do not lead to a greater understanding or insight into the^way features influence the classification. In areas such as health informatics a classifier that clearly identifies the influences on classification can be used to direct research and formulate interventions. This research investigates the practical applications of Automated Weighted Sum, (AWSum), a classifier that provides accuracy comparable to other techniques whilst providing insight into the data. This is achieved by calculating a weight for each feature value that represents its influence on the class value. The merits of this approach in classification and insight are evaluated on a Cystic Fibrosis and Diabetes datasets with positive results.

Inter-firm labor mobility and knowledge diffusion: a theoretical approach

[cat] Analitzem una economia amb dues característiques principals: la mobilitat dels treballadors implica transferència de coneixement i la productivitat de l’empresa augmenta amb l’intercanvi de coneixement. Cada empresa desenvolupa un tipus de coneixement que serà trasmès a la resta de la indústria mitjançant la mobilitat de treballadors. Estudiem dues estructures de mercat laboral i utilitzant un anàlisi comparatiu derivem les implicacions del model. Els resultats revelen com la mobilitat de treballadors depèn en la varietat i nivell del coneixement, la presència de costos de mobilitat, les institucions, la capacitat d’absorvir coneixement per part de les empreses i la mida de la indústria. Els resultats no depenen de l’estructura del mercat laboral.

Seismic reflectivity of the sediment-covered seafloor: Effects of velocity gradients and fine-scale layering

Knowledge of the reflectivity of the sediment-covered seabed is of significant importance to marine seismic data acquisition and interpretation as it governs the generation of reverberations in the water layer. In this context pertinent, but largely unresolved, questions concern the importance of the typically very prominent vertical seismic velocity gradients as well as the potential presence and magnitude of anisotropy in soft surficial seabed sediments. To address these issues, we explore the seismic properties of granulometric end-member-type clastic sedimentary seabed models consisting of sand, silt, and clay as well as scale-invariant stochastic layer sequences of these components characterized by realistic vertical gradients of the P- and S-wave velocities. Using effective media theory, we then assess the nature and magnitude of seismic anisotropy associated with these models. Our results indicate that anisotropy is rather benign for P-waves, and that the S-wave velocities in the axial directions differ only slightly. Because of the very high P- to S-wave velocity ratios in the vicinity of the seabed our models nevertheless suggest that S-wave triplications may occur at very small incidence angles. To numerically evaluate the P-wave reflection coefficient of our seabed models, we apply a frequency-slowness technique to the corresponding synthetic seismic wavefields. Comparison with analytical plane-wave reflection coefficients calculated for corresponding isotropic elastic half-space models shows that the differences tend to be most pronounced in the vicinity of the elastic equivalent of the critical angle as well as in the post-critical range. We also find that the presence of intrinsic anisotropy in the clay component of our layered models tends to dramatically reduce the overall magnitude of the P-wave reflection coefficient as well as its variation with incidence angle.

Inter-firm labor mobility and knowledge diffusion: a theoretical approach

[cat] Analitzem una economia amb dues característiques principals: la mobilitat dels treballadors implica transferència de coneixement i la productivitat de l’empresa augmenta amb l’intercanvi de coneixement. Cada empresa desenvolupa un tipus de coneixement que serà trasmès a la resta de la indústria mitjançant la mobilitat de treballadors. Estudiem dues estructures de mercat laboral i utilitzant un anàlisi comparatiu derivem les implicacions del model. Els resultats revelen com la mobilitat de treballadors depèn en la varietat i nivell del coneixement, la presència de costos de mobilitat, les institucions, la capacitat d’absorvir coneixement per part de les empreses i la mida de la indústria. Els resultats no depenen de l’estructura del mercat laboral.

Medical residents' feedback on needs and acquired skills following a short course on cross-cultural competence

Objectives The purpose of this study is to assess short and long term changes in knowledge, attitudes, and skills among medical residents following a short course on cultural competency and to explore their perspectives on the experience. Methods Eighteen medical residents went through a short training programme comprised of two seminars lasting 30' and 60' respectively over two days. Three months later, we conducted three focus groups, with 17 residents to explore their thoughts, perspectives and feedback about the course. To measure changes over time, we carried out a quantitative sequential survey before the seminars, three days after, and three months later using the Multicultural Assessment Questionnaire. Results Residents expressed a wide variety of perspectives on the main themes related to the content of the training - culture, trialogue, stereotypes, status, epidemiology, history and geopolitics - and related to its organization - relevance, volume, timing, target audience, training tools, and working material. Using the MAQ, we observed a higher global performance score (n=16) at three days (median=38) compared to results before the training (median=33) revealing a median difference of 5.5 points (z=2.4, p=0.015). This difference was still present at three months (∆=4.5, z=2.4, p=0.018), mainly due to knowledge acquisition (∆=3) rather than attitudes (∆=0) or skills (∆=1). Conclusions Cross-cultural competence training not only brings awareness of multicultural issues but also helps participants understand their own cultures, perception of others and preconceived ideas. Physicians' education should however also focus on improving implementation of acquired knowledge in cross-cultural competence.

Implementation of guidelines on delirium in a General Hospital: a before-after study of their impact on caregivers' knowledge and clinical skills

INTRODUCTION: Delirium is a highly prevalent disorder, with serious consequences for the hospitalised patient. Nevertheless, it remains under-diagnosed and under-treated. We developed evidence-based clinical practice guidelines (CPGs) focusing on prevention, screening, diagnosis, and treatment of delirium in a general hospital. This article presents the implementation process of these CPGs and a before-after study assessing their impact on healthcare professionals' knowledge and on clinical practice. METHODS: CPGs on delirium were first implemented in two wards (Neurology and Neurosurgery) of the Lausanne university hospital. Interactive one-hour educational sessions for small groups of nurses and physicians were organised. Participants received a summary of the guidelines and completed a multiple choice questionnaire, assessing putative changes in knowledge, before and three months after the educational session. Other indicators such as "diagnosis of delirium" reported in the discharge letters, and mean duration of patients' hospital stay before and after implementation were compared. RESULTS: Eighty percent of the nurses and physicians from the Neurology and Neurosurgery wards attended the educational sessions. Both nurses and physicians significantly improved their knowledge after the implementation (+9 percentage-points). Other indicators were not modified by the intervention. CONCLUSION: A single interactive intervention improved both nurses' and physicians' knowledge on delirium. Sustained and repeated interventions are probably needed to demonstrate changes in clinical practice.

Simultaneous measurement of regional cerebral blood flow by perfusion CT and stable xenon CT: a validation study.

BACKGROUND AND PURPOSE: Knowledge of cerebral blood flow (CBF) alterations in cases of acute stroke could be valuable in the early management of these cases. Among imaging techniques affording evaluation of cerebral perfusion, perfusion CT studies involve sequential acquisition of cerebral CT sections obtained in an axial mode during the IV administration of iodinated contrast material. They are thus very easy to perform in emergency settings. Perfusion CT values of CBF have proved to be accurate in animals, and perfusion CT affords plausible values in humans. The purpose of this study was to validate perfusion CT studies of CBF by comparison with the results provided by stable xenon CT, which have been reported to be accurate, and to evaluate acquisition and processing modalities of CT data, notably the possible deconvolution methods and the selection of the reference artery. METHODS: Twelve stable xenon CT and perfusion CT cerebral examinations were performed within an interval of a few minutes in patients with various cerebrovascular diseases. CBF maps were obtained from perfusion CT data by deconvolution using singular value decomposition and least mean square methods. The CBF were compared with the stable xenon CT results in multiple regions of interest through linear regression analysis and bilateral t tests for matched variables. RESULTS: Linear regression analysis showed good correlation between perfusion CT and stable xenon CT CBF values (singular value decomposition method: R(2) = 0.79, slope = 0.87; least mean square method: R(2) = 0.67, slope = 0.83). Bilateral t tests for matched variables did not identify a significant difference between the two imaging methods (P >.1). Both deconvolution methods were equivalent (P >.1). The choice of the reference artery is a major concern and has a strong influence on the final perfusion CT CBF map. CONCLUSION: Perfusion CT studies of CBF achieved with adequate acquisition parameters and processing lead to accurate and reliable results.

Interfirm Knowledge Transfer in Coopetitive Relationships

Tämä tutkimuskeskittyy yritysten väliseen samanaikaiseen kilpailuun ja yhteistyöhön. Suurin mielenkiinto tässä tutkimuksessa kohdistuu yritysten väliseen tietämyksen siirtoon. Tietämyksen siirto samanaikaisissa kilpailu- ja yhteistyösuhteissa voi olla erityisen hyödyllistä samankaltaisten toimintalogiikoiden ja ymmärryksen takia. Toisaalta, mahdollinen kriittisen tiedon vuotaminen kilpailevalle yritykselle onriski, joka täytyy ottaa huomioon, kun yhteistyötä kilpailijan kanssa suunnitellaan. Tämän tutkimuksen tavoitteena on selvittää, kuinka tietämystä siirretään samanaikaisissa kilpailu- ja yhteistyösuhteissa välttäen kuitenkin tähän liittyvät riskit. Tutkimuksen empiirinen osa sisältää kolme erilaista case-esimerkkiä samanaikaisista kilpailu- ja yhteistyösuhteista. Empiirisessä osassa tehdyt havainnot tukevat pääasiassa teoriaosuudessa käsiteltyjä asioita. Tietämyksen siirron motiivit, suhdekohtaiset tietämyksen omaksumiskyvyt, tietojohtamiskäytännöt ja luottamus ovat tekijöitä, jotka vaikuttavat tietämyksen siirron tehokkuuteen. Pääasialliset keinot tietämyksen siirron riskin välttämiseksi samanaikaisissa kilpailu- ja yhteistyösuhteissa ovat hierarkkisen hallintomuodon käyttäminen tai horisontaalisesti ja vertikaalisesti rajattu yhteistyön laajuus.

Absorptive capacity and the effect of social integration mechanisms in knowledge utilization

Tiedosta on tullut määräävä tekijä yrityksensuorituskyvylle. Yritykset hankkivat aktiivisesti uutta tietoa ulkoisesta ympäristöstään ja tallentavat sitä tietokantoihinsa. Uusi tieto on innovaatioiden ja uusien ideoiden peruselementti. Uudet ideat pitää myös kaupallistaa, jotta niiden avulla voidaan hankkia kilpailuetua. Absorptiivisen kapasiteetin malli yhdistää tiedon prosessointiin liittyvät kyvykkyydet, jotka vaikuttavat yrityksen kykyyn hyödyntää tietoa tehokkaasti. Ennen kuin tietoa voidaan käyttää uusien tuotteiden ja palveluiden luomiseen, täytyy sitä jakaa yrityksessä ja muuttaa se yrityksen toimintaa palvelevaksi. Aiemmissa tutkimuksissa innovaatiot ovat vahvasti liitetty yrityksen kykyyn uudistua. Tämä pro gradu -tutkielma tutkii sosiaalisten integraatiomekanismien vaikutusta potentiaalisen absorptiivisen kapasiteetin muuttamiseen toteutuneeksi absorptiiviseksi kapasiteetiksi. Yksilöiden ja osastojen välisen yhteistyön sekä luottamuksen vaikutus tiedon sisäistämiseen tutkittiin. Tutkielma pohjautuu monikansallisessa yrityksessä keväällä 2006 suoritettuun uudistumiskyky-tutkimukseen. Tutkielma keskittyy yrityksen kykyyn uudistua uuden tiedon ja innovaatioiden avulla. Tutkielma on kvantitatiivinen tapaustutkimus. Tutkielmassa tehtyjen havaintojen mukaan sosiaaliset integraatiomekanismit ovat tärkeitä uuden tiedon hyödyntämisessä. Tiedon eksplisiittyyden havaitaan vaikuttavan tiedon muuttamiseen yritykselle hyödylliseksi resurssiksi.

Information System ProcessInnovation Adoption, Adaptation, Learning, and Unlearning: A Longitudinal Case Study

This thesis examines the history and evolution of information system process innovation (ISPI) processes (adoption, adaptation, and unlearning) within the information system development (ISD) work in an internal information system (IS) department and in two IS software house organisations in Finland over a 43-year time-period. The study offers insights into influential actors and their dependencies in deciding over ISPIs. The research usesa qualitative research approach, and the research methodology involves the description of the ISPI processes, how the actors searched for ISPIs, and how the relationships between the actors changed over time. The existing theories were evaluated using the conceptual models of the ISPI processes based on the innovationliterature in the IS area. The main focus of the study was to observe changes in the main ISPI processes over time. The main contribution of the thesis is a new theory. The term theory should be understood as 1) a new conceptual framework of the ISPI processes, 2) new ISPI concepts and categories, and the relationships between the ISPI concepts inside the ISPI processes. The study gives a comprehensive and systematic study on the history and evolution of the ISPI processes; reveals the factors that affected ISPI adoption; studies ISPI knowledge acquisition, information transfer, and adaptation mechanisms; and reveals the mechanismsaffecting ISPI unlearning; changes in the ISPI processes; and diverse actors involved in the processes. The results show that both the internal IS department and the two IS software houses sought opportunities to improve their technical skills and career paths and this created an innovative culture. When new technology generations come to the market the platform systems need to be renewed, and therefore the organisations invest in ISPIs in cycles. The extent of internal learning and experiments was higher than the external knowledge acquisition. Until the outsourcing event (1984) the decision-making was centralised and the internalIS department was very influential over ISPIs. After outsourcing, decision-making became distributed between the two IS software houses, the IS client, and itsinternal IT department. The IS client wanted to assure that information systemswould serve the business of the company and thus wanted to co-operate closely with the software organisations.

Competitor Information andCompetitive Knowledge Management in a Large Industrial Organization

Thisthesis supplements the systematic approach to competitive intelligence and competitor analysis by introducing an information-processing perspective on management of the competitive environment and competitors therein. The cognitive questions connected to the intelligence process and also the means that organizational actors use in sharing information are discussed. The ultimate aim has been to deepen knowledge of the different intraorganizational processes that are used in acorporate organization to manage and exploit the vast amount of competitor information that is received from the environment. Competitor information and competitive knowledge management is examined as a process, where organizational actorsidentify and perceive the competitive environment by using cognitive simplification, make interpretations resulting in learning and finally utilize competitor information and competitive knowledge in their work processes. The sharing of competitive information and competitive knowledge is facilitated by intraorganizational networks that evolve as a means of developing a shared, organizational level knowledge structure and ensuring that the right information is in the right place at the right time. This thesis approaches competitor information and competitive knowledge management both theoretically and empirically. Based on the conceptual framework developed by theoretical elaboration, further understanding of the studied phenomena is sought by an empirical study. The empirical research was carried out in a multinationally operating forest industry company. This thesis makes some preliminary suggestions of improving the competitive intelligence process. It is concluded that managing competitor information and competitive knowledge is not simply a question of managing information flow or improving sophistication of competitor analysis, but the crucial question to be solved is rather, how to improve the cognitive capabilities connected to identifying and making interpretations of the competitive environment and how to increase learning. It is claimed that competitive intelligence can not be treated like an organizational function or assigned solely to a specialized intelligence unit.

Cross-border post-acquisition integration performed by a Nordic information & telecommunication technology company in the transition economy context of the Czech Republic

Diplomityön tarkoituksena oli arvioida akvisition jälkeistä integraatioprosessia. Integraation tarkoitus on mukauttaa ostettu yritys toimivaksi osaksi konsernia. Työn empiirisenä ongelmana oli yleisesti tunnustettu integraatiojohtamisen kompleksisuus. Samoin myöskin akateemisesta kirjallisuudesta puuttui koherentti malli, jolla arvioida integraatiota. Tutkimuskohteena oli akvisitio, jossa suomalainen tietotekniikkan suuryritys osti osake-enemmistön tsekkiläisestä keskisuuresta ohjelmistoyrityksestä. Tutkimuksessa generoitiin integraatiojohtamisen malli tietopohjaiseen organisaatioon. Mallin mukaan integraatio koostuu kolmesta eriävästä, mutta toisiaan tukevasta alueesta: organisaatiokulttuurin yhdentyminen, tietopääoman tasaaminen ja konsernin sisäisten prosessien yhdenmukaistaminen. Näistä kaksi kaksi jälkimmäistä ovat johdettavissa, mutta kulttuurin yhdentymiseen integraatiojohtamisella voidaan vaikuttaa vain katalysoivasti. Organisaatiokulttuuri levittäytyy vain osallisten vuorovaikuksien kautta. Lisäksi tutkimus osoitti, miten akvisitio on revolutionaarinen vaihe yrityksen kehityksessä. Integraation ensimmäinen ajanjakso on revolutionaarista. Tällöin suurimmat ja näkyvimmät johdettavat muutokset pyritään saamaan aikaan, jotta integraatiossa edettäisiin evolutionaariseen kehitykseen. Revolutionaarisen intergaation vetojuhtana toimii integraatiojohto, kun taas evolutionaarinen integraatio etenee osallisten (organisaation jäsenten) itsensä toiminnan ja vuorovaikutusten kautta.