Corporate Entrepreneurship: Building a Knowledge-Based View of the Firm

Increasing globalisation and dynamism in the economy has made it necessary for established companies to regenerate themselves and renew their ability to compete. This is the goal of Corporate Entrepreneurship (CE) activities, which involve extending the firm’s domain of competence and corresponding opportunity set, through internally generated new resource combinations. The purpose of this study is to contribute to the understanding of the way the process of CE is developed within the organizations. In order to achieve this, a model relating key components of the CE process (opportunity, initiative and capability) to five phases of knowledge creation taken from Nonaka & Takeuchi is proponed.organizational knowledge creation; corporate entrepreneurship; knowledge-base view; innovation; development of capabilities

The Role of Social and Institutional Contexts in Social Innovations of Spanish Academic Spinoffs

Social innovations developed by academic spinoffs (ASOs) are acquiring an ever-increasing relevance in the literature on academic entrepreneurship. Previous studies have considered the importance of the social and institutional contexts of entrepreneurial ecosystems for the development of these innovations, although a greater depth of analysis is required in this field of study. This research analyzes the influence of the frequency of contact with agents of social and institutional contexts of the entrepreneurial ecosystem on the social innovations of ASOs. From a sample of 173 Spanish ASOs, the results indicate that frequent contact with government and academic support units improves this type of innovation of ASOs. Regarding social context, an increase in the frequency of contact with customers, suppliers, and competitors favors the development of social innovation. However, frequent contact with venture capital firms inhibits the development of this type of innovation

Opportunity recognition in academic spin-offs: a contingency approach

This paper analyses the factors that influence opportunity recognition of academic spin-offs from a contingency perspective. We focus on factors linked to the academic entrepreneur and propose that their relevance for explaining opportunity recognition in academic spin-offs depends on the context in which these firms operate: discovery (the necessary information for entrepreneurs to assess the new opportunities is available in the market) vs. creation (complete information about opportunity exploitation and the likelihood of achieving certain outcomes is not available in the market). Results obtained in a sample of 167 Spanish academic spin-offs show that, in a discovery context, academic entrepreneurs’ opportunity recognition is positively related to entrepreneurial self-efficacy, previous managerial experience, and access to academic and industry networks. In a creation context, only entrepreneurial self-efficacy and access to industry networks become critical to opportunity recognition, whereas previous managerial experience exerts a negative effect. Our results also show that the most relevant factor in a discovery context is previous managerial experience, while in a creation context, entrepreneurial self-efficacy is the most significant.Área de Organización de Empresa

Effectiveness of an intervention for improving drug prescription in primary care patients with multimorbidity and polypharmacy:Study protocol of a cluster randomized clinical trial (Multi-PAP project)

This study was funded by the Fondo de Investigaciones Sanitarias ISCIII (Grant Numbers PI15/00276, PI15/00572, PI15/00996), REDISSEC (Project Numbers RD12/0001/0012, RD16/0001/0005), and the European Regional Development Fund ("A way to build Europe").Background: Multimorbidity is associated with negative effects both on people's health and on healthcare systems. A key problem linked to multimorbidity is polypharmacy, which in turn is associated with increased risk of partly preventable adverse effects, including mortality. The Ariadne principles describe a model of care based on a thorough assessment of diseases, treatments (and potential interactions), clinical status, context and preferences of patients with multimorbidity, with the aim of prioritizing and sharing realistic treatment goals that guide an individualized management. The aim of this study is to evaluate the effectiveness of a complex intervention that implements the Ariadne principles in a population of young-old patients with multimorbidity and polypharmacy. The intervention seeks to improve the appropriateness of prescribing in primary care (PC), as measured by the medication appropriateness index (MAI) score at 6 and 12months, as compared with usual care. Methods/Design: Design:pragmatic cluster randomized clinical trial. Unit of randomization: family physician (FP). Unit of analysis: patient. Scope: PC health centres in three autonomous communities: Aragon, Madrid, and Andalusia (Spain). Population: patients aged 65-74years with multimorbidity (≥3 chronic diseases) and polypharmacy (≥5 drugs prescribed in ≥3months). Sample size: n=400 (200 per study arm). Intervention: complex intervention based on the implementation of the Ariadne principles with two components: (1) FP training and (2) FP-patient interview. Outcomes: MAI score, health services use, quality of life (Euroqol 5D-5L), pharmacotherapy and adherence to treatment (Morisky-Green, Haynes-Sackett), and clinical and socio-demographic variables. Statistical analysis: primary outcome is the difference in MAI score between T0 and T1 and corresponding 95% confidence interval. Adjustment for confounding factors will be performed by multilevel analysis. All analyses will be carried out in accordance with the intention-to-treat principle. Discussion: It is essential to provide evidence concerning interventions on PC patients with polypharmacy and multimorbidity, conducted in the context of routine clinical practice, and involving young-old patients with significant potential for preventing negative health outcomes. Trial registration: Clinicaltrials.gov, NCT02866799Publisher PDFPeer reviewe

Facilitadores de los procesos de compartir conocimiento y su influencia sobre la innovación

This paper pursues two aims. Firstly, to indentify knowledge sharing enablers, and secondly, to analyze the effect of knowledge sharing processes on innovation performance. Regarding the first aim, two groups of factors have been considered: motivational factors, such as affective commitment and high involvement human resource management practices; and factors that create the opportunity to share knowledge, including informal communication, structured teamwork and information and communication technologies. Hypotheses have been tested on a sample of 87 Spanish innovative firms. Results show that both motivational factors positively influence the extent to which knowledge is shared, playing affective commitment a partial mediator role between high involvement practices and knowledge sharing. Regarding opportunity factors, only those that allow face to face interactions, such as informal communication and teamwork, represents effective mechanisms to encourage knowledge sharing processes. Finally, knowledge sharing within the organization positively affects innovation performance.Este trabajo persigue un doble objetivo. Por un lado, identificar facilitadores del proceso de compartir conocimiento, y por otro, analizar el efecto de dicho proceso sobre el desempeño innovador. Con respecto al primer objetivo, se han considerado dos grupos de facilitadores: factores motivacionales, como el compromiso afectivo y las prácticas de recursos humanos de alta implicación; y factores de oportunidad, como la comunicación informal, equipos de trabajo y tecnologías de la información y comunicación. Las hipótesis se han contrastado en una muestra de 87 empresas innovadoras españolas. Los resultados evidencian que los factores motivacionales influyen positivamente sobre el grado en que se comparte conocimiento, desempeñando el compromiso afectivo un efecto mediador parcial entre las prácticas de alta implicación y compartir conocimiento. Respecto a los factores de oportunidad, sólo los que permiten una interacción cara a cara, como la comunicación informal y los equipos, constituyen mecanismos efectivos para favorecer los procesos de compartir conocimiento. Finalmente, compartir conocimiento dentro de la organización afecta positivamente al desempeño innovador de las empresas

Contemporary use of cefazolin for MSSA infective endocarditis: analysis of a national prospective cohort

Objectives: This study aimed to assess the real use of cefazolin for methicillin-susceptible Staphylococcus aureus (MSSA) infective endocarditis (IE) in the Spanish National Endocarditis Database (GAMES) and to compare it with antistaphylococcal penicillin (ASP). Methods: Prospective cohort study with retrospective analysis of a cohort of MSSA IE treated with cloxacillin and/or cefazolin. Outcomes assessed were relapse; intra-hospital, overall, and endocarditis-related mortality; and adverse events. Risk of renal toxicity with each treatment was evaluated separately. Results: We included 631 IE episodes caused by MSSA treated with cloxacillin and/or cefazolin. Antibiotic treatment was cloxacillin, cefazolin, or both in 537 (85%), 57 (9%), and 37 (6%) episodes, respectively. Patients treated with cefazolin had significantly higher rates of comorbidities (median Charlson Index 7, P <0.01) and previous renal failure (57.9%, P <0.01). Patients treated with cloxacillin presented higher rates of septic shock (25%, P = 0.033) and new-onset or worsening renal failure (47.3%, P = 0.024) with significantly higher rates of in-hospital mortality (38.5%, P = 0.017). One-year IE-related mortality and rate of relapses were similar between treatment groups. None of the treatments were identified as risk or protective factors. Conclusion: Our results suggest that cefazolin is a valuable option for the treatment of MSSA IE, without differences in 1-year mortality or relapses compared with cloxacillin, and might be considered equally effective

Initial invasive or conservative strategy for stable coronary disease

BACKGROUND Among patients with stable coronary disease and moderate or severe ischemia, whether clinical outcomes are better in those who receive an invasive intervention plus medical therapy than in those who receive medical therapy alone is uncertain. METHODS We randomly assigned 5179 patients with moderate or severe ischemia to an initial invasive strategy (angiography and revascularization when feasible) and medical therapy or to an initial conservative strategy of medical therapy alone and angiography if medical therapy failed. The primary outcome was a composite of death from cardiovascular causes, myocardial infarction, or hospitalization for unstable angina, heart failure, or resuscitated cardiac arrest. A key secondary outcome was death from cardiovascular causes or myocardial infarction. RESULTS Over a median of 3.2 years, 318 primary outcome events occurred in the invasive-strategy group and 352 occurred in the conservative-strategy group. At 6 months, the cumulative event rate was 5.3% in the invasive-strategy group and 3.4% in the conservative-strategy group (difference, 1.9 percentage points; 95% confidence interval [CI], 0.8 to 3.0); at 5 years, the cumulative event rate was 16.4% and 18.2%, respectively (difference, 121.8 percentage points; 95% CI, 124.7 to 1.0). Results were similar with respect to the key secondary outcome. The incidence of the primary outcome was sensitive to the definition of myocardial infarction; a secondary analysis yielded more procedural myocardial infarctions of uncertain clinical importance. There were 145 deaths in the invasive-strategy group and 144 deaths in the conservative-strategy group (hazard ratio, 1.05; 95% CI, 0.83 to 1.32). CONCLUSIONS Among patients with stable coronary disease and moderate or severe ischemia, we did not find evidence that an initial invasive strategy, as compared with an initial conservative strategy, reduced the risk of ischemic cardiovascular events or death from any cause over a median of 3.2 years. The trial findings were sensitive to the definition of myocardial infarction that was used

Health-status outcomes with invasive or conservative care in coronary disease

BACKGROUND In the ISCHEMIA trial, an invasive strategy with angiographic assessment and revascularization did not reduce clinical events among patients with stable ischemic heart disease and moderate or severe ischemia. A secondary objective of the trial was to assess angina-related health status among these patients. METHODS We assessed angina-related symptoms, function, and quality of life with the Seattle Angina Questionnaire (SAQ) at randomization, at months 1.5, 3, and 6, and every 6 months thereafter in participants who had been randomly assigned to an invasive treatment strategy (2295 participants) or a conservative strategy (2322). Mixed-effects cumulative probability models within a Bayesian framework were used to estimate differences between the treatment groups. The primary outcome of this health-status analysis was the SAQ summary score (scores range from 0 to 100, with higher scores indicating better health status). All analyses were performed in the overall population and according to baseline angina frequency. RESULTS At baseline, 35% of patients reported having no angina in the previous month. SAQ summary scores increased in both treatment groups, with increases at 3, 12, and 36 months that were 4.1 points (95% credible interval, 3.2 to 5.0), 4.2 points (95% credible interval, 3.3 to 5.1), and 2.9 points (95% credible interval, 2.2 to 3.7) higher with the invasive strategy than with the conservative strategy. Differences were larger among participants who had more frequent angina at baseline (8.5 vs. 0.1 points at 3 months and 5.3 vs. 1.2 points at 36 months among participants with daily or weekly angina as compared with no angina). CONCLUSIONS In the overall trial population with moderate or severe ischemia, which included 35% of participants without angina at baseline, patients randomly assigned to the invasive strategy had greater improvement in angina-related health status than those assigned to the conservative strategy. The modest mean differences favoring the invasive strategy in the overall group reflected minimal differences among asymptomatic patients and larger differences among patients who had had angina at baseline