In search of information systems value : a case study of the EHR benefits realisation efforts of three Swedish hospitals.

The Swedish public health care organisation could very well be undergoing its most significant change since its specialisation during the late 19th and early 20th century. At the heart of this change is a move from using manual patient journals to electronic health records (EHR). EHR are complex integrated organisational wide information systems (IS) that promise great benefits and value as well as presenting great challenges to the organisation. The Swedish public health care is not the first organisation to implement integrated IS, and by no means alone in their quest for realising the potential benefits and value that it has to offer. As organisations invest in IS they embark on a journey of value-creation and capture. A journey where a costbased approach towards their IS-investments is replaced with a value-centric focus, and where the main challenges lie in the practical day-to-day task of finding ways to intertwine technology, people and business processes. This has however proven to be a problematic task. The problematic situation arises from a shift of perspective regarding how to manage IS in order to gain value. This is a shift from technology delivery to benefits delivery; from an ISimplementation plan to a change management plan. The shift gives rise to challenges related to the inability of IS and the elusiveness of value. As a response to these challenges the field of IS-benefits management has emerged offering a framework and a process in order to better understand and formalise benefits realisation activities. In this thesis the benefits realisation efforts of three Swedish hospitals within the same county council are studied. The thesis focuses on the participants of benefits analysis projects; their perceptions, judgments, negotiations and descriptions of potential benefits. The purpose is to address the process where organisations seek to identify which potential IS-benefits to pursue and realise, this in order to better understand what affects the process, so that realisation actions of potential IS-benefits could be supported. A qualitative case study research design is adopted and provides a framework for sample selection, data collection, and data analysis. It also provides a framework for discussions of validity, reliability and generalizability. Findings displayed a benefits fluctuation, which showed that participants’ perception of what constituted potential benefits and value changed throughout the formal benefits management process. Issues like structure, knowledge, expectation and experience affected perception differently, and this in the end changed the amount and composition of potential benefits and value. Five dimensions of benefits judgment were identified and used by participants when finding accommodations of potential benefits and value to pursue. Identified dimensions affected participants’ perceptions, which in turn affected the amount and composition of potential benefits. During the formal benefits management process participants shifted between judgment dimensions. These movements emerged through debates and interactions between participants. Judgments based on what was perceived as expected due to one’s role and perceived best for the organisation as a whole were the two dominant benefits judgment dimensions. A benefits negotiation was identified. Negotiations were divided into two main categories, rational and irrational, depending on participants’ drive when initiating and participating in negotiations. In each category three different types of negotiations were identified having different characteristics and generating different outcomes. There was also a benefits negotiation process identified that displayed management challenges corresponding to its five phases. A discrepancy was also found between how IS-benefits are spoken of and how actions of IS benefits realisation are understood. This was a discrepancy between an evaluation and a realisation focus towards IS value creation. An evaluation focus described IS-benefits as well-defined and measurable effects and a realisation focus spoke of establishing and managing an on-going place of value creation. The notion of valuescape was introduced in order to describe and support the understanding of IS value creation. Valuescape corresponded to a realisation focus and outlined a value configuration consisting of activities, logic, structure, drivers and role of IS.

Corporate social responsibility in online retail – Perceptions from online discussions on Amazon

Online retail has experienced substantial growth due to the increased utilization of digital technologies. The growth in the industry has created numerous multinational corporations, which serve customers all around the world. As a result, the online retailers’ efforts in sustainability have been more often in publicity. Corporate Social Responsibility (CSR), the efforts going beyond the company’s interest in order to bring social good, have been discussed in the academic community for decades. While the various effects of CSR in retail and business generally have been realized, the research aims to make a contribution by examining the concept from the viewpoint of online retail by focusing on interaction at online discussion forums. The main research question asks: What is the role of online retailer CSR in the online discussion forum context? In order to answer this question, additional three sub-research questions are suggested: 1) What elements of CSR are relevant in the online retailer context? 2) How are discussion forums used in communication regarding CSR and online retail by different discusser types? 3) What kind of company perceptions and consumer behavior appear in online discussions of Amazon’s CSR? The study is qualitative of nature, using the content analysis research method to examine posts found from four different public online discussion forums. A qualitative, interpretative analysis was used, although quantitative measures regarding discussion posts were also presented. The analysis contains a coding process, where attributes are attached to discussion posts. As a result of the process, specific patterns can be indicated in order to categorize the posts. As the research uses Amazon as the case company, the case study method is also adopted. In the online retail context, ethics regarding the online retailer’s tax and labor policies are found as most relevant elements. Customers, using discussion forums to share their experiences and opinions regarding online retailer CSR efforts, are realized as the most prominent stakeholder. The research also highlights the role of online retailer employees providing details on internal business practices. However, the not realize the possibility to participate in discussions. Most discussion posts refer either to a positive, negative or mixed reaction towards CSR efforts, it is suggested that the concept is relevant also in online retail. Although online retailer CSR efforts are somewhat linked to company perceptions, the concept has a minimal role in consumer behavior. In online retail, CSR efforts can reduce the risk of being involved in discussions related to controversies. In addition, online retailer CSR efforts should communicate how the retailer contributes locally.

Governance of Healthcare Data: International Standards and Recommendations

In the global phenomenon, the aging population becomes a critical issue. Data and information concerning elderly citizens are increasing and are not well organized. In addition, these unstructured data and information cause the problems for decision makers. Since we live in a digital world, Information Technology is considered to be a tool in order to solve problems. Data, information, and knowledge are crucial components to facilitate success in IT service system. Therefore, it is necessary to study how to organize or to govern data from various sources related elderly citizens. The research is conducted due to the fact that there is no internationally accepted holistic framework for governance of data. The research limits the scope to study on the healthcare domain; however, the results can be applied to the other areas. The research starts with an ongoing research of Dahlberg and Nokkala (2015) as a theory. It explains the classification of existing data sources and their characteristics with the focus on managerial perspectives. Then the studies of existing frameworks at international and national level organizations have been performed to show the current frameworks, which have been used and are useful in compiling data on elderly citizens. The international organizations in this research are selected based on their reputations and the reliability to obtain information. The selected countries at national level provide different point of views between two countries. Australia is a forerunner in IT governance while Thailand is the country which the author has familiar knowledge of the current situation. Considered the discussions of frameworks at international and national organizations level illustrate the main characteristics of each framework. At international organization level gives precedence to the interoperability of exchanging data and information between different parties. Whereas at national level shows the importance of the acknowledgement of using frameworks throughout the country in order to make the frameworks to be effective. After the studies of both international and national organization levels, the thesis shows the summarized tables to answer the fitness to the proposed framework by Dahlberg and Nokkala whether the framework help to consolidate data from various sources with different formats, hierarchies, structures, velocities, and other attributes of data storages. In addition, suggestions and recommendations will be proposed for the future research.

Corporate social responsibility in online retail – Perceptions from online discussions on Amazon

Online retail has experienced substantial growth due to the increased utilization of digital technologies. The growth in the industry has created numerous multinational corporations, which serve customers all around the world. As a result, the online retailers’ efforts in sustainability have been more often in publicity. Corporate Social Responsibility (CSR), the efforts going beyond the company’s interest in order to bring social good, have been discussed in the academic community for decades. While the various effects of CSR in retail and business generally have been realized, the research aims to make a contribution by examining the concept from the viewpoint of online retail by focusing on interaction at online discussion forums. The main research question asks: What is the role of online retailer CSR in the online discussion forum context? In order to answer this question, additional three sub-research questions are suggested: 1) What elements of CSR are relevant in the online retailer context? 2) How are discussion forums used in communication regarding CSR and online retail by different discusser types? 3) What kind of company perceptions and consumer behavior appear in online discussions of Amazon’s CSR? The study is qualitative of nature, using the content analysis research method to examine posts found from four different public online discussion forums. A qualitative, interpretative analysis was used, although quantitative measures regarding discussion posts were also presented. The analysis contains a coding process, where attributes are attached to discussion posts. As a result of the process, specific patterns can be indicated in order to categorize the posts. As the research uses Amazon as the case company, the case study method is also adopted. In the online retail context, ethics regarding the online retailer’s tax and labor policies are found as most relevant elements. Customers, using discussion forums to share their experiences and opinions regarding online retailer CSR efforts, are realized as the most prominent stakeholder. The research also highlights the role of online retailer employees providing details on internal business practices. However, the not realize the possibility to participate in discussions. Most discussion posts refer either to a positive, negative or mixed reaction towards CSR efforts, it is suggested that the concept is relevant also in online retail. Although online retailer CSR efforts are somewhat linked to company perceptions, the concept has a minimal role in consumer behavior. In online retail, CSR efforts can reduce the risk of being involved in discussions related to controversies. In addition, online retailer CSR efforts should communicate how the retailer contributes locally.

Nietzsche's children : a physiological analysis of the scholar's task

Throughout Nietzsche's writings we find discussions of the proper relationship of the scholar/scientist to the philosopher, wi th the scholar of ten being presented in a derogatory light. In this thesis, I examine Nietzsche's por t rai t of the scholar through the lens of his physiological or clinical perspective as articulated by Dr. Daniel R. Ahern in his monograph entitled Nietzsche as Cultural Physician. My aim in doing so is to grasp the affirmative, creative aspect of this seemingly destructive polemic against scholars. I begin wi th a detailed discussion of Nietzsche's por t rai t of the scholar in Beyond Good and Evil. This includes an explication of Ahern's position, followed by an application of the diagnostic perspective to Nietzsche's discussion of the objective type, the skeptic, and the critic. I then look at how the characteristics of all three types are present in the Nietzschean 'free spirit.' I also discuss the physiological basis of esotericism in Nietzsche's work, as well as Nietzsche's revaluation of the scholarly vi r tue known as Red/ichkeit (or 'honesty'). I conclude wi th comments on the free spirit's relationship to the future.

Conflict of Interest Policies at Canadian Universities: Clarity and Content

Abstract Discussions of conflict of interest (COI) in the university have tended to focus on financial interests in the context of medical research; much less attention has been given to COI in general or to the policies that seek to manage COI. Are university COI policies accessible and understandable? To whom are these policies addressed (faculty, staff, students)? Is COI clearly defined in these policies and are procedures laid out for avoiding or remedying such situations? To begin tackling these important ethical and governance questions, our study examines the COI policies at the Group of Thirteen (G13) leading Canadian research universities. Using automated readability analysis tools and an ethical content analysis, we begin the task of comparing the strengths and weaknesses of these documents, paying particular attention to their clarity, readability, and utility in explaining and managing COI.

Nothing New (Ethically) Under the Sun: Policy & Clinical Implications of Nanomedicine

Article

Modulation of nociception and pain by attention and stress

Les facteurs psychologiques tels que l'hypnose, l'émotion, le stress et l’attention exercent un effet modulant puissant sur la nociception et la douleur. Toutefois, l’influence de l'attention sur la nociception et la douleur, ainsi que les mécanismes neuronaux sous-jacents, ne sont pas clairs. La littérature actuelle sur la modulation attentionnelle des réponses spinales nociceptives, telles que mesurées par le réflexe RIII, et de la perception de l’intensité de la douleur est discordante et souvent contradictoire. Ce mémoire fournit un nouveau cadre pour examiner la modulation du réflexe RIII et de la douleur par l’attention. Une tâche de discrimination sensorielle a été décomposée en trois composantes attentionnelles : la vigilance, l’orientation, et le contrôle exécutif. Auparavant, la nature multidimensionnelle de l’attention fut largement ignorée dans la littérature. Nous démontrons que les composantes attentionnelles ont des effets modulatoires distincts sur la nociception et la douleur et suggérons que ceci représente une partie de la confusion présente dans la littérature. En prenant compte du stress indépendamment, nous démontrons, pour la première fois, que le stress inhibe la modulation attentionnelle du réflexe RIII ce qui indique une interaction et dissociation de la modulation des réponses nociceptives par l’attention et le stress. Ces résultats importants clarifient, en grande partie, les contradictions dans la littérature, puisque les tâches cognitives produisent souvent des augmentations du stress ce qui confond l’interprétation des résultats. De plus, la tâche de discrimination inclut des stimuli visuels et somatosensoriels et révèle que l’influence de l'attention sur la douleur est spatialement spécifique tandis que la modulation attentionnelle de la nociception est spécifique à la modalité des stimuli, au moins en ce qui concerne les modalités examinées. A partir de ces résultats, un nouveau modèle de la modulation attentionnelle des processus de la douleur, basée sur les composantes attentionnelles, a été proposé. Celui-ci est appuyé par la littérature et fournit une explication systématique et intégratrice des résultats antérieurement contradictoires. De plus, à partir de ce modèle, plusieurs mécanismes neuronaux ont été proposés pour sous-tendre la modulation attentionnelle de la nociception et de la douleur.

Socio-Economic Dimensions of Health Care Development Among Tribals in Kerala: A Study of Tribal Communities in Wynad

The contemporary explanations and discussions of the relationship between medicine and health, and society centre around assumptions that can be broadly classified into three setsl. The first set considers health and illness as predominantly ‘biological’ and therefore, having nothing to do with the social and economic environment in which it occurs. The struggle to combat illness therefore, lies entirely within the purview of modern medicine which is neutral to economic or social change. The second considers practice of medicine as a natural science. It allows the doctor to separate himself from his subject matter, the patient, in the samelway as the natural scientist is assumed to separate himself from his subject matter, the natural world. As a 'science' and with the scientific method, it can produce unchallengable and autonomous body of knowledge which is free from the wider social and economic context. The third, different from the above, recognises the relationship between health, medicine and society. Social and environmental aspects as determinants of illness or of health comes to sharp focus here and it assigns to medicine the status of a mediator, the only viable mediator, between people and diseases. In this scheme of things the usefulness of medicine is unquestionable but the problem lies in not having enough of it to go arounds.

On the use of QoS requirements as base of multicast charging

We propose a charging scheme for cost distribution along a multicast tree when cost is the responsibility of the receivers. This scheme focuses on QoS considerations and it does not depend on any specific type of service. The scheme has been designed to be used as a bridge between unicast and multicast services, solving the problem of charging multicast services by means of unicast charging and existing QoS routing mechanisms. We also include a numerical comparison and discussions of the case of non-numerical or relative QoS and on the application to some service examples in order to give a better understanding of the proposal

Eternal peace, perpetual war? A critical investigation into Kant's conceptualisations of war

Most discussions of Immanuel Kant's political theory of international politics focus on his work on Eternal Peace and its normative and empirical relevance for contemporary international relations and international law. Yet for all his concern with peace, Kant's work is characterised by a fascinating preoccupation with the concept of war and its role in human history. The purpose of this essay is to investigate critically Kant's different conceptualisations of war and to evaluate his writing as a critique against contemporary versions of Liberal war and peace, as well as recent attempts to reduce war to an immanent logic of biopolitics.

Are conventions solutions to uncertainty? Contrasting visions of social coordination

In recent years, there has been an increase in research on conventions motivated by the game-theoretic contributions of the philosopher David Lewis. Prior to this surge in interest, discussions of convention in economics had been tied to the analysis of John Maynard Keynes's writings. These literatures are distinct and have very little overlap. Yet this confluence of interests raises interesting methodological questions. Does the use of a common term, convention, denote a set of shared concerns? Can we identify what differentiates the game theoretic models from the Keynesian ones? This paper maps out the three most developed accounts of convention within economics and discusses their relations with each other in an attempt to provide an answer.

Wide-angle X-ray scattering study of structural parameters in non-crystalline polymers

The paper presents an analysis of WAXS (wide-angle X-ray scattering) data which aids an understanding of the structure of non-crystalline polymers. Experimental results are compared with calculations of scattering from possible models. Evidence is presented which supports the view that the chains in molten PE do not lie parallel but have a conformation in accord with the predictions of energy calculations. However, the evidence indicates that in “molten” PTFE the chains lie parallel over distances well in excess of their diameters. WAXS-based proposals are made for the conformations of a-PMMA and a-PS.

Markov models of aging: theory and practice

We review and structure some of the mathematical and statistical models that have been developed over the past half century to grapple with theoretical and experimental questions about the stochastic development of aging over the life course. We suggest that the mathematical models are in large part addressing the problem of partitioning the randomness in aging: How does aging vary between individuals, and within an individual over the lifecourse? How much of the variation is inherently related to some qualities of the individual, and how much is entirely random? How much of the randomness is cumulative, and how much is merely short-term flutter? We propose that recent lines of statistical inquiry in survival analysis could usefully grapple with these questions, all the more so if they were more explicitly linked to the relevant mathematical and biological models of aging. To this end, we describe points of contact among the various lines of mathematical and statistical research. We suggest some directions for future work, including the exploration of information-theoretic measures for evaluating components of stochastic models as the basis for analyzing experiments and anchoring theoretical discussions of aging.

The effect of BREEAM on clients and construction professionals

The effects and influence of the Building Research Establishment’s Environmental Assessment Methods (BREEAM) on construction professionals are examined. Most discussions of building assessment methods focus on either the formal tool or the finished product. In contrast, BREEAM is analysed here as a social technology using Michel Foucault’s theory of governmentality. Interview data are used to explore the effect of BREEAM on visibilities, knowledge, techniques and professional identities. The analysis highlights a number of features of the BREEAM assessment process which generally go unremarked: professional and public understandings of the method, the deployment of different types of knowledge and their implication for the authority and legitimacy of the tool, and the effect of BREEAM on standard practice. The analysis finds that BREEAM’s primary effect is through its impact on standard practices. Other effects include the use of assessment methods to defend design decisions, its role in both operationalizing and obscuring the concept of green buildings, and the effect of tensions between project and method requirements for the authority of the tool. A reflection on assessment methods as neo-liberal tools and their adequacy for the promotion of sustainable construction suggests several limitations of lock-in that hinder variation and wider systemic change.