Knowledge management in health: a systematic literature review

Knowledge has been used as a resource for intelligent and effective action planning in organizations. Interest in research on knowledge management processes has intensified in different areas. A systematic literature review was accomplished, based on the question: what are the contributions of Brazilian and international journal publications on knowledge management in health? The sample totaled 32 items that complied with the inclusion criteria. The results showed that 78% of journals that published on the theme are international, 77% of researchers work in higher education and 65% have a Ph.D. The texts gave rise to five thematic categories, mainly: development of knowledge management systems in health (37.5%), discussion of knowledge management application in health (28.1%) and nurses' function in knowledge management (18.7%).

Knowledge management, market orientation, innovativeness and organizational outcomes: a study on companies operating in Brazil

This article analyzes the study of the relationship among knowledge management, the company's market orientation, innovativeness and organizational outcomes. The survey was conducted based on a survey held with executives from 241 companies in Brazil. The evidence found indicates that knowledge management directly contributes to market orientation, but it requires a clearly defined strategic direction to achieve results and innovativeness. It was also concluded that knowledge, as a resource, leverages other resources of the company, while it requires a direction in relation to the organizational goals in order to be effective.

Searching and retrieving in content-based repositories of formal mathematical knowledge

In this thesis, the author presents a query language for an RDF (Resource Description Framework) database and discusses its applications in the context of the HELM project (the Hypertextual Electronic Library of Mathematics). This language aims at meeting the main requirements coming from the RDF community. in particular it includes: a human readable textual syntax and a machine-processable XML (Extensible Markup Language) syntax both for queries and for query results, a rigorously exposed formal semantics, a graph-oriented RDF data access model capable of exploring an entire RDF graph (including both RDF Models and RDF Schemata), a full set of Boolean operators to compose the query constraints, fully customizable and highly structured query results having a 4-dimensional geometry, some constructions taken from ordinary programming languages that simplify the formulation of complex queries. The HELM project aims at integrating the modern tools for the automation of formal reasoning with the most recent electronic publishing technologies, in order create and maintain a hypertextual, distributed virtual library of formal mathematical knowledge. In the spirit of the Semantic Web, the documents of this library include RDF metadata describing their structure and content in a machine-understandable form. Using the author's query engine, HELM exploits this information to implement some functionalities allowing the interactive and automatic retrieval of documents on the basis of content-aware requests that take into account the mathematical nature of these documents.

Making research works visible and stimulating a research milieu in the field of social work - The European Resource Centre for Social Work Research (CERTS)

The project to create a European Resource Centre for Social Work Research (CERTS) has been agreed in December 2001 by the General Research Board of the European Commission within the framework programme 'Accompanying Measures for the improving the Human research potential and the Socio Economic Knowledge Base'.

ICOMF: Towards a Multi-cloud Ecosystem for Dynamic Resource Composition and Scaling

Modern cloud-based applications and infrastructures may include resources and services (components) from multiple cloud providers, are heterogeneous by nature and require adjustment, composition and integration. The specific application requirements can be met with difficulty by the current static predefined cloud integration architectures and models. In this paper, we propose the Intercloud Operations and Management Framework (ICOMF) as part of the more general Intercloud Architecture Framework (ICAF) that provides a basis for building and operating a dynamically manageable multi-provider cloud ecosystem. The proposed ICOMF enables dynamic resource composition and decomposition, with a main focus on translating business models and objectives to cloud services ensembles. Our model is user-centric and focuses on the specific application execution requirements, by leveraging incubating virtualization techniques. From a cloud provider perspective, the ecosystem provides more insight into how to best customize the offerings of virtualized resources.

Shying away: An observer-based microprocess analysis of experiential avoidance and resource activation in outpatients with generalized anxiety spectrum disorder

Despite long-standing calls for patient-focused research on individuals with generalized anxiety spectrum disorder there is little systematized knowledge about the in-session behaviors of these patients. The primary objective of this study was to describe of in-session trajectories of the patients' level of explication (as an indicator of an elaborated exposure of negative emotionality) and the patients' focus on their own resources and how these trajectories are associated with post-treatment outcome. In respect to GAD patients, a high level of explication might be seen as an indicator of successful exposure of avoided negative emotionality during therapy sessions. Observers made minute-by-minute ratings of 1100 minutes of video of 20 patients-therapists dyads. The results indicated that a higher level of explication generally observed at a later stage during the therapy sessions and the patients' focus on competencies at an early stage was highly associated with positive therapy outcome at assessment at post treatment, independent of pretreatment distress, rapid response of well-being and symptom reduction, as well as the therapists' professional experience and therapy lengths. These results will be discussed under the perspective of emotion regulation of patients and therapist's counterregulation. It is assumed that GAD-Patients are especially skilled in masking difficult emotions. Explication level and emotion regulation are important variables for this patient group but there's relation to outcome is different.

Local environmental knowledge: a key input for the sustainable development of Andean mountain communities

Local knowledge is crucial to both human development and environmental conservation. This is especially the case in mountain regions, where a combination of remoteness, harsh climatic conditions, rich cultural heritage, and high biological diversity has led to the development of complex local environmental knowledge systems. In the Andes for instance, rural populations mainly rely on their own environmental knowledge to ensure their food security and health. Recent studies conducted within Quechua communities in Peru and Bolivia showed that this knowledge was both persistent and dynamic, and that it responded to socio-economic and environmental changes through cultural resistance and adaptation. As this paper argues, combining local knowledge and so-called scientific knowledge – especially in development projects – can lead to innovative solutions to the socio-environmental challenges facing mountain communities in our globalized world. Based on experiences from the Andes, this paper will provide concrete recommendations to policymakers and practitioners for integrating local knowledge into development and natural resource management initiatives.

Dynamics of Traditional Ecological Knowledge, Local Use and Conservation of Native Trees and Shrubs in the Bolivian Andes

Native trees and shrubs are essential components of rural landscapes in the semi-arid inner-Andean valleys of Bolivia. They can be found as hedges and bushes in various agroecosystems such as terrace walls, slopes, field boundaries and fallow land. Their distribution and floristic composition are the result of dynamic spatial and temporal interactions between local farmers and the environment. Local uses of natural resources and biodiversity reflect the constantly evolving Andean culture, which can be generally characterised as an intertwining of the human, natural, and spiritual worlds. The aim of the present ethnobotanical study was to analyse the dynamics of traditional ecological knowledge, to ascertain local farmers’ perceptions and uses of native woody species in Andean communities and to associate the results with local conservation activities for the trees and shrubs concerned. Our case study was carried out within two communities of the Tunari National Park (Dept. Cochabamba) in Bolivia. For data collection, research methods from social science (semi-structured interviews, participative observation, participatory mapping) as well as vegetation surveys were combined. Local actors included women and men of all ages as well as families from different social categories and altitudinal levels of permanent residence. Our study indicates that, due to a multitude of socio-economic pressures (e.g. migration of young people) as well as changes in use of biodiversity (e.g. replacement of native by exotic introduced species), the traditional ecological knowledge base of native trees and shrubs and their respective uses has become diminished over time. In many cases it has led to a decline in people’s awareness of native species and as a consequence their practical, emotional and spiritual relationships with them have been lost. However, results also show that applied traditional ecological knowledge has led to local conservation strategies, which have succeeded in protecting those tree and shrub species which are most widely regarded for their multifunctional, constant and exclusive uses (e.g. Schinus molle, Prosopis laevigata, Baccharis dracunculifolia). The presentation will discuss the question if and how applied traditional ecological knowledge positively contributes to local initiatives of sustainable use and conservation of biodiversity in rural areas.

Knowledge for sustainable development in the Tajik Pamir Mountains

The paper presents the results of a multi-year baseline study project in which 10 sectors ranging from agriculture to natural hazards were assessed by a transdisciplinary Swiss–Tajik research team. This knowledge base was enhanced in a development strategy workshop that brought together stakeholders from the local to the international levels. The methodology applied was found appropriate to initiate a broad reflection and negotiation process among various stakeholder groups, leading to a joint identification of possible measures to be taken. Knowledge—and its enhancement through the involvement of all stakeholder levels— appeared to be an effective carrier of innovation and changes of attitudes, thus containing the potential to effectively contribute to sustainable development in marginalized and resource-poor mountain areas.

Defining barriers in caring for seriously-ill children in a resource-limited setting: An observational study of 2 children's hospitals in Haiti

Background. According to the WHO 2007 country report, Haiti lags behind the Millennium Development Goal of reducing child mortality and maintains the highest under-5 mortality rate in the Western hemisphere. 3 Overall, few studies exist that seek to better grasp barriers in caring for a seriously ill child in a resource-limited setting and only a handful propose sustainable, effective interventions. ^ Objectives. The objectives of this study are to describe the prevalence of serious illnesses among children hospitalized at 2 children's hospitals in Port au Prince, to determine the barriers faced when caring for seriously ill children, and to report hospital outcomes of children admitted with serious illnesses. ^ Methods. Data were gathered from 2 major children's hospitals in Port au Prince, Haiti (Grace Children's Hospital [GCH] and Hopital d l'Universite d'Etat d'Haiti [HUEH]) using a triangulated approach of focus group discussions, physician questionnaires, and retrospective chart review. 23 pediatric physicians participated in focus group discussions and completed a self-administered questionnaire evaluating healthcare provider knowledge, self-efficacy, and perceived barriers relating to the care of seriously ill children in a resource-limited setting. A sample of 240 patient charts meeting eligibility criteria was abstracted for pertinent elements including sociodemographics, documentation, treatment strategies, and outcomes. Factors associated with mortality were analyzed using χ2 test and Fisher exact test [Minitab v.15]. ^ Results. The most common primary diagnoses at admission were gastroenteritis with moderate dehydration (35.5%), severe malnutrition (25.8%), and pneumonia (19.3%) for GCH, and severe malnutrition (32.6%), sepsis (24.7%), and severe respiratory distress (18%) for HUEH. Overall, 12.9% and 27% of seriously ill patients presented with shock to GCH and HUEH, respectively. ^ Shortage of necessary materials and equipment represented the most commonly reported limitation (18/23 respondents). According to chart data, 9.4% of children presenting with shock did not receive a fluid bolus, and only 8% of patients presenting with altered mental status or seizures received a glucose check. 65% of patients with meningitis did not receive a lumbar puncture due to lack of materials. ^ Hospital mortality rates did not differ by gender or by institution. Children who died were more likely to have a history of prematurity (OR 4.97 [95% CI 1.32-18.80]), an incomplete vaccination record (OR 4.05 [95% CI 1.68-9.74]), or a weight for age ≤3rd percentile (OR 6.1 [95% CI 2.49-14.93]. Case-fatality rates were significantly higher among those who presented with signs of shock compared with those who did not (23.1% vs. 10.7%, RR=2.16, p=0.03). Caregivers did not achieve shock reversal in 21% of patients and did not document shock reversal in 50% of patients. ^ Conclusions. Many challenges face those who seek to optimize care for seriously ill children in resource-limited settings. Specifically, in Haiti, qualitative and quantitative data suggest major issues with lack of supplies, pre-hospital factors, including malnutrition as a comorbidity, and early recognition and management of shock. A tailored intervention designed to address these issues is needed in order to prospectively evaluate improvements in child mortality in a high-risk population.^

Community health workers: The critical link to sustainable, healthy societies in low-resource settings---A model for the Baylor Shoulder to Shoulder Foundation

Community health workers (CHWs) can serve as a bridge between healthcare providers and communities to positively impact social determinants of health and, thus, the overall health of the population. The potential to effect lasting change is particularly significant within resource-poor settings with limited access to formally trained health care providers such as the small, rural village of Santa Ana Intibucá, Honduras and surrounding areas—located on the geographically and politically isolated border of Honduras and El Salvador. The Baylor Shoulder to Shoulder Foundation (BSTS) works in conjunction with Santa Ana's volunteer health committee to bring a health brigade that has provided health care and public health projects to the area at least twice a year since 2001. They have also hired a full-time Honduran physician, a Honduran in-country administrative director, and built a clinic; yet, no community health worker program exists. This CHW program model is the response to a clear need for a CHW program within the area served by BSTS and presents a CHW program model specific to Santa Ana Intibucá and surrounding areas to be implemented by BSTS. Methods used to develop this model include reviewing the literature for recommendations from leading authorities as well as successfully implemented CHW programs in comparable regions. This information was incorporated into existing knowledge and materials currently being used in the area. Using the CHW model proposed here, each brigade, in conjunction with the communities served, can help develop new modules to respond to the specific health priorities of the region at that time, incorporating consistent modes of contact with the local physician and the CHWs to provide refresher courses, training in new topics of interest, and to be reminded of the importance of community health workers' role as the critical link to healthy societies. With cooperation, effort, and support, the brigade can continue to help integrate a sustainable CHW system in which communities may be able to maximize the care they receive while also learning to care for their own health and the future of their communities.^

Environmental policy and knowledge. Copying with complexity through inclusive management

Scholars agree that governance of the public environment entails cooperation between science, policy and society. This requires the active role of public managers as catalysts of knowledge co-production, addressing participatory arenas in relation to knowledge integration and social learning. This paper deals with the question of whether public managers acknowledge and take on this task. A survey accessing Directors of Environmental Offices (EOs) of 64 municipalities was carried out in parallel for two regions - Tuscany (Italy) and Porto Alegre Metropolitan Region (Brazil). The survey data were analysed using the multiple correspondence method. Results showed that, regarding policy practices, EOs do not play the role of knowledge co-production catalysts, since when making environmental decisions they only use technical knowledge. We conclude that there is a gap between theory and practice, and identify some factors that may hinder local environmental managers in acting as catalyst of knowledge co-production, raising a further question for future research.

Impact of knowledge brokering on performance heterogeneity among business models

Purpose – The strategic management literature lacks a comprehensive explanation as to why seemingly similar business models in the same industry perform differently. This paper strives to explain this phenomenon. Design/methodology/approach – The model is conceptualized and accompanied by a case study on the airline industry to explain knowledge brokerage that creates value from the effective utilization of knowledge resources acquired from intra- and inter-firm environments. Findings – The model explains a cyclical view of business model flexibility in which the knowledge-based resource accumulation of the business model is spread across the intra- and inter-firm environments. Knowledge brokerage strategies from the inter- and intra-firm environments result in improved performance of the business model. The flexibility that the business model acquires is determined by how efficiently resource accumulation is aligned with its external environment. Originality/value – The paper effectively integrates the concepts of knowledge brokerage and business models from a resource accumulation-based view and simultaneously arrives at the performance heterogeneity of seemingly similar business models within the same industry. It has performance implications for firms that start out without any distinct resources of their own, or that use an imitated business model, to attain better performance through business model evolution aligned with successful knowledge brokerage strategies. It adds to the resource accumulation literature by explaining how resources can be effectively acquired to create value.

The Spanish water ?pressure cooker?: Threading the interplay between resource resilient water governance outcomes by strengthening the robustness of water governance processes.

This paper uses the metaphor of a pressure cooker to highlight how water problems in Spain are highly geographical and sectorial in nature, with some specific hotspots which raise the temperature of the whole water complex system, turning many potentially solvable water problems into ?wicked problems?. The paper discusses the tendency for water governance to be hydrocentric, when often the drivers and in turn the ?solutions? to Spanish water problems lie outside the water sphere. The paper analyzes of the current water governance system by looking at water governance as both a process, and its key attributes like participation, trans- parency, equity and rule of law, as well as an analysis of water governance as an outcome by looking at efficiency and sustainability of water use in Spain. It concludes on the need to have a deeper knowledge on the interactions of water governance as a process and as an outcome and potential synergies and arguing that water governance is an inherently political process which calls for strengthening the capacity of the system by looking at the interactions of these different governance attributes.