Making Knowledge Work for Health: A Strategy for Health Research

Making Knowledge Work for Health: A Strategy for Health Research, provides a framework for the development of health research to enhance health and quality of life and help ensure that our research compares favourably with the rest of the world. I believe that an active research community working close to the delivery of health care in clinical settings, laboratories, the community, third-level institutions and the healthcare industry is critical to the improvement of the quality of health services generally. It is vital for professional development and career satisfaction of health service staff. It is also important for the translation of ideas into medical and IT products that can add value to our economy Download the Report here

The impact of two education methods on knowledge of schistosomiasis transmission and prevention among schoolchildren in a rural community in northern Minas Gerais, Brazil

The objective of this study was to analyse the effect of using two health education approaches on knowledge of transmission and prevention of schistosomiasis of school children living in a rural endemic area in the state of Minas Gerais, Brazil. The 87 children participating in the study were divided into three groups based on gender, age and presence or absence of Schistosoma mansoni infection. In the first group the social representation model and illness experience was used. In the second group, we used the cognitive model based on the transmission of information. The third group, the control group, did not receive any information related to schistosomiasis. Ten meetings were held with all three groups that received a pre-test prior to the beginning of the educational intervention and a post-test after the completion of the program. The results showed that knowledge levels in Group 1 increased significantly during the program in regard to transmission (p = 0.038) and prevention (p = 0.001) of schistosomiasis. Groups 2 and 3 did not show significant increase in knowledge between the two tests. These results indicate that health education models need to consider social representation and illness experience besides scientific knowledge in order to increase knowledge of schistosomiasis transmission and prevention.

Trends in yearly prevalence of third-generation cephalosporin and fluoroquinolone resistant Enterobacteriaceae infections and antimicrobial use in Spanish hospitals, Spain, 1999 to 2010.

Escherichia coli, Klebsiella pneumoniae, and Enterobacter spp. are a major cause of infections in hospitalised patients. The aim of our study was to evaluate rates and trends of resistance to third-generation cephalosporins and fluoroquinolones in infected patients, the trends in use for these antimicrobials, and to assess the potential correlation between both trends. The database of national point prevalence study series of infections and antimicrobial use among patients hospitalised in Spain over the period from 1999 to 2010 was analysed. On average 265 hospitals and 60,000 patients were surveyed per year yielding a total of 19,801 E. coli, 3,004 K. pneumoniae and 3,205 Enterobacter isolates. During the twelve years period, we observed significant increases for the use of fluoroquinolones (5.8%-10.2%, p<0.001), but not for third-generation cephalosporins (6.4%-5.9%, p=NS). Resistance to third-generation cephalosporins increased significantly for E. coli (5%-15%, p<0.01) and for K. pneumoniae infections (4%-21%, p<0.01) but not for Enterobacter spp. (24%). Resistance to fluoroquinolones increased significantly for E. coli (16%30%, p<0.01), for K. pneumoniae (5%-22%, p<0.01), and for Enterobacter spp. (6%-15%, p<0.01). We found strong correlations between the rate of fluoroquinolone use and the resistance to fluoroquinolones, third-generation cephalosporins, or co-resistance to both, for E. coli (R=0.97, p<0.01, R=0.94, p<0.01, and R=0.96, p<0.01, respectively), and for K. pneumoniae (R=0.92, p<0.01, R=0.91, p<0.01, and R=0.92, p<0.01, respectively). No correlation could be found between the use of third-generation cephalosporins and resistance to any of the latter antimicrobials. No significant correlations could be found for Enterobacter spp.. Knowledge of the trends in antimicrobial resistance and use of antimicrobials in the hospitalised population at the national level can help to develop prevention strategies.

Bowling for fascism: Social capital and the rise of the Nazi Party in Weimar Germany, 1919-33

Social capital a dense network of associations facilitating cooperation within a community typically leads to positive political and economic outcomes, as demonstrated by a large literature following Putnam. A growing literature emphasizes the potentially "dark side" of social capital. This paper examines the role of social capital in the downfall of democracy in interwar Germany by analyzing Nazi party entry rates in a cross-section of towns and cities. Before the Nazi Party's triumphs at the ballot box, it built an extensive organizational structure, becoming a mass movement with nearly a million members by early 1933. We show that dense networks of civic associations such as bowling clubs, animal breeder associations, or choirs facilitated the rise of the Nazi Party. The effects are large: Towns with one standard deviation higher association density saw at least one-third faster growth in the strength of the Nazi Party. IV results based on 19th century measures of social capital reinforce our conclusions. In addition, all types of associations veteran associations and non-military clubs, "bridging" and "bonding" associations positively predict NS party entry. These results suggest that social capital in Weimar Germany aided the rise of the Nazi movement that ultimately destroyed Germany's first democracy.

Long-Life Concrete: How Long Will My Concrete Last? A Synthesis of Knowledge of Potential Durability of Concrete, TPF-5(159), 2013

There is an ongoing discussion about moving toward performance-based specifications for concrete pavements. This document seeks to move the discussion forward by outlining the needs and the challenges, and proposing some immediate actions. However, this approach may increase risk for all parties until performance requirements are agreed upon and, more importantly, how the requirements can be measured. A fundamental issue behind pavement construction activities is that the owner/designer needs to be assured that the concrete in place will survive for the intended period (assuming there are no changes in the environment or loading) and, therefore, that full payment should be made. At the same time, each party along the supply chain needs to be assured that the material being supplied to them is able to meet the required performance, as is the product/system they are delivering. The focus of this document is a discussion of the issues behind this need, and the technologies that are available, or still needed, to meet this need, particularly from the point of view of potential durability

Projektisapuolten vaatimukset kolmannen sukupolven matkaviestinverkon rakentamisprojektin knowledge management -järjestelmälle

Projektin johtaminen informaatioaikakaudella merkitsee, yhä useammassa tapauksessa, virtuaalisen verkoston tietämyksen hallitsemista ja johtamista. Kolmannen sukupolven matkaviestinverkon rakentaminen on virtuaaliverkostoa hyväkseen käyttävä projekti, joka koostuu lukuisista osapuolista.Matkaviestinverkkoprojektien laajentuminen ja kilpailun kiristyminen alalla ovat nostaneet knowledge management -järjestelmien kysyntää. Kysyntä kohdistuu voimakkaimmin järjestelmiin, joiden avulla matkaviestinverkkotoimitusprojektin kaikki toiminnot pystytään käsittelemään yhdessä järjestelmässä. Tämän tutkimuksen pääasiallisena tavoitteena on ollut selvittää keskeisimmät vaatimukset kolmannen sukupolven matkaviestinverkon rakentamisprojektin knowledge management ?järjestelmälle. Tutkimus toteutettiin kirjallisuuden ja avoimien teemahaastattelujen avulla, käyttäen kvalitatiivisiä tutkimusmenetelmiä.Haastattelut osoittivat, että tärkeimmät vaatimukset kolmannen sukupolven matkaviestinverkkoja rakentavan projektiorganisaation knowledge management -järjestelmälle ovat: 1. Knowledge management -järjestelmän tulee toimia keskitettynä tietovarastona.2. Projektissa käsiteltävään tietoon on pystyttävä porautumaan vähintään prosessi- ja paikkatietoon pohjautuvista näkökulmista. 3. Pääsyn knowledge management -järjestelmään tulee olla mahdollista kaikille projektin osapuolille.4. Pääsyn knowledge management -järjestelmään tulee olla mahdollista mistä tahansa ja mihin kellonaikaan tahansa.5. Knowledge management -järjestelmän käyttöliittymän tulee olla mahdollisimman yksinkertainen. Järjestelmän tulee olla yhteydessä organisaatioiden muihin järjestelmiin.

Proportionality and Party Success in Europe

This thesis consists of four articles and an introductory section. The main research questions in all the articles are about proportionality and party success in Europe, at European, national or district levels. Proportionality in this thesis denotes the proximity of seat shares parties receive compared to their respective vote shares, after the electoral system’s allocation process. This proportionality can be measured through numerous indices that illustrate either the overall proportionality of an electoral system or a particular election. The correspondence of a single party’s seat shares to its vote shares can also be measured. The overall proportionality is essential in three of the articles (1, 2 and 4), where the system’s performance is studied by means of plots. In article 3, minority party success is measured by advantage-ratios that reveal single party’s winnings or losses in the votes to seat allocation process. The first article asks how proportional are the European parliamentary (EP) electoral systems, how do they compare with results gained from earlier studies and how do the EP electoral systems treat different sized parties. The reasons for different outcomes are looked for in explanations given by traditional electoral studies i.e. electoral system variables. The countries studied (EU15) apply electoral systems that vary in many important aspects, even though a certain amount of uniformity has been aspired to for decades. Since the electoral systems of the EP elections closely resemble the national elections, the same kinds of profiles emerge as in the national elections. The electoral systems indeed treat the parties differentially and six different profile types can be found. The counting method seems to somewhat determine the profile group, but the strongest variables determining the shape of a countries’ profile appears to be the average district magnitude and number of seats allocated to each country. The second article also focuses on overall proportionality performance of an electoral system, but here the focus is on the impact of electoral system changes. I have developed a new method of visualizing some previously used indices and some new indices for this purpose. The aim is to draw a comparable picture of these electoral systems’ changes and their effects. The cases, which illustrate this method, are four elections systems, where a change has occurred in one of the system variables, while the rest remained unchanged. The studied cases include the French, Greek and British European parliamentary systems and the Swedish national parliamentary system. The changed variables are electoral type (plurality changed to PR in the UK), magnitude (France splitting the nationwide district into eight smaller districts), legal threshold (Greece introducing a three percent threshold) and counting method (d’Hondt was changed to modified Sainte-Laguë in Sweden). The radar plots from elections after and before the changes are drawn for all country cases. When quantifying the change, the change in the plots area that is created has also been calculated. Using these radar plots we can observe that the change in electoral system type, magnitude, and also to some extent legal threshold had an effect on overall proportionality and accessibility for small parties, while the change between the two highest averages counting method had none. The third article studies the success minority parties have had in nine electoral systems in European heterogeneous countries. This article aims to add more motivation as to why we should care how different sized parties are treated by the electoral systems. Since many of the parties that aspire to represent minorities in European countries are small, the possibilities for small parties are highlighted. The theory of consociational (or power-sharing) democracy suggests that, in heterogeneous societies, a proportional electoral system will provide the fairest treatment of minority parties. The OSCE Lund Recommendations propose a number of electoral system features, which would improve minority representation. In this article some party variables, namely the unity of the minority parties and the geographical concentration of the minorities were included among possible explanations. The conclusions are that the central points affecting minority success were indeed these non-electoral system variables rather than the electoral system itself. Moreover, the size of the party was a major factor governing success in all the systems investigated; large parties benefited in all the studied electoral systems. In the fourth article the proportionality profiles are again applied, but this time to district level results in Finnish parliamentary elections. The level of proportionality distortion is also studied by way of indices. The average magnitudes during the studied periodrange from 7.5 to 26.2 in the Finnish electoral districts and this opens up unequal opportunities for parties in different districts and affects the shape of the profiles. The intra-country case allows the focus to be placed on the effect of district magnitude, since all other electoral systems are kept constant in an intra-country study. The time span in the study is from 1962 to 2007, i.e. the time that the districts have largely been the same geographically. The plots and indices tell the same story, district magnitude and electoral alliances matter. The district magnitude is connected to the overall proportionality of the electoral districts according to both indices, and the profiles are, as expected, also closer to perfect proportionality in large districts. Alliances have helped some small parties to gain a much higher seat share than their respective vote share and these successes affect some of the profiles. The profiles also show a consistent pattern of benefits for the small parties who ally with the larger parties.

Critical Success and Failure Factors of Knowledge Management Implementation in a Large Multinational Company

More and more companies are interested in implementing knowledge management. However, the majority of knowledge management initiatives will fail to have any significant impact. In this study, theories regarding knowledge management implementation and adoption are investigated further. The objective of this study is to deepen understanding regarding the critical factors that contribute to successful knowledge management adoption in large multinational companies. The study is formulated around the following four research questions: 1. What are the key success and failure factors in knowledge management implementation? 2. How can knowledge management adoption be improved at the individual, group and organizational levels of the company? 3. What are the critical factors that hinder knowledge management adoption in the case company? 4. How can the case company promote the adoption of knowledge management among company personnel? The methodology used in this study is a combination of a literature review and an explanatory, exploratory, qualitative single-case study. The literature review answers the first and second research questions. Based on the literature review, a framework is presented to illustrate the factors contributing to the success of knowledge management implementation. The framework also links together knowledge management implementation and adoption. The third research question is answered by revealing the relevant findings from 21 expert interviews and 2 online questionnaires with 42 respondents in total. By comparing and contrasting the results of the literature review with the findings of the empirical case study, the fourth research question is answered. The concrete outcomes of this study are a framework to elucidate the factors contributing to the success of knowledge management implementation, a case study highlighting the issues that hinder knowledge management adoption within the case company, and recommendations for the case company.

Medical students' knowledge about end-of-life decision-making

The influence of medical students' knowledge concerning end-of-life care, considering ethical theories and clinical practice, remains controversial. We aimed to investigate medical students' knowledge of bioethical concepts related to moral kinds of death (euthanasia, disthanasia, and orthothanasia) and to analyze the influence of their clinical experience on practicing such approaches in a tertiary hospital in the state of São Paulo, Brazil. We interviewed 180 medical students [distributed in Group 1 (G1) - first to third- year students, and Group 2 (G2) - fourth to sixth-year students] to evaluate the influence of the course on "medical ethics" on ethical theories and clinical practice, using a closed questionnaire. The course on "medical ethics" did not distinguish the groups (P=0.704) in relation to bioethical concepts. Neologisms such as "cacothanasia" and "idiothanasia" were incorrectly viewed as bioethical concepts by 28% of the interviewees. Moreover, 45.3% of the sample considered health care professionals incapable of managing terminally ill patients, especially G2 (29%) as compared to G1 (16.5%, P=0.031). The concept of euthanasia was accepted by 41% of sample, as compared to 98.2% for orthothanasia. Among medical students that accepted ways to abbreviate life (22.9%), 30.1% belonged to G1, and only 16.1% to G2 (P=0.049). These medical students were unfamiliar with common bioethical concepts. Moreover, they considered healthcare professionals incapable of managing terminally ill patients. The ethical ideal of the "good death" reflects better acceptance of orthothanasia by medical students, suggesting a tendency to apply it in their future clinical practice.

Organizing for Systemic Innovations – Research on Knowledge, Interaction and Organizational Interdependencies

Systemic innovation has emerged as an important topic due to the interconnected technological and sociotechnical change of our current complex world. This study approaches the phenomenon from an organizing perspective, by analyzing the various actors, collaborative activities and resources available in innovation systems. It presents knowledge production for innovation and discusses the organizational challenges of shared innovation activities from a dynamic perspective. Knowledge, interaction, and organizational interdependencies are seen as the core elements of organizing for systemic innovations. This dissertation is divided into two parts. The first part introduces the focus of the study and the relevant literature and summarizes conclusions. The second part includes seven publications, each reporting on an important aspect of the phenomenon studied. Each of the in-depth single-case studies takes a distinct and complementary systems approach to innovation activities – linking the refining of knowledge to the enabling of organizations to participate in shared innovation processes. These aspects are summarized as theoretical and practical implications for recognizing innovation opportunities and turning ideas into innovations by means of using information and organizing activities in an efficient manner. Through its investigation of the existing literature and empirical case studies, this study makes three main contributions. First, it describes the challenges inherent in utilizing information and transforming it into innovation knowledge. Secondly, it presents the role of interaction and organizational interdependencies in innovation activities from various novel perspectives. Third, it highlights the interconnection between innovations and organizations, and the related path dependency and anticipatory aspects in innovation activities. In general, the thesis adds to our knowledge of how different aspects of systems form innovations through interaction and organizational interdependencies. It highlights the continuous need to redefine information and adjust organizations and networks based on ongoing activities – stressing the emergent, systemic nature of innovation.

Can low domain knowledge be compensated for when using the internet? /

Previous researchers have found that learners do not benefit fi-om using the Internet when domain knowledge is low. The purpose of the current study was to investigate possible methods to compensate for low domain knowledge. Specifically, the presence of notes, more time to search the Internet, and high levels of motivation to use the Internet were examined as possible compensating factors. Sixty Political Science and Kinesiology undergraduate students were randomly assigned to one of three conditions. Students searched the Internet for an hour prior to vmting an essay with notes present, searched the Internet for an hour prior to writing an essay without notes present, or did not search the Internet prior to completing an essay. Each participant completed the same two essays, one corresponding to a high knowledge domain and another corresponding to a low knowledge domain. First, the presence of notes did not significantly improve essay scores in comparison to the absence of notes. Second, learners did benefit fi-om using the Internet for 1 hour in comparison to their peers who were not exposed to the Internet, regardless of level of domain knowledge. Third, high levels of motivation did not affect essay performance. A discussion of why time may have compensated for low domain knowledge while notes and motivation did not is included. In addition, methods that may compensate for low domain knowledge when time is restricted are suggested.

Transfer of knowledge of the structural components of the model Q400 and Global Express: the case of Aerospace Bombardier, Querétaro

The aim of this paper is to analyze the knowledge transfer in the production of structural components of two aircraft:Q400 and Global Express of Bombardier Aerospace Company, Querétaro. Bombardier Aerospace is a pioneer company in the aviation sector in Mexico, and the third largest civil aircraft manufacturer. In 2005, Bombardier decided to invest in Mexico, creating Bombardier Aerospace de Mexico S. A. C. V. and transferring production lines from Japan and Toronto to Queretaro. The relocation strategy of both plants aims to reduce modular and general production costs facing other competitors. The relocation has been supported by the State Government funds, through a trust and the creation of Queretaro aerospace cluster. Among various benefits, the State of Queretaro donated seventy-eight acres of land where the Queretaro International Airport (QIA) and a training centre will be built to promote the development of this sector. The interest in this research is to analyze and describe the transfer of knowledge to the production of structural components of both aircraft models, thanks to the results of productivity and internal and external factors which have contributed along with this transfer

Knowledge-based modelling and simulation of operational problems of microbiological origin in wastewater treatment plants

The activated sludge and anaerobic digestion processes have been modelled in widely accepted models. Nevertheless, these models still have limitations when describing operational problems of microbiological origin. The aim of this thesis is to develop a knowledge-based model to simulate risk of plant-wide operational problems of microbiological origin.For the risk model heuristic knowledge from experts and literature was implemented in a rule-based system. Using fuzzy logic, the system can infer a risk index for the main operational problems of microbiological origin (i.e. filamentous bulking, biological foaming, rising sludge and deflocculation). To show the results of the risk model, it was implemented in the Benchmark Simulation Models. This allowed to study the risk model's response in different scenarios and control strategies. The risk model has shown to be really useful providing a third criterion to evaluate control strategies apart from the economical and environmental criteria.

Innovation, entrepreneurship and outsourcing: essays on the use of knowledge in business environments

Innovació, emprenedoria i subcontractació són els pilars temàtics de la present tesi doctoral. L'ús del coneixement per part de les empreses representa l'element comú d'aquestes temàtiques. Les evidències empíriques provenen principalment del món empresarial, però es complementen amb les del món acadèmic com a principal proveïdor de coneixement a la societat actual, la finalitat de la qual és crear riquesa i benestar socioeconòmic. L'objectiu principal d'aquesta tesi doctoral és contribuir a les diferents àrees de recerca. La primera, gestió de la innovació, més concretament innovació organitzativa, reflexionant sobre la seva importància i monitorització a través d'enquestes. Tot seguit, un exemple d'innovació organitzativa -treball en equip- s'analitza en profunditat, així com també els seus determinants. La segona, analitza el procés de transició d'una universitat tradicional cap a una universitat emprenedora, començant per la fase de disseny fins a l'actualitat contemplant la seva funcionalitat i eficiència en el marc de les institucions públiques de recerca d'Europa. I la tercera, descriu les barreres que les empreses han de fer front a l'hora de cooperar, en general, i amb universitats, en particular. La mateixa mostra d'empreses gasela també serveix per analitzar la decisió de fer-o-comprar. El resum d'aquests resultats, les conclusions, així com les futures línies de recerca finalitzen el treball.