O desenvolvimento das tecnologias da informação e comunicação, em especial a Internet, cria novos canais de comunicação dos quais a sociedade tem se utilizado, de forma inovadora, no desenvolvimento de atividades sociais e econômicas. Governos, em todos os níveis e em diversas partes do mundo, têm utilizado os recursos de TIC no aumento da eficiência dos processos internos da administração pública, ou na prestação dos serviços aos cidadãos. Mais recentemente, estão sendo implementadas experiências que utilizam os meios eletrônicos para a ampliação da prática democrática – a e-Democracia. Este trabalho foca-se nas iniciativas de democracia eletrônica que utilizam a Internet para a criação de espaços virtuais de participação do cidadão e da sociedade nos processos decisórios do governo. O objetivo é identificar um conjunto de elementos que, potencialmente, influenciam a implementação de espaços virtuais de participação pelos governos, seja como habilitadores da sua implementação, seja como inibidores. A pesquisa realizada é de natureza exploratória. A partir da revisão de literatura e de uma entrevista com roteiro aberto a cinco especialistas no campo, montou-se uma lista preliminar de elementos habilitadores e inibidores. Depois, seguindo o método survey na Internet, a lista foi enviada a 155 especialistas, dos quais 55 manifestaram o seu grau de concordância com os elementos listados e a eles atribuíram importância. Os questionários foram respondidos por agentes públicos envolvidos na implantação e operação de projetos de governo eletrônico com ações de e-Democracia, por pesquisadores acadêmicos desse campo e consultores ligados a organizações da sociedade envolvidas na sua execução. Como resultado, este trabalho identifica um conjunto de habilitadores e outro de inibidores nas dimensões política e de governança, sócio-cultural, econômica, tecnológica e legal-regulatória. Conclui-se que há diferenças entre as visões dos respondentes de diferentes setores de atuação (governo, academia e consultoria). Também há diferenças entre os resultados da pesquisa e a literatura consultada. Na visão política, a literatura dá ênfase aos aspectos legais e regulatórios, que não aparecem com ênfase nos resultados da amostra. O tamanho da amostra (55 respondentes) foi uma limitação para realização de análises estatísticas mais robustas. Sugere-se que estudos futuros aprofundem a análise de fatores habilitadores e inibidores em cada um dos grupos, assim como investiguem o fenômeno a partir do ponto de vista dos cidadãos. / The development of information and communication technologies, particularly the Internet, creates new communication channels which the society has been using, in innovative ways, to develop social and economic activities. Governments at all levels and in various parts of the world have used ICT resources to increase the efficiency of public administration’s internal processes, or to provide services to citizens. More recently, experiments are being implemented using electronic means to enhance democratic practice - e-Democracy. This work focuses on electronic democracy initiatives that use the Internet to create virtual spaces of participation for citizens and the society in decision making processes of government. The goal is to identify a number of elements that enables or inhibits the implementation of these virtual spaces by governments. The research is exploratory in nature. After the literature review and interviewing five experts in the field, with open script, a preliminary list of enabler and inhibitor elements was set up. Then, applying the survey method, on the Internet, the list was sent to 155 experts, of which, 55 expressed their degree of agreement with the elements listed, and attributed a level of importance. The questionnaires were answered by public officials in charge of the implementation and operation of egovernment projects with actions of e-Democracy, by academic researchers in this field and by consultants connected to other organizations of the society, involved with the implementation of e-Democracy projects. As a result, this study identifies a set of enablers and other of inhibitors in the following dimensions: political and governance, socio-cultural, economic, technological and legal-regulatory. The study concludes that there are differences between the views of respondents from different sectors of activity (government, academia and consultancy). There are also differences between the results of the research and literature. In the political view, the literature emphasizes the legal and regulatory aspects, which do not appear with emphasis on sample results. The sample size (55 respondents) was a limitation for performing more robust statistical analysis. It is suggested that future studies should deepen the analysis of enabling factors and inhibitors in each group, as well as investigate the phenomenon from the viewpoint of citizens.

O desenvolvimento das tecnologias da informação e comunicação, em especial a Internet, cria novos canais de comunicação dos quais a sociedade tem se utilizado, de forma inovadora, no desenvolvimento de atividades sociais e econômicas. Governos, em todos os níveis e em diversas partes do mundo, têm utilizado os recursos de TIC no aumento da eficiência dos processos internos da administração pública, ou na prestação dos serviços aos cidadãos. Mais recentemente, estão sendo implementadas experiências que utilizam os meios eletrônicos para a ampliação da prática democrática – a e-Democracia. Este trabalho foca-se nas iniciativas de democracia eletrônica que utilizam a Internet para a criação de espaços virtuais de participação do cidadão e da sociedade nos processos decisórios do governo. O objetivo é identificar um conjunto de elementos que, potencialmente, influenciam a implementação de espaços virtuais de participação pelos governos, seja como habilitadores da sua implementação, seja como inibidores. A pesquisa realizada é de natureza exploratória. A partir da revisão de literatura e de uma entrevista com roteiro aberto a cinco especialistas no campo, montou-se uma lista preliminar de elementos habilitadores e inibidores. Depois, seguindo o método survey na Internet, a lista foi enviada a 155 especialistas, dos quais 55 manifestaram o seu grau de concordância com os elementos listados e a eles atribuíram importância. Os questionários foram respondidos por agentes públicos envolvidos na implantação e operação de projetos de governo eletrônico com ações de e-Democracia, por pesquisadores acadêmicos desse campo e consultores ligados a organizações da sociedade envolvidas na sua execução. Como resultado, este trabalho identifica um conjunto de habilitadores e outro de inibidores nas dimensões política e de governança, sócio-cultural, econômica, tecnológica e legal-regulatória. Conclui-se que há diferenças entre as visões dos respondentes de diferentes setores de atuação (governo, academia e consultoria). Também há diferenças entre os resultados da pesquisa e a literatura consultada. Na visão política, a literatura dá ênfase aos aspectos legais e regulatórios, que não aparecem com ênfase nos resultados da amostra. O tamanho da amostra (55 respondentes) foi uma limitação para realização de análises estatísticas mais robustas. Sugere-se que estudos futuros aprofundem a análise de fatores habilitadores e inibidores em cada um dos grupos, assim como investiguem o fenômeno a partir do ponto de vista dos cidadãos. / The development of information and communication technologies, particularly the Internet, creates new communication channels which the society has been using, in innovative ways, to develop social and economic activities. Governments at all levels and in various parts of the world have used ICT resources to increase the efficiency of public administration’s internal processes, or to provide services to citizens. More recently, experiments are being implemented using electronic means to enhance democratic practice - e-Democracy. This work focuses on electronic democracy initiatives that use the Internet to create virtual spaces of participation for citizens and the society in decision making processes of government. The goal is to identify a number of elements that enables or inhibits the implementation of these virtual spaces by governments. The research is exploratory in nature. After the literature review and interviewing five experts in the field, with open script, a preliminary list of enabler and inhibitor elements was set up. Then, applying the survey method, on the Internet, the list was sent to 155 experts, of which, 55 expressed their degree of agreement with the elements listed, and attributed a level of importance. The questionnaires were answered by public officials in charge of the implementation and operation of egovernment projects with actions of e-Democracy, by academic researchers in this field and by consultants connected to other organizations of the society, involved with the implementation of e-Democracy projects. As a result, this study identifies a set of enablers and other of inhibitors in the following dimensions: political and governance, socio-cultural, economic, technological and legal-regulatory. The study concludes that there are differences between the views of respondents from different sectors of activity (government, academia and consultancy). There are also differences between the results of the research and literature. In the political view, the literature emphasizes the legal and regulatory aspects, which do not appear with emphasis on sample results. The sample size (55 respondents) was a limitation for performing more robust statistical analysis. It is suggested that future studies should deepen the analysis of enabling factors and inhibitors in each group, as well as investigate the phenomenon from the viewpoint of citizens.

O desenvolvimento das tecnologias da informação e comunicação, em especial a Internet, cria novos canais de comunicação dos quais a sociedade tem se utilizado, de forma inovadora, no desenvolvimento de atividades sociais e econômicas. Governos, em todos os níveis e em diversas partes do mundo, têm utilizado os recursos de TIC no aumento da eficiência dos processos internos da administração pública, ou na prestação dos serviços aos cidadãos. Mais recentemente, estão sendo implementadas experiências que utilizam os meios eletrônicos para a ampliação da prática democrática – a e-Democracia. Este trabalho foca-se nas iniciativas de democracia eletrônica que utilizam a Internet para a criação de espaços virtuais de participação do cidadão e da sociedade nos processos decisórios do governo. O objetivo é identificar um conjunto de elementos que, potencialmente, influenciam a implementação de espaços virtuais de participação pelos governos, seja como habilitadores da sua implementação, seja como inibidores. A pesquisa realizada é de natureza exploratória. A partir da revisão de literatura e de uma entrevista com roteiro aberto a cinco especialistas no campo, montou-se uma lista preliminar de elementos habilitadores e inibidores. Depois, seguindo o método survey na Internet, a lista foi enviada a 155 especialistas, dos quais 55 manifestaram o seu grau de concordância com os elementos listados e a eles atribuíram importância. Os questionários foram respondidos por agentes públicos envolvidos na implantação e operação de projetos de governo eletrônico com ações de e-Democracia, por pesquisadores acadêmicos desse campo e consultores ligados a organizações da sociedade envolvidas na sua execução. Como resultado, este trabalho identifica um conjunto de habilitadores e outro de inibidores nas dimensões política e de governança, sócio-cultural, econômica, tecnológica e legal-regulatória. Conclui-se que há diferenças entre as visões dos respondentes de diferentes setores de atuação (governo, academia e consultoria). Também há diferenças entre os resultados da pesquisa e a literatura consultada. Na visão política, a literatura dá ênfase aos aspectos legais e regulatórios, que não aparecem com ênfase nos resultados da amostra. O tamanho da amostra (55 respondentes) foi uma limitação para realização de análises estatísticas mais robustas. Sugere-se que estudos futuros aprofundem a análise de fatores habilitadores e inibidores em cada um dos grupos, assim como investiguem o fenômeno a partir do ponto de vista dos cidadãos. / The development of information and communication technologies, particularly the Internet, creates new communication channels which the society has been using, in innovative ways, to develop social and economic activities. Governments at all levels and in various parts of the world have used ICT resources to increase the efficiency of public administration’s internal processes, or to provide services to citizens. More recently, experiments are being implemented using electronic means to enhance democratic practice - e-Democracy. This work focuses on electronic democracy initiatives that use the Internet to create virtual spaces of participation for citizens and the society in decision making processes of government. The goal is to identify a number of elements that enables or inhibits the implementation of these virtual spaces by governments. The research is exploratory in nature. After the literature review and interviewing five experts in the field, with open script, a preliminary list of enabler and inhibitor elements was set up. Then, applying the survey method, on the Internet, the list was sent to 155 experts, of which, 55 expressed their degree of agreement with the elements listed, and attributed a level of importance. The questionnaires were answered by public officials in charge of the implementation and operation of egovernment projects with actions of e-Democracy, by academic researchers in this field and by consultants connected to other organizations of the society, involved with the implementation of e-Democracy projects. As a result, this study identifies a set of enablers and other of inhibitors in the following dimensions: political and governance, socio-cultural, economic, technological and legal-regulatory. The study concludes that there are differences between the views of respondents from different sectors of activity (government, academia and consultancy). There are also differences between the results of the research and literature. In the political view, the literature emphasizes the legal and regulatory aspects, which do not appear with emphasis on sample results. The sample size (55 respondents) was a limitation for performing more robust statistical analysis. It is suggested that future studies should deepen the analysis of enabling factors and inhibitors in each group, as well as investigate the phenomenon from the viewpoint of citizens.

Dans ces travaux de recherche, nous proposons une méthodologie de l’approche Lean prenant en compte les aspects socioculturels dans un contexte globalisé. Cette méthodologie englobe à la fois des éléments culturels et techniques du Lean (facilitateurs et outils), afin de répondre aux besoins concurrentiels des organisations. Pour atteindre cet objectif, un sondage a été réalisé auprès de 115 gestionnaires originaires de différents pays. Ce sondage a permis d’évaluer l’intégration de facilitateurs Lean dans les entreprises et d’analyser les relations entre les facilitateurs Lean et les dimensions culturelles. Les résultats d’analyse quantitative du sondage nous ont fourni des aspects clés pour l'élaboration de la méthodologie. / In this research, we propose a methodology of Lean approach taking account socio-cultural aspects in a globalized context. This methodology relates the culture and Lean technical elements (enablers and tools), in order to meet competitive needs of the organization. To achieve this goal, a survey was conducted among 115 managers from different countries. The survey had assessed the integration of Lean enablers in companies and to analyze the relationships between Lean enablers and cultural dimensions. Quantitative analysis of surveys has helped develop an implementation methodology.

Context. Flexibility in requirements management allows organizations to react quickly to changes in market demand. Organizations rely primarily on different documents to track projects, which are inefficient at maintaining traceability between requirements and other development artifacts. Finding a model to structure change impact analysis and change propagation is needed. Objectives. First, this thesis studies the current practice for enabling flexibility of scoping decisions. Second it evaluates the identified flexibility enablers – requirements centralization, requirements abstraction, and requirements grouping – in an industry context. The current practice is then contrasted with these flexibility enablers. Methods. To understand current practice, a case study was performed in industry. Data collection relied on interviews and document and repository observations, and grounded theory was used to analyze it. A solution containing the flexibility enablers was developed and evaluated at the organization where feedback on the tool was received. Results. The practitioners followed a strategy to handle changes in requirements where the impact analysis and decision making process were the most critical. Several challenges were identified which hindered flexibility for scoping decision. As a consequence, the studied project suffered from delay and budget overrun. The three presented enablers supported flexibility in decision making. The flexibility enablers facilitated decision making by providing a single, linked, consistent, and versioned set of requirements of multiple abstraction levels. Traceability between requirements was maintained which allowed propagation of changes between requirements. The multiple abstraction levels allowed for targeted viewing of the requirements based on role. Grouping requirements with implementation proposals provided traceability between the requirements and the design, which further helped change propagation. Conclusions. Although the studied organization followed standard procedures such as Change Control Boards (CCB) and change impact analysis (CIA) to enabling flexible decision making, they did not adopt any of the methods provided in recent studies. Additionally, the organization still depended on documentation to capture requirements and counted on their tacit knowledge to analyze the impact of changes. This hindered flexibility for scoping decision. Traceability as a strong point of centralization was aligned with previous studies in enabling flexibility while the family feature was a concept with no previous empirical evidence. We also proved that abstraction enabled flexibility, which has not been discussed in any previous studies. Similarly, we found no empirical evidence related to requirement grouping based on implementation proposals in enabling flexibility in decision making. Although the three enablers supported flexibility for scoping decision, the practitioners still had to invest a certain amount of manual work to benefit from them, since the tool did not handle everything automatically.

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The high prevalence of back and neck pain results in enormous social, psychological, and economic burden. Most seeking help for back or neck pain consult general practitioners or chiropractors. Chiropractic is a regulated health profession (serving approximately 10 – 15% of the population) that has contributed to the health and well-being of North Americans for over a century. Despite available evidence for optimal management of back and neck pain, poor adherences to guidelines and wide variations in services have been noted. For instance, overuse and misuse of imaging services have been reported in the chiropractic literature. Inappropriate use of spine imaging has a number of potential adverse outcomes, including inefficient and potentially inappropriate invasive diagnosis and subsequent treatment, and unnecessary patient exposure to ionizing radiation. Although evidence-based diagnostic imaging guidelines for spinal disorders are available, chiropractors are divided on whether these guidelines apply to them. While guidelines can encourage practitioners to conform to best practices and lead to improvements in care, reviews have demonstrated that dissemination of guidelines alone is rarely sufficient to optimise care. Evidence regarding effective methods to promote the uptake of guidelines is still lacking. There is growing acceptance that problem analysis and development of interventions to change practice should be guided by relevant theories and tailored to the target audience. To date, very little knowledge translation research has addressed research-practice gaps in chiropractic. This thesis reports rigorous methods to: (1) assess practice and providers’ characteristics, (2) determine baseline rates and variations in spine x-ray ordering, (3) evaluate the impact of disseminating guidelines to optimise spine x-ray ordering, and (4) assess determinants of spine x-ray ordering and potential targets for change prior to the design of a tailored intervention. A mixed method using two disciplinary perspectives (epidemiology and psychology) was undertaken. A cross-sectional analysis of administrative claims data was carried out on a sample of chiropractors enlisted in a large American provider network. Despite available clinical practice guidelines, wide geographical variations in x-ray use persist. Higher x-ray ordering rates were associated with practice location (Midwest and South US census regions), setting (urban, suburban), chiropractic school attended, male provider, employment, and years in practice. The impact of web-based guideline dissemination was evaluated over a five year period using interrupted time series and demonstrated a stepwise relative reduction of 5.3% in the use of x-rays. Passive guidelines dissemination appeared to be a simple, cost effective strategy in this setting to improve but not optimise x-ray ordering rates. Focus groups using the theoretical domains framework were conducted among Canadian and US chiropractors to explore their beliefs about managing back pain without x-rays. Findings were used to develop a theory-based survey to identify theoretical constructs predicting spine x-ray ordering practice. Psychological theories and theoretical constructs explained a significant portion of the variance in both behavioural simulation and intention. Results from this thesis provide an empirically-supported, theoretical basis to design quality improvement strategies to increase guidelines adherence and promote behaviour change in chiropractic. Other researchers interested in improving uptake of evidenced-based information could use this method in their own setting to investigate determinants of behaviour among other professional groups. Future research may use knowledge gained to inform the development and evaluation of a theory-based tailored intervention to improve guideline adherence and reduce the use of spine x-rays among targeted providers.

The manufacturing industryis developing and the increase in sharp competition, is a result of globalization, therefore companies strive to increase their competitiveness. Lean is one of the methods that is regularly used within the traditional manufacturing companies but with the implementation of Lean, some studies show that the change will not stick if not the culture of the company is also changed. Therefore, the purpose of this study is to investigate an organisations readiness to implement Lean with a focuson organizational change. To achieve this purpose a single case study has been conducted at a company planning to implement Lean and three RQ:screated which are: •RQ1: What are the enablers for an organization to undergo a lean transformation? •RQ2: What are the challenges for an organization to undergo a lean transformation? •RQ3: How can a company prepare its organization for lean transformation? By conducting interviews, the potential enabler and challenges for the implementation were analysed as well as how a company could prepare for it. The results show that there are three main enablers; the commitment and support for Lean from the management, change leaders with change management and Lean knowledge and change agents with deep knowledge of the company’s production. The main challenges that were found were communication, company culture and defining Lean. On how to prepare an organisation there was found to be five necessary aspects, creating a focus group, educate the focus group to get a good knowledge of Lean, use the focus group to define Lean in the context of the company, establish forums for communication and involvement, and plan for an employee development program.

The provision of decent, affordable and well-located housing for low-income communities has been an intractable problem, especially for developing countries. The empirical puzzle that motivated this study is that, despite the adverse macro environment in Zimbabwe, there appears to be private-sector developers who are successfully developing housing benefiting the low-income group. This is so, despite numerous studies that claim that given the magnitude of the housing challenge, a neoliberal doxa in a developing country context as a solution is a fallacy. Working on the broad premise that these developments represent a successful adaptation to the structural environment, the main question guiding the study was - what accounts for the success of market provided low-income housing developments in Zimbabwe despite the environment not being conducive for it? The two sub-questions flowing from this main question were firstly, how does the structural environment enable and/or constrain private sector low-income developments in Zimbabwe? Secondly, what strategies do developers adopt in response to the structural enablers and/or constraints to develop low-income housing in Zimbabwe? From these questions, the study has two hypotheses – the first hypothesis is that despite the adverse environment there exists in Zimbabwe structural enablers that make market solutions to the low-income housing challenge possible. The second hypothesis states that developers have specific discernible strategies that they employ in response to the adverse operating environment to reduce development costs to levels that enable them to provide low-income housing successfully. Using the Structure-Agency model, which is a theoretical framework rooted in institutional economics, a conceptual model to study the development process was developed and used to theorise the impact of structure on agency in the development process. Empirical evidence was gathered using observation, household surveys, and semi-structured interviews. This evidence was obtained from five housing schemes, the local authority, central government, financiers and the developers of the housing schemes, and then processed using NVIVO and SPSS. The study finds that most challenges faced by developers emanate from the institutional environment and access to resources. These challenges are namely central-local government dynamics fuelled by political undertones, lack of access to land suitable for the target group, a bureaucratic and stiff regulatory framework as well as a lack of market provided developer and end-user finance. Enabling factors were mainly the withdrawal of the government in the provision of housing in line with World-Bank neoliberal orthodoxy and incapacitation of the local authority, which eliminated alternative sources of housing for the low income group other than market provided housing, thus widening the market base for the developers. Strategies used by the developers include developer provided finance to the target group, preselling developments, sidestepping the local authority through buying land at the periphery of the local authority boundary, sidestepping regulatory barriers through engaging in corruption, backward integration to promote efficient resource allocation, and an innovative approach to risk management that caters for the low-income group. The study concludes that all these strategies have one overriding objective of cost containment. The findings indicate that there is potential, appetite and scope for more private-sector engagement. On this basis, it is recommended that the key to unlocking this potential lies with the state, as there are several policy implications that flow from these findings if the highlighted constraints are to be addressed. The study makes a number of key contributions to knowledge on market solutions to the low-income housing challenge in the area of theory, methodology, policy and empirical data.

Sweden is a country that stands out in terms of attracting highly skilled workers and having a large number of young firms. However, with the young age and specifically put in a concrete context of the COVID-19 pandemic, young firms may face the risk of losses due to a lack of funds to maintain or having volatile financial sources.  Therefore, this thesis tries to provide insights on the relation between knowledge management activities (KMAs) and financial performance in young firms from 5 to 10 years old in Sweden. In other words, the thesis aims to understand how young firms in Sweden have implemented KMAs inside their firms. More specifically, striving to determine which knowledge management enablers influence KMAs, what kinds of KMAs young firms are applying, and at what level those kinds of activities impact young firms’ financial performance. A mixed-method approach has been selected to utilize both qualitative and quantitative methods. Together with semi-structured interviews, Exploratory Sequential Design is applied in the thesis, which enables defining the impact of KMAs on the financial performance of young firms in Sweden and the availability of the presented conceptual framework in practice.