Our study examines brokering of situated knowledge within an organizational context, characterized by professional hierarchy. We examine how professional affiliation and associated power differentials impact upon knowledge brokering at the individual and group levels within an organization. Our empirical case, which combines social network analysis and qualitative fieldwork, is set in healthcare with a focus upon integration of management, psychosocial and clinical component knowledge domains deemed necessary for treatment of a long-term condition. Our study shows that peer-to-peer knowledge brokering, which is framed by professional hierarchy, remains pervasive with respect to medical knowledge brokering. However, social structures might be mediated through developing architectural knowledge, reflected in both formal and informal organizational routines and schema, which engenders community tendencies that transcend professional hierarchy, so that knowledge brokering is more widely distributed to benefit patients.

The systems approach, or systems thinking, has been intimately connected with the development of OR and management science initially through the work of founders such as Churchman and Ackoff and latterly through innovations such as soft systems. In this paper we have undertaken a review of the contribution that systems thinking has been making more recently, especially to the practice of OR. Systems thinking is a discipline in its own right, with many theoretical and methodological developments, but it is also applicable to almost any problem area because of its generality, and so such a review must always be selective. We have looked at the literature from both a theoretical and an applications orientation. In the first part we consider the main systems theories and methodologies in terms of their recent developments and also their applications. This covers: the systems approach, complexity theory, cybernetics, system dynamics, soft OR and PSMs, critical systems and multimethodology. In the second part we review the main domains of application: strategy, information systems, organisations, production and operations, ecology and agriculture, and medicine and health. Our overall conclusion is that while systems may not be well established institutionally, in terms of academic departments, it is incredibly healthy in terms of the quantity and variety of its applications.

Logistic regression analysis was performed on data drawn from a clinical trials database for Staphylococcus aureus septicaemia treated with teicoplanin. Variables analysed were age, body weight, mean pre-dose and post-dose serum teicoplanin concentrations, mean dose (mg or mg/kg body weight) and combination versus monotherapy. Only two variables correlated with clinical outcome at a significance level better than 0.05: age (P = 0.012) and mean pre-dose serum concentration (P = 0.010). The probability of successful treatment declined with age and increased with mean pre-dose serum concentration.

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1Highlights  Paper presents a conceptual framework and methodological guide for researching and understanding OR interventions. The paper outlines the main theoretical and methodological concerns that need to be appreciated in studying PSM interventions. The paper explores activity theory as an approach to study them. A case study describing the use of this approach is provided. AbstractThis article argues that OR interventions, particularly problem structuring methods (PSM), are complex events that cannot be understood by conventional methods alone. In this paper an alternative approach is introduced, where the units of analysis are the activity systems constituted by and constitutive of PSM interventions. The paper outlines the main theoretical and methodological concerns that need to be appreciated in studying PSM interventions. The paper then explores activity theory as an approach to study them. A case study describing the use of this approach is provided.