Are Imitation and Replication Mirror Image Problems?

All knowledge is context dependent. The relevant context is the social community where it resides, i.e. the ‘epistemic community’ formed as groups of people define and legitimize the knowledge they possess. In the mutual engagement in a common enterprise, epistemic communities develop, maintain and nurture the codes, tools and theories that provide the basis of their practice. Commonalities of code, tools and theory facilitate both voluntary transfer and involuntary imitation of knowledge within communities, also ones spanning organizational boundaries. Conversely, knowledge transfer between different epistemic communities, whether desired or unintended, is often cumbersome and fraught with difficulties. In order to achieve effective integration and cooperation between its various professional communities and subcultures, firms must therefore undertake investments in boundary-spanning mechanisms. Since these investments are specific to the context in which they take place and to the transactions that they enable, they cannot easily be organized through arm’s length contracts. Firms exist because they have a relative advantage over markets in the integration of diverse knowledge. However, the associated capabilities need not translate into a relative advantage also in the transfer of knowledge, i.e. knowledge exchanged between members of the same epistemic community. Within communities, knowledge disseminates with relative ease both intentionally and through emulation. Knowledge thus acquired can generally be applied also outside the context of the exchange and the effort or investment expended in its acquisition is not transaction specific. The governance mode applied in such exchanges is therefore determined by strategic and contextual factors, including those of traditional transaction cost logic

Governance and Knowledge Exchange within and Between Epistemic Communities

All knowledge is context dependent. The relevant context is the social community where it resides, i.e. the ‘epistemic community’ formed as groups of people define and legitimize the knowledge they possess. In the mutual engagement in a common enterprise, epistemic communities develop, maintain and nurture the codes, tools and theories that provide the basis of their practice. Commonalities of code, tools and theory facilitate both voluntary transfer and involuntary imitation of knowledge within communities, also ones spanning organizational boundaries. Conversely, knowledge transfer between different epistemic communities, whether desired or unintended, is often cumbersome and fraught with difficulties. In order to achieve effective integration and cooperation between its various professional communities and subcultures, firms must therefore undertake investments in boundary-spanning mechanisms. Since these investments are specific to the context in which they take place and to the transactions that they enable, they cannot easily be organized through arm’s length contracts. Firms exist because they have a relative advantage over markets in the integration of diverse knowledge. However, the associated capabilities need not translate into a relative advantage also in the transfer of knowledge, i.e. knowledge exchanged between members of the same epistemic community. Within communities, knowledge disseminates with relative ease both intentionally and through emulation. Knowledge thus acquired can generally be applied also outside the context of the exchange and the effort or investment expended in its acquisition is not transaction specific. The governance mode applied in such exchanges is therefore determined by strategic and contextual factors, including those of traditional transaction cost logic

The firm as an epistemic community: The knowledge based view revisited

Based on a social-constructivist conceptualization of knowledge as residing in groups of practitioners, epistemic communities, this paper proposes a new perspective on the knowledge based view of the firm and sketches the outline of a new research agenda. It argues that the cost of governing knowledge processes depends as much on the cognitive background of the exchange partners as on the tacitness of the knowledge. Firms exist because they may form epistemic communities in their own right with enabling and motivational properties superior to those of markets in the governance of knowledge processes across epistemic boundaries. Establishing a firm as an epistemic community requires transaction specific investments that are difficult to realize under market forms of governance

Toupet versus Dor as a procedure to prevent reflux after cardiomyotomy for achalasia: Results of a randomised clinical trial

AbstractBackgroundThe optimal anti-reflux procedure after Heller cardiomyotomy for oesophageal achalasia remains unclear. The most commonly used procedure is the anterior partial fundoplication according to Dor, although during recent years the posterior counterpart (Toupet) has become popular.MethodsPatients with newly diagnosed achalasia and referred for cardiomyotomy were randomised to receive either an anterior or partial posterior fundoplication following a classical cardiomyotomy. The effect of surgery was assessed during the first postoperative year by Eckardt scores, EORTC QLQ-OES18 scores and HRQL questionnaires. Timed barium oesophagogram (TBO) and ambulatory 24-h pH monitoring were performed to determine oesophageal emptying and the degree of reflux control, respectively.ResultsForty-two patients were randomised into Dor (n = 20) and Toupet (n = 22) groups. Eckardt scores improved dramatically with both procedures, but the EORTC QLQ-OES18 (functional scales) scores revealed significantly better relative improvements in the Toupet group compared to the Dor repair (P = 0.044). Corresponding advantages in favour of Toupet were observed postoperatively in the percentage of oesophageal emptying at TBO (P = 0.011 in height and P = 0.018 in area), an effect not observed in the Dor group. There were no other significant differences recorded between the study groups concerning HRQL evaluations and objective assessment of gastro-oesophageal acid reflux.ConclusionsA partial posterior fundoplication after cardiomyotomy seems to achieve more improvement in oesophageal emptying and EORTC QLQ-OES18 functional scale scores than the anterior fundoplication. Otherwise no differences between the two anti-reflux repairs were noted.Trial registration numberClinicalTrials.gov Identifier: NCT01933373