Study of management decision making by ward sisters in a hospital and the effects on decision making after the implementation of a decision support sytem

This thesis considers management decision making at the ward level in hospitals especially by ward sisters, and the effectiveness of the intervention of a decision support system. Nursing practice theories were related to organisation and management theories in order to conceptualise a decision making framework for nurse manpower planning and deployment at the ward level. Decision and systems theories were explored to understand the concepts of decision making and the realities of power in an organisation. In essence, the hypothesis was concerned with changes in patterns of decision making that could occur with the intervention of a decision support system and that the degree of change would be governed by a set of `difficulty' factors within wards in a hospital. During the course of the study, a classification of ward management decision making was created, together with the development and validation of measuring instruments to test the research hypothesis. The decision support system used was rigorously evaluated to test whether benefits did accrue from its implementation. Quantitative results from sample wards together with qualitative information collected, were used to test this hypothesis and the outcomes postulated were supported by these findings. The main conclusion from this research is that a more rational approach to management decision making is feasible, using information from a decision support system. However, wards and ward sisters that need the most assistance, where the `difficulty' factors in the organisation are highest, benefit the least from this type of system. Organisational reviews are needed on these identified wards, involving managers and doctors, to reduce the levels of un-coordinated activities and disruption.

Kant and Darwin

The central theses of Kant's critical philosophy are sometimes said to have been overtaken by evolutionary biology. This paper considers how far this proposition can be sustained. I argue that the ‘architectonic’ or ‘system-building’ character of the mind, the categories and the forms of intuition, can indeed be seen as the outcome of a particular evolutionary lineage in a Darwinian world. I argue, further, that the principal motive energizing the critical philosophy is the 'nightmare' of physical determinism. An alternative escape route from this particular nightmare is rehearsed. If this route is taken, the intricate arguments of the Critiques are unnecessary to save moral action in a world of things. Nonetheless, insofar as 'first philosophy' necessarily starts from within the philosopher's own subjectivity, Kant's work retains its power. I suggest that the Kantian and the Darwinian interpretations are to an extent complementary. If this is so, some form of evolutionarily-informed dual-aspect psychoneural identity theory could combine the essence of the two interpretations.

The knowledge-based perspective of risk management in healthcare organisations

The aim of this research is to investigate how risk management in a healthcare organisation can be supported by knowledge management. The subject of research is the development and management of existing logs called "risk registers", through specific risk management processes employed in a N.H.S. (Foundation) Trust in England, in the U.K. Existing literature on organisational risk management stresses the importance of knowledge for the effective implementation of risk management programmes, claiming that knowledge used to perceive risk is biased by the beliefs of individuals and groups involved in risk management and therefore is considered incomplete. Further, literature on organisational knowledge management presents several definitions and categorisations of knowledge and approaches for knowledge manipulation in the organisational context as a whole. However, there is no specific approach regarding "how to deal" with knowledge in the course of organisational risk management. The research is based on a single case study, on a N.H.S. (Foundation) Trust, is influenced by principles of interpretivism and the frame of mind of Soft Systems Methodology (S.S.M.) to investigate the management of risk registers, from the viewpoint of people involved in the situation. Data revealed that knowledge about risks and about the existing risk management policy and procedures is situated in several locations in the Trust and is neither consolidated nor present where and when required. This study proposes a framework that identifies required knowledge for each of the risk management processes and outlines methods for conversion of this knowledge, based on the SECI knowledge conversion model, and activities to facilitate knowledge conversion so that knowledge is effectively used for the development of risk registers and the monitoring of risks throughout the whole Trust under study. This study has theoretical impact in the management science literature as it addresses the issue of incomplete knowledge raised in the risk management literature using concepts of the knowledge management literature, such as the knowledge conversion model. In essence, the combination of required risk and risk management related knowledge with the required type of communication for risk management creates the proposed methods for the support of each risk management process for the risk registers. Further, the indication of the importance of knowledge in risk management and the presentation of a framework that consolidates knowledge required for the risk management processes and proposes way(s) for the communication of this knowledge within a healthcare organisation have practical impact in the management of healthcare organisations.

Modelling data and voice traffic over IP networks using continuous-time Markov models

Common approaches to IP-traffic modelling have featured the use of stochastic models, based on the Markov property, which can be classified into black box and white box models based on the approach used for modelling traffic. White box models, are simple to understand, transparent and have a physical meaning attributed to each of the associated parameters. To exploit this key advantage, this thesis explores the use of simple classic continuous-time Markov models based on a white box approach, to model, not only the network traffic statistics but also the source behaviour with respect to the network and application. The thesis is divided into two parts: The first part focuses on the use of simple Markov and Semi-Markov traffic models, starting from the simplest two-state model moving upwards to n-state models with Poisson and non-Poisson statistics. The thesis then introduces the convenient to use, mathematically derived, Gaussian Markov models which are used to model the measured network IP traffic statistics. As one of the most significant contributions, the thesis establishes the significance of the second-order density statistics as it reveals that, in contrast to first-order density, they carry much more unique information on traffic sources and behaviour. The thesis then exploits the use of Gaussian Markov models to model these unique features and finally shows how the use of simple classic Markov models coupled with use of second-order density statistics provides an excellent tool for capturing maximum traffic detail, which in itself is the essence of good traffic modelling. The second part of the thesis, studies the ON-OFF characteristics of VoIP traffic with reference to accurate measurements of the ON and OFF periods, made from a large multi-lingual database of over 100 hours worth of VoIP call recordings. The impact of the language, prosodic structure and speech rate of the speaker on the statistics of the ON-OFF periods is analysed and relevant conclusions are presented. Finally, an ON-OFF VoIP source model with log-normal transitions is contributed as an ideal candidate to model VoIP traffic and the results of this model are compared with those of previously published work.

Design and evaluation for the future of m-interaction

Mobile technology has been one of the major growth areas in computing over recent years (Urbaczewski, Valacich, & Jessup, 2003). Mobile devices are becoming increasingly diverse and are continuing to shrink in size and weight. Although this increases the portability of such devices, their usability tends to suffer. Fuelled almost entirely by lack of usability, users report high levels of frustration regarding interaction with mobile technologies (Venkatesh, Ramesh, & Massey, 2003). This will only worsen if interaction design for mobile technologies does not continue to receive increasing research attention. For the commercial benefit of mobility and mobile commerce (m-commerce) to be fully realized, users’ interaction experiences with mobile technology cannot be negative. To ensure this, it is imperative that we design the right types of mobile interaction (m-interaction); an important prerequisite for this is ensuring that users’ experience meets both their sensory and functional needs (Venkatesh, Ramesh, & Massey, 2003). Given the resource disparity between mobile and desktop technologies, successful electronic commerce (e-commerce) interface design and evaluation does not necessarily equate to successful m-commerce design and evaluation. It is, therefore, imperative that the specific needs of m-commerce are addressed–both in terms of design and evaluation. This chapter begins by exploring the complexities of designing interaction for mobile technology, highlighting the effect of context on the use of such technology. It then goes on to discuss how interaction design for mobile devices might evolve, introducing alternative interaction modalities that are likely to affect that future evolution. It is impossible, within a single chapter, to consider each and every potential mechanism for interacting with mobile technologies; to provide a forward-looking flavor of what might be possible, this chapter focuses on some more novel methods of interaction and does not, therefore, look at the typical keyboard and visual display-based interaction which, in essence, stem from the desktop interaction design paradigm. Finally, this chapter touches on issues associated with effective evaluation of m-interaction and mobile application designs. By highlighting some of the issues and possibilities for novel m-interaction design and evaluation, we hope that future designers will be encouraged to “think out of the box” in terms of their designs and evaluation strategies.

Capturing strategy as an everyday practice:quantitative methodologies for analysing practice data

Few works address methodological issues of how to conduct strategy-as-practice research and even fewer focus on how to analyse the subsequent data in ways that illuminate strategy as an everyday, social practice. We address this gap by proposing a quantitative method for analysing observational data, which can complement more traditional qualitative methodologies. We propose that rigorous but context-sensitive coding of transcripts can render everyday practice analysable statistically. Such statistical analysis provides a means for analytically representing patterns and shifts within the mundane, repetitive elements through which practice is accomplished. We call this approach the Event Database (EDB) and it consists of five basic coding categories that help us capture the stream of practice. Indexing codes help to index or categorise the data, in order to give context and offer some basic information about the event under discussion. Indexing codes are descriptive codes, which allow us to catalogue and classify events according to their assigned characteristics. Content codes are to do with the qualitative nature of the event; this is the essence of the event. It is a description that helps to inform judgements about the phenomenon. Nature codes help us distinguish between discursive and tangible events. We include this code to acknowledge that some events differ qualitatively from other events. Type events are codes abstracted from the data in order to help us classify events based on their description or nature. This involves significantly more judgement than the index codes but consequently is also more meaningful. Dynamics codes help us capture some of the movement or fluidity of events. This category has been included to let us capture the flow of activity over time.

CSR and the "underserving":a role for the state, civil society and business?

Purpose – The purpose of this paper is to demonstrate how the conceptual lens of corporate social responsibility (CSR), business and civil society can be used to explore “less popular causes” (in this case, a community-based public sector empirical study of initiatives with offenders) and, in particular, respond to the question used by Walzer “In which society can lives be best led?” Design/methodology/approach – This is a formative and summative evaluation study of a National Offender Management “community payback” offender scheme based in the UK using a mixed method, predominantly qualitative approach that integrates theory and practice. Findings – The paper finds that citizenship actions of front-line public sector employees, working in partnership with other agencies in the community, embody the essence of Walzer's notion of CSR and civil society by going beyond the call of duty to provide additional training and moral support for the community offenders. Originality/value – The paper contributes towards an understanding of how CSR and civil society debates can inform wider aspects of public policy and business through its application to areas of society that are perceived to be “challenging” and “undeserving”.

Investigation on probing schemes in probe-based multicast admission control

Multicast is an efficient approach to save network bandwidth for multimedia streaming services. To provide Quality of Services (QoS) for the multimedia services while maintain the advantage of multicast in bandwidth efficiency, admission control for multicast sessions are expected. Probe-based multicast admission control (PBMAC) schemes are of a sort of scalable and simple admission control for multicast. Probing scheme is the essence of PBMAC. In this paper, after a detailed survey on three existing probing schemes, we evaluate these schemes using simulation and analysis approaches in two aspects: admission correctness and group scalability. Admission correctness of the schemes is compared by simulation investigation. Analytical models for group scalability are derived, and validated by simulation results. The evaluation results illustrate the advantages and weaknesses of each scheme, which are helpful for people to choose proper probing scheme for network.

Case study as a research strategy : investigating extreme weather resilience of construction SMEs in the UK

Determining an appropriate research methodology is considered as an important element in a research study; especially in a doctoral research study. It involves approach to the entire process of a research study, starting from theoretical underpinnings and spanning to data collection and analysis, and extending to developing the solutions for the problems investigated. Research methodology in essence is focused around the problems to be investigated in a research study and therefore varies according to the problems investigated. Thus, identifying the research methodology that best suits a research in hand is important, not only as it will benefit achieving the set objectives of a research, but also as it will serve establishing the credibility of the work. Research philosophy, approach, strategy, choice, and techniques are inherent components of the methodology. Research strategy provides the overall direction of the research including the process by which the research is conducted. Case study, experiment, survey, action research, grounded theory and ethnography are examples for such research strategies. Case study is documented as an empirical inquiry that investigates a contemporary phenomenon within its real-life context, especially when the boundaries between phenomenon and context are not clearly evident. Case study was adopted as the overarching research strategy, in a doctoral study developed to investigate the resilience of construction Small and Medium-sized Enterprises (SMEs) in the UK to extreme weather events. The research sought to investigate how construction SMEs are affected by EWEs, respond to the risk of EWEs, and means of enhancing their resilience to future EWEs. It is argued that utilising case study strategy will benefit the research study, in achieving the set objectives of the research and answering the research questions raised, by comparing and contrasting with the alternative strategies available. It is also claimed that the selected strategy will contribute towards addressing the call for improved methodological pluralism in construction management research, enhancing the understanding of complex network of relationships pertinent to the industry and the phenomenon being studied.

Gender equality and religion:a multi-faith exploration of young adults’ narratives

This paper presents findings from research on young adults in the UK from diverse religious backgrounds. Utilizing questionnaires, interviews, and video diaries it assesses how religious young adults understood and managed the tensions in popular discourse between gender equality as an enshrined value and aspirational narrative, and religion as purportedly instituting gender inequality. We show that, despite varied understandings, and the ambivalence and tension in managing ideal and practice, participants of different religious traditions and genders were committed to gender equality. Thus, they viewed gender-unequal practices within their religious cultures as an aberration from the essence of religion. In this way, they firmly rejected the dominant discourse that religion is inherently antithetical to gender equality.

Case study as a research strategy:investigating extreme weather resilience of construction SMEs in the UK

Determining an appropriate research methodology is considered as an important element in a research study; especially in a doctoral research study. It involves approach to the entire process of a research study, starting from theoretical underpinnings and spanning to data collection and analysis, and extending to developing the solutions for the problems investigated. Research methodology in essence is focused around the problems to be investigated in a research study and therefore varies according to the problems investigated. Thus, identifying the research methodology that best suits a research in hand is important, not only as it will benefit achieving the set objectives of a research, but also as it will serve establishing the credibility of the work. Research philosophy, approach, strategy, choice, and techniques are inherent components of the methodology. Research strategy provides the overall direction of the research including the process by which the research is conducted. Case study, experiment, survey, action research, grounded theory and ethnography are examples for such research strategies. Case study is documented as an empirical inquiry that investigates a contemporary phenomenon within its real-life context, especially when the boundaries between phenomenon and context are not clearly evident. Case study was adopted as the overarching research strategy, in a doctoral study developed to investigate the resilience of construction Small and Medium-sized Enterprises (SMEs) in the UK to extreme weather events. The research sought to investigate how construction SMEs are affected by EWEs, respond to the risk of EWEs, and means of enhancing their resilience to future EWEs. It is argued that utilising case study strategy will benefit the research study, in achieving the set objectives of the research and answering the research questions raised, by comparing and contrasting with the alternative strategies available. It is also claimed that the selected strategy will contribute towards addressing the call for improved methodological pluralism in construction management research, enhancing the understanding of complex network of relationships pertinent to the industry and the phenomenon being studied.

Online-questionaire design guidelines

As a new medium for questionnaire delivery, the internet has the potential to revolutionize the survey process. Online (web-based) questionnaires provide several advantages over traditional survey methods in terms of cost, speed, appearance, flexibility, functionality, and usability. Designers of online-questionnaires are faced with a plethora of design tools to assist in the development of their electronic questionnaires. Little, if any, support is incorporated, however, within these tools to guide online-questionnaire designers according to best practice. In essence, an online-questionnaire combines questionnaire-based survey functionality with that of a webpage/site. As such, the design of an online-questionnaire should incorporate principles from both contributing fields. Drawing on existing guidelines for paper-based questionnaire design, website design (paying particular attention to issues of accessibility and usability), and existing but scarce guidelines for electronic surveys, we have derived a comprehensive set of guidelines for the design of online-questionnaires. This article introduces this comprehensive set of guidelines – as a practical reference guide – for the design of online-questionnaires.

Online-questionnaire design:establishing guidelines and evaluating existing eupport

As a new medium for questionnaire delivery, the internet has the potential to revolutionise the survey process. Online (web-based) questionnaires provide several advantages over traditional survey methods in terms of cost, speed, appearance, flexibility, functionality, and usability [1, 2]. For instance, delivery is faster, responses are received more quickly, and data collection can be automated or accelerated [1- 3]. Online-questionnaires can also provide many capabilities not found in traditional paper-based questionnaires: they can include pop-up instructions and error messages; they can incorporate links; and it is possible to encode difficult skip patterns making such patterns virtually invisible to respondents. Like many new technologies, however, online-questionnaires face criticism despite their advantages. Typically, such criticisms focus on the vulnerability of online-questionnaires to the four standard survey error types: namely, coverage, non-response, sampling, and measurement errors. Although, like all survey errors, coverage error (“the result of not allowing all members of the survey population to have an equal or nonzero chance of being sampled for participation in a survey” [2, pg. 9]) also affects traditional survey methods, it is currently exacerbated in online-questionnaires as a result of the digital divide. That said, many developed countries have reported substantial increases in computer and internet access and/or are targeting this as part of their immediate infrastructural development [4, 5]. Indicating that familiarity with information technologies is increasing, these trends suggest that coverage error will rapidly diminish to an acceptable level (for the developed world at least) in the near future, and in so doing, positively reinforce the advantages of online-questionnaire delivery. The second error type – the non-response error – occurs when individuals fail to respond to the invitation to participate in a survey or abandon a questionnaire before it is completed. Given today’s societal trend towards self-administration [2] the former is inevitable, irrespective of delivery mechanism. Conversely, non-response as a consequence of questionnaire abandonment can be relatively easily addressed. Unlike traditional questionnaires, the delivery mechanism for online-questionnaires makes estimation of questionnaire length and time required for completion difficult1, thus increasing the likelihood of abandonment. By incorporating a range of features into the design of an online questionnaire, it is possible to facilitate such estimation – and indeed, to provide respondents with context sensitive assistance during the response process – and thereby reduce abandonment while eliciting feelings of accomplishment [6]. For online-questionnaires, sampling error (“the result of attempting to survey only some, and not all, of the units in the survey population” [2, pg. 9]) can arise when all but a small portion of the anticipated respondent set is alienated (and so fails to respond) as a result of, for example, disregard for varying connection speeds, bandwidth limitations, browser configurations, monitors, hardware, and user requirements during the questionnaire design process. Similarly, measurement errors (“the result of poor question wording or questions being presented in such a way that inaccurate or uninterpretable answers are obtained” [2, pg. 11]) will lead to respondents becoming confused and frustrated. Sampling, measurement, and non-response errors are likely to occur when an online-questionnaire is poorly designed. Individuals will answer questions incorrectly, abandon questionnaires, and may ultimately refuse to participate in future surveys; thus, the benefit of online questionnaire delivery will not be fully realized. To prevent errors of this kind2, and their consequences, it is extremely important that practical, comprehensive guidelines exist for the design of online questionnaires. Many design guidelines exist for paper-based questionnaire design (e.g. [7-14]); the same is not true for the design of online questionnaires [2, 15, 16]. The research presented in this paper is a first attempt to address this discrepancy. Section 2 describes the derivation of a comprehensive set of guidelines for the design of online-questionnaires and briefly (given space restrictions) outlines the essence of the guidelines themselves. Although online-questionnaires reduce traditional delivery costs (e.g. paper, mail out, and data entry), set up costs can be high given the need to either adopt and acquire training in questionnaire development software or secure the services of a web developer. Neither approach, however, guarantees a good questionnaire (often because the person designing the questionnaire lacks relevant knowledge in questionnaire design). Drawing on existing software evaluation techniques [17, 18], we assessed the extent to which current questionnaire development applications support our guidelines; Section 3 describes the framework used for the evaluation, and Section 4 discusses our findings. Finally, Section 5 concludes with a discussion of further work.

Optimization of the Investment Portfolio in the Conditions of Uncertainty

Portfolio analysis exists, perhaps, as long, as people think about acceptance of rational decisions connected with use of the limited resources. However the occurrence moment of portfolio analysis can be dated precisely enough is having connected it with a publication of pioneer work of Harry Markovittz (Markovitz H. Portfolio Selection) in 1952. The model offered in this work, simple enough in essence, has allowed catching the basic features of the financial market, from the point of view of the investor, and has supplied the last with the tool for development of rational investment decisions. The central problem in Markovitz theory is the portfolio choice that is a set of operations. Thus in estimation, both separate operations and their portfolios two major factors are considered: profitableness and risk of operations and their portfolios. The risk thus receives a quantitative estimation. The account of mutual correlation dependences between profitablenesses of operations appears the essential moment in the theory. This account allows making effective diversification of portfolio, leading to essential decrease in risk of a portfolio in comparison with risk of the operations included in it. At last, the quantitative characteristic of the basic investment characteristics allows defining and solving a problem of a choice of an optimum portfolio in the form of a problem of quadratic optimization.

Expert System for Decision-Making Problem in Economics

An expert system (ES) is a class of computer programs developed by researchers in artificial intelligence. In essence, they are programs made up of a set of rules that analyze information about a specific class of problems, as well as provide analysis of the problems, and, depending upon their design, recommend a course of user action in order to implement corrections. ES are computerized tools designed to enhance the quality and availability of knowledge required by decision makers in a wide range of industries. Decision-making is important for the financial institutions involved due to the high level of risk associated with wrong decisions. The process of making decision is complex and unstructured. The existing models for decision-making do not capture the learned knowledge well enough. In this study, we analyze the beneficial aspects of using ES for decision- making process.