University of Kentucky

About: University of Kentucky is a education organization based out in Lexington, Kentucky, United States. It is known for research contribution in the topics: Population & Poison control. The organization has 43933 authors who have published 92195 publications receiving 3256087 citations. The organization is also known as: UK.

The knowledge chain model: activities for competitiveness

Abstract: Today, there is a growing recognition by researchers and practitioners about the importance of managing knowledge as a critical source for competitive advantage. Various assertions about competitiveness through knowledge management (KM) are consistent with results of empirical studies and lessons learned on the knowledge highways and byways. In spite of these macro-level contentions and success stories, there has been little investigation of a systematic means for studying connections between KM activity and competitiveness. This chapter advances a knowledge chain model that identifies and characterizes KM activities an organization can focus on to achieve competitiveness. The model is analogous to Porter’ s value chain and is grounded in a descriptive KM framework developed via a Delphi-study involving international KM experts. It is comprised of five primary activities that an organization’ s knowledge processors perform in manipulating knowledge resources, plus four secondary activities that support and guide their performance. Each activity is discussed in detail, including examples. Evidence is provided from the literature illustrating each activity’ s role in adding value to an organization to increase its competitiveness through improved productivity, agility, reputation, and innovation. In conclusion, we present some observations about avenues for future research to extend, test, and apply the model in business practices.

Laparoscopic ventral and incisional hernia repair in 407 patients.

Abstract: Background: Recurrence rates after primary repair of ventral and incisional hernias range from 25% to 52%. Recurrence after open surgery is less likely if mesh is used, but the wide fascial dissection and required flap creation increase complication rates. Laparoscopic techniques offer an alternative. Study Design: To assess the safety and efficacy of laparoscopic ventral and incisional herniorrhaphy, we reviewed the records of all our patients who underwent such a procedure from November 1993 to August 1999. A laparoscopic approach was attempted in all patients considered to require a mesh repair. Patient demographic characteristics, operative details, and outcomes were recorded. Results: Of 415 patients scheduled to undergo laparoscopic ventral or incisional herniorrhaphy, conversion to an open procedure was necessary in 8. All the remaining 407 patients (205 men and 202 women; mean age 53.2 years; range 13 to 88 years) were included in the study. Mean fascial defect size was 100.1 cm 2 (range 1 to 480 cm 2 ). In 97% of patients, expanded polytetrafluoroethylene mesh was used. Mean operating time was 97 minutes (range 11 to 270 minutes). Mean estimated blood loss was 35 mL (range 10 to 150 mL). Average hospital stay was 1.8 days (range 0 to 17 days). There were 53 complications (13.0%), including cellulitis of a trocar site, infection requiring mesh removal, prolonged suture pain, persistent seroma, intestinal injury, hematoma or postoperative bleeding, prolonged ileus, urinary retention, respiratory distress, fever, intraabdominal abscess, and trocar site herniation. There were no deaths. During a mean followup time of 23 months (range 1 to 60 months), there were 14 hernia recurrences (3.4%), 6 in patients in whom only a stapling device (no sutures) had been used to secure the mesh to the abdominal wall. Conclusions: Laparoscopic repair was completed in 98.1% of patients in whom it was attempted. The complication rate was acceptable. A short hospital stay and minimal blood loss were documented. The recurrence rate was 3.4%. Laparoscopic ventral and incisional hernia repair appear to be safe and effective.