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\"Oaxaca is known for many things--its indigenous groups, archaeological sites, crafts, and textiles--but not for mental health care. When one talks with Oaxacans about mental health, most say it's a taboo topic and that people there think you \"have to be crazy to go to a psychologist.\" Yet throughout Oaxaca are signs advertising the services of a psicâologico; there are prominent conferences of mental health professionals; and self-help groups like Neurotics Anonymous thrive, where participants rise to say, \"Hola, mi nombre es Raquel, y soy neurâotica.\"How does one explain the recent growth of Euroamerican-style therapies in the region? Author Whitney L. Duncan analyzes this phenomenon of \"psy-globalization\" and develops a rich ethnography of its effects on Oaxacans' understandings of themselves and their emotions, ultimately showing how globalizing forms of care are transformative for and transformed by the local context. She also delves into the mental health impacts of migration from Mexico to the United States, both for migrants who return and for the family members they leave behind.This book is a recipient of the Norman L. and Roselea J. Goldberg Prize from Vanderbilt University Press for the best book in the area of medicine\"-- Provided by publisher.

How and when does team member voice facilitate team innovation? Integrating research on member voice and a dialectic perspective of innovation, we advance a model in which team member promotive voice enhances team innovation through team knowledge utilization, whereas team member prohibitive voice enhances team innovation through team reflexivity in a nonlinear fashion. We further propose that the differential effects of team member promotive and prohibitive voice will be stronger at different stages (idea generation vs. idea implementation) of the innovation cycle. Survey data from 78 research and development project teams showed a positive indirect effect between team member promotive voice and team innovation through team knowledge utilization, although this relationship was also mediated through team reflexivity. Moreover, the indirect effect of team member promotive voice on team innovation via team knowledge utilization was stronger for teams in the idea generation stage of team innovation. Results also confirmed a nonlinear indirect relationship between team member prohibitive voice and team innovation via team reflexivity such that the positive effects of team member prohibitive voice tapered off at high levels. Contrary to our expectations, the effects of prohibitive voice held regardless of stage. Theoretical and practical implications are discussed.

Purpose This paper aims to investigate the following issues: the mechanisms through which different types of top management team’s social capital influence the innovation quality of high-tech firms, and the moderating effect of organizational knowledge utilization on the relationship between top management team’s social capital and innovation quality in high-tech firms. Design/methodology/approach This study categorizes top management team’s social capital into political, business and academic dimensions, investigating their impact on innovation quality in high-tech firms. Furthermore, a research model is developed with organizational knowledge utilization as the moderating variable. Data from Chinese high-tech firms between 2010 and 2019 are collected as samples for analysis. Findings The innovation quality of high-tech firms shows an inverted U-shaped trend as the top management team’s political capital and business capital increase. The top management team’s academic capital has a significantly positive correlation with the innovation quality of high-tech firms. Moreover, organizational knowledge utilization plays a significant moderating role in the relationship between the top management team’s social capital and innovation quality in high-tech firms. Originality/value This study explores the relationship among different dimensions of top management team’s social capital, innovation quality and organizational knowledge utilization. It holds significant theoretical value in enriching and refining the interactions between top management team’s social capital, knowledge management theory and innovation management theory. In addition, it offers important practical implications for firms to rationally approach top management team’s social capital, emphasize top management team configuration management and establish a comprehensive and efficient organizational knowledge utilization mechanism.

Focus on evidence-based policymaking is greater than ever, and public spending on evaluations is rising. A primary merit of these expenditures is that politicians actually use new knowledge instrumentally - to influence and inform decision making. Nevertheless, we know surprisingly little about whether and how research-based knowledge is utilised. This paper presents a new way of documenting Degrees of Knowledge Utilisation: The DoKU-scale. The scale is tested empirically in a five-year meta-evaluation covering 54 evaluations and 334 legal sources. Through robust method triangulation, the DoKU-scale enables comparison of knowledge utilisation across large numbers of knowledge sources and over time.

Although the number of direct Ebola-related deaths from the 2013 to 2016 West African Ebola outbreak has been quantified, the number of indirect deaths, resulting from decreased utilization of routine health services, remains unknown. Such information is a key ingredient of health system resilience, essential for adequate allocation of resources to both ‘crisis response activities’ and ‘core functions’. Taking stock of indirect deaths may also help the concept of health system resilience achieve political traction over the traditional approach of disease-specific surveillance. This study responds to these imperatives by quantifying the extent of the drop in utilization of essential reproductive, maternal and neonatal health services in Sierra Leone during the Ebola outbreak by using interrupted time-series regression to analyse Health Management Information System (HMIS) data. Using the Lives Saved Tool, we then model the implication of this decrease in utilization in terms of excess maternal and neonatal deaths, as well as stillbirths. We find that antenatal care coverage suffered from the largest decrease in coverage as a result of the Ebola epidemic, with an estimated 22 percentage point (p.p.) decrease in population coverage compared with the most conservative counterfactual scenario. Use of family planning, facility delivery and post-natal care services also decreased but to a lesser extent (-6, -8 and -13 p.p. respectively). This decrease in utilization of life-saving health services translates to 3600 additional maternal, neonatal and stillbirth deaths in the year 2014–15 under the most conservative scenario. In other words, we estimate that the indirect mortality effects of a crisis in the context of a health system lacking resilience may be as important as the direct mortality effects of the crisis itself.

Instrumental knowledge utilization is the process whereby knowledge influences political decision making. Such processes are complex and, consequently, hard to measure. Nevertheless, knowing what determines degrees of knowledge utilization is a prerequisite for fostering more evidence-based policy making. Numerous factors that contribute to, and co-determine, knowledge utilization are beyond the reach of researchers, but among the factors that researchers can influence, one variable has been presented as being crucial: the degree to which researchers adapt their research to meet the demands of intended knowledge users. In other words, making their research comprehensible, operational, realistic in terms of interventions and implications, and appealing to users. Drawing on the conceptual work of Landry, Amara, and Lamari, this paper develops a new, and more direct, measurement of adaptation. This measurement is subsequently applied in an analysis employing the Degrees of Knowledge Utilization (DoKU) scale and, thus, extending Knudsen’s five-year meta-evaluation related to the Danish pesticide area. Surprisingly, the statistical tests show that degrees of adaptation have no significant influence on degrees of knowledge utilization.

Background Change agency in its various forms is one intervention aimed at improving the effectiveness of the uptake of evidence. Facilitators, knowledge brokers and opinion leaders are examples of change agency strategies used to promote knowledge utilization. This review adopts a realist approach and addresses the following question: What change agency characteristics work, for whom do they work, in what circumstances and why? Methods The literature reviewed spanned the period 1997-2007. Change agency was operationalized as roles that are aimed at effecting successful change in individuals and organizations. A theoretical framework, developed through stakeholder consultation formed the basis for a search for relevant literature. Team members, working in sub groups, independently themed the data and developed chains of inference to form a series of hypotheses regarding change agency and the role of change agency in knowledge use. Results 24, 478 electronic references were initially returned from search strategies. Preliminary screening of the article titles reduced the list of potentially relevant papers to 196. A review of full document versions of potentially relevant papers resulted in a final list of 52 papers. The findings add to the knowledge of change agency as they raise issues pertaining to how change agents’ function, how individual change agent characteristics effect evidence-informed health care, the influence of interaction between the change agent and the setting and the overall effect of change agency on knowledge utilization. Particular issues are raised such as how accessibility of the change agent, their cultural compatibility and their attitude mediate overall effectiveness. Findings also indicate the importance of promoting reflection on practice and role modeling. The findings of this study are limited by the complexity and diversity of the change agency literature, poor indexing of literature and a lack of theory-driven approaches. Conclusion This is the first realist review of change agency. Though effectiveness evidence is weak, change agent roles are evolving, as is the literature, which requires more detailed description of interventions, outcomes measures, the context, intensity, and levels at which interventions are implemented in order to understand how change agent interventions effect evidence-informed health care.

Purpose Effectively handling knowledge is crucial for any organization to survive and prosper in the turbulent environments of the modern era. Leadership is a central element for knowledge creation, acquisition, utilization and integration processes. Based on these considerations, this study aims to offer an overview of the evolution of the literature regarding the knowledge management-leadership relationship published over the past 20 years. Design/methodology/approach A bibliometric analysis coupled with a systematic literature review were performed over a data set of 488 peer-reviewed articles published from 1990 to 2018. Findings The authors discovered the existence of four well-polarized clusters with the following thematic focusses: human and relational aspects, systematic and performance aspects, contextual and contingent aspects and cultural and learning aspects. The authors then investigated each thematic cluster by reviewing the most relevant contributions within them. Research limitations/implications Based on the bibliometric analysis and the systematic literature review, the authors developed an interpretative framework aimed at uncovering several promising and little explored research areas, thus suggesting an agenda for future knowledge management-leadership research. Some steps of the paper selection process may have been biased by the interpretation of the researcher. The authors addressed this concern by performing a multiple human subject reading process whose reliability was confirmed by a Krippendorf’s alpha coefficient value >0.80. Originality/value To the best knowledge, this is the first study to map, systematize and discuss the literature concerned to the topic of the knowledge management-leadership relationship.

Background Recently, numerous disease network models have been developed using large-scale health utilization data. One widely used method for representing these networks as knowledge graphs is the random walk approach. However, random walks assume mutually exclusive transitions, making them inadequate for capturing multimorbidity and the inherent complexity of disease trajectories. To overcome this limitation, we propose a microsimulation-based method to extract disease trajectories and generate embeddings for disease network applications. Methods Using the previously developed disease progression network built on data from 50 million individuals in the Korean population, we used transition probabilities to model the progression from one disease to another. From each disease node, we simulated 100 trajectories, each consisting of 100 disease walks. These trajectories were embedded using Word2Vec. To evaluate the utility of the embeddings, we performed next-disease prediction using a Transformer model trained on Korea Health Panel Survey data from 12,746 individuals. For comparison, we also assessed embeddings generated directly from raw data and from standard random walks on the disease network. Results Embeddings derived directly from the data and via random walk both showed signs of overfitting, with minimum losses of 4.0521 and 3.8339, respectively. In contrast, the microsimulation-based embeddings achieved superior performance with a lower minimum loss of 3.8009. Furthermore, when visualized using the embedding projector, the microsimulation embeddings revealed more coherent and meaningful disease groupings. Conclusions These findings suggest that, from the perspective of pretrained foundation models, incorporating disease networks as knowledge graphs can enhance predictive performance in various prediction studies that utilize ICD-10 disease codes. Key messages • The disease networks can work like a knowledge graph to represent the relationship among diseases. • Microsimulation embedding can be effectively used when embedding disease networks.

Interventions for dementia caregivers should be scalable and available at the point of care. CommunityRx‐Dementia (CRxD) is an IT‐based intervention to improve caregiver outcomes by providing information about local community resources and connection to a resource navigator and online resource finder. We compared self‐reported unmet needs and resource knowledge among 343 caregivers enrolled in a randomized trial of CRxD vs usual care (UC). At baseline,1 and 3 months, caregivers’ reported their knowledge of and need for any of 14 resource types (e.g., respite care, end‐of‐life planning, food) and, at 12 months, they reported their use of acute care. For the outcomes of knowledge and needs, mixed‐effects regression models were fit with treatment arm, time, treatment arm by time interaction and baseline knowledge or needs as predictors. For acute care utilization outcomes, negative binomial regression models were fit with treatment group and baseline utilization as predictors. Incidence rate ratios (IRR) and corresponding 95% CIs were calculated. Participants (78% women, 81% non‐Hispanic Black, 49% aged 50‐64, 64% income ≥$50k/year) included both newer (22% 6 months‐2 years) and more experienced caregivers (44% > 5 years). At baseline, caregivers in both study arms reported an average of 4 unmet needs (87% ≥1, 65% ≥3, most often [61%] for caregiver education), and knew of an average of 6 resources. At 3 months, the number of known resources was greater in the CRxD than UC group (6.5 vs 5.2; β: 1.0, 95% CI 0.3, 1.7) and the number of unmet needs was lower (2.8 vs 3.6; β: ‐0.5, 95% CI ‐1.1, 0.0). Over 12 months, caregivers in CRxD had lower ED visits rates than UC participants (0.3 vs 0.5; IRR: 0.6, 95% CI 0.3, 0.9) but similar hospitalization rates (0.1 vs 0.2; IRR: 0.7, 95% CI 0.3, 1.2). This low‐intensity social care intervention for dementia caregivers may improve knowledge of available resources, decrease unmet needs, and reduce caregivers’ use of emergency care.