891 resultados para Healthcare integration


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Over the years, cross-border mergers and acquisitions have become a popular strategic option for variety of firms. Companies often seek rapid growth through acquiring potentially valuable enterprises or attempting to enhance their organization’s profitability by merging with other firms. However, managing the change of organizational culture is a major managerial challenge as companies often confront difficulties when merging two previously autonomous organizational cultures into one, joint organizational culture. Therefore, the purpose of this study is to increase understanding related to the challenges and possibilities concerning the management of organizational culture change in cross-border mergers and acquisitions. The research question “How to manage the change of organizational culture in cross-border mergers and acquisitions?” is analysed in relation to the theories presented in this thesis regarding organizational culture, organizational change and acculturation as well as in relation with the collected empirical data. The research question is divided into three sub-questions according to the following: (1) “What is the role of organizational culture in organizations?”, (2) “How to manage organizational change in mergers and acquisitions?” and (3) “How to manage organizational culture change through acculturation?”. The thesis is conducted as a qualitative case study research including three personal interviews and one group interview. The interviews were conducted as a combination of semi-structured and unstructured interviews. Theories related to organizational culture, the management of change as well as acculturation are studied and further analysed in relation to empirical material collected by the researcher. Research findings indicate that that several factors can influence the success of managing the organizational culture change in cross-border mergers and acquisitions. Factors such as defining the preferred acculturation model prior the merger; managing the resistance of change; open communication; acknowledgement of local culture and cultural differences; involvement of personnel in change processes; as well as the formulation and implementation of comprehensive change plans proved to be important factors with relation to successful management of organizational culture change

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The growth of the companies working in the Logistics area has raised the need for using several Logistics systems that can meet the increased requirements in business processes. Different companies may use one or more Logistics systems internally and may use different Logistics systems that other collaborated companies use. Furthermore, these Logistics systems are required to communicate with each other in order to process and manage the flow of the information. Integrating the Logistics systems is beneficial as it allows interaction between the whole systems and services instead of the need to replace them. In addition, it improves the efficiency, lowers the possible errors in the supply chain, reduces the costs and facilitates the access of suppliers and customers to the information. This in turn leads to better relationships with both suppliers and customers. Usually local integration of several Logistics systems is not very difficult, especially that mostly the companies buy their system from a single source. However, the case is different for integrating several logistics systems across the companies’ borders. In this case, there are many factors play major roles in limiting the integration, such as using different systems and different output. This thesis highlights these factors and challenges, demonstrates some solutions for the logistics inter-organizational integration from the perspective of information systems and presents some approaches for integrating these systems. There are many studies about the integration inside a company but fewer studies focused about the technical side and the information systems integration across company’s borders or what is called inter-organizational integration. This study is a literature review that aims at illustrating the challenges, the requirements and some approaches in inter-organizational logistics information systems integration of logistics systems across the companies’ borders.

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The issue of selecting an appropriate healthcare information system is a very essential one. If implemented healthcare information system doesn’t fit particular healthcare institution, for example there are unnecessary functions; healthcare institution wastes its resources and its efficiency decreases. The purpose of this research is to develop a healthcare information system selection model to assist the decision-making process of choosing healthcare information system. Appropriate healthcare information system helps healthcare institutions to become more effective and efficient and keep up with the times. The research is based on comparison analysis of 50 healthcare information systems and 6 interviews with experts from St-Petersburg healthcare institutions that already have experience in healthcare information system utilization. 13 characteristics of healthcare information systems: 5 key and 7 additional features are identified and considered in the selection model development. Variables are used in the selection model in order to narrow the decision algorithm and to avoid duplication of brunches. The questions in the healthcare information systems selection model are designed to be easy-to-understand for common a decision-maker in healthcare institution without permanent establishment.

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Discussions concerning the challenges of combining work and family are certainly not new, and still actively continue. There is, however, a silence in the related literature regarding a comprehensive description of integrating specifically university academic ~. work and family responsibilities. This silence is especially evident for men who are parents as well as academics. With the participation of 4 key informants, this qualitative research study gave voice to men and women who participate in the academic labour of a Canadian university as professors, and as graduate students, along with the parenting labour of at least 1 child under the age of7. Methodology was developed to reveal in-depth perspectives regarding the work practices employed by 4 key informants as they combined intellectual and child-care responsibilities. Multiple data collection methods included journal reflections, day time observation sessions, a focus group, and a final evaluation questionnaire. Using research findings, together with information extrapolated from Three Models of the Family (Eichler, 1997), this study also took steps toward developing a Proposed "Three Models of the University," to offer explanation for the work practices of the key informants as academics/parents, and also for future consideration in university policy formation.

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This research acknowledges the difficulties experienced by teachers presenting integrated arts curricula. Instructional support is offered by arts organizations that provide arts partnerships with local schools boards. The study focuses on the experiences of 8 teachers from a Catholic school board in southern Ontario who participated in integrated arts programs offered by The Royal Conservatory of Music's Learning Through the Arts™ (LTTATM) program and a local art gallery's Art Based Integrated Learning (ABIL) program and examines their responses to the programs and their perception of personal and professional development through this association. Additionally, questions were posed to the . "aftisfs"from-tneSe]Jfograrrrs;-and"they liiscus·sed·how"participating in-collaboration with teachers in the development of in-school programs enabled them to experience personal and professional development as well. Seven themes emerged from the data. These themes included: teachers' feelings of a lack of preparedness to teach the arts; the value of the arts and arts partnerships in schools; the role of the artists in the education of teachers; professional development for both teachers and artists; the development of collegiality; perceptions of student engagement; and the benefits and obstacles of integrating the arts into the curriculum. This document highlights the benefits to both teachers and artists of arts partnerships between schools and outside arts organizations.

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Adenoviral vectors are currently the most widely used gene therapeutic vectors, but their inability to integrate into host chromosomal DNA shortened their transgene expression and limited their use in clinical trials. In this project, we initially planned to develop a technique to test the effect of the early region 1 (E1) on adenovirus integration by comparing the integration efficiencies between an E1-deleted adenoviral vector (SubE1) and an Elcontaining vector (SubE3). However, we did not harvest any SubE3 virus, even if we repeated the transfection and successfully rescued the SubE1 virus (2/4 transfections generated viruses) and positive control virus (6/6). The failure of rescuing SubE3 could be caused by the instability of the genomic plasmid pFG173, as it had frequent intemal deletions when we were purifying It. Therefore, we developed techniques to test the effect of E1 on homologous recombination (HR) since literature suggested that adenovirus integration is initiated by HR. We attempted to silence the E1 in 293 cells by transfecting E1A/B-specific small interfering RNA (siRNA). However, no silenced phenotype was observed, even if we varied the concentrations of E1A/B siRNA (from 30 nM to 270 nM) and checked the silencing effects at different time points (48, 72, 96 h). One possible explanation would be that the E1A/B siRNA sequences are not potent enough to Induce the silenced phenotype. For evaluating HR efficiencies, an HR assay system based on bacterial transfonmatJon was designed. We constmcted two plasmids ( designated as pUC19-dl1 and pUC19-dl2) containing different defective lacZa cassettes (forming white colonies after transformation) that can generate a functional lacZa cassette (forming blue colonies) through HR after transfecting into 293 cells. The HR efficiencies would be expressed as the percentages of the blue colonies among all the colonies. Unfortunately, after transfonnation of plasmid isolated from 293 cells, no colony was found, even at a transformation efficiency of 1.8x10^ colonies/pg pUC19, suggesting the sensitivity of this system was low. To enhance the sensitivity, PCR was used. We designed a set of primers that can only amplify the recombinant plasmid fomied through HR. Therefore, the HR efficiencies among different treatments can be evaluated by the amplification results, and this system could be used to test the effect of E1 region on adenovirus integration. In addition, to our knowledge there was no previous studies using PCR/ Realtime PCR to evaluate HR efficiency, so this system also provides a PCR-based method to carry out the HR assays.

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This study \Alas initiated in response to the Junior Division Review (1985) publ ished by the Ministry of Education for the Province of Ontario. Curriculum integration is an element used within the educational paradigm designed by the Ontario Ministry of Education. It is a term frequent1y verbal ized b>' educators in this province, but because of 1 imi ted resource support regarding this methodology, it was open to broad interpretation resulting in an extreme v ar i at i on i nit simp 1 eme n tat i on • I n de ed, the Min i s try intimated that it was not occurring to any significant degree across the province. The objective of this thes is was· to define integration in the junior classroom and de-:.ign a meas.ur·ement in-:.tr-ument which would in turn high 1 i gh t indicators of curriculum integration. The :.tudy made a prel iminary, field-based survey of educa tiona 1 professionals in order to generate a relevant description of integrated curr-iculum programm i ng as def i ned in the j un i or classroom. The description was a compilation of views expressed by a random selection of teachers, consultants, supervisory officers and principals. The survey revea 1 ed a much more comprehens i ve vi et·<,l of the attributes of integrated programming than tradition would dictate and resulted in a functional definition tha t was broader than past prac t ices. Based on the information generated by this survey, an instrument ou t 1 in i ng program cr iter i a of was devised. an integrated junior cla~·sroom Th i s measuremen t i nstrumen t , designed for all levels of educators, was named uThe Han~.son I nstrumen t for the Measuremen t of Program Integrat ion in the Jun i or Cl assroom". It refl ected five categories intrinsic to the me thodol ogy of integration: Teacher Behaviour, Student Behaviour, Classroom Layout, Cl as~·r oom Environment and Progr amm i ng. Each category and the items therein were successfully tested in val idi ty and rel iabi 1 i ty checKs. Interestingly, the individual class was found to be the major variable programming in in the measuremen t the j un i or d i vis i on • of The integrated instrument demonstrated potential not onl)' a~· an initial measure of the degree of integrated curriculum, but as a guide to strategies to implement such a methodology.

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- The present study was an investigation into the effect ofschool integration on the friendships ofyouth with developmental disabilities and their peers without disabilities. The youths, their parents, and their teachers provided insights into the youths' friendships. A qualitative paradigm was used in this research. The researcher guided the collection and analysis ofthe data with the phenomenologicallifeworld existentials of body, space, time, and human relation (Van Manen, 1990). Individual interviews were conducted with each youth, and group interviews were conducted with each triad (a youth, their parent(s), and their teacher) to discuss the youth's friendships and the supports necessary to facilitate the friendships. Through phenomenological analysis of the data, four thematic statements emerged: friendships are far from perfect, to have a friend you have to be a friend, parents as choreographers offriendship, and teachers as reluctant partners in friendship facilitation. Based on the results ofthis study, it was concluded that the development of friendships between youth with developmental disabilities and their peers without disabilities was happening in integrated school settings. However, it was also evident that the support ofteachers and parents alike were required to facilitate the development and maintenance ofsuch friendships. Recommendations for practice are discussed, including the need for active participation by the youth's parents in the facilitation offriendships, and the use ofa "circle offriends" to facilitate friendship development. Also discussed are the recommendations for further research, including the need for the youth's friends to be interviewed regarding their friendships with the youth with disabilities, and the need for researcher observation ofth~ friendships in action. Further research could also explore the role ofthe mother versus the father in facilitating friendships, and the role of recreation and leisure opportunities in the ,development offriendships.

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Pakistan had a plural society per excellence. Its people were divided geographically between two separate regions, spoke different languages, had different cultures and economic structures. Like other plural societies elsewhere, Pakistan also faced the problem of national integration. Cleavages along the lines of traditional attachments are fundamental to any plural society, as they were in Pakistan. But their political manifestation could have been kept within managable limits if the Central Government, overwhelmingly composed of the West Pakistanis, was seriously committed to the task. All that Pakistan needed to maintain her integrated existence was deliberate, calculated and conscious efforts on the part of the Central Government to give the Bengalis, the majority linguistic and geographic group in the country, a partnership in the state of Pakistan, an effective power in the decision-making process of the country, a reasonable share from the economic resources of the country, and to show respect to their hopes and aspirations. In addition, Pakistan needed a national platform to bring her divergent linguistic and geographic groups toge~her for some common, national purpos~s. Political parties were the only institutions which could have served this purpose. Pakistan miserably failed to sustain national political parties and failed to satisfy Bengalis' demands. This failure eventually resulted in the falling apart of the political system of Pakistan in 1971.

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The study purpose was to examine differences between competitive and recreational weight trainers on indices of motivation, goals and behaviour. Data was collected from a purposive sample of competitive (n = 177; Mage = 30.86; SDage = 11.35) and recreational (n = 196; Mage = 21.97; SDage = 6.05) weight trainers using a cross-sectional, non-experimental design. Participants completed the Behavioural Regulation in Exercise Questionnaire-2R, Exercise Motivations Inventory-2, assessment of weight training behaviour and demographic questions. Multivariate analyses of variance indicated higher endorsement of autonomous motives and mostly intrinsically-oriented goals, while independent samples t-tests indicated higher frequency of weight training behaviour among the competitive weight trainers. Group differences were independent of demographic factors. Findings suggest that autonomous motives and intrinsic goals may not be undermined by competition among competitive weight trainers. This study also provides support for the utility of organismic integration theory and goal contents theory in examining strength-based exercise.

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The research presented is a qualitative case study of educators’ experiences in integrating living skills in the context of health and physical education (HPE). In using semi-structured interviews the study investigated HPE educators’ experiences and revealed their insights relative to three major themes; professional practice, challenges and support systems. Professional practice experiences detailed the use of progressive lesson planning, reflective and engaging activities, explicit student centered pedagogy as well as holistic teaching philosophies. Even further, the limited knowledge and awareness of living skills, conflicting teaching philosophies, competitive environments between subject areas and lack of time and accessibility were four major challenges that emerged throughout the data. Major supportive roles for HPE educators in the integration process included other educators, consultants, school administration, public health, parents, community programs and professional organizations. The study provides valuable discussion and suggestions for improvement of pedagogical practices in teaching living skills in the HPE setting.

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The purpose of this study was to explore how transgender individuals were supported to navigate the healthcare system to achieve positive healthcare experiences. A single case study was conducted in Southern Ontario, which included ten individual interviews. Data was analyzed through thematic analysis, allowing for seven themes to emerge within macro (large-scale system), meso (local/interpersonal), and micro (individual/internal) levels of healthcare system support. Themes that emerged within the levels of system support included: 1) existing deficits with hope for change; 2) significant external supports; 3) importance of informal networking; 4) support from local area family physicians and walk-in clinics; 5) navigating the healthcare system alone; 6) personality traits for successful healthcare experiences; and 7) the development of strategies to achieve positive healthcare experiences. This study outlined factors that contributed to positive healthcare experiences for transgender individuals, showing that meso and micro level support are compensating for large-scale healthcare system deficits.

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Lorraine Sheremeta, Research Associate, Health Law Institute, University of Alberta

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An exemination of a series of indicators of economic integration in the western hemisphere (Canada-USA-Latin America) indicates that it is proceeding under the influence of formal trade agreements and informal forces including technological change, multinational firm rationalization and location strategies, etc.

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Les pratiques relationnelles de soin (PRS) sont au cœur même des normes et valeurs professionnelles qui définissent la qualité de l’exercice infirmier, mais elles sont souvent compromises par un milieu de travail défavorable. La difficulté pour les infirmières à actualiser ces PRS qui s’inscrivent dans les interactions infirmière-patient par un ensemble de comportements de caring, constitue une menace à la qualité des soins, tout en créant d’importantes frustrations pour les infirmières. En mettant l’accent sur l’aspect relationnel du processus infirmier, cette recherche, abordée sous l'angle du caring, renvoie à une vision novatrice de la qualité des soins et de l'organisation des services en visant à expliquer l’impact du climat organisationnel sur le façonnement des PRS et la satisfaction professionnelle d’infirmières soignantes en milieu hospitalier. Cette étude prend appui sur une adaptation du Quality-Caring Model© de Duffy et Hoskins (2003) qui combine le modèle d’évaluation de la qualité de Donabedian (1980, 1992) et la théorie du Human Caring de Watson (1979, 1988). Un devis mixte de type explicatif séquentiel, combinant une méthode quantitative de type corrélationnel prédictif et une méthode qualitative de type étude de cas unique avec niveaux d’analyse imbriqués, a été privilégié. Pour la section quantitative auprès d’infirmières soignantes (n = 292), différentes échelles de mesure validées, de type Likert ont permis de mesurer les variables suivantes : le climat organisationnel (global et cinq dimensions composites) ; les PRS privilégiées ; les PRS actuelles ; l’écart entre les PRS privilégiées et actuelles ; la satisfaction professionnelle. Des analyses de régression linéaire hiérarchique ont permis de répondre aux six hypothèses du volet quantitatif. Pour le volet qualitatif, les données issues des sources documentaires, des commentaires recueillis dans les questionnaires et des entrevues effectuées auprès de différents acteurs (n = 15) ont été traités de manière systématique, par analyse de contenu, afin d’expliquer les liens entre les notions d’intérêts. L’intégration des inférences quantitatives et qualitatives s’est faite selon une approche de complémentarité. Nous retenons du volet quantitatif qu’une fois les variables de contrôle prises en compte, seule une dimension composite du climat organisationnel, soit les caractéristiques de la tâche, expliquent 5 % de la variance des PRS privilégiées. Le climat organisationnel global et ses dimensions composites relatives aux caractéristiques du rôle, de l’organisation, du supérieur et de l’équipe sont de puissants facteurs explicatifs des PRS actuelles (5 % à 11 % de la variance), de l’écart entre les PRS privilégiées et actuelles (4 % à 9 %) ainsi que de la satisfaction professionnelle (13 % à 30 %) des infirmières soignantes. De plus, il a été démontré, qu’au-delà de l’important impact du climat organisationnel global et des variables de contrôle, la fréquence des PRS contribue à augmenter la satisfaction professionnelle des infirmières (ß = 0,31 ; p < 0,001), alors que l’écart entre les PRS privilégiées et actuelles contribue à la diminuer (ß = - 0,30 ; p < 0,001) dans des proportions fort similaires (respectivement 7 % et 8 %). Le volet qualitatif a permis de mettre en relief quatre ordres de facteurs qui expliquent comment le climat organisationnel façonne les PRS et la satisfaction professionnelle des infirmières. Ces facteurs sont: 1) l’intensité de la charge de travail; 2) l’approche d’équipe et la perception du rôle infirmier ; 3) la perception du supérieur et de l’organisation; 4) certaines caractéristiques propres aux patients/familles et à l’infirmière. L’analyse de ces facteurs a révélé d’intéressantes interactions dynamiques entre quatre des cinq dimensions composites du climat, suggérant ainsi qu’il soit possible d’influencer une dimension en agissant sur une autre. L’intégration des inférences quantitatives et qualitatives rend compte de l’impact prépondérant des caractéristiques du rôle sur la réalisation des PRS et la satisfaction professionnelle des infirmières, tout en suggérant d’adopter une approche systémique qui mise sur de multiples facteurs dans la mise en oeuvre d’interventions visant l’amélioration des environnements de travail infirmier en milieu hospitalier.