Does Knowledge Management enhance Decision-Making speed?

Every manager has to make daily decisions the efficacy of which will affect firm performance and so decision-making (DM) and problem-solving (PS) are very important skills able to make the difference between the success and the failure of a firm. At the same time markets have reached such a level of complexity that uncertainty and risk connected to decisions are higher than ever before while market turbulence forces firms to make faster and faster decisions in order to quickly adapt to the changing environment. For this reason time and knowledge are strictly connected resources. Speedy decisions in fact allow firms to adopt new technology or to take advantage of new market opportunities before competitors do so. According to several scholars knowledge management (KM) seems very useful to improve DM and PS processes. However, to date, few studies have investigated the impact that KM practices have on decision speed and efficacy. Therefore the present paper aims to empirically prove the impact that KM has on the organizational decision-making process and how this, in turn, impacts on firm performance. We collected survey data from 113 leading Italian companies and tested the structural model with Partial Least Square (PLS) method. Results, suggest that some KM practices significantly impact on the firm's ability to make speedy and effective decisions and also on firm performance. A very interesting result is the fact that the firm's ability to make speedy and effective decisions does not impact on firm performance. The main limitations of the present paper concern the fact that it has not been possible to stratify problem solving skills by hierarchical levels (i.e., strategic, tactical, operational) and the generalizability of results, considering that the data was collected from one single European country

I sistemi informativi automatizzati a supporto dei processi di direzione aziendale. Ancora un ritardo cronico per le piccole imprese?

Il lavoro esamina i sistemi informativi automatizzati funzionali al supporto delle attività di pianificazione e controllo, allo scopo di verificare se aziende di dimensione diversa registrano tassi di adozione differenti. Inoltre, particolare attenzione viene dedicata alla percezione dei potenziali benefici derivanti dall’adozione di tali sistemi. I risultati confermano la tendenza delle piccole imprese ad utilizzare i sistemi informativi automatizzati soprattutto a livello operativo e poco a sostegno della formulazione delle strategie

Pubis bone osteomyelitys after robotic radical cystectomy with continent intracorporeal urinary diversion: Multidisciplinary approach to a complex situation

Pubic bone osteomyelitis is a rare infectious condition which is characterized by a complex diagnostic and therapeutic workup, due to its various clinical manifestations. Among the many causes of this condition, urinary fistula is the most common in case of previous urological procedures. In order to solve this complication, it is crucial to treat both the fistula and (moreover) the infectious locus arising from it, because treating the fistula alone does not provide any control on the infectious noxa. We present the first case of pubic bone osteomyelitis arising from a urinary fistula after a robotic radical cystectomy with intra corporeal continent neobladder, which has been successfully treated through a multidisciplinary approach

Adding systematic biopsy to magnetic resonance ultrasound fusion targeted biopsy of the prostate in men with previous negative biopsy or enrolled in active surveillance programs

Magnetic resonance imaging (MRI) targeted biopsy (TBx) of the prostate demonstrated to improve detection rate (DR) of clinically significant prostate cancer (csPCa) in biopsy-naive patients achieving strong level of evidence. Nevertheless, the csPCa yield for TBx alone versus TBx plus systematic biopsy (SBx) after accounting for overlapping of SBx cores with TBx cores, in prior-negative or active surveillance (AS) patients has not been well established.The objective of the study was to investigate benefits in terms of detection rate and pathological stratification of prostate cancer (PCa) using contextual SBx during MRI-TBx.Patients previously submitted to negative-SBx (cohort A) and those enrolled in an AS program (cohort B) who showed at least 1 suspicious area with a PIRADSv2 score ≥ 3 were prospectively and randomly assigned to only TBx strategy versus TBx plus SBx strategy. SBx locations could not encompass the TBx sites, so that the results of each type of biopsy were independent and did not overlap.A total of 312 patients were included in the 2 cohorts (cohort A: 213 cases; cohort B: 99 cases). No significant differences were found in terms of overall PCa-DR (77.6% vs 69.6% respectively; P = .36) and csPCa-DR (48.2% vs 60.9 respectively; P = .12). The MRI-TBx alone cohort showed higher csPCa/PCa ratio (87.5% vs 62.2%; P = .03). The MRI-TBx plus SBx group subanalysis showed significantly higher csPCa-DR obtained at the MRI-TBx cores when compared with the SBx cores (43.7% vs 24.1%, respectively; P = .01). Independently to age, prostatic-specific antigen and prostate imaging-reporting and data system score, either in rebiopsy (OR 0.43, 0.21-0.97) or AS (OR 0.46, 0.32-0.89) setting, SBx cores were negatively associated with the csPCa-DR when combined to TBx cores.MRI-TBx should be considered the elective method to perform prostate biopsy in patients with previous negative SBx and those considered for an AS program. Adding SBx samples to MRI-TBx did not improve detection rate of csPCa

Posterior muscle-fascial reconstruction and knotless urethro-neo bladder anastomosis during robot-assisted radical cystectomy: Description of the technique and its impact on urinary continence

Objective: The aim of our study is to describe the use of posterior muscle-fascial reconstruction during urethro-ileal anastomosis in bladder cancer (BC) patients submitted to robot-assisted radical cystectomy (RC) with orthotopic neobladder (ON) and its role in facilitating day- and night-time continence recovery during a 12-month follow up. Materials and methods: We prospectively collected data from 42 consecutive patients who underwent RARC with totally intracorporeal ON and extended pelvic lymph node dissection (PLND) at our Institution from June 2014 to October 2017. Prior to the urethro-neobladder anastomosis we reconstructed the Denonvilliers Fascia (DF) as previously described for radical prostatectomy using a bidirectional barbed suture. Day and night-time recovery rates were reported at 3, 6 and 12 months after surgery, with continent patients being those using either no urinary pads or 1 safety pads. Results: Median age at surgery was 63 yrs, 41 (97.6%) patients were male. 28 (66.7%) patients presented a clinical T2 disease. Median operative time and median ON reconstruction time were 450 minutes and 180 minutes respectively. 13 (31%) individuals had non-organ confined disease, with 11 (26.2%) patients with positive lymph nodes (median 3 positive lymph nodes) and 2 (4.8%) with non-urothelial cancer at final pathologic examination. Median hospital stay and median catheterization time were 7 (IQR 7-8) and 21 (IQR 19-22). During first 30 post-operative days we recorded 7 (16.7%) low-grade Clavien and 2 (4.8%) IIIa Clavien complications, whereas between 30 and 90 postoperative days we recorded 4 (9.5%) low-grade, 4 (9.5) IIIa and 1 (2.4%) IIIb complications. Day-time and night-time continence rates were 61.9% vs 52.4%, 73.8% vs 64.3% and 90.5% vs 73.8% at three, six and twelve months follow up. Day-time continence was significantly superior in the younger group (97% vs 57%, p 0.01); night-time continence rates were also superior among < 70 yrs patients, despite not reaching statistical significance (77% vs 57%, p 0.3). Conclusions: Posterior muscle-fascial reconstruction aids continence recovery in BC patients undergoing RARC with ON, with younger and fitter patients most benefitting from ON reconstruction

Hyperbaric exposure and oxidative Stress in occupational activities (HEOxS): the study protocol

Background: Hyperbaric exposure (HE) is proven to be a stressor to several mechanisms in living cells. Even if after homeostasis restoration, harmful effects are expected, in particular a presence of free radicals. These latter are the stimulus to negative phenomenon as inflammation or cancer. In Italy, with 7500 km of sea shores, a large quantity of workers is exposed to HE during occupational activities. A deep knowledge of HE and bodily effects is not well defined; hence a multidisciplinary assessment of risk is needed. To detect one or more indicators of HE a research group is organised, under the INAIL sponsorship. The research project focused on the oxidative stress (OxS) and this paper details on the possible protocol to estimate, with a large amount of techniques on several human liquids, the relationship between OxS and HE. Specific attention will be paid to identify confounding factors and their influence. Methods: Blood and urine will be sampled. Several lab techniques will be performed on samples, both targeted, to measure the level of well-known biomarkers, and untargeted. Regard the formers: products of oxidation of DNA and RNA in urine; inflammation and temperature cytokines and protein carbonyles in blood. Untargeted evaluation will be performed for a metabolomics analysis in urine. Confounding factors: temperature, body fat, fitness, allergies and dietary habits. These factors will be assessed, directly or indirectly, prior and after HE. The final scope of the project is to determine one or more indicators that relates to HE in hits twofold nature: depth and duration. Conclusion: The relationship between OxS and HE is not deeply investigated and literature proposes diverging results. The project aims to define the time dependence of biomarkers related to OxS, to rise knowledge in risk assessment in workers exposed to HE

The vital role of knowledge management and creativity for performance

It is common opinion that knowledge management practices and creativity are very important factors for firms facing a turbulent and dynamic environment. Knowledge and creativity in fact are a helpful support for managers that have to make decisions under uncertain and complex conditions. Knowledge generates economic value when it is utilized to solve problems and making decisions and so problem solving becomes the way thanks to which it is possible to link firm knowledge to firm performance. But when facing new problems, people and organizations will have to go beyond their knowledge maps and find a new path that will allow them to find new solutions. That is why PS involves a great deal of creativity. They are not only complementary but also synergic in the problem solving process. This paper aims to shed light on the benefits that knowledge and creativity are able to produce for the problem solving process and how this, in turn, impacts on firms’ performance. We collected survey data from January to March 2015 from a sample of 1525 leading Italian industrial companies. Findings confirm that work design, organizational culture and structure increase organizational creativity and, more generally, the firm’s ability to solve problems (efficacy in finding and implementing new and useful solutions). Results also suggest that in order to successfully win challenges and arrive where nobody else has been before people need to rely on both their knowledge and creativity. Furthermore it seems very clear that creativity deploys its greatest potential when it rests on strong epistemic bases. It can be gathered that for a better understanding of the potential benefits deriving from knowledge and creativity it is necessary to consider the synergy they could activate. One of the main limitations of the present paper is that it has not been possible to stratify problem solving skills by hierarchical levels (i.e., strategic, tactical, operational) nor split them in to functional areas (i.e., marketing, finance, R&D, etc.). Another limitation is the generalizability of results given that the data was collected from one single European country

Knowledge versus creativity: which of them really matter?

It is common opinion that knowledge management practices and creativity are very important factors for firms facing a turbulent and dynamic environment. Knowledge and creativity in fact are a helpful support for managers that have to make decisions under uncertain and complex conditions: they are not only complementary but also synergic in the problem solving process. This paper aims to shed light on the benefits that knowledge and creativity are able to produce for organizational decision making, underlining differences and analogies between them. Only once certain aspects have been clarified it will be easier to judge the opportunity of investing in KM infrastructure or, in the case it already exists, what kind of changes are needed to improve creativity and/or decision-making speed

The use of information systems in small and medium-sized firms. Operational tools or instruments for management control and strategy development?

The paper is the product of an empirical research conducted by the University of Urbino and it aim to analyze the diffusion rate and the type of use of Business Information Systems (IS) among italian SMEs. Results suggest that micro and small enterprises still record a lower IS adoption rate and prefer operational IS rather than managerial and strategic ones, although they are quite aware of possible benefits linked to the use of information systems

Knowledge Management, Strategic Decision-Making, Intuition and Planning Effectiveness

Academic studies on planning and strategic decision-making have traditionally contrasted the technocratic decision-making style with the intuitive-based style (Khandwalla, 1977; Covin et al, 2001; Elbanna, 2010), sustaining that the former leads to better decisions compared to the latter. A technocratic style consists in a highly rational and structured (systematic) process that requires managers to break down a problem into smaller pieces necessary to solve it, search and evaluate relevant objective information, and prefer the use of quantitative tools when assessing and choosing among alternatives (Grünig et al, 2005) . On the contrary, an intuitive style consists in the use “of the mass of facts, patterns, concepts, techniques, abstractions, and generally what we call formal knowledge or beliefs, which are impressed on our minds” (Barnard, cited in Simon, 1987). However, nowadays both styles are necessary. Firms have to rely on both managers’ rationality and intuition to make effective decisions because of today’s very complex and uncertain environment. Since information and knowledge are at the basis of both decision-making processes, we aim to understand the linkage between knowledge management practices, rationality and intuition, in order to analyse the impact they have on planning effectiveness. To test our hypotheses we developed a conceptual model in which knowledge management practices directly affect rationality, intuition and planning effectiveness. At the same time, we focused on the impact that rationality and intuition have on planning effectiveness. The model was empirically tested on a sample of 169 Italian medium high-tech firms using structural equation modelling (SEM) based on consistent partial least square (PLSc). Results clearly show that knowledge management practices have a positive direct impact on rationality and planning effectiveness. In addition, knowledge management practices provide a strong contribution to intuition, but intuition has no impact on planning effectiveness. This paper enriches existing literature by highlighting the linkage between knowledge management practices and intuition, which has remained under researched in academia. The main limitation of this study concerns the fact that it focuses only on Italian technology-based firms and thus, results cannot be generalized