Considering the receiver in knowledge sharing: when the receiver seems ready the sharer appears

The knowledge needs and knowledge-related behaviours of receivers are among the most crucial, yet of ten overlooked, aspects of successful knowledge-sharing. This research examines how sharers consider receivers\u27 knowledge needs and knowledge-related behaviours when choosing whether to share their knowledge and which channels to use for the transmission of that knowledge. A new theory of knowledge sharing - Receiver Theory - is introduced, and a receiver-based model of knowledge sharing is developed from existing literature. Two exploratory case studies are conducted using the model as a guiding framework. A key finding shows that perceived receiver knowledge needs and behaviours are Important motivators and inhibitors in sharer choices in intra-organisational knowledge sharing. This finding was suggested for both personalised and codified knowledge sharing strategies. The study suggests that for companies to realise more effective knowledge sharing, they should develop better ways to connect potential sharers with receivers\u27 real knowledge needs. The study also suggests that sharing on a need-to know basis impedes change In organisational power structures and prevents the integration of isolated pockets of knowledge that may yield new value.<br /

Receiver influences on knowledge sharing

Sharer consideration of receiver knowledge needs and behaviours may improve the quality and results of knowledge sharing. This paper examines how sharers may be influenced by perceived receiver knowledge needs and behaviours when making knowledge sharing choices. Such a consideration adopts an emancipatory approach aimed at acknowledging the rights of those employees who need knowledge to receive it, despite the conflicting goals, agendas or efficiency pressures of sharers. Based on a literature review, a receiver-based theory of knowledge sharing is proposed. Empirical data from two case studies highlight the key role played by perceived receiver knowledge needs and behaviours as motivators and inhibitors in sharer choices. A set of key receiver influences on knowledge sharing is provided. This study concludes that companies should develop better ways to connect potential sharers with the real knowledge needs of receivers, particularly when knowledge technologies mediate sharing. Further, the findings suggest that sharing on a need-to-know basis impedes change in organisational power structures and prevents the integration of isolated pockets of knowledge that may yield new value.<br /

Dynamic knowledge integration in socio-technical networks: an interpretive study of intranet use for knowledge integration

A major challenge facing firms competing in electronic business markets is the dynamic integration of knowledge within and beyond the firm, enabled by internet-based infrastructure and emergent fluid socio-technical networks. This paper explores how social actors dynamically employ intranets to integrate formal and informal knowledge within evolving socio-technical networks that emerge, permeate and extend beyond the organisational boundary. The paper presents two case studies that illustrate how static intranets can be useful for dynamically integrating knowledge when they are interwoven with other knowledge channels such as e-mail through which flows the informal knowledge needed to make sense of and situate formal organisational knowledge. The findings suggest that businesses should carefully examine how employees integrate intranets with other channels in their work, and the shaping of knowledge outcomes that flows from such use. There are practical implications for the proper skilling of thepeople who share and integrate knowledge in this way. The paper also provides a framework for dynamic knowledge integration in socio-technical networks, which can help underpin future research in this area.<br /

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Toward a receiver-based theory of knowledge sharing

Managers and researchers alike have sought new ways to address the challenges of sharing dispersed knowledge in modern business environments. Careful consideration by sharers of receivers\u27 knowledge needs and behaviours may improve the effectiveness of knowledge sharing. This research examines how sharers react to their perceptions of receivers\u27 knowledge needs and behaviours when making choices relating to sharing knowledge. The focus of this article is to propose and empirically explore a theoretical framework for a study of the role of the receiver in knowledge sharing--receiver-based theory. Data collected from two case studies highlight a key role played by perceived receiver knowledge needs and behaviours in shaping sharer choices when explicit knowledge is shared. A set of receiver influences on knowledge sharing is provided that highlights key receiver and sharer issues. The paper concludes that companies should develop better ways to connect potential sharers with receivers\u27 real knowledge needs. Further, the findings suggest that sharing on a need-to-know basis hinders change in organisational power structures, and prevents the integration of isolated pockets of knowledge that may yield new value.<br /