Thèses sur le sujet « Use and impact of information »

The domestication of IT has been a major socio-technical trend during the last decade and yet there is more to be known about the ways it has been adopted and used by working age women (16-59) carers and the impacts it has in practical terms on their lives. The main aim of this research was to investigate women carers' perceptions of use and impact of IT in their daily lives, and so to understand the extent of their empowerment and advancement and their contribution to an inclusive Information Society. Existing literature, including quantitative studies, has thrown light on the impact of domestic technologies and telephony on women's lives. The research, however, evolved from single view of merely concentrating on women as sole carers to appreciating men carers and hence the 'role of caring' came to fore as the main theme in relation to the use of IT alongside other domestic technologies. This study builds on previous work, using qualitative methods to inquire deeply into life experiences of a small number of carers in their access to and use of IT, within the broader context of their home life and duties. Fieldwork research was conducted through interviews with nine participants - six women and three men in caring positions - in their homes or university. The interviewing process was semi-structured, but was also cumulative. Each interview was followed by transcription and initial data processing (before the next interview was conducted). The collected data were encoded using the grounded theory approach, with the aid of Nvivo - a data management software tool for qualitative data analysis. The analysis produced conceptualisations of participants' use of both domestic and information technology in their daily lives. Cognitive mapping was used to bring out some of the important threads in the thinking of participants as shown in the transcriptions. An emergent theory grounded in the data was the main outcome of this research. The study contributes to the understanding of the reasons behind different ways that carers use IT and the impact it has on their lives. It also extends sociotechnical analysis into the domestic context, viewing that context itself against the background of the information society. Key findings include:- 1) Participants' use of IT differs according to occupation, income and family structure. 2) Personal qualities and self-perception have an influence in shaping carers' use of IT, while self-perceptions are likely to change as they become more proficient in the use of IT. 3) Use of IT can open up new economic and social opportunities for the participants, but may not necessarily do so, depending on their personal qualities and their perceptions of themselves and hence the ways they use the technology. 4) There was no consistent view among the participants about what could count as technology or about different types of technologies, nor any clear distinction made between domestic technology and information technology when applied in domestic situation. 5) The adoption of IT in the domestic context is a sociotechnical process, but one which does not exactly conform to the sociotechnical model of organisations.

The use and success of Information Systems (IS) is becoming increasingly reliant on users. Therefore, this study sought to develop and test a construct around the notion of User Capital, which this research defines as the attributes possessed by an individual that enable them to use an IS to perform tasks. User Capital was formed by the dimensions of self-regulation, competence, mastery orientation, and attitude. To test the construct a largely quantitative field study approach was adopted. User Capital was found to be a significant driver of effective use and a key construct in the examination of IS success.

Models of the need-driven information search and the information appraisal process were formed from a comprehensive literature review of factors affecting perceived credibility and trust in online information. The social component of online credibility has not, to date, been thoroughly researched. This component s impact on the development of the perceived credibility of online information was examined in two experiments. In the first experiment, the impact of positive, mixed, and negative social feedback on the development of the perceived credibility of a web page was evaluated. In the second experiment, the effect of social feedback on credibility was examined under two levels of motivation for information use to investigate whether social feedback becomes less important as motivation to obtain quality information increases. The results of Experiment 1 suggest that type of feedback can influence perceived web page credibility. Pages with negative audience feedback received the lowest credibility ratings, while pages with positive audience feedback received the highest credibility ratings. Pages with mixed or no audience feedback received higher credibility ratings than pages with negative feedback, but lower credibility ratings than pages with positive feedback. In Experiment 2, high motivation did not impact the number of web page elements participants reported that they used to determine credibility. High motivation for information use also did not reduce the impact of audience feedback on perceived credibility.<br>Ph.D.<br>Department of Psychology<br>Sciences<br>Psychology PhD

Background: The use of mobile devices for learning has been on the increase due to the availability of affordable data and free WiFi networks across institutions of higher learning. However, very few studies seek to understand if there is any impact that these devices have on a student's overall learning experience particularly from a developing country's perspective. Objectives: This research study determines the positive and negative impacts smartphone use has on a student's learning experience and whether this leads to overall satisfaction with mobile learning. Methods/Approach: Quantitative and qualitative data were collected through an online survey that was distributed via email to a student body from the sample. Statistica software was used to analyse the quantitative data while Nvivo software was used to analyse the qualitative data. Results: With over 400 responses, we found evidence for some, but not all hypothesized positive and negative impacts. Additionally, there was very strong support for how these impacts contribute to the overall satisfaction of using a smartphone for learning, explaining more than 60% of the variance. Conclusions: We found that the overall positive satisfaction leads to differentiated, continued uses of the smartphone for learning.

An increasing number of patients actively seek health information from the internet. Patients value the internet for health; however evidence suggests that health professionals perceive it as a challenge to their role. This study aims to investigate patients' use of the internet in primary care and to investigate the association between socio-economic status and internet use. Patients (n=851) attending two general practices in South Wales were surveyed about use of the internet for health in Phase 1. In Phase 2 interviews were conducted with a sample of these patients (n=50) and practice staff (n=10) to explore their views about patients' use of the internet and its impact on primary care. In the final phase, an on-line discussion forum with relevant stakeholders (n=73) explored views about the current and future role of the internet for patient information. Patients accessed their doctor significantly more for information about health in comparison to any other source. The internet was also highly valued, with 52% of study participants having used it for health information. Generally, primary care patients used the internet to complement rather than replace - information received by their doctor. There were differences amongst patients according to age, gender and socio-economic status in internet access, variety of health information used, and reliance on health professionals. Most health internet users acknowledged that their decision making was more informed and autonomous. A more patient-centred approach to consultations is advocated in the form of partnership with health professionals. This has yet to be realised in primary care, partly due to reluctance by patients and partly due to the current constraints on primary care consultations. This study shows that the internet is clearly an agent of change, which is shifting the way patients interact with health professionals in primary care. Patients would prefer to use the internet in partnership with health professionals, yet this need is currently not met within a primary care environment. It is important that patients and health professionals receive adequate training in using the internet for health information to make best use of this resource in the future.

INTRODUCTION The deployment of new health care models based on the coordination between different levels is a priority at European level to manage the dysfunctions generated by health and social impact of chronic diseases. The transfer of complexity from specialized health care in general hospital-based, to primary care professionals is one of the central elements of change in the health model. This involves the redesign of clinical processes and preparing the workforce for the new environment. The potential of Information and Communications Technology (ICT) as a facilitator element of collaboration between levels of care and greater patient accessibility, have an important role in the deployment and coordination of Integrated Care Services (ICS) that configure the new health model. In this context, the transfer of specialized diagnostic interventions to primary care is a highly relevant area in the change process. The central hypothesis of this thesis is the transfer of functional testing from specialized to primary care within a coordinated care scenario will improve the efficiency of delivery of care and will generate cross-fertilization between levels of care. The general hypothesis is that extensive deployment of different, well-articulated ICS-ICTs covering the entire spectrum of severity of chronic patients generates efficiencies at a system level. This PhD thesis focuses on functional testing and specifically addresses forced spirometry as a use case. This PhD thesis aims to identify the key factors that seem to modulate success of the transfer of forced spirometry (FS) testing to primary care and to other non-specialized professionals and to explore the deployment of services with potential for scalability. The thesis is structured around four specific objectives: OBJECTIVE 1 – TRANSFERABILITY OF FS TO PRIMARY CARE AND PHARMACY OFFICES The first objective is to assess the deployment of the transfer of FS in two scenarios, each with different purposes. The first manuscript analyzes the sustainability of a service to ensure high-quality forced spirometry in primary care. The two other manuscripts under Objective 1 examine the potential of transferability to pharmacy offices, to generate a COPD case-finding program. In the first study "Telemedicine Enhances Quality of Forced Spirometry in Primary Care" efficacy was demonstrated over time (12 m) for quality control of the FS performed by non specialist in five Spanish regions. It was shown that remote collaboration between primary care and specialists has a sustained positive effect on the quality of the FS performed by non-expert personnel. A significant difference between the intervention group (71.5% high quality FS) and the control group (59.5% high quality FS) during the 12 months of the study (p <0.001) was observed. The research generated valuable information to plan properly scalability of the program at regional level, and facilitate the redesign of the role of diagnostic tests in the management of chronic patients in an environment of integrated care. Studies 2 “Early detection of COPD in customers of urban community pharmacies: a pilot-study” and 3 “Spirometry in community-pharmacies: a novel strategy to reduce COPD underdiagnosis”. Results clearly indicate the potential of the community pharmacy as a health partner in close collaboration with primary care. Note that both studies only provide information about feasibility. The efficiency analysis is planned as an activity beyond this thesis, under the EU Project Synergy-COPD and the Master Plan for Respiratory Diseases (PDMAR) of the Department of Health of the Generalitat de Catalunya. OBJECTIVE 2 - ASSESSMENT OF REQUIREMENTS FOR SCALABILITY AT REGIONAL LEVEL Within objective 2, we performed two clusters of studies. The first two (manuscripts 4 and 5) “Survey about the use of Lung Function Testing in Public Hospitals in Catalonia in 2009” and “Estudio de la función pulmonar básica en los centros de atención primaria de Cataluña” analyze the status and needs of FS testing in Catalonia. The second cluster includes two studies (manuscripts 6 and 7) “Design of a basic training program to get quality spirometry” and “HERMES Spirometry: the European Spirometry Driving Licence” with specific proposals for training programs for deployment in Catalonia and at a European level. All these studies were performed directly under the auspices of the Catalan Master Plan of Respiratory Diseases. OBJETIVE 3 - TECHNOLOGICAL CONTRIBUTIONS In this PhD thesis, two areas were identified in which specific technological contributions were needed to ensure the success of the deployment. Firstly, “Technical Requirements of Spirometers in the Strategy for Guaranteeing the Access to Quality Spirometry” the design and production of a FS-CDA for structured data transfer using the protocol HL7 and Clinical Document Architecture (CDA) with the R2 standard supporting interoperability across healthcare tiers (manuscript 8) and, secondly, “Improving quality control of forced spirometry: a new algorithm for automatic evaluation” the development of an automatic tool (algorithm) for remote FS quality control (manuscript 9). The results of the validation with 778 spirometric curves indicated that the sensitivity and specificity of the algorithm was of 96.1 and 94.9%, respectively. The validation of the algorithm provided a second technology element necessary for scalability transfer program of FS to primary care and community pharmacies. The algorithm has been integrated in the ICT management platform for chronic patients. The clinical validation process will be within the EU project Synergy-COPD and scalability in Catalonia plan will materialize in the short term under the PDMAR. CONCLUSIONS 1. The potential for transferability of Forced Spirometry testing to Primary Care was demonstrated by the effectiveness of the web-based collaborative tool that showed sustainable enhancement of high-quality testing performed by non-specialized professionals (manuscript 1). 2. The feasibility of having pharmacy offices play a complementary role to primary care in early diagnosis of chronic respiratory disorders has been proven. Moreover, the potential of pharmacy offices in a future COPD case-finding program has been identified and will be developed beyond this PhD thesis (manuscripts 2 & 3). 3. The lung function testing map in Catalonia was drawn up and requirements for the deployment of high-quality FS within a coordinated care scenario were identified (manuscripts 4 & 5). 4. Conventional and novel coaching strategies to be further developed and integrated into the ICT-supported platform were analyzed (manuscripts 6 & 7) 5. Technological contributions to health system interoperability aimed at facilitating adoption of a high quality FS service supported by ICT were developed and validated, namely: Clinical Document Architecture and an algorithm for automatic assessment of FS quality.<br>INTRODUCCIÓ El desplegament de nous models de salut basats en la coordinació entre nivells assistencials constitueixen una prioritat a nivell europeu davant la necessitat de gestionar les disfuncions generades per l’elevat impacte sanitari i social de les malalties cròniques. La transferència de la complexitat des de l’atenció sanitària especialitzada, en general de base hospitalària, a professionals d’Atenció Primària constitueix un dels elements centrals del canvi en el model de salut. Això implica el redisseny de processos clínics i la preparació del personal sanitari pel nou entorn. L’ús eficient del potencial que ofereixen les Tecnologies de la Informació i la Comunicació (TIC), com a element facilitador de la col•laboració entre nivells assistencials i d’una major accessi­bilitat del pacient, té un rol important en el desplegament i l’articulació dels Serveis d’Atenció Integrada (SAI) que configuren el nou model de salut. En aquest context, la transferència de les intervencions diagnòstiques especialitzades a l’atenció primària constitueix un àrea molt rellevant en el procés de canvi. L’hipòtesi central de la present tesi doctoral és que la transferència de determinades proves diagnòstiques a l’atenció primària genera eficiències a nivell del sistema de salut. Els diferents estudis realitzats en la tesi es centren en l’espirometria forçada (EF), seleccionada, per les seves característiques, com una prova de concepte. Els objectius generals són explorar aquells fac­tors que s’han identificat com a claus en la modulació del procés de la transferència de l’EF, així com definir estratègies per a la seva escalabilitat regional. La tesi s’estructura en base a 3 objectius específics: OBJECTIU 1 - ANÀLISI DE LA TRANSFERÈNCIA DE LA EF A ATENCIÓ PRIMÀRIA I A OFICINES DE FARMÀCIA. En el primer estudi “Telemedicine enhances Quality of Forced Spirometry in Primary Care” es va demostrar l’eficàcia en el temps (12 m) d’un servei centralitzat pel control de qualitat de l’EF efectuada per professionals no especialitzats de tres regions espanyoles. Es va demostrar que la col•laboració remota entre professionals de primària i especialistes de funció pulmonar tenen un efecte positiu sostingut sobre la qualitat de l’EF realitzada per personal no expert. Es va observar una diferència significativa entre el grup d’intervenció (71.5% EF d’alta qualitat) i el grup control (59.5% EF d’alta qualitat) durant els 12 mesos de l’estudi (p<0.001). La investigació va generar informació valuosa per planejar de forma adient l’escalabilitat del programa a nivell regional. Els resultats d’aquest estudi, junt amb altres apartats de la tesi i d’altres investigacions en curs, facilitaran el redisseny del rol de les proves diagnòstiques en la gestió dels pacients crònics en un entorn d’atenció integrada. Els estudis 2 (Early detection of COPD in customers of urban community pharmacies: a pilot­study) i 3 (Spirometry in community-pharmacies: a novel strategy to reduce COPD underdiag­nosis) de la tesi responen de forma afirmativa a la següent pregunta: Poden les oficines de farmàcia tenir un rol rellevant en un programa de detecció de casos de MPOC? Els resultats són clarament indicatius del potencial de les oficines de farmàcia com a agent sanitari en estreta col•laboració amb Atenció Primària. Cal senyalar que amdos estudis sola­ment aporten informació sobre factibilitat. L’anàlisi d’eficiència es planeja com a una activitat més enllà d’aquesta tesi doctoral, en el marc del projecte EU Synergy-COPD i del Pla Director de Malalties de l’Aparell Respiratori (PDMAR) del Departament de Salut de la Generalitat de Catalunya. OBJECTIU 2 – AVALUACIÓ DE REQUERIMENTS PER A L’ESCALABILITAT REGIONAL A NIVELL DE CATALUNYA En els estudis 4 (Encuesta de utilización de la función pulmonar en los hospitales públicos de Cataluña en 2009) y 5 (Estudio de la función pulmonar básica en los centros de atención pri­maria de Cataluña. Atención Primaria) s’analitzà la situació i necessitats futures de les proves de funció pulmonar a Catalunya a nivell hospitalari i extra-hospitalari en el marc del PDMAR. Els resultats obtinguts confirmen la necessitat de desplegar l’EF a l’Atenció Primària i d’incrementar l’homogeneïtat territorial en el que respecta a l’accés a les proves de funció pul­monar per a pacients i professionals. Es confirma la necessitat del programa de transferència de l’EF plantejat en la tesi doctoral. En un segon grup d’estudis en el Objectiu 2 de la tesi, efectuats en el marc del PDMAR, s‘analitzaren les necessitats i estratègies pel que fa a l’entrenament dels professionals no es­pecialitzats tant en l’àmbit català, estudi 6 (Disseny d’un programa de formació basic para aconseguir espirometries de qualitat), com a nivell europeu, estudi 7 (HERMES Spirometry: the European Spirometry Driving Licence). OBJECTIU 3 – CONTRIBUCIONS TECNOLÒGIQUES A L’ESCALABILITAT L’estudi 8 (Requerimientos técnicos de los espirómetros en la estrategia para garantizar el acceso a una espirometría de calidad) va aportar un element essencial per assegurar l’interoperabilitat de les dades de l’EF al assegurar l’estandardització de la transferència d’informació utilitzant el protocol HL7 v3 i CDA (Clinical Document Architecture) amb estàndard R2. Efectuat amb el suport de l’Oficina d’Estàndards i Interoperabilitat del Departament de Salut de la Generalitat de Catalunya dins el Pla de Digitalizació de la Imatge Mèdica. L’estàndard de transferència de l’EF ha estat ja adoptat per alguns fabricants d’equips de medició i és un requeriment per als concursos públics a nivell regional. A més, a l’estudi 9 (Clinical Decision Support System to Enhance Quality Control of Forced Spi­rometry) es va generar i validar un algoritme per el control automàtic de la qualitat de l’EF. Els resultats de la validació amb 778 corbes espiromètriques varen indicar que la sensibilitat i especificitat de l’algoritme era del 96.1 i 94.9%, respectivament. La validació de l’algoritme aportà un segon element tecnològic necessari per a l’escalabilitat del programa de transfer­ència de l’EF a Atenció Primària i a les oficines de farmàcia. L’algoritme ha estat integrat a la plataforma TIC de gestió de malalts crònics. La validació del procés clínic s’efectuarà dins del projecte EU Synergy-COPD i el pla d’escalabilitat a Catalunya es materialitzarà a curt termini en el marc del PDMAR. CONCLUSIONS 1. Es demostra el potencial de transferibilitat de l’EF a Atenció Primària amb el suport d’una aplicació web de treball col•laboratiu que va facilitar un augment significatiu i sostenible de la qualitat de les proves efectuades per personal no especialitzat (manuscrit 1). 2. Es verificà la factibilitat del rol de les oficines de farmàcia per a la detecció de casos de MPOC en un programa coordinat amb Atenció Primària. Les oficines de Farmàcia podrien tenir un rol complementari a l’Atenció Primària en el diagnòstic de MPOC oculta. El desenvolupament i validació del programa es completarà una vegada finalitzada la present tesi doctoral (manuscrits 2 i 3). 3. L’elaboració del mapa de proves de funció pulmonar a Catalunya va permetre la identifi­cació dels requeriments per a l’escalabilitat regional del programa de transferència de l’EF en el marc d’un model de atenció integrada (manuscrits 4 i 5). 4. Es va verificar el rol essencial de les estratègies d’entrenament dels professionals no espe­cialitzats com a component essencial d’un programa de transferència d’EF de qualitat a l’ Atenció Primària (manuscrits 6 i 7). 5. Es van efectuar dos contribucions tecnològiques rellevants per assegurar la interoperabilitat de l’EF a nivell del sistema de salut: l’elaboració del CDA (manuscrit 8) i el desenvolupament i validació d’un algoritme per l’avaluació automàtica de la qualitat de l’EF (manuscrit 9).<br>INTRODUCCIÓN El despliegue de nuevos modelos de salud basados en la coordinación entre niveles asisten­ciales constituye una prioridad a nivel Europeo ante la necesidad de gestionar las disfunciones generadas por elevado impacto sanitario y social de las enfermedades crónicas. La transferencia de complejidad desde la atención sanitaria especializada, en general de base hospitalaria, a profesionales de Atención Primaria, constituye uno de los elementos centrales del cambio en el modelo de salud. Ello implica el rediseño de procesos clínicos y la preparación del personal sanitario para el nuevo entorno. El uso eficiente del potencial que ofrecen las Tecnologías de la Información y la Comunicación (TIC), como elemento facilitador de la colaboración entre niveles asistenciales y de una mayor accesibilidad del paciente, tiene un papel importante en el despliegue y articulación de los Servicios de Atención Integrada (SAI) que configuran el nuevo modelo de salud. En este con­texto, la transferencia de las intervenciones diagnósticas especializadas a la atención primaria constituye un área muy relevante en el proceso de cambio. La hipótesis central de la presente tesis doctoral es que la transferencia de determinadas pruebas diagnósticas a la atención primaria genera eficiencias a nivel del sistema de salud. Los dife­rentes estudios realizados en la tesis se centran en la espirometría forzada (EF), seleccionada, por sus características, como una prueba de concepto. Los objetivos generales son explorar aquellos factores que se han identificado como claves en la modulación del proceso de la transferencia de la EF, así como definir estrategias para su escalabilidad regional. La tesis se estructura en base a 3 objetivos específicos: OBJETIVO 1 - ANÁLISIS DE LA TRANSFERENCIA DE LA EF A ATENCIÓN PRIMARIA Y A OFICINAS DE FARMACIA. En el primer estudio “Telemedicine enhances Quality of Forced Spirometry in Primary Care” se demostró la eficacia en el tiempo (12 m) de un servicio centralizado para control de calidad de la EF efectuada por profesionales no especializados de tres regiones españolas. Se demostró que la colaboración remota entre profesionales de primaria y especialistas de función pulmonar tiene un efecto positivo sostenido sobre la calidad de la EF realizada por personal no experto. Se observó una diferencia significativa entre el grupo intervención (71.5% EF de alta calidad) y el grupo control (59.5% EF de alta calidad) durante los 12 meses del estudio (p<0.001). La investigación generó información valiosa para planear de forma adecuada la escalabilidad del programa a nivel regional. Los resultados de este estudio, junto con otros apartados de la tesis y otras investigaciones en curso, facilitarán el rediseño del papel de las pruebas diagnósticas en la gestión de los pacientes crónicos en un entorno de atención integrada. Los estudios 2 (Early detection of COPD in customers of urban community pharmacies: a pilot­study) y 3 (Spirometry in community-pharmacies: a novel strategy to reduce COPD underdiag­nosis) de la tesis responden de forma afirmativa a la siguiente pregunta: Pueden las oficinas de farmacia tener un papel relevante en un programa de detección de casos de EPOC? Los resultados son claramente indicativos del potencial de las oficinas de farmacia como agente sanitario en estrecha colaboración con Atención Primaria. Cabe señalar que ambos estudios solo aportan información sobre factibilidad. El análisis de eficiencia se planea como una actividad más allá de esta tesis doctoral, en el marco del proyecto EU Synergy-COPD y del Plan Director de Enfermedades de Aparato Respiratorio (PDMAR) del Departamento de Salud de la Generalitat de Catalunya. OBJETIVO 2 – EVALUACIÓN DE REQUERIMIENTOS PARA LA ESCALABILIDAD REGIONAL A NIVEL DE CATALUNYA En los estudios 4 (Encuesta de utilización de la función pulmonar en los hospitales públicos de Cataluña en 2009) y 5 (Estudio de la función pulmonar básica en los centros de atención primaria de Cataluña. Atención Primaria) se analizó la situación y necesidades futuras de las pruebas de función pulmonar en Catalunya a nivel hospitalario y extra-hospitalario en el marco del PDMAR. Los resultados obtenidos confirman la necesidad de desplegar la EF en Atención Primaria y de incrementar la homogeneidad territorial en lo que respecta al acceso a las pruebas de función pulmonar para pacientes y profesionales. Se confirma la necesidad del programa de transferencia de la EF planteado en la tesis doctoral. En un segundo grupo de estudios en el Objetivo 2 de la tesis, efectuados en el marco del PDMAR, se analizaron las necesidades y estrategias en lo que respecta al entrenamiento de profesionales no especializados tanto en el ámbito catalán, estudio 6 (Diseño de un programa de formación básico para conseguir espirometrías de calidad), como a nivel Europeo, estudio 7 (HERMES Spirometry: the European Spirometry Driving Licence). OBJETIVO 3 – CONTRIBUCIONES TECNOLÓGICAS A LA ESCALABILIDAD El estudio 8 (Requerimientos técnicos de los espirómetros en la estrategia para garantizar el ac­ceso a una espirometría de calidad) aportó un elemento esencial para asegurar la interopera­bilidad de los datos de EF al asegurar la estandarización de la transferencia de información uti­lizando el protocolo HL7 v3 y CDA (Clinical Document Architecture) con estándar R2. Efectuado con el soporte de la Oficina de Estándares e Interoperabilidad del Departament de Salut de la Generalitat de Catalunya dentro del Plan de Digitalización de la Imagen Médica. El estándar de transferencia de la EF ha sido ya adoptado por algunos fabricantes de equipos de medición y es un requerimiento para los concursos públicos a nivel regional. Además, en el estudio 9 (Clinical Decision Support System to Enhance Quality Control of Forced Spirometry) se generó y validó un algoritmo para el control automático de la calidad de la EF. Los resultados de la validación con 778 curvas espirométricas indicaron que la sensibilidad y especificidad del algoritmo era del 96.1 y 94.9%, respectivamente. La validación del algoritmo aportó un segundo elemento tecnológico necesario para la escalabilidad del programa de transferencia de la EF a Atención Primaria y a oficinas de farmacia. El algoritmo ha sido inte­grado a la plataforma TIC de gestión de pacientes crónicos. La validación del proceso clínico se efectuará dentro del proyecto EU Synergy-COPD y el plan de escalabilidad en Catalunya se materializará a corto plazo en el marco del PDMAR. CONCLUSIONES 1. Se demostró el potencial de transferibilidad de la EF a Atención Primaria con el soporte de una aplicación web de trabajo colaborativo que facilitó un aumento significativo y sostenible de la calidad de las pruebas efectuadas por personal no especializado (manuscrito 1). 2. Se verificó la factibilidad del rol de las oficinas de farmacia para la detección de casos de EPOC en un programa coordinado con Atención Primaria. Las oficinas de Farmacia podrían tener un rol complementario a la Atención Primaria en el diagnóstico de EPOC oculta. El desarrollo y validación del programa se completará una vez finalizada la presente tesis doc­toral (manuscritos 2 y 3). 3. La elaboración del mapa de pruebas de función pulmonar en Catalunya permitió la identi­ficación de los requerimientos para la escalabilidad regional del programa de transferencia de la EF en el marco de un modelo de atención integrada (manuscritos 4 y 5). 4. Se verificó el papel esencial de las estrategias de entrenamiento de profesionales no espe­cializados como componente esencial de un programa de transferencia de EF de calidad a Atención Primaria (manuscritos 6 y 7). 5. Se efectuaron dos contribuciones tecnológicas relevantes para asegurar la interoperabi­lidad de la EF a nivel del sistema de salud: la elaboración del CDA (manuscrito 8) y el desarrollo y validación de un algoritmo para la evaluación automática de la calidad de la EF (manuscrito 9).

This study applied social disruption as a concept that highlights factors responsible for the breakdown of social relationships in societies. Social disruption has many forms, however, the focus in this study was on strikes, which create constant social disruption in Nigerian public universities and could have serious impact on students' information behavior. Two universities – Federal University of Technology Owerri (FUTO) and Imo State University Owerri (IMSU) – were chosen for the study, and data was obtained through an online survey across sample of approximately 250 participants from the two selected public universities in Nigeria. The study applied the principle of least effort theory and the model of information search process to investigate the research questions of this dissertation which were: (1) what kinds of information do university students in Nigeria seek, and to what extent do strikes have implications on their information behavior?; (2) how do Nigerian students perceive the impact of strikes on their information source location and information resource usage?; (3) to what extent can information and communication technology (ICT) minimize the impact of strikes on students' information behavior?; and (4) how can universities in Nigeria prevent strikes from impacting students' information behavior? t-Tests were applied to test the hypotheses. Findings suggested that strikes negatively impacted students information behavior in certain areas of information needs, information use and information sources.

Do we know whether the use of geographic information systems (GIS) in law enforcement agencies increases police performance? This study examines the impact of GIS use to police performance outcomes in cities and counties of the U.S. between 2000 and 2007. Current research uses computerized mapping conceptualization to operationalize its measurement. Second, the police performance methodological context is used to measure the organizational impact of GIS. Finally, a new theoretical framework, information technology capacity that combines organizational, environmental and managerial factors to explain IT applications, is used to encompass most relevant dimensions of the subject matter. Findings indicate that the use of GIS in police agencies increased sharply between 2003 and 2007. Additionally, the contribution of GIS use on police performance was found to be statistically significant, but in the opposite direction. Overall, results of the present study indicate significant links between crime rate (DV) and independent variables (IV) in law enforcement agencies. IVs are having a professional form of government andfull time specialized crime analysis personnel, police strength, the use of GIS, population, being located in the Northeast and West regions, poverty, having encouraged SARA type projects and a community policing unit.

A dissertation submitted in partial fulfilment of the Degree of Master of Library and Information Science (MLIS) in the Department of Library and Information Science at the University of Zululand, South Africa, 2010.<br>Social Informatics is the field of study concentrating on the social aspects of Information and Communication Technologies (ICT) utilisation with researchers in the field concentrating on aspects such as human interaction with ICTs, the effect of certain hardware and software on utilisation and the impact that the use of ICTs have on the daily lives of people in society. One of the areas where the use of ICTs can have a huge influence is on governmental service delivery, where these tools can be used to speed up processes, beef up security, provide access to, and disseminate information, and be used in virtually all government departments to provide a more effective and efficient service to all its people. The aim of the study was to examine the use, impact and interaction of ICTs for service delivery among Civil Servants in the uMhlatuze area. The study was carried out using both qualitative and quantitative methods through survey research. The objectives of the study were: to determine the nature of the services rendered in the three targeted Departments (Education, Health and Social Development), to establish the types of ICTs currently in use by Civil Servants in uMhlatuze area, to explore how the Civil Servants interact with ICTs in the municipality, to explore the impact of the Civil Servants` interaction with ICTs, to determine the training needs of the Civil Servants, in so far as effective ICT utilisation is concerned, to determine users level of satisfaction with the standard of service delivery, to outline the challenges faced in the service provision. Data was collected via questionnaires that were submitted to the three departments by the researcher. Interviews were also conducted with both civil servants and their clients. The aim of the interviews was to get their personal opinions on problems facing service provision. The number of responses from the distributed questionnaires varied: Education (21), Health (9) and Social Development (5). Managers from the three departments were interviewed with an aim of understanding types of services they offer to clients, clients satisfaction with service offered to them, the use of computers in providing services, the level of computer literacy among staff (Civil Servants), difficulties experienced when providing services to clients, and the effect of the availability of computers in providing service delivery. The study revealed that not all ICT tools are generally available and/or used by civil servants in the uMhlatuze Municipality It was also found that most new technologies were neither used, nor available, or could not be accessed by civil servants in the departments, e.g. the Internet, laptop computers, databases, video cameras, video recorders, sound/tape recorders, overhead projectors, and information systems. The government also does not appear to make much use of radio and television, which are mediums that are often used in this country for communication. The researcher recommended that the government should ensure that each civil servant has a computer linked to the Internet on his or her table. All available ICT tools should also be provided to the different departments because they deal with different social needs everyday that may require different solutions. A lack of skills to operate a number of ICTs, especially the computers was identified as a serious impediment to effective service delivery. Therefore it was recommended that the Departments of Education, Health and Social Development send their staff for training on the efficient utilization of ICT tools, specifically computer related training. It was further recommended that computer literacy courses and refresher courses be offered on a continual basis in order to elevate the level of computer literacy among the civil servants, especially for programmes such as Word processing, Excel and PowerPoint which are used almost daily in the public service.

Social endorsements are user-generated endorsements of products or services, such as “likes” and personal collections, in an online social platform. We examine the effect of prior social endorsements on subsequent users’ tendency to endorse or examine a product in a social shopping context, where a social platform connect consumers and enable a collaborative shopping experience. This research consists of two parts. In part I, we identify two ways prior social endorsements can affect subsequent user behavior: as a crowd endorsement, which is an aggregate number of endorsements a product receives for anyone who comes across the product, and as a friend endorsement, which is an endorsement with the endorser’s identity delivered only to the endorser’s friends or followers. Using a panel data of 1656 products on a leading social shopping platform, we quantify the relationship between crowd and friend endorsements and subsequent examination (“click”) and endorsement (“like”) of the products, noting that examination is a private behavior while endorsement is a public behavior. Our results are consistent with the identity signaling theory where identity-conscious consumers converge with the aspiration group (the followers) in their public behavior (e.g. endorsement) and diverge from the avoidance groups (the crowd). We also find differences between public and private behaviors. Moreover, the symbolic nature of social shopping platform trumps the traditional dichotomy of symbolic/functional product attributes. Part II of this study seeks to clarify the underlying mechanism through lab experiments. We hypothesize that consumers’ evaluative attitude, specifically the value-expressive type, moderates the relationship between crowd and friend endorsements and a focal user’s product choice. Our initial results of the second study show support for this idea in the cases when the product choice is not obvious.

Today, flexibility is widely concemed as the key capability an organisation should possess due to the fast change of business and technology environment (Haeckel 1999; Golden and Powell 2000). Business is fundamentally concerned with and driven by changes. It requires flexibility to quickly respond to new conditions, to absorb sudden shocks and to accommodate diversity and heterogeneity. All of these demands, in turn, feed through to the computer-systems that modem organisations rely upon (CBDi Forum 2001). The attainment of information system flexibility is becoming an essential requirement for the business (Golden and Powell 2000; Behrsin et al 1994). Despite ITAS has been developed to achieve great flexibility and functionality in order to provide more agile and more effective solution for the businesses, it is also Widely subject to criticism for its inflexibility and rigidity (Allen and Boynton 1991; Avison et al 1995; Davenport 2000). This research addresses the IS flexibility issue and studies "how organisations adapt their ISs/ESs to accommodate ongoing business changes" A model of tactical ES adaptation for ongoing business changes has been developed from three organisations' ES post-implementation experience. This model depicts a complicated decision making process for ES adaptation to support ongoing business changes and attain flexibility. It demonstrates the dynamic relationship among emerging business needs, adaptation tactics, adaptation activities, performance and resource measurement, and risk evaluation.

This thesis investigates the attitudes of human resource professionals towards human resource information systems (HRIS) in order to better understand their enablers and effects on individuals and organisations. Focusing on factors influencing HRIS acceptance, the study identifies key dimensions relating to HRIS benefits specifically perceived usefulness and user satisfaction, organisational, social, and technical drivers of acceptance, and the consequences of satisfaction with HRIS for organisational behaviour. Drawing mainly on the theory of reasoned action TRA, the technology acceptance model and the DeLoan & McLean success model, a comprehensive multidimensional model is suggested. Data were collected from companies in the Libyan oil, gas and banking sectors and multivariate analysis was used to test the proposed theoretical framework. The findings show that top management support has a significant impact on perceived usefulness and satisfaction with HRIS. Furthermore, information quality, HRIS flexibility, ease of use, and IT staff support have considerable impacts on satisfaction with HRIS via perceived usefulness. Findings also show that social influence and the number of strategic applications also have a significant influence on user satisfaction. User satisfaction has the strongest impact on affective commitment compared to continuance and normative commitment. The study contributes in two ways. In terms of theoretical value, this study extends and develops theory of technology acceptance by relating social interactions, organisational support, and number of HRIS applications in terms of routine and strategic contexts and organisational behaviour. Second, it expands the technology acceptance model to examine and explain the perceptions and attitudes of HR professionals towards HRIS. There is also a practical contribution as Libya is a developing country characterised by a lack of understanding about technology adoption and the impact of technology on human resources activities. The findings inform top management, HR professionals and IT staff about the current practice of HRIS in a Libyan environment highlighting the variables (enablers and barriers) which can enhance or impede individual and organizational performance.

The study of <I>export</I> information use is in its infancy stage since the export information literature has tended to focus on <I>acquisition</I> rather than <I>use </I>issues. The objectives were thus the development of reliable and valid measures of export information use, and the assessment or antecedents and impact on export performance. After reviewing the literature, an exploratory study of export decision-makers was undertaken. The results suggested the existence of two types of export information use: <I>instrumental/conceptual </I>and <I>symbolic</I>. A mail questionnaire was developed on the basis of both the literature review (Chapter Two) and the exploratory study (Chapter Three). The research instrument was pretested. For the main mail survey, a sample of 198 cases was achieved. Established measure development procedures were employed for producing scales of use of information acquired via different types of sources. In addition, measures of export information acquisition, intra-organisational use (reflecting <I>extent </I>of use) and export performance were developed to enhance the analysis. Finally, an overall model of export information use was tested via a series of multiple regression and moderated regression approaches. The antecedents to export information use examined in this study encompassed company size, export experience, export structure, export dependence, and export complexity, acquisition from different types of sources, awareness of export information sources, information intensity, over-acquisition, overload and environmental turbulence. Some of these variables were found to be directly related to export information use while others were linked to use through acquisition. Intra-organisational use of export information was found to have a positive link with export performance, as did instrumental/conceptual use of export market intelligence information. Instrumental/conceptual use of both export marketing research and export assistance information were found to be negatively related to export performance.

Abstract The 2009 American Recovery and Reinvestment Act has earmarked 27 billion dollars to promote the adoption of Health Information Technologies (HIT) in the US, and to gain access to these funds, providers must document “Meaningful Use” during the care process. While individual HIT use according to lean measures, including meaningful use, is prevalent in the IS literature, few studies have incorporated rich measures to account for the task, the technology, and the user in a team context. This dissertation conceptualizes Team Deep Structure Use of Computerized Provider Order Entry (CPOE) as an IT- enabled coordination mechanism, and Relational Coordination as the inherent ability of clinical teams to coordinate care spontaneously using informal, relationship based mechanisms. IT-enabled and Relational Coordination mechanisms are each evaluated across five maximally different patient conditions to simultaneously examine their impact on our outcome measure, Patient Satisfaction with the clinical care team. The extant literature has established a deep understanding of IT adoption shortly after implementation, yet the literature is silent on the antecedents of IT use according to rich measures well after the shake down phase, a period in which the majority of organizations operate. We incorporate the Adaptive Structuration Theory (AST) constructs of Faithfulness of Appropriation, and Consensus on Appropriation as the focal antecedents of Deep Structure Use of the clinical system by team members. To our knowledge, no prior research has linked these two AST constructs to clinical outcomes through the incorporation of a rich use mediator such as Deep Structure Use of a Health IT. To test our model, we relied on survey responses from 555 physicians, nurses and mid-levels which had cared for 261 patients across five patient conditions, ranging from vaginal birth, to organ transplant, as well as pneumonia, knee/hip replacement and cardiovascular surgery. Our results confirm that the Adaptive Structuration constructs of Faithfulness of Appropriation and Consensus on Appropriation, generate positive and statistically significant path coefficients predicting Team Deep Structure Use of CPOE. We also report differential effects on Patient Satisfaction with the care team resulting from technology use. Results range from a significant positive path coefficient (.285) associated with higher Team Deep Structure Use on combined Pneumonia and Organ Transplant teams, to a significant negative path coefficient (-.174) on cardiovascular surgery teams. As expected, Pneumonia, Organ Transplant and Cardiovascular Surgery teams all reported positive effects on Patient Satisfaction with the care team as a result of higher Relational Coordination scores. For teams caring for patient conditions consistently associated with a shorter length of stay, including vaginal birth and knee/hip replacement, higher reported use of IT- enabled, or Relational Coordination mechanisms, did not result in a significant increase in Patient Satisfaction. This dissertation contributes to the growing Health IT literature, and has practical implications for clinicians, hospital administrators and Health IT professionals. This dissertation is the first to operationalize a rich measure of use of an HIT by clinical teams, and to simultaneously measure the impact of IT enabled and Relational Coordination mechanisms on Patient Satisfaction. Secondly, through the introduction of Adaptive Structuration constructs, our model establishes a methodology for predicting rich, nuanced use in teams well after the initial shake down phase associated with recent HIT implementation. Through the juxtaposition of the impact of IT-enabled and Relational Coordination mechanisms across patient conditions, practitioners can design interventions and adjust the level of resources applied to process improvement accordingly.

Organizations make large investments in Information Systems (IS) expecting positive impacts to the organisation and its functions. Yet, there exists much controversy surrounding the 'potential' impacts of these systems, with some studies reporting broadly positive impacts of IS across organizations (Barua, Kriebel and Mukhopadhyay 1995; Barua and Lee 1997; Brynjolfsson and Hitt 1996; Lehr and Lichtenberg 1999; Mukherjee, Ray and Miller 2001), while others have shown nil or detrimental impacts (Attewell and Rule 1984; Brynjolfsson and Yang 1996; Cameron and Quinn 1988; Wilson 1993). Various authors have suggested that these conflicting results may be due to poor measurement - E.g. incomplete or inappropriate measures of success (DeLone and McLean 1992; Gable 1996; Melone 1990), lack of theoretical grounding and hence agreement on appropriate measures of success (Bonner 1995; Myers, Kappelman and Prybutok 1998), myopic focus on financial performance indicators (Ballantine, Bonner, Levy, Martin, Munro and Powell 1996; Kaplan and Norton 1996), weaknesses in survey instruments employed (Gable, Sedera and Chan 2003) (e.g., constructs lacking in validity), or (5) inappropriate data collection approach (Seddon, Staples, Patnayakuni and Bowtell 1999; Sedera and Gable 2004) (e.g., asking the wrong people, unrepresentative sample). Enterprise Systems (ES) have over the past decade emerged to be one of the most important developments in the corporate use of information technology. Anecdotal evidence reveals discontent with these large application software packages. Yet Enterprise System investments are seldom systematically evaluated post-implementation; the review process and measures typically being idiosyncratic and lacking credibility. Impacts resulting from 'Enterprise Systems' are particularly difficult to measure, with an Enterprise System entailing many users ranging from top executives to data entry operators; many applications that span the organization; and a diversity of capabilities and functionality. Despite the substantial investments made by organizations and the anecdotal evidence of discontent, systematic attempts to measure their success have been few. The primary objective of this research is to develop and test a standardized instrument for measuring ES-Success. Other related objectives of this research include: (1) to identify the dimensions and measures of ES-Success, (2) to validate a maximally generalizable measurement model and survey instrument for gauging ES-Success; (3) to develop an understanding of the state of Enterprise Systems using descriptive/comparative statistics, and (4) to identify and test an antecedent of ES-Success. With the above objectives, and in attention to the weaknesses identified in past IS-success research, this study follows and extends the 'research cycle' guidelines of Mackenzie and House (1979) and McGrath (1979). The research cycle entails two main phases: (1) an exploratory phase to develop the hypothesized measurement model, and (2) a confirmatory phase, to test the hypothesized measurement model against new data. The two surveys (termed as identification-survey and specification-survey) conducted in the exploratory phase of this research go beyond the activities recommended by Mackenzie and House (1979) and McGrath (1979). A third "confirmation-survey" was completed in the confirmatory phase of the research cycle. The three surveys gathered and analyzed data from six hundred (600) respondents. The purpose of the identification-survey was to discover the salient ES-Success dimensions and measures to include in an a-priori ES-Success model. Data from 137 respondents representing 27 Australian State Government Agencies that had implemented SAP R/3 in the late 1990s were analyzed. The analysis of identification-survey data yielded an a-priori model with 41 measures of 5 dimensions of ES-Success that provide a holistic view across the organization from strategic to operational levels. The specification-survey was employed to validate the a-priori ES-Success measurement model derived in the preceding identification-survey. Employing 310 responses from the same 27 public sector organizations, exploratory data analysis validated 27 measures of success pertaining to the 4 dimensions: information quality, system quality, individual impact and organizational impact. Data for testing the influence of an antecedent of ES-Success was simultaneously gathered during the specification-survey. This analysis, based on the Adaptive Structuration Theory (AST), investigated the influence of Knowledge Management Structures Adequacy (KMSA) on ES-Success. Preliminary results indicate a strong relationship between the Knowledge Management Structures Adequacy and ES-Success. The purpose of the confirmation-survey was to further validate the dimensions and measures of the ES-Success model, using new data, employing confirmatory statistical techniques. Data was gathered from 153 respondents across a large University that had implemented the Oracle Enterprise System, which facilitated further construct validity of the ES-Success measurement instrument was further established using Structural Equation Modeling (SEM).

Organizations make large investments in Information Systems (IS) expecting positive impacts to the organisation and its functions. Yet, there exists much controversy surrounding the 'potential' impacts of these systems, with some studies reporting broadly positive impacts of IS across organizations (Barua, Kriebel and Mukhopadhyay 1995; Barua and Lee 1997; Brynjolfsson and Hitt 1996; Lehr and Lichtenberg 1999; Mukherjee, Ray and Miller 2001), while others have shown nil or detrimental impacts (Attewell and Rule 1984; Brynjolfsson and Yang 1996; Cameron and Quinn 1988; Wilson 1993). Various authors have suggested that these conflicting results may be due to poor measurement - E.g. incomplete or inappropriate measures of success (DeLone and McLean 1992; Gable 1996; Melone 1990), lack of theoretical grounding and hence agreement on appropriate measures of success (Bonner 1995; Myers, Kappelman and Prybutok 1998), myopic focus on financial performance indicators (Ballantine, Bonner, Levy, Martin, Munro and Powell 1996; Kaplan and Norton 1996), weaknesses in survey instruments employed (Gable, Sedera and Chan 2003) (e.g., constructs lacking in validity), or (5) inappropriate data collection approach (Seddon, Staples, Patnayakuni and Bowtell 1999; Sedera and Gable 2004) (e.g., asking the wrong people, unrepresentative sample). Enterprise Systems (ES) have over the past decade emerged to be one of the most important developments in the corporate use of information technology. Anecdotal evidence reveals discontent with these large application software packages. Yet Enterprise System investments are seldom systematically evaluated post-implementation; the review process and measures typically being idiosyncratic and lacking credibility. Impacts resulting from 'Enterprise Systems' are particularly difficult to measure, with an Enterprise System entailing many users ranging from top executives to data entry operators; many applications that span the organization; and a diversity of capabilities and functionality. Despite the substantial investments made by organizations and the anecdotal evidence of discontent, systematic attempts to measure their success have been few. The primary objective of this research is to develop and test a standardized instrument for measuring ES-Success. Other related objectives of this research include: (1) to identify the dimensions and measures of ES-Success, (2) to validate a maximally generalizable measurement model and survey instrument for gauging ES-Success; (3) to develop an understanding of the state of Enterprise Systems using descriptive/comparative statistics, and (4) to identify and test an antecedent of ES-Success. With the above objectives, and in attention to the weaknesses identified in past IS-success research, this study follows and extends the 'research cycle' guidelines of Mackenzie and House (1979) and McGrath (1979). The research cycle entails two main phases: (1) an exploratory phase to develop the hypothesized measurement model, and (2) a confirmatory phase, to test the hypothesized measurement model against new data. The two surveys (termed as identification-survey and specification-survey) conducted in the exploratory phase of this research go beyond the activities recommended by Mackenzie and House (1979) and McGrath (1979). A third "confirmation-survey" was completed in the confirmatory phase of the research cycle. The three surveys gathered and analyzed data from six hundred (600) respondents. The purpose of the identification-survey was to discover the salient ES-Success dimensions and measures to include in an a-priori ES-Success model. Data from 137 respondents representing 27 Australian State Government Agencies that had implemented SAP R/3 in the late 1990s were analyzed. The analysis of identification-survey data yielded an a-priori model with 41 measures of 5 dimensions of ES-Success that provide a holistic view across the organization from strategic to operational levels. The specification-survey was employed to validate the a-priori ES-Success measurement model derived in the preceding identification-survey. Employing 310 responses from the same 27 public sector organizations, exploratory data analysis validated 27 measures of success pertaining to the 4 dimensions: information quality, system quality, individual impact and organizational impact. Data for testing the influence of an antecedent of ES-Success was simultaneously gathered during the specification-survey. This analysis, based on the Adaptive Structuration Theory (AST), investigated the influence of Knowledge Management Structures Adequacy (KMSA) on ES-Success. Preliminary results indicate a strong relationship between the Knowledge Management Structures Adequacy and ES-Success. The purpose of the confirmation-survey was to further validate the dimensions and measures of the ES-Success model, using new data, employing confirmatory statistical techniques. Data was gathered from 153 respondents across a large University that had implemented the Oracle Enterprise System, which facilitated further construct validity of the ES-Success measurement instrument was further established using Structural Equation Modeling (SEM).

Thesis (M.S. in Information Technology Management) Naval Postgraduate School, Sept. 2000.<br>Thesis advisor(s): Osmundson, John; Buddenberg, Rex. Includes bibliographical references (p. 209-212). Also available online.

Although the impact of IT-enabled information on firm performance has been well documented in the business value of IT literature, our understanding of how adopting GPS can transform operational decision-making and foster differential firm performance is limited. Moreover, price and service quality have been highlighted as key determinants of industrial customer satisfaction, yet there is little understanding of how IT-enabled information utilisation influences these relationships. In response, I employ two-phase research. In the first phase, I conduct an exploratory comparative case study of three transport firms that have implemented GPS in their operations. The results show that increased use of GPS-enabled information enhances information quality and makes operational decision-making more fact-based and collaborative. I also find that such transformations in operational decision-making can have differential performance impacts. However, I warn scholars and practitioners that a firm’s information management capability and organisational factors can facilitate the effective use of GPS-enabled information in operational decision-making and, thus, moderate the differential performance benefits of adopting GPS. In the second phase, I carry out a quantitative study with transport firms’ customers. The findings make two contributions. First, I find that the more an industrial firm utilises IT-enabled information in the service process, the less emphasis its customers place on prices when it comes to determining their satisfaction. Drawing on equity theory, I theorise that information utilisation in the service process may mobilise perceptions of fairness and transparency, thereby suppressing the relative impact of price on the formation of industrial customer satisfaction. Second, I find that industrial customers view the utilisation of IT-enabled information in the service process as a value-adding capability that boosts their service quality perceptions. Interestingly, although I had expected that the utilisation of IT-enabled information would also increase the importance of service quality in forming customer satisfaction, the results suggested that this was not the case.

<p> Electronic Medical Records (EMRs) are increasingly being used in healthcare organizations. However, there are few factors influencing the physician adoption rate of EMRs. The purpose of this paper is to investigate the meaningful use incentives, and the type of specialty practices in relationship to the physician use of EMRs. Data from the National Ambulatory Medical Care Survey (NAMCS) were analyzed to how meaningful use incentives and the type of physician practices affect the physician use of EMRs. The Chi-Square test and ANOVA test have been use to examine the hypothesis, and the association was found to be statistically significant.</p>

This thesis consists of three papers on the economics of corporate social responsibility (CSR). The papers study different aspects of CSR from the perspectives of consumers and firms. The first paper looks at how consumers value CSR and their willingness to pay for ethical attributes in a product. We include a CSR signal to examine how information on CSR affects individuals’ preferences and willingness to pay. The second paper builds on the study in the first paper, however, we also include a CSR nudge and the Big Five Inventory on personality to examine the interaction between information and personality traits on the willingness to pay for CSR. Finally, in the third paper we look at how firms’ CSR signal can influence their financial performance.

In recent times, there has been a rapid increase in technological initiatives to promote electronic commerce. Delivery of services via the Internet or other remote computing technology now represents the trend for most organizations. In keeping with market trends, the banking industry in Jamaica and other countries worldwide have also adapted a variety of technological initiatives to enhance the delivery of services to remote customers. As these trends continue, there is heightened interest in information systems (IS) research to understand the factors that motivate or encourage individuals to use these technologies. This situation exists because interactions in these environments are significantly different from the traditional face to face settings. The original Technology Acceptance Model (TAM) has long been studied, modified, and extended by IS researchers as a classical model for understanding individual's intention to use (IU) an IS. According to TAM, IU an IS is based on two constructs: perceived ease of use (PEOU) and perceived usefulness (PU). Researchers have identified other factors such as trust (TRST) and computer self-efficacy (CSE) that impact an individual's IU an IS. In this predictive study, the researcher examined the integration of TRST and CSE into TAM and their overall impact on customers' intentions to use banking information systems (BIS) in Jamaica. A 32-item Web-based survey instrument was used to collect data from 374 customers of three major banks in Jamaica. A revised TAM model was proposed and SPSS's AMOS 7.0 statistical package was used to perform data analysis and model fit testing based on structural equation modeling (SEM). Results showed that while CSE did not significantly predict TRST and PEOU, it significantly predicted PU. Additionally, TRST significantly predicted both PEOU and PU, and PEOU positively predicted PU and attitude (ATT) towards BIS. Furthermore, PU was a significant predictor of ATT and IU, and ATT significantly impacted IU. The findings also revealed that only TRST varied significantly across males and females and the original TAM had a slightly better fit than the revised TAM. The research laid the foundation for future exploratory studies of TAM in specialized contexts such as BIS in Jamaica.

Apesar de ser uma técnica de avaliação de impactos ambientais reconhecida e utilizada internacionalmente, a Avaliação do Ciclo de Vida (ACV) encontra dificuldades em integrar aspectos espaciais e temporais em suas avaliações. Esta questão tem fomentado pesquisas voltadas à inserção da diferenciação espacial tanto na fase de inventário (ICV), por meio do levantamento de dados contendo informações espaciais em diversas escalas, quanto na fase de avaliação de impacto (AICV), por meio do desenvolvimento de fatores de caracterização espacialmente diferenciados. Os usos da terra e suas dinâmicas temporais e espaciais têm sido foco destas pesquisas de modo a verificar suas implicações sobre a biodiversidade e os serviços dos ecossistemas decorrentes, principalmente de atividades como a agricultura. Sendo a cana-de-açúcar a principal matéria-prima para o etanol combustível no Brasil e ocupando extensas áreas na Bacia Hidrográfica do Tietê-Jacaré-SP, o presente trabalho se propõe a discutir a aplicabilidade de modelos de caracterização de impactos relacionados aos usos da terra em uma abordagem específica ao local, adotando-se como base para aplicação o cenário de expansão da cana-de-açúcar nesta bacia. Para tal, foram selecionados três modelos de caracterização relacionados a três vias de impacto: biodiversidade, produção biótica potencial (PBP) e potencial de regulação da erosão (PRE). Esses modelos foram aplicados ao processo produtivo da cana-de-açúcar adaptando-os para a área de estudo, nos quais os dados de inventário foram levantados por meio dos softwares de SIG IDRISI TAIGA e ArcGis 10.2 e na literatura. Posteriormente esses modelos foram aplicados utilizando a abordagem loco-dependente e os resultados comparados com os da avaliação específica. Para a categoria biodiversidade houve maior dificuldade para obtenção de informações locais e, portanto, utilizou-se uma simplificação do modelo selecionado, não sendo possível sua aplicação loco-dependente. Já para as outras categorias, a aplicação apresentou acentuada diferenciação dos resultados em relação à abordagem loco-dependente, indicando que os valores globais de ICV sugeridos pelos autores para estas categorias não representam a realidade brasileira e, portanto, valores específicos ao local oferecem informações de maior qualidade para tomada de decisão em âmbito regional e local. Os resultados ainda apontam significativas diferenças nas avaliações segundo os diferentes tipos de solo e bioma nos quais ocorrerá a expansão da cana para as categorias PBP e PRE. Conclui-se que os modelos desenvolvidos para PBP e PRE possuem potencial de aplicação em escala local ao passo que os modelos desenvolvidos para biodiversidade necessitam de algumas simplificações e implicam em maiores incertezas. A disponibilidade dos dados necessários para esta abordagem pode constituir um fator limitante para sua aplicação, além disso, a escolha da melhor abordagem a ser utilizada irá depender dos objetivos do estudo.<br>Despite its international use and recognized nature as an Environmental Impact Assessment technique, the Life Cycle Assessment (LCA) leads to difficulties on integrating spatial and temporal aspects in their assessment. There has been a rising interest in researches related to the inclusion of spatial differentiation both in the inventory phase (LCI), through data collection containing spatial information at various scales, and in the impact assessment phase (LCIA), through the development of spatially explicit characterization factors. Land use and its temporal and spatial dynamics have receive priority attention in order to verify their implications on biodiversity and ecosystem services derived mainly from activities such as agriculture. Since sugarcane is the main raw material for fuel ethanol in Brazil and occupying large areas in the Tietê-Jacaré-SP watershed, this study aims to discuss the applicability of characterization models of impacts associated to land uses in a site specific approach, adopting as the basis for application the expansion scenario of sugarcane in this area. This has been done by selecting three characterization models related to three impact pathways: biodiversity, biotic production potential (BPP) and erosion regulation potential (ERP). These models were applied to the sugarcane production process by means of their adaptation to the area of study and taking into account the literature and the inventory collected through GIS software IDRISI TAIGA and ArcGIS 10.2. Later, these models were applied using the site-dependent approach and the results were compared to the site specific assessment. Obtaining local information of biodiversity impact category was found to be difficult, therefore, simplifications of the model selected were employed, not allowing site-dependent application. Regarding the other categories, the research results demonstrate pronounced differentiation compared to site-dependent approach. This indicate that global values used on the papers of de the models developed do not represent Brazilian reality and therefore site-specific assessments have greater benefit for decision making at regional and local level. Moreover, the assessments show significant differences according to different soil types and biome in which sugarcane expansion will occur for BPP and ERP impact categories. Against this backdrop, it is concluded that the models developed for BPP and ERP have potential of application at local scale while the models developed for biodiversity require some simplifications and imply greater uncertainty. The availability of necessary data to this approach can be a limiting factor in their application. Furthermore selecting the best approach to be used will depend on the objectives of the study.

In this study, computer human interaction factors are examined as a possible source of information to aid in the operation and management of local area computer networks. Users' perceptions of computer performance and response time are evaluated in relation to specific modifications in the information organization of a file server in a local area network configuration running in Novell 3.11.

Business Administration/Management Information Systems<br>Ph.D.<br>The prolific use of social media tools such as blogs and wikis is leading several organizations to adopt these tools. However, success of social media depends on its use by employees to share and seek knowledge. Based on a unique data set obtained from a large multi-national corporation, I examined three different aspects of knowledge seeking and sharing. First, I investigated two-sided network externalities on seeking and sharing. My analysis shows that significant network externalities occur not only at the demand side, which has been the primary focus in prior literature, but also at the supply as well as cross-sides (from supply to demand as well as from demand to supply). Second, I also explored the impact of hierarchical and geographical distribution on knowledge seeking and sharing. My results show that how a firm is structurally organized can yield different influences on the use of corporate social media based on whether the employee is seeking or sharing. Finally, I investigated the impact of social capital. New insights are captured in how different dimensions of social capital influence employee use of corporate social media for seeking and sharing knowledge within the organization.<br>Temple University--Theses

This thesis is an investigation of the relevance of information literacy to student academic work. The study specifically looks at student perceptions of information literacy as sociocognitively relevant when used to complete an assignment. This research provides quantitative and qualitative data to explain student perceptions of the information literacy experience through their work. The factors that make information literacy relevant and how users perceive information literacy to be useful and meaningful are shared and the implications of these findings are presented.

El trabajo de tesis estudia la conformación de diferentes niveles de accesos sociales y comunicativos en el marco del proyecto de Sociedad d ella Información, haciendo hincapié en las políticas europeas y contrastándolas con indicadores socioeconómicos y con las directrices que, sobre el mismo proyecto, formulan países latinoamericanos.<br/>La tesis doctoral elucida los procesos de concentración y convergencia de industrias de la comunicación y la información, como procesos críticos de un abordaje analítico enmarcado en los estudios de economía política de la comunicación.<br/>La construcción de un modo de desarrollo en el que aparecen las tecnologías de información y comunicación como elementos centrales (centralidad que se verifica en la estructuración de las sociedades nombradas como "informacionales") es parte medular de la tesis doctoral, que también presenta el análisis de contenido de los principales documentos de la Comisión Europea y de la Organización para la Cooperación y el Desarrollo Económico (OCDE) en la última década del Siglo XX.<br>The thesis object is to study the different levels of social and communicative access with the Information Society as a framework. Thus, the thesis empathises the european policies of the Information Society project, and the thesis work contrasts this policies with socioeconomic indicators, as well as the main directives of Latin American countries in the same field.<br/>The thesis focuses on the concentration and convergence processes localised at the information and communication industries, due to the critical impact of these two processes in the economic structure of contemporaneous societies.<br/>The conceptual framework of the thesis is linked to the political economy of communications studies. The thesis also presents the content analysis of the main documents produced by the European Commission and the OECD.