Barriers to reaching human immunodeficiency virus (HIV) testing prevent Canada from achieving The Joint United Nations Programme on HIV and AIDS (UNAIDS) target of 90 percent of undiagnosed people living with HIV knowing their HIV status by 2020 and receive treatment.(1) Fourteen percent (9,090 of 63,100) of Canadians living with HIV were unaware of their status by the end of 2016.(1)(p.9)Individuals exposed to HIV through heterosexual contact are overrepresented (28%) among the undiagnosed people living with HIV in Canada compared to other groups, such as men who have sex with men (18%) and people who inject drugs (20%).(2)(par.15)The reasons preventing this population to present themselves for testing in Ottawa, Ontario, remain poorly understood in the literature. Most of the literature on barriers to accessing HIV testing focuses on the traditional key groups who are likely to test, and limits analysis of these barriers on one or two levels. Equally, health service providers rarely understand challenges behind HIV testing for particularly young heterosexual African migrant men. These challenges may be contributing key barriers to HIV testing. On other hand, late presentation to treatment remains a global issue. Psychosocial outcomes especially after a new positive diagnosis can delay reaching early treatment and prevention services. Indeed, all test results negative or positive have consequences. Even those with a new negative test can return to risk taking behaviour if they delay accessing prevention education. Yet no systematic study exists in this area essential for quality improvement. Programming more equitable HIV testing services will require more comprehensive evidence about challenges and barriers behind accessing HIV testing and treatment to achieve UNAIDS target of 90 percent of undiagnosed people living with HIV knowing their status and receive treatment. This research aimed to contribute to this evidence through two phases. Phase 1 used the Joanna Briggs Institute methods to implement a scoping review on psychosocial outcomes and their measurements immediately following a new HIV diagnosis. This review considered all participants who tested for HIV – whether their results were positive or negative, as any test results have consequences, and regardless of age, sex, or setting – reported in published articles between 2007 -to the present date. Paper 1 presents the scoping review. Phase 2 relied on a qualitative methodology using Grounded Theory informed by a socio-ecological framework and a framework of access to healthcare to understand experiences of accessing HIV testing services in two parts: 1) to examine barriers to reaching HIV testing among young heterosexual African migrants, focusing on young men, in Ottawa (Paper 2); and 2) to identify challenges experienced by health service providers who make accessible HIV testing services to this population in Ottawa (Paper 3). There is some ambiguity in the use of the terms “first generation immigrants” and “second generation immigrants” (or children of first immigrants). In this study, the term migrants referred to both. Selecting participants from both groups (first and second generation) was important to include a wide variety of experiences and interpretations that reflect the study population. Furthermore, the term “health service providers” was used to refer to both healthcare providers and frontline service providers. Healthcare providers referred to those who conduct HIV testing in health facilities, whereas frontline service providers referred to those who provide care and support services needed by members in their communities before and after testing within AIDS organizations and community-based organizations.

全球的經濟發展階段已進入知識經濟與服務經濟時代，在知識經濟與服務經濟的交錯發展下，服務業當中依賴專業知識或是特定技術或特定功能領域，並具有高附加價值之知識密集服務業，成為下一波的經濟成長動力。有鑑於知識是知識密集服務業創新的基本要素，知識密集服務業如何透過有效的知識管理提升組織知識的價值，進而不斷的產生創新性的產品或服務，以形成企業的競爭優勢，為企業在經營管理上的重要課題。 本研究將知識密集服務業之知識管理與服務創新模式相結合，探討當企業將知識管理作為策略性工具來實現服務創新的目標時，兩者之關聯性。同時，本研究並深入分析知識密集服務業之知識管理促動因子、知識管理活動以及服務創新的重要影響因素。本研究之研究對象是以一家在國內已推行知識管理多年，且服務創新相當成功的法律事務所作為代表性個案進行研究，並經由學理驗證得出以下研究結論： 在知識管理促動因子與知識管理之關聯性得出以下結論： 1.領導者的態度與明確的知識管理策略是知識管理成功的關鍵因素。 2.企業的團隊合作文化與信任文化越盛行，知識創造與擴散活動越容易進行。 3.資訊科技的選擇性導入，有助於提升組織知識吸收、蓄積與擴散的速度。 4.企業是否提供員工長期性的獎勵措施，會影響員工對知識吸收、創造與擴散活動的參與意願及貢獻程度。 在知識密集服務業之知識管理活動方面得出以下結論： 1.在知識密集服務業的公司，輸入及吸收外部知識是組織能持續進行知識創造的重要方式。 2.基於知識密集服務業之高專業性、高知識密集性的特性，人員的知識與技能是公司知識蓄積的主要載體。 3.知識密集服務業的公司採取以師徒制度為主，教育訓練為輔的人員訓練方式，對知識擴散活動有正面的影響。 在知識密集服務業之服務創新方面得出以下結論： 1.知識密集服務業的公司會根據市場變化與客戶需求來創新服務概念，以提升核心競爭力。 2.知識密集服務業之新客戶介面的重要創新因素，在於能依據實際及潛在客戶的需求特性，建立具有附加價值的服務平台，以提升顧客滿意度。 3.在知識密集服務業的公司，完善的人員教育訓練與人才培育是新服務傳遞系統的重要創新因素。 4.成功創新的知識密集服務業者，於新服務概念、新客戶介面、新服務傳遞系統三構面間的相互配合程度相當良好。 在知識密集服務業之知識管理與服務創新的關聯性得出以下結論： 1.知識密集服務業之知識吸收與創造活動，有助於加速新服務概念的形成。 2.知識密集服務業與客戶間的知識吸收與創造活動，有助於建構符合客戶需求之新客戶介面，並降低創新過程中不確定的風險。 3.知識密集服務業之知識蓄積與擴散活動，對新服務傳遞系統的進行有顯著的正面影響。 4.知識密集服務業將知識管理作為創新服務的策略性工具時，有助於加速實現服務創新的目標。 / In the 21st century, the world economy has two highly important developments: the rise of the service sectors and the growing role of knowledge. Especially, the service sectors have increased dramatically in recent years and they occupy a large share of the economy of advanced industrial societies. Among the service sectors, knowledge-intensive business services (KIBS) is strong momentum of the economic growth. As “knowledge” is a basic element of KIBS’s innovation, how to implement knowledge management effectively to enhance the value of organizational knowledge and make KIBS continually produce innovative products or services as well as create a competitive advantage is an important issue on business management for enterprises. This research aims to combine knowledge management with service innovation and to analyze when KIBS firms adopt knowledge management as a strategy to achieve the objective of service innovation, the relationships between knowledge management and service innovation. This research also describes the issues of knowledge management enablers, knowledge management activities and service innovation implemented in KIBS firms. Additionally, this research, through a case study conducted on a successful law firm in Taiwan, further explored the relationships between knowledge management and service innovation. The conclusion of this research may include in four aspects: 1.The findings of the research regarding relationships between knowledge management enablers and knowledge management in KIBS are as follows: (1)Leadership and clear knowledge management strategy are critical success factors in knowledge management. (2)The more teamwork culture and trust culture existed in KIBS firms, the easier knowledge creation and diffusion activities implemented. (3)Application of appropriate information technology in KIBS firms can enhance the speed of organizational knowledge absorption, accumulation and diffusion. (4)Whether enterprises can offer long-tem incentives to employees will affect employees’ participation willingness and contribution degree for knowledge absorption, creation and diffusion activities thereof. 2.The findings of the research regarding knowledge management activities in KIBS are as follows: (1)In KIBS firms, input and absorb knowledge from external sources is an important manner of continually facilitating knowledge creation. (2)Based on KIBS’s characteristics of high professional and high knowledge-intensive, personnel’s knowledge and skills are main carriers of knowledge accumulation in KIBS firms. (3)In KIBS firms, adoption of “mentoring-based, education and training-supplemented” as staff training methods will make positive impact on knowledge diffusion activities. 3.The findings of the research regarding service innovation in KIBS are as follows: (1)To enhance the core competitiveness, KIBS firms will create “new service concept” in accordance with market changes and customers’ needs. (2)In KIBS firms, a critical innovation factor of “new client interface” is whether they can build a value-added service platform in accordance with actual and potential customers’ needs so as to enhance customer satisfaction. (3)Successful education and training on employees is a critical innovation factor of “new services delivery system” in KIBS firms. (4)In successful KIBS firms, organizational interaction and coordination between “new service concept”, “new customer interface” and “new service delivery system” would be excellent. 4.The findings of the research regarding relationships between knowledge management and service innovation in KIBS are as follows: (1)In KIBS firms, through knowledge absorption and creation activities, it can speed up the formation of “new service concept”. (2)Through Knowledge absorption and creation activities between KIBS firms and their clients, it can assist KIBS firms in building “new client interface” and reducing potential risk in the innovation process. (3)In KIBS firms, knowledge accumulation and diffusion activities may make a significant positive impact on “new service delivery system”. (4)When KIBS firms adopt knowledge management as a strategy to innovate services, it can speed up to achieve the objective of service innovation.

This thesis investigates the way to implement a valuable e-commerce solution. With the growing importance of information technologies in business practices, more and more companies are adopting e-commerce as a selling and ordering process. However, depending on the market environment, the level of success of the implementation may differ. The purpose of this study is therefore to examine what are the conditions required for a successful B2B e-commerce implementation in different market contexts. Theories related to the impact of markets' contexts on e-commerce, the business process, and the drivers and enablers of e-commerce have been considered. Thereafter the current situation of Star Laundry Solutions (SLS) has been studied. The context of different markets – France, United Kingdom, Turkey - where they have dealers, the business process drivers of implementations and success factors of a valuable e-commerce solution have been investigated. The result of the empirical studied are analyzed in comparison with the theoretical findings. Through this method, the main research question of the thesis, namely “What are the necessary conditions to implement a value-adding e-commerce solution in different market contexts?” can be answered. Several conditions have been identified in order to succeed the implementation and bring value to the different players along the supply chain, from the manufacturer to the end-customer. The market should first answer different criteria. Further, future users of the web solution must support the implementation, trust between parties must also emerge from the implementation, and additional information must be provided on the website such as product numbers (PNCs), products' availability and delivery times. The provided recommendations of this thesis regarding the features of the web solution, the range of products that dealers and importers should be able to order online and the range of companies that should be allowed to use the web solution in Turkey.

Knowledge management (KM) is regarded as a strategic asset and a source of competitive advantage for organisations. While the issues of KM have been widely discussed by many researchers, there is a paucity of studies pertaining to the role of KM in enhancing the performance of universities, especially Ghanaian universities. Similarly, there is the lack of formal strategy that would provide an appropriate framework for these systems to ensure maximum utilisation of available knowledge for competitive advantage. Due to this, Ghanaian universities have been continually reinventing the wheel each time they lose knowledge through expertise leaving the universities. This loss of knowledge through expert staff exiting raises the need to have systems and strategies in place that will help the universities to capture that relevant knowledge. The research thus set out to address these problems by assessing the implementation of KM systems in Ghanaian universities and the strategies that could be adopted to manage and safeguard knowledge as a competitive advantage and for future use. A survey and a mixed method research approach, which encompasses a questionnaire and interview schedules, were used to collect data from the stratified sampled respondents. One hundred and eighteen (80.27%) questionnaires were successfully received from the respondents, while all nine interviewees successfully responded to the interviews. Pattern matching, content analysis and explanation-building were used to analyse the qualitative data. The Microsoft spreadsheet and SPSS software were used to analyse the quantitative data and descriptive statistics in the form of tables, pie charts and histograms were used to present the findings. The findings of this study showed that: the concepts of KM was universally understood by the respondents; KM processes were effective; systems and facilities such as internet, intranet, e-mails, mobile technology and DVD/VCD/CD were used to facilitate KM at the universities; leadership, culture, technologies and strategies were the KM enablers; e-learning, coaching and mentorship, communities of practice, and storytelling were the main strategies used to manage and safeguard knowledge; and KM systems had a positive impact on the universities. The study finally formulated an integrated KM framework to guide the implementation of KM systems in universities. / Information Science / D. Litt. et Phil. (Information Science)

Purpose: The purpose of this study is to examine what possibilities start-up companies have to work in an environmentally sustainable way, and what barriers they face in that context. The study moreover presents enabling factors which help start-ups realize opportunities and overcome barriers. To fulfill the purpose, it has been divided into two research questions, which follows: What opportunities and barriers do start-up companies, who want to work in an environmentally sustainable way, face? Which enablers can an environmentally sustainable start-up companies make use of to seize opportunities and lower barriers? Method: To fulfill the purpose a single case study was conducted. Empirical data was collected from a case company by semi structured interviews based on the theoretical framework. The selected case company is a start up with high focus on sustainability and the environment. A business incubator was also interviewed using semi structured questions to complement the empirical data collected from the case company. This empirical data was then analyzed against the theoretical framework which then lead to the study’s results. Findings: The study identified three major opportunities which help start-ups in an environmentally sustainable way: an increase in demand for environmentally products; tightened environmental regulations, and increased credibility from stakeholders. Moreover, four major barriers to environmental sustainability in start-ups were found: a low degree of market maturity; lack of financial resources and human capital; competition from established firms; and difficulties in attracting investors. In terms of enablers, the following factors were deemed instrumental in seizing opportunities and overcoming barriers: start-ups’ organizational flexibility, which allows them to rather quickly master necessary organizational change processes towards environmental sustainability; usage of environmental principles; social capital; and incubators as well as other external guidance. Implications: Presented opportunities, barriers and enablers are based on previous studies, the result of this study increase the understanding about how start-ups can work more environmentally focused. The empirical findings about incubators role in helping start-ups becoming more environmentally focused is an unexplored area and needs more attention in the literature. Societies can benefit from this increased understanding since it can lead to a decreased environmental impact, both on a local level by consuming less resources and a global level by slowing down the climate threat. Limitations: By including only one case company and one incubator combined with the qualitative research approach, the study covers a wide but shallow area. By including multiple case companies and incubators the study would have reached a higher level of generalization. Documents could have been studied in order to reach a more quantitative result with could have increased the credibility of the study. / Syfte: Studiens syfte är att skapa en tydligare förståelse för vilka förutsättningar start-up företag har att arbeta miljöfokuserat genom att identifiera väsentliga möjligheter, hinder och möjliggörare. För att uppfylla syftet har det delats upp i två frågeställningar, vilka lyder: Vilka möjligheter och hinder har start-up företag som vill arbeta miljöfokuserat? Vilka möjliggörare finns för start-up företag att ta tillvara på möjligheter samt minska hinder? Metod: För att uppfylla syftet har en enfallsstudie genomförts. Empiriska data har samlats in från ett fallföretag genom semistrukturerade intervjuer som baserats på det teoretiska ramverket. Valt fallföretag är ett start-up med stort fokus på hållbarhet och miljöfrågor. En inkubator har också intervjuats med hjälp av semistrukturerade frågor för att komplettera insamlade data från fallföretaget. Data från empirin har sedan analyserats mot det teoretiska ramverket och genererat i studiens resultat. Resultat: Studien har identifierat tre möjligheter som hjälper start-up företag att arbeta miljöfokuserat: ökad efterfrågan på miljövänliga produkter, bättre förutsättningar tack vare miljöregleringar och ökad trovärdighet mot kunder och intressenter. Det har även identifierats fyra hinder för start-ups att arbeta miljöfokuserat: marknadens bristande mognadsgrad, begränsade resurser i form av kapital och kunskap, konkurrens från etablerade företag samt svårigheter att hitta investerare har identifierats för start-ups som vill arbeta miljöfokuserat. Fyra möjliggörare har även identifierats för att ta vara på dessa möjligheter och minska hindren, nämligen enklare och snabbare förändringsprocess, användning av miljöprinciper, socialt kapital samt inkubatorer och annan extern rådgivning. Implikationer: Presenterade möjligheter, hinder och möjliggörare är baserade på tidigare studier, denna studies resultat skapar en tydligare förståelse för vilka förutsättningar ett start- up har att arbeta mijlfokuserat. Empiriska data kring inkubatorers roll att vägleda start-ups att bli mer miljöfokuserade är ett outforskat område som skulle behöva utvecklas ytterligare. Samhällen kan gynnas av denna tydligare förståelse då det kan leda till en minskad miljöpåverkan, både på en lokal nivå genom ett minskat utnyttjande av resurser samt på en global nivå genom att klimathotet kan bromsas. Begränsningar: Genom att endast studera ett fallföretag och en inkubator kombinerat med den kvalitativa ansatsen blir studiens perspektiv relativt brett och grunt. Genom att inkludera fler fallföretag och fler inkubatorer skulle studien få en större generaliserbarhet. En dokumentstudie hade kunnat genomföras för att nå ett mer kvantitativt resultat vilket skulle leda till en mer trovärdig studie.

One of the challenges imposed by the 21st century is to retain talented staff by keeping employees engaged in their work. Engagement in itself is a complex construct, which still requires much clarification. One of the gaps in the literature is the link between engagement and the competencies required by individuals to craft a career in the 21st century. These competencies are referred to as psychological career resources (Coetzee, 2008). This study was conducted in a medium-sized South African software and services organisation using a random sample of 111 consultants. The primary objective of the study was to investigate the relationship between psychological career resources (career preferences, career values, career enablers, career drivers and career harmonisers) and engagement (dedication, vigour and absorption). The second and third objectives were to find whether there were any significant differences between individuals who differed as to gender, age, marital status, occupational field, occupational level and department in which employed with regard to engagement and psychological career resources. A further objective was to establish the dominant psychological career resources and engagement constructs of the consultants in the sample. The data was collected using the 9-item U-WES (Utrecht Work Engagement Scale) and the PCRI (Psychological Career Resources Inventory). The study found that behavioural adaptability and self-esteem have a significant impact on vigour and dedication, while behavioural adaptability also has a significant impact on absorption. This study could contribute meaningful information to the field of well-being and career development, allowing professionals to assist individuals in developing career competencies that contribute to engagement and ultimately to well-being. / Dissertation (MCom)--University of Pretoria, 2012. / Human Resource Management / unrestricted

Skatten på engångsplastbärkassar som implementerades i Sverige år 2020 möttes med ideologiskt motstånd. Den forskning som gör gällande skatt på plastbärkassar finns främst i internationell kontext och är fokuserad på konsumenters beteenden och reaktioner. Denna studie gör gällande hur berörda verksamheter och organisationer resonerar kring skattens införande, samt dess resultat. Studien syftar också till att identifiera hinder och drivkrafter för implementeringen. För att undersöka förhållandet användes en explorativ ansats där intervjuer med en variation av berörda verksamheter utgjorde materialet för studien. Resultaten visar på att implementeringen mötts av missnöje av hälften av deltagarna på grund av skattens singulära syfte, samtidigt som den andra hälften anser att tillämpningsområdet var tillfredsställande. De hinder som identifierades var svårigheter att definiera engångs-, respektive flergångskassar, samt bristen på synkronisering eller kombination med andra styrmedel. De drivkrafter som identifierades relaterade till organiseringen och kommunikationen mellan de berörda verksamheterna, till trots förbättringsmöjligheter för dessa aspekter. En av slutsatserna är att styrmedel som detta bör nyttja både ett teknocentriskt perspektiv om plastbärkassens miljö-, och klimatpåverkan, samt ett socioekonomiskt perspektiv utgående från berörda verksamheter och organisationers behov. / The Swedish tax on plastic carrier bags that was implemented in 2020 was initially met with dissatisfaction from the public and stakeholders. Current research investigating the tax on plastic carrier bags was done in other countries and is focused on the reactions and behaviours of consumers. Thus, this study investigates stakeholders’ reasoning around the implementation of the tax as well as its results. Another aim is to identify obstacles and driving forces for the implementation. To do so, an explorative approach in combination with interviews of stakeholders were used. The results show that implementation was met with dissatisfaction by half of the participants in the study, owing to the singular aim of the tax. The other half of participants viewed the tax purpose as satisfactory. The obstacles that were identified was difficulties in distinguishing single-use from multi-use plastic carrier bags, as well as the lack of synchronization or combination with other measures. The driving forces that were identified related to the organization and communication between stakeholder, despite opportunities for improvement. One of the conclusions of the study was that policy measures like this tax should use a technocentric perspective on the environmental impact of the plastic carrier bag, in combination with a socioeconomic perspective on the needs of stakeholders.

This study set out to explore the strategising practices of middle managers and thereby expand the body of knowledge in terms of middle management practices in strategising in general, and makes an original contribution at the frontiers of middle management practices in a university context in South Africa. Although some research has been done on middle managers and strategy, a knowledge gap still exists, especially regarding strategising in emerging economies, such as South Africa. More specifically, the actions of middle managers at universities are open for exploration. Universities are increasingly exposed to new challenges in a competitive environment due to declining state funding, changing student demographics, new technological developments and increased market pressures. The sustainability of universities is also threatened by changes inside the universities, such as the drive for corporatisation and a changing internal focus. The way universities respond to and pre-empt dealing with these challenges will influence the sustainability and competitiveness of the university and subsequently the nations it serves. However, very little is known about the university managers who are powerful in terms of the administrative systems and decision processes. In order to understand strategy work viii and to know what enables or constrains it, it is necessary to look at middle managers at universities. This research puts forward three main arguments: firstly, strategy is dispersed throughout the entire organisation and includes middle managers’ strategising activities. Secondly, a need exists for practically relevant research founded in the organisational realities. Thirdly, universities present a relevant context within which to study strategising practices. An exploratory qualitative case study was followed to answer the research questions. Findings indicate that university middle managers, who operate within a machine bureaucracy, create systems within systems in order to cope with the organisational demands. Middle managers are mostly responsible for strategy implementation and the support role of university managers is prominent. Findings also indicate that the strategy loses its meaning and in an environment where the strategy textual artefacts and talk are abundant. In such an environment compliance takes precedence over buy-in. Finally, this study identified the enablers of and constraints on the strategy work of university middle managers. This research confirmed that strategy and strategising are human actions and confirmed that knowledge of what people do in relation to the strategies of organisations is required. / Economics / D. Com. (Business Management)

[ES] Internet de las Cosas (IoT) es un paradigma tecnológico que está transformando y revolucionando el mundo en el cual vivimos, liderando la transformación digital y generando enormes posibilidades desde el punto de vista tecnológico que pueden solucionar grandes problemas y retos en nuestra sociedad y efectuar cambios profundos en nuestra economía e industria, y transformar nuestra vida cotidiana . Sin embargo, para poder obtener estos grandes beneficios y explotar todo su potencial todavía hace falta abordar y resolver grandes retos tecnológicos asociados. La interoperabilidad es el mayor reto tecnológico del paradigma IoT, conjuntamente con la seguridad, a causa de la vasta heterogeneidad inherente del universo IoT a todos los niveles y la falta de una estandarización global aceptada de facto capaz de alinear sus diferentes elementos y aspectos, que actualmente no se considera viable conseguir. La capacidad de elementos y sistemas de comunicarse y compartir información de manera efectiva entre ellos habilita intercambios de información relevante, coordinación o cooperación entre sí y sinergias. La fragmentación de la información de sistemas IoT y falta inherente de interoperabilidad en este paradigma causa graves problemas económicos y tecnológicos, e impide las sinergias entre sistemas. Se considera que la carencia de interoperabilidad es el mayor obstáculo para la formación de un ecosistema global de IoT, un hito en la transformación digital, puesto que impide la integración horizontal de mercados verticales y deja una gran fragmentación entre los sistemas basados en información obtenida con la tecnología IoT. IoT, uno de los paradigmas o habilitadores clave de la transformación digital, está enormemente limitada por carencias de interoperabilidad, que impiden su crecimiento, evolución y despliegue de todo su potencial. Es absolutamente crítico resolver el problema de falta intrínseca de interoperabilidad entre plataformas IoT para poder avanzar tecnológicamente hacia el Internet del Futuro, la Nueva Generación de IoT y la digitalización del mundo. La habilitación de la interoperabilidad entre sistemas y a lo largo de los sistemas, para conseguir un ecosistema interconexionado global, es un reto complejo y de múltiples facetas. Entre ellas, la interoperabilidad semántica, que implica el entendimiento completo, automático y sin ambigüedades de la información compartida entre sistemas, es singularmente compleja de obtener entre plataformas IoT a causa de la alta heterogeneidad entre sus modelos de información. En esta tesis se abarca el estudio, diseño, especificación, implementación y validación de habilitadores digitales (herramientas tecnológicas que promueven la digitalización del mundo) para establecer interoperabilidad en IoT en diferentes niveles (técnico, sintáctico, semántico) con especial enfoque en la interoperabilidad semántica entre plataformas heterogéneas, uno de los retos técnicos más complejos actualmente en IoT. También se abordan en el estudio y construcción de estos habilitadores temas a resolver de Internet del Futuro y la Nueva Generación de Internet de las Cosas. / [CA] Internet de les Coses (IoT) és un paradigma tecnològic que està transformant i revolucionant el món en el qual vivim, liderant la transformació digital i generant enormes possibilitats des del punt de vista tecnològic que poden solucionar grans problemes i reptes en la nostra societat i efectuar canvis profunds en la nostra economia i indústria, i transformar la nostra vida quotidiana. No obstant això, per a poder obtindre aquests grans beneficis i explotar tot el seu potencial encara fa falta abordar i resoldre grans reptes tecnològics associats. La interoperabilitat és el major repte tecnològic del paradigma IoT, conjuntament amb la seguretat, a causa de la vasta heterogeneïtat inherent de l'univers IoT a tots els nivells i la falta d'una estandardització global acceptada de facto capaç d'alinear els seus diferents elements i aspectes, que actualment no es considera viable aconseguir. La capacitat d'elements i sistemes de comunicar-se i compartir informació de manera efectiva entre ells habilita intercanvis d'informació rellevant, coordinació o cooperació entre si i sinergies. La fragmentació de la informació de sistemes IoT i falta inherent d'interoperabilitat en aquest paradigma causa greus problemes econòmics i tecnològics, i impedeix les sinergies entre sistemes. Es considera que la manca d'interoperabilitat és el major obstacle per a la formació d'un ecosistema global de IoT, una fita en la transformació digital, ja que impedeix la integració horitzontal de mercats verticals i deixa una gran fragmentació entre els sistemes basats en informació obtinguda amb la tecnologia IoT. La IoT, un dels paradigmes o habilitadors clau de la transformació digital, està enormement limitada per manques d'interoperabilitat, que impedeixen el seu creixement, evolució i desplegament de tot el seu potencial. És absolutament crític resoldre el problema de falta intrínseca d'interoperabilitat entre plataformes IoT per a poder avançar tecnològicament cap a la Internet del Futur, la Nova Generació de IoT i la digitalització del món. L'habilitació de la interoperabilitat entre sistemes i al llarg dels sistemes, per a aconseguir un ecosistema interconnectat global, és un repte complex i de múltiples facetes. Entre elles, la interoperabilitat semàntica, que implica l'enteniment complet, automàtic i sense ambigüitats de la informació compartida entre sistemes, és singularment complexa d'obtindre entre plataformes IoT a causa de l'alta heterogeneïtat entre els seus models d'informació. En aquesta tesi s'abasta l'estudi, disseny, especificació, implementació i validació d'habilitadors digitals (eines tecnològiques que promouen la digitalització del món) per a establir interoperabilitat en IoT en diferents nivells (tècnic, sintàctic, semàntic) amb especial enfocament en la interoperabilitat semàntica entre plataformes heterogènies, un dels reptes tècnics més complexos actualment en IoT. També s'aborden en l'estudi i construcció d'aquests habilitadors temes a resoldre d'Internet del Futur i la Nova Generació d'Internet de les Coses. / [EN] The Internet of Things (IoT) is a technological paradigm that is transforming and revolutionising the world we live in, leading the digital transformation and generating enormous technological possibilities that could solve major challenges in our society, effect profound changes in our economy and industry and transform our daily lives. However, in order to realise these great benefits and exploit IoT's full potential, there are major associated technological challenges to be addressed and solved. Interoperability is the biggest technological challenge of the IoT paradigm, together with security, because of the vast inherent heterogeneity in IoT at all levels and the lack of a de facto global standard capable of aligning its different elements and aspects, which is currently not considered feasible to achieve. The ability of elements and systems to communicate and share information effectively with each other enables exchanges of relevant information, coordination or cooperation with each other and synergies. The fragmentation of information in IoT systems and inherent lack of interoperability in this paradigm causes serious economic and technological problems, and prevents synergies between systems. The lack of interoperability is considered to be the biggest obstacle to the formation of a global IoT ecosystem, a milestone in the digital transformation, as it prevents horizontal integration of vertical markets and leaves a large fragmentation between systems based on IoT-derived information. IoT, one of the key paradigms or enablers of digital transformation, is severely constrained by interoperability gaps, which impede its growth, evolution and deployment of its full potential. It is absolutely critical to solve the problem of intrinsic lack of interoperability between IoT platforms in order to move technologically towards the Future Internet, the Next Generation IoT and the digitisation of the world. The enablement of interoperability between and across systems to achieve a globally interconnected ecosystem is a complex and multi-faceted challenge. Among them, semantic interoperability, which implies an automatic unambiguous understanding of the information shared between systems, is hardly feasible between IoT platforms due to the high heterogeneity of information models. This thesis covers the study, design, specification, implementation and validation of digital enablers to establish IoT interoperability at different levels (technical, syntactic, semantic) with special focus on semantic interoperability between heterogeneous platforms, one of the most complex technical challenges currently in IoT. The study and construction of these enablers also address issues to solve in the Future Internet and the Next Generation of the Internet of Things. / González Usach, R. (2022). Diseño, especificación, implementación y validación de habilitadores digitales para la interoperabilidad de plataformas de Internet de las cosas (IoT) [Tesis doctoral]. Universitat Politècnica de València. https://doi.org/10.4995/Thesis/10251/181643 / TESIS

Poor decision making among clinicians to transferring human immune deficiency virus (HIV) patients into second-line antiretroviral therapy (ART) has led to an increase in morbidity and mortality to people living with HIV (PLHIV). No clear barriers are known for clinicians not switching their patients. This is a descriptive qualitative research aimed to discover obstacles that influence clinicians' decision making to transferring patients into second-line ART despite higher level resistance to first-line ART. The researcher applied a participatory action research framework to solve the identified barriers with clinicians. Using the research questions the researcher explored reasons, perceived barriers and enabling factors for clinicians delay in making decision to transferring HIV patients into second-line ART. In-depth semistructured interviews were conducted with 30 participants. Six thematic areas (a) clinicians' capacity to diagnose treatment failure, (b) laboratory investigations, (c) availability, access, and tolerability to second-line ART, (d) clinicians' perceptions on ARV medicines, (e) clients' readiness for ARV medicines, and (f) adherence and retention to ARV medicines were analysed using STATA. Readiness, adherence and retention to ART, knowledge, competence and experience on ART , lack of viral load testing, and shortage of second-line ART were the common major barriers for clinicians in determining transferring patients into second-line ART. The government of Tanzania should acknowledge and create participation, responsibility, and commitment strategies to reduce the observed barriers. Findings of this study generates knowledge and provide actionable plans to help clinicians easily identify HIV patients who are in need of second-line ART.