title: The impact of national cultures on structured knowledge transfer

authors: Chen, Jihong

subjects: China

abstract: Purpose – The purpose of this paper is to explore the impact of national culture on the structured knowledge transfer from a US-based (onshore) technical support center to an offshore support center in China. 
Design/methodology/approach – The research was conducted as an interpretive case study. Three techniques (i.e. document review, participant observation, and semi-structured interviews) were employed for data collection in the field. 
Findings – The findings identify that knowledge tacitness, knowledge gaps, cultural and communication difficulties and weak relationships were the critical barriers to successful knowledge transfer in a cross-cultural knowledge transfer context. It was found that, when a provider and a recipient are located in different individualism/collectivism, power distance, and uncertainty avoidance cultural dimensions, there will be a reduced likelihood of successful knowledge transfer in a structured knowledge transfer process. However, peer-to-peer help, close relationships and proactive learning may assist in decreasing the knowledge transfer difficulties. 
Research limitations/implications – The research was limited to one organization in one industry (the IT support industry) and in one country (China). There could be both industry-specific issues and national cultural issues that may affect the findings and conclusions. However, the paper has important practical implications for organizations that are trying to carry out transfer of organizational knowledge or to acquire organizational knowledge in a cross-cultural business context. 
Originality/value – The findings provide insight into the cultural issues implicated in the structured knowledge transfer process, when a knowledge provider and a recipient are from different cultural dimensions, as well as offering more general insight into the mechanism of knowledge transfer in the cross-cultural business context.

text: The impact of national cultures on structured knowledge transfer Purpose – The purpose of this paper is to explore the impact of national culture on the structured knowledge transfer from a US-based (onshore) technical support center to an offshore support center in China. 
Design/methodology/approach – The research was conducted as an interpretive case study. Three techniques (i.e. document review, participant observation, and semi-structured interviews) were employed for data collection in the field. 
Findings – The findings identify that knowledge tacitness, knowledge gaps, cultural and communication difficulties and weak relationships were the critical barriers to successful knowledge transfer in a cross-cultural knowledge transfer context. It was found that, when a provider and a recipient are located in different individualism/collectivism, power distance, and uncertainty avoidance cultural dimensions, there will be a reduced likelihood of successful knowledge transfer in a structured knowledge transfer process. However, peer-to-peer help, close relationships and proactive learning may assist in decreasing the knowledge transfer difficulties. 
Research limitations/implications – The research was limited to one organization in one industry (the IT support industry) and in one country (China). There could be both industry-specific issues and national cultural issues that may affect the findings and conclusions. However, the paper has important practical implications for organizations that are trying to carry out transfer of organizational knowledge or to acquire organizational knowledge in a cross-cultural business context. 
Originality/value – The findings provide insight into the cultural issues implicated in the structured knowledge transfer process, when a knowledge provider and a recipient are from different cultural dimensions, as well as offering more general insight into the mechanism of knowledge transfer in the cross-cultural business context.

year: 2010

title: When appearances are misleading: Psychosocial consequences of facial masking in Parkinson’s disease

authors: Wootton, Adrienne

subjects: Parkinson's disease

abstract: Facial masking, the loss of expressive facial mobility in Parkinson’s disease, has the potential to impact communication, emotion perception, subjective wellbeing, and social relationship functioning. This unique symptom has been studied in the context of the healthcare and casual interactions, but little is known about how it affects people who have Parkinson’s in their family interactions. Since no cure for Parkinson’s disease presently exists, lessening the impact of the condition is an important aspect of Parkinson’s management.  However, research has been missing the voices of those who experience facial masking. This gap underscores the need to deepen our understanding of this symptom and the difficulties it may create. Thus, this research project sought to understand experiences and challenges related to facial masking in Parkinson’s, to transform those insights to targeted clinical tools, and to investigate the significance of masking in the psychosocial wellbeing of both people with Parkinson’s and their partners or family members. 
	In Study 1, in-depth personal accounts were collected of nine people who had Parkinson’s and their spouses or partners were separately interviewed about their experiences of facial masking. The study aimed to explore the common experiences and challenges related to facial masking, on an individual level and within close relationships.  Facial masking was often falsely perceived by partners as a negative affect and wrongly interpreted to mean a lack of care or interest. The loss of expression and its misinterpretation was described as a barrier to emotional connection by some participants. Loss of the ability to physically embody one’s thoughts and feelings was unsettling and distressing for both people with Parkinson’s and their partners. The interviews revealed most participants had low awareness that this symptom was an aspect of Parkinson’s, with nearly all indicating a wish for greater education and support around this symptom. 
	Study 2 involved the development and validation of two separate questionnaires that evaluated the socioemotional consequences of facial masking, one for individuals who have Parkinson’s and the other for their partner, spouse, or other family member. Questionnaire items were derived from the findings of Study 1 and a review of relevant concepts in existing literature. Psychometric properties of the questionnaires were statistically evaluated among a community sample of 80 people who had Parkinson’s and 58 of their significant others. This included an item-level assessment, an exploratory investigation of the factor structure, an evaluation of the internal and test-retest reliability, and evaluation of the construct validity of the questionnaires. Results indicated the questionnaires had good reliability and initial evidence of validity. Modified (revised) versions of the questionnaires were produced based on the psychometric findings of Study 2. 	
	Study 3 described the functioning of the participants in the psychometric study above. This study investigated the relationship between perceptions of facial masking and various psychosocial outcomes, and a study-specific measure of the impact of facial masking in Parkinson’s (developed in Study 2). Ratings of facial masking were made by self-report and significant other reports, along with healthcare professional and researcher ratings based on a videotaped conversation. Healthcare professional ratings of FM were not found to be significantly related to self/significant other ratings of facial masking severity. Overall, having more negative consequences of FM was linked to poorer psychosocial outcomes, but suggested people with Parkinson’s and their significant others may be affected in different ways. 
	Findings of this programme of research add to what is known about the consequences of facial masking in casual and healthcare provider social interactions, by examining this symptom from the perspective of those living with facial masking in Parkinson’s. The results build upon and are generally consistent with the small amount of existing evidence showing that facial masking can have a detrimental impact on subjective wellbeing. The main implication of this research is that facial masking is a topic that warrants greater clinical attention and communication. The findings also call attention to the fact that facial masking is a common feature of Parkinson’s, yet in New Zealand, people with the condition and their families seem to lack knowledge about this symptom and desire greater education and support.

text: When appearances are misleading: Psychosocial consequences of facial masking in Parkinson’s disease Facial masking, the loss of expressive facial mobility in Parkinson’s disease, has the potential to impact communication, emotion perception, subjective wellbeing, and social relationship functioning. This unique symptom has been studied in the context of the healthcare and casual interactions, but little is known about how it affects people who have Parkinson’s in their family interactions. Since no cure for Parkinson’s disease presently exists, lessening the impact of the condition is an important aspect of Parkinson’s management.  However, research has been missing the voices of those who experience facial masking. This gap underscores the need to deepen our understanding of this symptom and the difficulties it may create. Thus, this research project sought to understand experiences and challenges related to facial masking in Parkinson’s, to transform those insights to targeted clinical tools, and to investigate the significance of masking in the psychosocial wellbeing of both people with Parkinson’s and their partners or family members. 
	In Study 1, in-depth personal accounts were collected of nine people who had Parkinson’s and their spouses or partners were separately interviewed about their experiences of facial masking. The study aimed to explore the common experiences and challenges related to facial masking, on an individual level and within close relationships.  Facial masking was often falsely perceived by partners as a negative affect and wrongly interpreted to mean a lack of care or interest. The loss of expression and its misinterpretation was described as a barrier to emotional connection by some participants. Loss of the ability to physically embody one’s thoughts and feelings was unsettling and distressing for both people with Parkinson’s and their partners. The interviews revealed most participants had low awareness that this symptom was an aspect of Parkinson’s, with nearly all indicating a wish for greater education and support around this symptom. 
	Study 2 involved the development and validation of two separate questionnaires that evaluated the socioemotional consequences of facial masking, one for individuals who have Parkinson’s and the other for their partner, spouse, or other family member. Questionnaire items were derived from the findings of Study 1 and a review of relevant concepts in existing literature. Psychometric properties of the questionnaires were statistically evaluated among a community sample of 80 people who had Parkinson’s and 58 of their significant others. This included an item-level assessment, an exploratory investigation of the factor structure, an evaluation of the internal and test-retest reliability, and evaluation of the construct validity of the questionnaires. Results indicated the questionnaires had good reliability and initial evidence of validity. Modified (revised) versions of the questionnaires were produced based on the psychometric findings of Study 2. 	
	Study 3 described the functioning of the participants in the psychometric study above. This study investigated the relationship between perceptions of facial masking and various psychosocial outcomes, and a study-specific measure of the impact of facial masking in Parkinson’s (developed in Study 2). Ratings of facial masking were made by self-report and significant other reports, along with healthcare professional and researcher ratings based on a videotaped conversation. Healthcare professional ratings of FM were not found to be significantly related to self/significant other ratings of facial masking severity. Overall, having more negative consequences of FM was linked to poorer psychosocial outcomes, but suggested people with Parkinson’s and their significant others may be affected in different ways. 
	Findings of this programme of research add to what is known about the consequences of facial masking in casual and healthcare provider social interactions, by examining this symptom from the perspective of those living with facial masking in Parkinson’s. The results build upon and are generally consistent with the small amount of existing evidence showing that facial masking can have a detrimental impact on subjective wellbeing. The main implication of this research is that facial masking is a topic that warrants greater clinical attention and communication. The findings also call attention to the fact that facial masking is a common feature of Parkinson’s, yet in New Zealand, people with the condition and their families seem to lack knowledge about this symptom and desire greater education and support.

year: 2021

title: Geographical and ethnic differences of osteoarthritis-associated hip and knee replacement surgeries in New Zealand: a population-based cross-sectional study

authors: Lao, Chunhuan

abstract: Objectives To (1) explore the regional and ethnic differences in rates of publicly funded osteoarthritis-associated hip and knee replacement surgeries and (2) investigate the mortality after surgery.

Design Population-based, retrospective, cross-sectional study.

Setting General population in New Zealand.

Participants Patients with osteoarthritis who underwent publicly funded primary hip and knee replacement surgeries in 2005–2017. Patients aged 14–99 years were included.

Primary and secondary outcome measures Age-standardised rate, standardised mortality ratio (SMR) and 30 days, 90 days and 1 year mortality.

Results We identified 53 439 primary hip replacements and 50 072 primary knee replacements with a diagnosis of osteoarthritis. The number and age-standardised rates of hip and knee replacements increased over time. Māori had the highest age-standardised rate of hip replacements, followed by European/others and Pacific, and Asian had the lowest rate. Pacific had the highest age-standardised rate of knee replacements, followed by Māori and European/others, and Asian had the lowest rate. The Northern Health Network had the lowest rate of hip surgeries, and the Southern Health Network had the lowest rate of knee surgeries. The SMRs of patients undergoing hip and knee replacements were lower than the general population: 0.92 (95% CI 0.89 to 0.95) for hip and 0.79 (95% CI 0.76 to 0.82) for knee. The SMRs were decreasing over time. The patterns of 30 days, 90 days and 1 year mortality were similar to the SMR.

Conclusions The numbers of publicly funded osteoarthritis-associated primary hip and knee replacements are steadily increasing. Māori people had the highest age-standardised rate of hip replacements and Pacific people had the highest rate of knee replacements. The Northern Health Network had the lowest rate of hip surgeries, and the Southern Health Network had the lowest rate of knee surgeries. Compared with the general population, patients who had hip and knee replacements have a better life expectancy.

text: Geographical and ethnic differences of osteoarthritis-associated hip and knee replacement surgeries in New Zealand: a population-based cross-sectional study Objectives To (1) explore the regional and ethnic differences in rates of publicly funded osteoarthritis-associated hip and knee replacement surgeries and (2) investigate the mortality after surgery.

Design Population-based, retrospective, cross-sectional study.

Setting General population in New Zealand.

Participants Patients with osteoarthritis who underwent publicly funded primary hip and knee replacement surgeries in 2005–2017. Patients aged 14–99 years were included.

Primary and secondary outcome measures Age-standardised rate, standardised mortality ratio (SMR) and 30 days, 90 days and 1 year mortality.

Results We identified 53 439 primary hip replacements and 50 072 primary knee replacements with a diagnosis of osteoarthritis. The number and age-standardised rates of hip and knee replacements increased over time. Māori had the highest age-standardised rate of hip replacements, followed by European/others and Pacific, and Asian had the lowest rate. Pacific had the highest age-standardised rate of knee replacements, followed by Māori and European/others, and Asian had the lowest rate. The Northern Health Network had the lowest rate of hip surgeries, and the Southern Health Network had the lowest rate of knee surgeries. The SMRs of patients undergoing hip and knee replacements were lower than the general population: 0.92 (95% CI 0.89 to 0.95) for hip and 0.79 (95% CI 0.76 to 0.82) for knee. The SMRs were decreasing over time. The patterns of 30 days, 90 days and 1 year mortality were similar to the SMR.

Conclusions The numbers of publicly funded osteoarthritis-associated primary hip and knee replacements are steadily increasing. Māori people had the highest age-standardised rate of hip replacements and Pacific people had the highest rate of knee replacements. The Northern Health Network had the lowest rate of hip surgeries, and the Southern Health Network had the lowest rate of knee surgeries. Compared with the general population, patients who had hip and knee replacements have a better life expectancy.

year: 2019