Ontology modeling for generation of clinical pathways

Purpose: Increasing costs of health care, fuelled by demand for high quality, cost-effective healthcare has drove hospitals to streamline their patient care delivery systems. One such systematic approach is the adaptation of Clinical Pathways (CP) as a tool to increase the quality of healthcare delivery. However, most organizations still rely on are paper-based pathway guidelines or specifications, which have limitations in process management and as a result can influence patient safety outcomes. In this paper, we present a method for generating clinical pathways based on organizational semiotics by capturing knowledge from syntactic, semantic and pragmatic to social level. Design/methodology/approach: The proposed modeling approach to generation of CPs adopts organizational semiotics and enables the generation of semantically rich representation of CP knowledge. Semantic Analysis Method (SAM) is applied to explicitly represent the semantics of the concepts, their relationships and patterns of behavior in terms of an ontology chart. Norm Analysis Method (NAM) is adopted to identify and formally specify patterns of behavior and rules that govern the actions identified on the ontology chart. Information collected during semantic and norm analysis is integrated to guide the generation of CPs using best practice represented in BPMN thus enabling the automation of CP. Findings: This research confirms the necessity of taking into consideration social aspects in designing information systems and automating CP. The complexity of healthcare processes can be best tackled by analyzing stakeholders, which we treat as social agents, their goals and patterns of action within the agent network. Originality/value: The current modeling methods describe CPs from a structural aspect comprising activities, properties and interrelationships. However, these methods lack a mechanism to describe possible patterns of human behavior and the conditions under which the behavior will occur. To overcome this weakness, a semiotic approach to generation of clinical pathway is introduced. The CP generated from SAM together with norms will enrich the knowledge representation of the domain through ontology modeling, which allows the recognition of human responsibilities and obligations and more importantly, the ultimate power of decision making in exceptional circumstances.

A Habermasian model of stakeholder (non)engagement and corporate (ir)responsibility reporting

Inspired by Habermas’ works, we develop a prescriptive conceptual model of stakeholder engagement and corporate social responsibility (CSR) reporting against which empirical descriptions can be compared and contrasted. We compare the high profile case of Kraft's takeover of Cadbury with the conceptual model to illustrate the gap between an ideal speech situation and practice. The paper conducts a desk study of documents relating to the takeover and interviews with stakeholders from the local community to gauge their views of stakeholder engagement and CSR reporting by Cadbury/Kraft. The findings lead to policy recommendations for enhancing stakeholder accountability through improved steering mechanisms.

Mapping the trickle out benefits of social and environmental enterprises: a pilot study of an East African eco business

• Objectives The objective of this paper is to propose a framework for mapping the sustainable development and poverty alleviation impacts of social and environmental enterprises in Africa. This framework is then piloted with reference to an East African Ecobusiness. • Prior Work This paper is based on data collected as part of a wider research project examining social and environmental enterprises across the 19 countries of Southern and Eastern Africa. In total, the sustainable development and poverty alleviation impacts of 20 in-depth case studies in 4 countries are being examined. • Approach Data was collected using in-depth interviews with multiple stakeholders associated with the case study business. Secondary materials were also analysed and a quantitative survey of customers undertaken. • Results In addition to their impacts on the environment, African eco businesses can also have substantial social, economic and wider poverty alleviation impacts. This paper maps the impacts of a case study East African ecobusiness, as part of developing a social and environmental enterprise impact framework for Africa and the wider developing world. In our case study, positive and negative impacts are identified, while questions are raised in relation to tradeoffs between social and environmental objectives and temporal dimensions of impact. The usefulness of existing frameworks for understanding the social, environmental and development impacts of these kinds of organisations are also considered. • Implications This paper outlines the necessity of building an African-centric impact map to capture the multi-level poverty alleviation and sustainable development impacts of social and environmental enterprise activity in developing world environments. The framework proposed also offers guidance to businesses operating in Africa about the factors that might be considered as part of their wider social and environmental responsibilities. • Value Assessing the impact of social and environmental enterprises, especially as a route to development within low income countries, is receiving increasing attention in academia and beyond. This paper presents a useful contribution to the scarce literature on social and environmental enterprises in Africa.

Tactical ethics: how the discourses of fairtrade and black economic empowerment change and interact in wine networks from South Africa to the UK.

This paper explores the spaces and power relations of ethical foodscapes. Ethics can offer a commodity a valuable unique selling point in a competitive marketplace but managing the changeable and multiple motivations for stakeholder participation throughout the commodity chain in order to utilise this opportunity is a complex negotiation. Through exploring the spaces and relations within three South African– UK ethical wine networks, the discursive tactics used to sustain these are uncovered. The discourses of Fairtrade, Black Economic Empowerment and organics are highly adaptive, interacting with each other in such a way as to always be contextually appealing. This ‘tactical mutability’ is combined with ‘scales of knowing’, which, this paper argues, are essential for network durability. ‘Scales of knowing’ refers to the recognition by stakeholders of the potential for different articulations of a discourse within the network, which combines with ‘tactical mutability’ to allow for a scalar, contextual and ’knowing’ (im)mutability to ensure the discourse’s continued appeal. However, even when one discourse is the ‘lead’ it always folds within it linkages to other ethical discourses at work, suggesting that ethical practice is mutually supportive discursively. This means that at the producer end ethical interactions may offer more capacity to enact genuine transformation than the solo operations of a discourse.

Building resilience in the face of recurring environmental crisis in African Sahel

The present food shortages in the Horn of Africa and the West African Sahel are affecting 31 million people. Such continuing and future crises require that people in the region adapt to an increasing and potentially irreversible global sustainability challenge. Given this situation and that short-term weather and seasonal climate forecasting have limited skill for West Africa, the Rainwatch project illustrates the value of near real-time monitoring and improved communication for the unfavourable 2011 West African monsoon, the resulting severe drought-induced humanitarian impacts continuing into 2012, and their exacerbation by flooding in 2012. Rainwatch is now coupled with a boundary organization (Africa Climate Exchange, AfClix) with the aim of integrating the expertise and actions of relevant institutions, agencies and stakeholders to broker ground-based dialogue to promote resilience in the face of recurring crisis.

Building climate resilience: lessons of early warning in Africa

Given the high levels of uncertainty and substantial variability in local weather and climate, what constitutes successful adaptation for the 800 million food-insecure people in Africa? In this context there is a need for building climate resilience through effective early warning systems, bringing real-time monitoring and decision-making together with stakeholders. The chapter presents two effective operational early warning systems in Africa: The Radio and Internet (RANET) network and the Rainwatch project. These examples were developed in partnership with local climate scientists and tailored to local development needs, enabled and encouraged with only modest international support. They deliver important lessons about how to prepare for crises using simple real-time monitoring. They also help us identify characteristics of managing for resilience in practice. The chapter concludes that successful adaptation requires adaptive, flexible, linked institutions, together with ground-based collaboration and practical tools. In the context of early warning three features stand out that make these systems successful: effective communication of current weather and climate information, a key individual within a bridging organization with the ability to navigate the governance systems, and sufficient time for innovation development.

Exploring socioeconomic impacts of forest based mitigation projects: Lessons from Brazil and Bolivia

This paper aims to contribute new insights globally and regionally on how carbon forest mitigation contributes to sustainable development in South America. Carbon finance has emerged as a potential policy option to tackling global climate change, degradation of forests, and social development in poor countries. This paper focuses on evaluating the socioeconomic impacts of a set of forest based mitigation pilot projects that emerged under the United Nations Framework Convention on Climate Change. The paper reviews research conducted in 2001–2002, drawing from empirical data from four pilot projects, derived from qualitative stakeholder interviews, and complemented by policy documents and literature. Of the four projects studied three are located in frontier areas, where there are considerable pressures for conversion of standing forest to agriculture. In this sense, forest mitigation projects have a substantial role to play in the region. Findings suggest however, that all four projects have experienced cumbersome implementation processes specifically, due to weak social objectives, poor communication, as well as time constraints. In three out of four cases, stakeholders highlighted limited local acceptance at the implementation stages. In the light of these findings, we discuss opportunities for implementation of future forest based mitigation projects in the land use sector.

The financial effects of uniform and mixed corporate social performance

Firms typically present a mixed picture of corporate social performance (CSP), with positive and negative indicators exhibited by the same firm. Thus, stakeholders’ judgements of corporate social responsibility (CSR) typically evaluate positives in the context of negatives, and vice versa. Building on social judgement theory, we present two alternative accounts of how stakeholders respond to such complexity, which provide differing implications for the financial effects of CSP: reciprocal dampening and rewarding uniformity. Echoing notable findings on strategic consistency, our US panel study finds that firms that exhibit uniformly positive or uniformly negative indicators in particular dimensions of CSP outperform firms that exhibit a mixed picture of positives and negatives, which supports the notion that stakeholders’ judgements of CSR reward uniformity.

Connecting the complex ‘lived’ world(s) of Fairtrade

Although certified Fairtrade continues to use discourses of defetishization, its move into mainstream markets has acted to refetishize the consumer–producer relationship through the use of a standardized label, which acts as a substitute for engaged knowledges. Through Fairhills, a South African Fairtrade wine project, this paper explores the contextual complexity on the producer side of the commodity network. By incorporating the national discourse of Black Economic Empowerment into its operations, both in Fairhills and in South Africa in general, Fairtrade has adapted to this context, ensuring its relevance and credibility to stakeholders. However, in the UK, little more information than that commonly associated with Fairtrade is offered to Fairhills consumers. The particular market challenges facing Fairtrade wine in the UK make this negotiation between regulation and representation extremely pertinent. A productive way forward may be to conceptualize commodity fetishism as a continuum rather than a binary particularly when considering the difficult balance required when adding complexity to the targeted message of the existing label. This strategy for the sustainability of Fairtrade may be enhanced by utilizing the micro-level dynamism and adaptability that this paper shows is inherent, and indeed essential, to the durability and transferability of the discourse of Fairtrade.

Participatory research approaches in the development of improved management practices in indigenous chickens production systems with smallholder farmers in Kenya

This thesis is concerned with development of improved management practices in indigenous chicken production systems in a research process that includes participatory approaches with smallholder farmers and other stakeholders in Kenya. The research process involved a wide range of activities that included on-station experiments, field surveys, stakeholder consultations in workshops, seminars and visits, and on-farm farmer participatory research to evaluate the effect of some improved management interventions on production performance of indigenous chickens. The participatory research was greatly informed from collective experiences and lessons of the previous activities. The on-station studies focused on hatching, growth and nutritional characteristics of the indigenous chickens. Four research publications from these studies are included in this thesis. Quantitative statistical analyses were applied and they involved use of growth models estimated with non-linear regressions for the growth characteristics, chi-square determinations to investigate differences among different reciprocal crosses of indigenous chickens and general linear models and covariance determination for the nutrition study. The on-station studies brought greater understanding of performance and production characteristics of indigenous chickens and the influence of management practices on these characteristics. The field surveys and stakeholder consultations helped in understanding the overarching issues affecting the productivity of the indigenous chickens systems and their place in the livelihoods of smallholder farmers. These activities created strong networking opportunities with stakeholders from a wide spectrum. The on-farm farmer participatory research involved selection of 200 farmers in five regions followed by training and introduction of interventions on improved management practices which included housing, vaccination, deworming and feed supplementation. Implementation and monitoring was mainly done by individual farmers continuously for close to one and half years. Six quarterly visits to the farms were made by the research team to monitor and provide support for on-going project activities. The data collected has been analysed for 5 consecutive 3-monthly periods. Descriptive and inferential statistics were applied to analyse the data collected involving treatment applications, production characteristics and flock demography characteristics. Out of the 200 farmers initially selected, 173 had records on treatment applications and flock demography characteristics while 127 farmers had records on production characteristics. The demographic analysis with a dissimilarity index of flock size produced 7 distinct farm groups from among the 173 farms. Two of these farm groups were represented in similar numbers in each of the five regions. The research process also involved a number of dissemination and communication strategies that have brought the process and project outcomes into the domain of accessibility by wider readership locally and globally. These include workshops, seminars, field visits and consultations, local and international conferences, electronic conferencing, publications and personal communication via emailing and conventional posting. A number of research and development proposals were also developed based on the knowledge and experiences gained from the research process. The thesis captures the research process activities and outcomes in 8 chapters which include in ascending order – introduction, theoretical concepts underpinning FPR, research methodology and process, on-station research output, FPR descriptive statistical analysis, FPR inferential statistical analysis on production characteristics, FPR demographic analysis and conclusions. Various research approaches both quantitative and qualitative have been applied in the research process indicating the possibilities and importance of combining both systems for greater understanding of issues being studied. In our case, participatory studies of the improved management of indigenous chickens indicates their potential importance as livelihood assets for poor people.

The effect of the national setting on employment practice: the case of downsizing

Although there is now a sizeable body of academic literature that tries to explain cross-country differences in terms of corporate control, capital market development, investor protection and politics, there is as yet very little literature on the degrees of protection accorded to other corporate stakeholders such as employees, based on a systematic comparison of firm level evidence. We find that both theories of legal origin and the varieties of capitalism approach are poor predictors of the relative propensity of firms to make redundancies in different settings. However, the political orientation of the government in place and even more so the nature of the electoral system are relatively good explanators of this propensity. In other words, political structures and outcomes matter more than more rigid institutional features such as legal origin. We explore the reasons for this, drawing out the implications for both theory and practice.

An industry viewpoint on the role of farm assurance in delivering food safety to the consumer: the case of the dairy sector in England and Wales

Food safety, alongside food quality, remains a primary concern of both consumers and those along the whole food supply chain, leading to regulation by government alongside private third party certification. Much has been written about the value of these systems primarily from the perception of the consumer. This paper reports on a study that examined industry perceptions on the regulatory and assurance systems within the dairy sector of England and Wales. It found that the primary producer found value in both systems, although from a food hygiene focus regulation was seen to be more rigorous. Other stakeholders along the dairy food supply chain saw the assurance scheme as more rigorous. All stakeholders recognised the need to reduce duplication in delivering food safety through combining key elements of both systems with the added potential for better communication of both food safety and quality to the final consumer.

The art of shooting the moving goal - explorative study of EA pilot

Enterprise Architecture (EA) has been recognised as an important tool in modern business management for closing the gap between strategy and its execution. The current literature implies that for EA to be successful, it should have clearly defined goals. However, the goals of different stakeholders are found to be different, even contradictory. In our explorative research, we seek an answer to the questions: What kind of goals are set for the EA implementation? How do the goals evolve during the time? Are the goals different among stakeholders? How do they affect the success of EA? We analysed an EA pilot conducted among eleven Finnish Higher Education Institutions (HEIs) in 2011. The goals of the pilot were gathered from three different stages of the pilot: before the pilot, during the pilot, and after the pilot, by means of a project plan, interviews during the pilot and a questionnaire after the pilot. The data was analysed using qualitative and quantitative methods. Eight distinct goals were recognised by the coding: Adopt EA Method, Build Information Systems, Business Development, Improve Reporting, Process Improvement, Quality Assurance, Reduce Complexity, and Understand the Big Picture. The success of the pilot was analysed statistically using the scale 1-5. Results revealed that goals set before the pilot were very different from those mentioned during the pilot, or after the pilot. Goals before the pilot were mostly related to expected benefits from the pilot, whereas the most important result was to adopt the EA method. Results can be explained by possibly different roles of respondents, which in turn were most likely caused by poor communication. Interestingly, goals mentioned by different stakeholders were not limited to their traditional areas of responsibility. For example, in some cases Chief Information Officers' goals were Quality Assurance and Process Improvement, whereas managers’ goals were Build Information Systems and Adopt EA Method. This could be a result of a good understanding of the meaning of EA, or stakeholders do not regard EA as their concern at all. It is also interesting to notice that regardless of the different perceptions of goals among stakeholders, all HEIs felt the pilot to be successful. Thus the research does not provide support to confirm the link between clear goals and success.

Theoretical perspectives of enterprise architecture

The number of published Enterprise Architecture (EA) research has increased during the last few years. As a discipline, EA is still young and lacking theoretical foundation. Lately some research trying to ground EA to theory has been published, including linkage to systems theory. Enterprise Architecture can be defined as; (i) a formal description of the current and future state(s) of an organisation, and (ii) a managed change between these states to meet organisation’s stakeholders’ goals and to create value to the organisation. Based on this definition, this conceptual paper tries to shed light to theoretical underpinnings of EA from three theoretical perspectives; EA as a communication media, EA as an activity, and EA as an information technology system. Our conclusions are that; (i) EA can be categorised as a communication media and theoretically underpinned by ontology and semiotics, (ii) EA can be explained and theoretically underpinned by Activity Theory, and (iii) EA can be categorised as an information technology system and theoretically underpinned by General Systems Theory and Technology Acceptance Theory.

Enabling sharing and reuse of scientific data

The purpose of this study was to develop an understanding of the current state of scientific data sharing that stakeholders could use to develop and implement effective data sharing strategies and policies. The study developed a conceptual model to describe the process of data sharing, and the drivers, barriers, and enablers that determine stakeholder engagement. The conceptual model was used as a framework to structure discussions and interviews with key members of all stakeholder groups. Analysis of data obtained from interviewees identified a number of themes that highlight key requirements for the development of a mature data sharing culture.