To maintain a sustained competitive position in the contemporary environment of  knowledge  economy,  organizations  as an open social systems must have an ability to learn and know  how to adapt to rapid changes  in a proper fashion so that organizational objectives will be achieved efficiently and effectively.  A multilevel approach is adopted proposing that organizational learning suffers from the lack of interest about the strategic competitive performance of the organization. This remains implicit almost in all models of organizational learning and there is little focus on how learning organizations achieve sustainable competitive advantage . A dynamic model that captures t

GA Al Omran, AA Noaimi, Z Al Madfai, H Al Hamamy, Journal of the Faculty of Medicine Baghdad, 2012

Background : Shoulder pain is a common problem that can pose difficult diagnostic and therapeutic challenges for the family physician It is the third most common musculoskeletal complaint in the general population, and account for 5% of all general practitioners musculoskeletal consults Objective: To determine the diagnostic performance of ultrasonography compared with the physical examination for detection of rotator cuff tears in painful shoulder syndrome. Method: Prospective study was done on seventy patients (48 male, 22 female), age ranged between 30-70 years (mean age 50 years), From February 2007 to July 2011, were subjected to comparative study in Al-Kindy teaching hospital with rotator cuff tears, including physical and ultrasonogr