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Resilience is commonly portrayed as a positive capability that allows individuals, groups, and organizations to thrive in dynamic contexts.This paper questions this oversimplified view based on a dialectical analysis of a telehealth innovation within a network of collaborating hospitals. We analyze the major contradictions that characterize the adoption of the innovation. First, we analyze contradictions between individuals and groups within each adopting organization. Second, we analyze contradictions between the adopting organizations. This multi-level analysis leads to a deeper understanding of resilience as a dialectical process. The analysis of the case shows that, although the participating individuals, groups, and organizations demonstrated apparent resilience in adopting the telehealth innovation, the innovation remained in a fragile state, where it was unclear whether it would continue to diffuse, stabilize as-is, or slowly deteriorate. Hence, while resilience facilitated swift and successful adoption, it also created tensions that endangered further diffusion and the long-term sustainability of the telehealth innovation. We suggest that understanding the future success of the innovation would be facilitated to a large extent by a dialectical analysis of the involved contradictions.

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Norovirus is one of the leading agents of gastroenteritis and is a major public health concern. In this study, the crystal structures of recombinant RNA-dependent RNA polymerase (RdRp) from murine norovirus-1 (MNV-1) and its complex with 5-fluorouracil (5FU) were determined at 2.5 Å resolution. Crystals with C2 symmetry revealed a dimer with half a dimer in the asymmetrical unit, and the protein exists predominantly as a monomer in solution, in equilibrium with a smaller population of dimers, trimers and hexamers. MNV-1 RdRp exhibited polymerization activity with a right-hand fold typical of polynucleotide polymerases. The metal ion modelled in close proximity to the active site was found to be coordinated tetrahedrally to the carboxyl groups of aspartate clusters. The orientation of 5FU observed in three molecules in the asymmetrical unit was found to be slightly different, but it was stabilized by a network of favourable interactions with the conserved active-site residues Arg185, Asp245, Asp346, Asp347 and Arg395. The information gained on the structural and functional features of MNV-1 RdRp will be helpful in understanding replication of norovirus and in designing novel therapeutic agents against this important pathogen.

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Purpose-The purpose of this paper is to help explain the paradox between the high potential of telehealth innovations and their slow diffusion by investigating the challenges involved in a successful case. Design/methodology/approach-The paper is based on a longitudinal study of a telestroke program from 2003-2007 seen from the point-of-view of the inventors. The program was initially used by a network of hospitals; it faced several challenges when the inventors sought to diffuse it to a broader marketplace; but, the inventors eventually succeeded to create a viable technology and business model. Findings-The authors offer a process model of this telehealth innovation consisting of four phases: invention, pilot test, commercialization, and penetration-with each phase demarcated by specific actors and activities. In addition, a chasm between the pilot test within a network of hospitals and the subsequent commercialization of a product aimed for the market is identified. Finally, the authors reveal how key actors negotiated the chasm to successfully diffuse the innovation beyond the initial hospital setting. Originality/value-The paper offers two contributions. First, it contributes a new model of IT-enabled innovation processes seen from the inventor's perspective and emphasizing the diffusion chasm as a key challenge. Second, it contributes a longitudinal, in-depth analysis of a telehealth innovation from initial invention to successful market penetration.