A managerial view of the knowledge flows of a health-care system

A health system has various knowledge structures enabling its knowledge resources to be efficiently applied. The literature has covered the management of clinical health information fairly extensively, but less is known about managerial knowledge flows. To address this knowledge gap, a regional health system in Finland is studied and managerial knowledge flows categorized in order to provide a better understanding of the inter-organizational knowledge networks of a health system. The paper contributes by illustrating and concretizing the knowledge dynamics of a health system. The empirical examination reveals the complexity of managerial knowledge flows and identifies three main categories of these: (1) national information steering, (2) regional information steering, and (3) internal control information. These categories are further elaborated with the data gathered through observation, interviews, and process modelling. A better understanding and management of knowledge flows is expected to have a positive effect on the performance of the health system.     

Narrating Your Work: an approach to supporting knowledge sharing in virtual teams

We propose an approach to enhancing knowledge sharing and connectedness in distributed teams. Termed ‘Narrating Your Work’ (NYW), the approach involves members of distributed team using a microblogging tool to post regular updates about their current work, accomplishments, and issues. The NYW approach was evaluated within a geographically and temporally distributed team at Shell International for a period of one month, using a mixed-method research design. Methodology comprised of a quantitative survey, followed by semi-structured interviews and analysis of microblogging updates posted during the month in which the approach was being trialled. The evaluation results suggest that NYW was viewed as a valid and practical approach to enhancing knowledge sharing and connectedness. A range of barriers and enablers that could impact the future application and embedding of the approach are identified and recommendations for implementation are outlined.     

Structural design of a double-layered porous hydrogel for effective mass transport

Mass transport in porous materials is universal in nature, and its worth attracts great attention in many engineering applications. Plant leaves, which work as natural hydraulic pumps for water uptake, have evolved to have the morphological structure for fast water transport to compensate large water loss by leaf transpiration. In this study, we tried to deduce the advantageous structural features of plant leaves for practical applications. Inspired by the tissue organization of the hydraulic pathways in plant leaves, analogous double-layered porous models were fabricated using agarose hydrogel. Solute transport through the hydrogel models with different thickness ratios of the two layers was experimentally observed. In addition, numerical simulation and theoretical analysis were carried out with varying porosity and thickness ratio to investigate the effect of structural factors on mass transport ability. A simple parametric study was also conducted to examine unveiled relations between structural factors. As a result, the porosity and thickness ratio of the two layers are found to govern the mass transport ability in double-layered porous materials. The hydrogel models with widely dispersed pores at a fixed porosity, i.e., close to a homogeneously porous structure, are mostly turned out to exhibit fast mass transport. The present results would provide a new framework for fundamental design of various porous structures for effective mass transport.     

Biofunctionalized nanoslits for wash-free and spatially resolved real-time sensing with full target capture

We propose biofunctionalized nanofluidic slits (nanoslits) as an effective platform for real-time fluorescence-based biosensing in a reaction-limited regime with optimized target capture efficiency. This is achieved by the drastic reduction of the diffusion length, thereby a boosted collision frequency between the target analytes and the sensor, and the size reduction of the sensing element down to the channel height comparable to the depletion layer caused by the reaction. Hybridization experiments conducted in DNA-functionalized nanoslits demonstrate the analyte depletion and the wash-free detection ∼10 times faster compared to the best microfluidic sensing platforms. The signal to background fluorescence ratio is drastically increased at lower target concentrations, in favor of low-copy number analyte analysis. Experimental and simulation results further show that biofunctionalized nanoslits provide a simple means to study reaction kinetics at the single-pixel level using conventional fluorescence microscopy with reduced optical depth.     

Collagen-based brain microvasculature model in vitro using three-dimensional printed template

We present an engineered three-dimensional (3D) in vitro brain microvasculature system embedded within the bulk of a collagen matrix. To create a hydrogel template for the functional brain microvascular structure, we fabricated an array of microchannels made of collagen I using microneedles and a 3D printed frame. By culturing mouse brain endothelial cells (bEnd.3) on the luminal surface of cylindrical collagen microchannels, we reconstructed an array of brain microvasculature in vitro with circular cross-sections. We characterized the barrier function of our brain microvasculature by measuring transendothelial permeability of 40 kDa fluorescein isothiocyanate-dextran (Stoke''s radius of ∼4.5 nm), based on an analytical model. The transendothelial permeability decreased significantly over 3 weeks of culture. We also present the disruption of the barrier function with a hyperosmotic mannitol as well as a subsequent recovery over 4 days. Our brain microvasculature model in vitro, consisting of system-in-hydrogel combined with the widely emerging 3D printing technique, can serve as a useful tool not only for fundamental studies associated with blood-brain barrier in physiological and pathological settings but also for pharmaceutical applications.     

CRP,but not TNF-α or IL-6, decreases after weight loss in patients with morbid obesity exposed to intensive weight reduction and balneological treatment

Objective

The aim of this study was to evaluate the concentrations of C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and the degree of homeostasis model assessment-insulin resistance (HOMA-IR) in patients with morbid obesity exposed to a three-week low-calorie diet and balneotherapy.

Methods

The study included 33 patients (25 females and 8 males; mean age 46 years) with body mass index (BMI) values of >40 kg/m². Evaluations of CRP, IL-6, TNF-α, lipid profile, HOMA-IR, and fasting glucose were carried out before (baseline data) and three weeks after the treatment. The control group consisted of 20 healthy volunteers (15 females and 5 males) with a mean age of 39 years and BMI values of ≤24.9 kg/m².

Results

In the blood of patients with morbid obesity we found significantly elevated levels of CRP, TNF-α, triglycerides, HOMA-IR and fasting glucose, but a decreased level of high density lipoprotein (HDL)-cholesterol, compared with the healthy individuals. The treatment resulted in about a 9.4% reduction in body weight from 122.5 to 111.0 kg and a significant decrease in the concentration of CRP, but no change in TNF-α or IL-6. HOMA-IR was significantly reduced.

Conclusion

The decrease in CRP level without changes in TNF-α or IL-6 concentrations after the low-calorie diet and balneological treatment, suggests that an essential amount of adipose tissue must be removed before proper adipocyte function is restored. The decrease in HOMA-IR indicates an improvement in insulin sensitivity, which is beneficial in obese patients.

     

Sustainability Strategies in the Forestry–Wood Chain Driven by Market Demands on Books and Other Products

This paper focuses on sustainability strategies for the Forestry–Wood chain (FWC) driven by market demands on books and other products. The main objective is to draft and suggest a process for market driven pro-active sustainability strategies for the FWC, based on a SWOT-analysis (strengths, weaknesses, opportunities and threats). Further to highlight the possible strategic implications and critical areas for actors upstream in the FWC, in the context of uncertain external future scenarios. Higher demands on product differentiation were found throughout the FWC, where also collaboration and stakeholder interaction was found important to improve sustainability. The work broadens the “traditional” perspectives on FWC sustainability to encompass also interacting value chains such as book production and publishing, to get a more holistic view.     

Young Diplomats?? Socialization to the Networked Professional Cultures of Their Workplace Communities

The purpose of the present investigation was to examine young diplomats’ socialization to the professional expert culture of the Ministry for Foreign Affairs of Finland over a six-month on-job training period, as part of their preparation for service in the diplomatic corps. Using social network analysis, we analyzed departments’ internal social structures, prevailing social relations, and the young diplomats’ role and position in the networks of knowledge acquisition, practical know-how, and professional collaboration. Data collected by contextual event sampling and theme interviews and analyzed by qualitative content analysis were used to characterize the young diplomats’ personal social support networks, resources obtained, as well as associated reflections regarding their functioning in and socialization to the departmental workplace community. The results indicated that across the six-month training period, the young diplomats became involved to the workplace communities’ networked expertise and were socialized to its expert culture, even if their achieved networking positions differed. The results revealed differences between levels of collective operational practices in the workplace communities as well as the nature of assignments in which the young diplomats participated and for which they were responsible. It was proposed that these differences mirrored distinction between expansive natures of young diplomats’ workplace communities as learning environments.